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Giovannetti G, Flori A, Martini N, Cademartiri F, Aquaro GD, Pingitore A, Frijia F. Hardware and Software Setup for Quantitative 23Na Magnetic Resonance Imaging at 3T: A Phantom Study. Sensors (Basel) 2024; 24:2716. [PMID: 38732822 PMCID: PMC11085578 DOI: 10.3390/s24092716] [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] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024]
Abstract
Magnetic resonance (MR) with sodium (23Na) is a noninvasive tool providing quantitative biochemical information regarding physiology, cellular metabolism, and viability, with the potential to extend MR beyond anatomical proton imaging. However, when using clinical scanners, the low detectable 23Na signal and the low 23Na gyromagnetic ratio require the design of dedicated radiofrequency (RF) coils tuned to the 23Na Larmor frequency and sequences, as well as the development of dedicated phantoms for testing the image quality, and an MR scanner with multinuclear spectroscopy (MNS) capabilities. In this work, we propose a hardware and software setup for evaluating the potential of 23Na magnetic resonance imaging (MRI) with a clinical scanner. In particular, the reliability of the proposed setup and the reproducibility of the measurements were verified by multiple acquisitions from a 3T MR scanner using a homebuilt RF volume coil and a dedicated sequence for the imaging of a phantom specifically designed for evaluating the accuracy of the technique. The final goal of this study is to propose a setup for standardizing clinical and research 23Na MRI protocols.
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Affiliation(s)
- Giulio Giovannetti
- Institute of Clinical Physiology, National Council of Research, Via G. Moruzzi 1, 56124 Pisa, Italy; (G.G.); (A.P.)
| | - Alessandra Flori
- Bioengineering Unit, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy; (A.F.)
| | - Nicola Martini
- Bioengineering Unit, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy; (A.F.)
| | - Filippo Cademartiri
- Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy;
| | - Giovanni Donato Aquaro
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, 56126 Pisa, Italy;
| | - Alessandro Pingitore
- Institute of Clinical Physiology, National Council of Research, Via G. Moruzzi 1, 56124 Pisa, Italy; (G.G.); (A.P.)
| | - Francesca Frijia
- Bioengineering Unit, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy; (A.F.)
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Raisi-Estabragh Z, Szabo L, McCracken C, Bülow R, Aquaro GD, Andre F, Le TT, Suchá D, Condurache DG, Salih AM, Chadalavada S, Aung N, Lee AM, Harvey NC, Leiner T, Chin CWL, Friedrich MG, Barison A, Dörr M, Petersen SE. Cardiovascular Magnetic Resonance Reference Ranges From the Healthy Hearts Consortium. JACC Cardiovasc Imaging 2024:S1936-878X(24)00061-5. [PMID: 38613554 DOI: 10.1016/j.jcmg.2024.01.009] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 01/06/2024] [Accepted: 01/19/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND The absence of population-stratified cardiovascular magnetic resonance (CMR) reference ranges from large cohorts is a major shortcoming for clinical care. OBJECTIVES This paper provides age-, sex-, and ethnicity-specific CMR reference ranges for atrial and ventricular metrics from the Healthy Hearts Consortium, an international collaborative comprising 9,088 CMR studies from verified healthy individuals, covering the complete adult age spectrum across both sexes, and with the highest ethnic diversity reported to date. METHODS CMR studies were analyzed using certified software with batch processing capability (cvi42, version 5.14 prototype, Circle Cardiovascular Imaging) by 2 expert readers. Three segmentation methods (smooth, papillary, anatomic) were used to contour the endocardial and epicardial borders of the ventricles and atria from long- and short-axis cine series. Clinically established ventricular and atrial metrics were extracted and stratified by age, sex, and ethnicity. Variations by segmentation method, scanner vendor, and magnet strength were examined. Reference ranges are reported as 95% prediction intervals. RESULTS The sample included 4,452 (49.0%) men and 4,636 (51.0%) women with average age of 61.1 ± 12.9 years (range: 18-83 years). Among these, 7,424 (81.7%) were from White, 510 (5.6%) South Asian, 478 (5.3%) mixed/other, 341 (3.7%) Black, and 335 (3.7%) Chinese ethnicities. Images were acquired using 1.5-T (n = 8,779; 96.6%) and 3.0-T (n = 309; 3.4%) scanners from Siemens (n = 8,299; 91.3%), Philips (n = 498; 5.5%), and GE (n = 291, 3.2%). CONCLUSIONS This work represents a resource with healthy CMR-derived volumetric reference ranges ready for clinical implementation.
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Affiliation(s)
- Zahra Raisi-Estabragh
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, United Kingdom; Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, United Kingdom
| | - Liliana Szabo
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, United Kingdom; Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, United Kingdom; Semmelweis University, Heart and Vascular Center, Budapest, Hungary
| | - Celeste McCracken
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Robin Bülow
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
| | - Giovanni Donato Aquaro
- Academic Radiology, Department of Surgical, Medical, and Molecular Pathology and of Critical Area, University of Pisa, Pisa, Italy
| | - Florian Andre
- Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Heidelberg, Germany
| | - Thu-Thao Le
- National Heart Centre Singapore, Singapore; Cardiovascular Academic Clinical Programme, Duke-National University of Singapore Medical School, Singapore
| | - Dominika Suchá
- University Medical Centre Utrecht, Department of Radiology and Nuclear Medicine, Utrecht, the Netherlands
| | - Dorina-Gabriela Condurache
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, United Kingdom; Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, United Kingdom
| | - Ahmed M Salih
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, United Kingdom; Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, United Kingdom; Department of Computer Science, Faculty of Science, University of Zakho, Zakho, Kurdistan Region, Iraq
| | - Sucharitha Chadalavada
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, United Kingdom; Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, United Kingdom
| | - Nay Aung
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, United Kingdom; Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, United Kingdom
| | - Aaron Mark Lee
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, United Kingdom
| | - Nicholas C Harvey
- The Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Tim Leiner
- University Medical Centre Utrecht, Department of Radiology and Nuclear Medicine, Utrecht, the Netherlands; Mayo Clinic, Department of Radiology, Rochester, Minnesota, USA
| | - Calvin W L Chin
- National Heart Centre Singapore, Singapore; Cardiovascular Academic Clinical Programme, Duke-National University of Singapore Medical School, Singapore
| | - Matthias G Friedrich
- Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Heidelberg, Germany; Department of Medicine and Diagnostic Radiology, McGill University, Montreal, Quebec, Canada
| | - Andrea Barison
- Cardiology and Cardiovascular Medicine, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Marcus Dörr
- Department of Internal Medicine B, Cardiology, Pneumology, Infectious Diseases, Intensive Care Medicine, University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Germany
| | - Steffen E Petersen
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, United Kingdom; Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, United Kingdom; Health Data Research UK, London, United Kingdom; Alan Turing Institute, London, United Kingdom.
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Pasqualetti F, Gabelloni M, Faggioni L, Aquaro GD, De Vietro F, Mendola V, Spina N, Frey J, Montemurro N, Cantarella M, Caccese M, Gadducci G, Giannini N, Valenti S, Morganti R, Ius T, Caffo M, Vergaro G, Cosottini M, Naccarato AG, Lombardi G, Bocci G, Neri E, Paiar F. Glioblastoma and Internal Carotid Artery Calcium Score: A Possible Novel Prognostic Partnership? J Clin Med 2024; 13:1512. [PMID: 38592330 PMCID: PMC10933913 DOI: 10.3390/jcm13051512] [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: 01/23/2024] [Revised: 02/24/2024] [Accepted: 02/29/2024] [Indexed: 04/10/2024] Open
Abstract
Purpose: Clinical evidence suggests an association between comorbidities and outcome in patients with glioblastoma (GBM). We hypothesised that the internal carotid artery (ICA) calcium score could represent a promising prognostic biomarker in a competing risk analysis in patients diagnosed with GBM. Methods: We validated the use of the ICA calcium score as a surrogate marker of the coronary calcium score in 32 patients with lung cancer. Subsequently, we assessed the impact of the ICA calcium score on overall survival in GBM patients treated with radio-chemotherapy. Results: We analysed 50 GBM patients. At the univariate analysis, methyl-guanine-methyltransferase gene (MGMT) promoter methylation (p = 0.048), gross total tumour resection (p = 0.017), and calcium score (p = 0.011) were significant prognostic predictors in patients with GBM. These three variables also maintained statistical significance in the multivariate analysis. Conclusions: the ICA calcium score could be a promising prognostic biomarker in GBM patients.
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Affiliation(s)
- Francesco Pasqualetti
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy; (M.C.); (G.G.); (N.G.); (S.V.); (F.P.)
| | - Michela Gabelloni
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy;
| | - Lorenzo Faggioni
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy; (L.F.); (G.D.A.); (F.D.V.); (V.M.); (N.S.); (J.F.); (E.N.)
| | - Giovanni Donato Aquaro
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy; (L.F.); (G.D.A.); (F.D.V.); (V.M.); (N.S.); (J.F.); (E.N.)
| | - Fabrizio De Vietro
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy; (L.F.); (G.D.A.); (F.D.V.); (V.M.); (N.S.); (J.F.); (E.N.)
| | - Vincenzo Mendola
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy; (L.F.); (G.D.A.); (F.D.V.); (V.M.); (N.S.); (J.F.); (E.N.)
| | - Nicola Spina
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy; (L.F.); (G.D.A.); (F.D.V.); (V.M.); (N.S.); (J.F.); (E.N.)
| | - Jessica Frey
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy; (L.F.); (G.D.A.); (F.D.V.); (V.M.); (N.S.); (J.F.); (E.N.)
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy;
| | - Martina Cantarella
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy; (M.C.); (G.G.); (N.G.); (S.V.); (F.P.)
| | - Mario Caccese
- Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy; (M.C.); (G.L.)
| | - Giovanni Gadducci
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy; (M.C.); (G.G.); (N.G.); (S.V.); (F.P.)
| | - Noemi Giannini
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy; (M.C.); (G.G.); (N.G.); (S.V.); (F.P.)
| | - Silvia Valenti
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy; (M.C.); (G.G.); (N.G.); (S.V.); (F.P.)
| | - Riccardo Morganti
- Section of Statistics, University Hospital of Pisa, 56124 Pisa, Italy;
| | - Tamara Ius
- Neurosurgery Unit, Head-Neck and NeuroScience Department, University Hospital of Udine, 33100 Udine, Italy;
| | - Maria Caffo
- Department of Neurosurgery, University of Messina, 98122 Messina, Italy;
| | - Giuseppe Vergaro
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant’Anna, 56127 Pisa, Italy;
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, 56127 Pisa, Italy
| | - Mirco Cosottini
- Department of Neuroradiology, University of Pisa, 56126 Pisa, Italy;
| | - Antonio Giuseppe Naccarato
- Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy;
| | - Giuseppe Lombardi
- Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy; (M.C.); (G.L.)
| | - Guido Bocci
- Department of Clinical and Experimental Medicine, Clinical Pharmacology, University of Pisa, 56126 Pisa, Italy
| | - Emanuele Neri
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy; (L.F.); (G.D.A.); (F.D.V.); (V.M.); (N.S.); (J.F.); (E.N.)
| | - Fabiola Paiar
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy; (M.C.); (G.G.); (N.G.); (S.V.); (F.P.)
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Simonini L, Frijia F, Ait Ali L, Foffa I, Vecoli C, De Gori C, De Cori S, Baroni M, Aquaro GD, Maremmani C, Lombardo F. A Comprehensive Review of COVID-19-Related Olfactory Deficiency: Unraveling Associations with Neurocognitive Disorders and Magnetic Resonance Imaging Findings. Diagnostics (Basel) 2024; 14:359. [PMID: 38396398 PMCID: PMC10888385 DOI: 10.3390/diagnostics14040359] [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: 01/02/2024] [Revised: 01/31/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Olfactory dysfunction (OD) is one of the most common symptoms in COVID-19 patients and can impact patients' lives significantly. The aim of this review was to investigate the multifaceted impact of COVID-19 on the olfactory system and to provide an overview of magnetic resonance (MRI) findings and neurocognitive disorders in patients with COVID-19-related OD. Extensive searches were conducted across PubMed, Scopus, and Google Scholar until 5 December 2023. The included articles were 12 observational studies and 1 case report that assess structural changes in olfactory structures, highlighted through MRI, and 10 studies correlating the loss of smell with neurocognitive disorders or mood disorders in COVID-19 patients. MRI findings consistently indicate volumetric abnormalities, altered signal intensity of olfactory bulbs (OBs), and anomalies in the olfactory cortex among COVID-19 patients with persistent OD. The correlation between OD and neurocognitive deficits reveals associations with cognitive impairment, memory deficits, and persistent depressive symptoms. Treatment approaches, including olfactory training and pharmacological interventions, are discussed, emphasizing the need for sustained therapeutic interventions. This review points out several limitations in the current literature while exploring the intricate effects of COVID-19 on OD and its connection to cognitive deficits and mood disorders. The lack of objective olfactory measurements in some studies and potential validity issues in self-reports emphasize the need for cautious interpretation. Our research highlights the critical need for extensive studies with larger samples, proper controls, and objective measurements to deepen our understanding of COVID-19's long-term effects on neurological and olfactory dysfunctions.
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Affiliation(s)
- Ludovica Simonini
- Institute of Clinical Physiology, National Research Council (CNR), 54100 Massa, Italy; (I.F.); (C.V.)
| | - Francesca Frijia
- Bioengineering Unit, Fondazione Toscana G. Monasterio, 56124 Pisa, Italy;
| | - Lamia Ait Ali
- Institute of Clinical Physiology, National Research Council (CNR), 54100 Massa, Italy; (I.F.); (C.V.)
- Pediatric Cardiology and GUCH Unit, Fondazione “G. Monasterio” CNR-Regione Toscana, 54100 Massa, Italy
| | - Ilenia Foffa
- Institute of Clinical Physiology, National Research Council (CNR), 54100 Massa, Italy; (I.F.); (C.V.)
| | - Cecilia Vecoli
- Institute of Clinical Physiology, National Research Council (CNR), 54100 Massa, Italy; (I.F.); (C.V.)
| | - Carmelo De Gori
- Department of Radiology, Fondazione Monasterio/CNR, 56124 Pisa, Italy; (C.D.G.); (S.D.C.); (F.L.)
| | - Sara De Cori
- Department of Radiology, Fondazione Monasterio/CNR, 56124 Pisa, Italy; (C.D.G.); (S.D.C.); (F.L.)
| | - Monica Baroni
- Fondazione “G. Monasterio” CNR-Regione Toscana, 54100 Massa, Italy;
| | - Giovanni Donato Aquaro
- Academic Radiology Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56124 Pisa, Italy;
| | - Carlo Maremmani
- Unit of Neurology, Ospedale Apuane, Azienda USL Toscana Nord Ovest, 54100 Massa, Italy;
| | - Francesco Lombardo
- Department of Radiology, Fondazione Monasterio/CNR, 56124 Pisa, Italy; (C.D.G.); (S.D.C.); (F.L.)
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Aquaro GD, Todiere G, Barison A, Grigoratos C, Parisella ML, Adami M, Grilli G, Pagura L, Faggioni L, Cioni D, Lencioni R, Emdin M, Neri E. Prognostic Role of the Progression of Late Gadolinium Enhancement in Hypertrophic Cardiomyopathy. Am J Cardiol 2024; 211:199-208. [PMID: 37949342 DOI: 10.1016/j.amjcard.2023.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/18/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023]
Abstract
In hypertrophic cardiomyopathy (HCM), late gadolinium enhancement (LGE) extent ≥15% of left ventricular mass is considered a prognostic risk factor. LGE extent increases over time and the clinical role of the progression of LGE over time (LGE rate) was not prospectively evaluated. We sought to evaluate the prognostic role of the LGE rate in HCM. We enrolled 105 patients with HCM who underwent cardiac magnetic resonance (CMR) at baseline (CMR-I) and after ≥2 years of follow-up (CMR-II). LGE rate was defined as the ratio between the increase of LGE extent (grams) and the time interval (months) between examinations. A combined end point of sudden cardiac death, resuscitated cardiac arrest, appropriate Implanted Cardioverter Defibrillator (ICD) intervention, and sustained ventricular tachycardia was used (hard events). The percentage of patients with LGE extent ≥15% increased from 9% to 20% from CMR-I to CMR-II (p = 0.03). During a median follow-up of 52 months, 25 hard events were recorded. The presence of LGE ≥15% at CMR-II allowed a significant reclassification of the risk of patients than at LGE ≥15% at CMR-I (net reclassification improvement 0.21, p = 0.046). On the MaxStat analysis, the optimal prognostic cut point for LGE rate was >0.07 g/month. On the Kaplan-Meier curve, patients with LGE rate >0.07 had worse prognosis than those without (p <0.0001). LGE rate >0.07 allowed a significant reclassification of the risk compared with LGE ≥15% at CMR-I and at CMR-II (net reclassification improvement 0.49, p = 0.003). In the multivariable models, LGE rate >0.07 was the best independent predictor of hard events. In conclusion, CMR should be repeated after 2 years to reclassify the risk for sudden death of those patients. A high LGE rate may be considered a novel prognostic factor in HCM.
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Affiliation(s)
- Giovanni Donato Aquaro
- Academic Radiology Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy.
| | - Giancarlo Todiere
- Cardiology Depatment, G. Monasterio CNR-Tuscany Foundation, Pisa, Italy
| | - Andrea Barison
- Cardiology Depatment, G. Monasterio CNR-Tuscany Foundation, Pisa, Italy
| | | | - Maria Luisa Parisella
- Academic Radiology Unit, Department of Translational research and of new technology in medicine and Surgery, University of Pisa, Pisa, Italy
| | - Margherita Adami
- Academic Radiology Unit, Department of Translational research and of new technology in medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giulia Grilli
- Cardiology Department, University of Trieste, Trieste, Italy
| | - Linda Pagura
- Cardiology Department, University of Trieste, Trieste, Italy
| | - Lorenzo Faggioni
- Academic Radiology Unit, Department of Translational research and of new technology in medicine and Surgery, University of Pisa, Pisa, Italy
| | - Dania Cioni
- Academic Radiology Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy
| | - Riccardo Lencioni
- Academic Radiology Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy
| | - Michele Emdin
- Cardiology Depatment, G. Monasterio CNR-Tuscany Foundation, Pisa, Italy
| | - Emanuele Neri
- Academic Radiology Unit, Department of Translational research and of new technology in medicine and Surgery, University of Pisa, Pisa, Italy
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Gabelloni M, Faggioni L, Brunese MC, Picone C, Fusco R, Aquaro GD, Cioni D, Neri E, Gandolfo N, Giovagnoni A, Granata V. An overview on multimodal imaging for the diagnostic workup of pleural mesothelioma. Jpn J Radiol 2024; 42:16-27. [PMID: 37676382 PMCID: PMC10764410 DOI: 10.1007/s11604-023-01480-5] [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: 07/04/2023] [Accepted: 08/03/2023] [Indexed: 09/08/2023]
Abstract
Pleural mesothelioma (PM) is an aggressive disease that has a strong causal relationship with asbestos exposure and represents a major challenge from both a diagnostic and therapeutic viewpoint. Despite recent improvements in patient care, PM typically carries a poor outcome, especially in advanced stages. Therefore, a timely and effective diagnosis taking advantage of currently available imaging techniques is essential to perform an accurate staging and dictate the most appropriate treatment strategy. Our aim is to provide a brief, but exhaustive and up-to-date overview of the role of multimodal medical imaging in the management of PM.
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Affiliation(s)
- Michela Gabelloni
- Nuclear Medicine Unit, Department of Translational Research, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Lorenzo Faggioni
- Academic Radiology, Department of Translational Research, University of Pisa, 56126, Pisa, Italy.
| | - Maria Chiara Brunese
- Diagnostic Imaging Section, Department of Medical and Surgical Sciences and Neurosciences, University of Molise, 86100, Campobasso, Italy
| | - Carmine Picone
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli, 80131, Naples, Italy
| | - Roberta Fusco
- Medical Oncology Division, Igea SpA, 80013, Naples, Italy
| | - Giovanni Donato Aquaro
- Academic Radiology, Department of Translational Research, University of Pisa, 56126, Pisa, Italy
| | - Dania Cioni
- Academic Radiology, Department of Translational Research, University of Pisa, 56126, Pisa, Italy
| | - Emanuele Neri
- Academic Radiology, Department of Translational Research, University of Pisa, 56126, Pisa, Italy
| | - Nicoletta Gandolfo
- Diagnostic Imaging Department, Villa Scassi Hospital-ASL 3, 16149, Genoa, Italy
| | - Andrea Giovagnoni
- Department of Radiology, University Hospital "Azienda Ospedaliera Universitaria Delle Marche", 60126, Ancona, Italy
- Department of Clinical, Special and Dental Sciences, Università Politecnica Delle Marche, 60126, Ancona, Italy
| | - Vincenza Granata
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli, 80131, Naples, Italy
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Aimo A, Burchielli S, Barison A, Aquaro GD, Musetti V, Masotti S, Pucci A, Modena M, Terlizzi D, Passino C, Emdin M. Effects of pirfenidone on scar size and ventricular remodeling after myocardial infarction: a preclinical study. J Cardiovasc Med (Hagerstown) 2023; 24:880-890. [PMID: 37942789 DOI: 10.2459/jcm.0000000000001534] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
BACKGROUND An intense fibrotic response after myocardial infarction (MI) may lead to scar expansion and left ventricular (LV) remodeling. We investigated the effects of the antifibrotic drug pirfenidone in this setting. METHODS Male Wistar rats were randomized to: sham procedure (n = 13), reperfused MI-induced by ligating the left anterior descending artery (LAD) for 45 min (n = 17), reperfused MI plus standard therapy (aspirin, angiotensin-converting enzyme inhibitor, beta blocker, and mineralocorticoid receptor antagonist) (n = 17), reperfused MI plus pirfenidone alone (n = 17), or reperfused MI plus standard therapy and pirfenidone (n = 17). Rats surviving MI induction underwent cardiac magnetic resonance scans after 72 h and 30 days from MI, and were sacrificed on day 31. RESULTS Rats completing the whole protocol numbered 11 in the sham group, 9 in the untreated MI group, 8 in the standard treatment group, 9 in the pirfenidone alone group, and 9 in the standard treatment plus pirfenidone group. No significant differences emerged between LV volumes, ejection fraction or mass at 30 days or the differences from 72 h to 30 days. Small, nonsignificant differences between rats on pirfenidone alone vs. those on standard therapy emerged. The total extent of LV fibrosis, quantified as area and percentage of the tissue sample, did not differ significantly between rats on pirfenidone alone vs. those on standard therapy alone. CONCLUSION Pirfenidone does not have additional effects on LV remodeling or fibrosis compared with standard therapy, but its effects are similar to standard therapy alone.
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Affiliation(s)
- Alberto Aimo
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa
| | | | - Andrea Barison
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa
| | | | - Veronica Musetti
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa
| | - Silvia Masotti
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa
| | - Angela Pucci
- Histopathology Department, University Hospital of Pisa, Italy
| | - Martina Modena
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
| | | | - Claudio Passino
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa
| | - Michele Emdin
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa
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8
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Parollo M, Mazzocchetti L, Di Cori A, Segreti L, De Lucia R, Grifoni G, Barletta V, Faggioni L, Aquaro GD, Neri E, Canu A, Viani S, Soldati E, Berruezo A, Zucchelli G. Lipomatous metaplasia as the most reliable computed tomography predictor for functional substrate localization in scar-related ventricular tachycardia. Heart Rhythm 2023; 20:1593-1594. [PMID: 37543303 DOI: 10.1016/j.hrthm.2023.07.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/28/2023] [Accepted: 07/28/2023] [Indexed: 08/07/2023]
Affiliation(s)
- Matteo Parollo
- Second Division of Cardiology, Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy
| | - Lorenzo Mazzocchetti
- Second Division of Cardiology, Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy
| | - Andrea Di Cori
- Second Division of Cardiology, Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy
| | - Luca Segreti
- Second Division of Cardiology, Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy
| | - Raffaele De Lucia
- Second Division of Cardiology, Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy
| | - Gino Grifoni
- Second Division of Cardiology, Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy
| | - Valentina Barletta
- Second Division of Cardiology, Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy
| | - Lorenzo Faggioni
- Academic Radiology Unit, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Giovanni Donato Aquaro
- Academic Radiology Unit, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Emanuele Neri
- Academic Radiology Unit, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Antonio Canu
- Second Division of Cardiology, Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy
| | - Stefano Viani
- Second Division of Cardiology, Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy
| | - Ezio Soldati
- Second Division of Cardiology, Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy
| | | | - Giulio Zucchelli
- Second Division of Cardiology, Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy.
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9
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Barison A, Ricci F, Pavon AG, Muscogiuri G, Bisaccia G, Camastra G, De Lazzari M, Lanzillo C, Raguso M, Monti L, Vargiu S, Pedrotti P, Piacenti M, Todiere G, Pontone G, Indolfi C, Dellegrottaglie S, Lombardi M, Schwitter J, Aquaro GD. Cardiovascular Magnetic Resonance in Patients with Cardiac Electronic Devices: Evidence from a Multicenter Study. J Clin Med 2023; 12:6673. [PMID: 37892813 PMCID: PMC10607654 DOI: 10.3390/jcm12206673] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 09/13/2023] [Revised: 10/11/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Most recent cardiac implantable electronic devices (CIEDs) can safely undergo a cardiovascular magnetic resonance (CMR) scan under certain conditions, but metal artifacts may degrade image quality. The aim of this study was to assess the overall diagnostic yield of CMR and the extent of metal artifacts in a multicenter, multivendor study on CIED patients referred for CMR. METHODS We analyzed 309 CMR scans from 292 patients (age 57 ± 16 years, 219 male) with an MR-conditional pacemaker (n = 122), defibrillator (n = 149), or loop recorder (n = 38); CMR scans were performed in 10 centers from 2012 to 2020; MR-unsafe implants were excluded. Clinical and device parameters were recorded before and after the CMR scan. A visual analysis of metal artifacts was performed for each sequence on a segmental basis, based on a 5-point artifact score. RESULTS The vast majority of CMR scans (n = 255, 83%) were completely performed, while only 32 (10%) were interrupted soon after the first sequences and 22 (7%) were only partly acquired; CMR quality was non-diagnostic in 34 (11%) scans, poor (<1/3 sequences were diagnostic) in 25 (8%), or acceptable (1/3 to 2/3 sequences were diagnostic) in 40 (13%), while most scans (n = 201, 68%) were of overall good quality. No adverse event or device malfunctioning occurred, and only nonsignificant changes in device parameters were recorded. The most affected sequences were SSFP (median score 0.32 [interquartile range 0.07-0.91]), followed by GRE (0.18 [0.02-0.59]) and LGE (0.14 [0.02-0.55]). ICDs induced more artifacts (median score in SSFP images 0.87 [0.50-1.46]) than PMs (0.11 [0.03-0.28]) or ILRs (0.11 [0.00-0.56]). Moreover, most artifacts were located in the anterior, anteroseptal, anterolateral, and apical segments of the LV and in the outflow tract of the RV. CONCLUSIONS CMR is a versatile imaging technique, with a high safety profile and overall good image quality even in patients with MR-conditional CIEDs. Several strategies are now available to optimize image quality, substantially enhancing overall diagnostic yield.
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Affiliation(s)
- Andrea Barison
- Fondazione Toscana Gabriele Monasterio, 56127 Pisa, Italy
- Life Science Institute, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
| | - Fabrizio Ricci
- Department of Neuroscience, Imaging and Clinical Sciences, G. d’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy
| | - Anna Giulia Pavon
- Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland
| | - Giuseppe Muscogiuri
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
| | - Giandomenico Bisaccia
- Department of Neuroscience, Imaging and Clinical Sciences, G. d’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy
| | | | - Manuel De Lazzari
- Department of Cardiac Thoracic and Vascular Sciences and Public Health, University of Padua, 35122 Padova, Italy
| | | | - Mario Raguso
- Ospedale Policlinico Casilino, 00169 Roma, Italy
| | - Lorenzo Monti
- IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Sara Vargiu
- Cardiologia 3, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
| | - Patrizia Pedrotti
- Cardiac Magnetic Resonance Laboratory, Cardiologia 4, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
| | | | | | - Gianluca Pontone
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
| | - Ciro Indolfi
- Division of Cardiology, Magna Graecia University, 88100 Catanzaro, Italy
- Center for Cardiovascular Research, Magna Graecia University, 88100 Catanzaro, Italy
- Mediterranea Cardiocentro, 80122 Naples, Italy
| | - Santo Dellegrottaglie
- Advanced Cardiovascular Imaging Unit, Ospedale Medico-Chirurgico Accreditato Villa dei Fiori, 80011 Acerra, Italy
| | - Massimo Lombardi
- Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, 20097 Milan, Italy
| | - Juerg Schwitter
- Division of Cardiology, Cardiovascular Department, University Hospital Lausanne—CHUV, 1011 Lausanne, Switzerland
- CMR Center, University Hospital Lausanne—CHUV, 1011 Lausanne, Switzerland
- Faculty of Biology & Medicine, University of Lausanne—UniL, 1015 Lausanne, Switzerland
| | - Giovanni Donato Aquaro
- Academic Radiology Unit, Department of Surgical Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
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10
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Barison A, Ceolin R, Palmieri A, Tamborrino PP, Todiere G, Grigoratos C, Gueli IA, De Gori C, Clemente A, Pistoia L, Pepe A, Aquaro GD, Positano V, Emdin M, Cademartiri F, Meloni A. Biventricular Tissue Tracking with Cardiovascular Magnetic Resonance: Reference Values of Left- and Right-Ventricular Strain. Diagnostics (Basel) 2023; 13:2912. [PMID: 37761278 PMCID: PMC10527573 DOI: 10.3390/diagnostics13182912] [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: 07/18/2023] [Revised: 08/31/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
We derived reference values of left-ventricular (LV) and right-ventricular (RV) strain parameters in a cohort of 100 healthy subjects by feature tracking cardiac magnetic resonance (FT-CMR). Global and regional strain values were calculated for the LV; circumferential and radialSAX strain parameters were derived from the short-axis (SAX) stack, while longitudinal and radialLAX strain parameters were assessed in three long-axis (LAX) views. Only global longitudinal strain (GLS) was calculated for the RV. Peak global LV circumferential strain was -16.7% ± 2.1%, LV radialSAX strain was 26.4% ± 5.1%, LV radialLAX strain was 31.1% ± 5.2%, LV GLS was -17.7% ± 1.9%, and RV GLS was -23.9% ± 4.1%. Women presented higher global LV and RV strain values than men; all strain values presented a weak relationship with body surface area, while there was no association with age or heart rate. A significant association was detected between all LV global strain measures and LV ejection fraction, while RV GLS was correlated to RV end-diastolic volume. The intra- and inter-operator reproducibility was good for all global strain measures. In the regional analysis, circumferential and radial strain values resulted higher at the apical level, while longitudinal strain values were higher at the basal level. The assessment of cardiac deformation by FT-CMR is feasible and reproducible and gender-specific reference values should be used.
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Affiliation(s)
- Andrea Barison
- Cardiology and Cardiovascular Medicine, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
- Institute of Life Sciences, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
| | - Roberto Ceolin
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, 34128 Trieste, Italy
| | - Alessandro Palmieri
- Cardiothoracovascular Department, Careggi University Hospital, 50134 Florence, Italy
| | - Pietro Paolo Tamborrino
- Cardiology Division, Cardiothoracic and Vascular Department, Pisa University Hospital, 56124 Pisa, Italy
| | - Giancarlo Todiere
- Cardiology and Cardiovascular Medicine, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
| | - Chrysanthos Grigoratos
- Cardiology and Cardiovascular Medicine, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
| | - Ignazio Alessio Gueli
- Cardiology and Cardiovascular Medicine, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
- Institute of Life Sciences, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
| | - Carmelo De Gori
- Department of Radiology, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
| | - Alberto Clemente
- Department of Radiology, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
| | - Laura Pistoia
- Department of Radiology, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
- Clinical Research Unit, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
| | - Alessia Pepe
- Institute of Radiology, Department of Medicine, University of Padua, 35128 Padova, Italy
| | - Giovanni Donato Aquaro
- Academic Radiology Unit, Department of Surgical Medical and Molecular Pathology and Critical Area, University of Pisa, 56124 Pisa, Italy
| | - Vincenzo Positano
- Department of Radiology, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
- Department of Bioengineering, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
| | - Michele Emdin
- Cardiology and Cardiovascular Medicine, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
- Institute of Life Sciences, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
| | - Filippo Cademartiri
- Department of Radiology, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
| | - Antonella Meloni
- Department of Radiology, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
- Department of Bioengineering, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
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11
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Aquaro GD, Monastero S, Todiere G, Barison A, De Gori C, Grigoratos C, Parisella ML, Faggioni L, Cioni D, Lencioni R, Neri E. Diagnostic Role of Native T1 Mapping Compared to Conventional Magnetic Resonance Techniques in Cardiac Disease in a Real-Life Cohort. Diagnostics (Basel) 2023; 13:2461. [PMID: 37510205 PMCID: PMC10377876 DOI: 10.3390/diagnostics13142461] [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: 06/06/2023] [Revised: 07/03/2023] [Accepted: 07/23/2023] [Indexed: 07/30/2023] Open
Abstract
We sought to compare native T1 mapping to conventional late gadolinium enhancement (LGE) and T2-STIR techniques in a cohort of consecutive patients undergoing cardiac MRI (CMR). CMR was performed in 323 patients, 206 males (64%), mean age 54 ± 8 years, and in 27 age- and sex- matched healthy controls. In T2-STIR images, myocardial hyperintensity suggesting edema was found in 41 patients (27%). LGE images were positive in 206 patients (64%). T1 mapping was abnormal in 171 (49%). In 206 patients (64%), a matching between LGE and native T1 was found. T1 was abnormal in 32 out of 41 (78%) with edema in T2-STIR images. Overall, LGE and/or T2-STIR were abnormal in 209 patients, whereas native T1 was abnormal in 154 (52%). Conventional techniques and T1 mapping were concordant in 208 patients (64%). In 39 patients, T1 mapping was positive despite negative conventional techniques (12%). T1 mapping was able in conditions with diffuse myocardial damage such as cardiac amyloidosis, scleroderma, and Fabry disease (additive role in 42%). In contrast, T1 mapping was less effective in cardiac disease with regional distribution of myocardial damage such as myocardial infarction, HCM, and myocarditis. In conclusion, conventional LGE/T2-STIR and T1 mapping are complementary techniques and should be used together in every CMR examination.
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Affiliation(s)
- Giovanni Donato Aquaro
- Academic Radiology Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | | | - Giancarlo Todiere
- Academic Radiology Unit, Department of Translational Research and of New Technology in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Andrea Barison
- Academic Radiology Unit, Department of Translational Research and of New Technology in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Carmelo De Gori
- Academic Radiology Unit, Department of Translational Research and of New Technology in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Crysanthos Grigoratos
- Academic Radiology Unit, Department of Translational Research and of New Technology in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | | | | | - Dania Cioni
- Academic Radiology Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Riccardo Lencioni
- Academic Radiology Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Emanuele Neri
- Gabriele Monasterio CNR-Tuscany Foundation, 56127 Pisa, Italy
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12
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Aquaro GD, De Gori C, Grilli G, Licordari R, Barison A, Todiere G, Ianni U, Parollo M, Grigoratos C, Restivo L, De Luca A, Faggioni L, Cioni D, Sinagra G, Di Bella G, Neri E. Dark papillary muscles sign: a novel prognostic marker for cardiac magnetic resonance. Eur Radiol 2023; 33:4621-4636. [PMID: 36692598 PMCID: PMC10289986 DOI: 10.1007/s00330-023-09400-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: 08/23/2022] [Revised: 12/15/2022] [Accepted: 12/23/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVES The prognostic role of left ventricular (LV) papillary muscle abnormalities in patients with preserved LV systolic ejection fraction (LVEF) is unknown. We sought to evaluate the prognosis role of LV papillary muscle abnormalities by CMR in patients with ventricular arrhythmias, preserved LVEF with no cardiac disease. METHODS A total of 391 patients with > 500/24 h premature ventricular complexes and/or with non-sustained ventricular tachycardia (NSVT), preserved LVEF, and no cardiac disease were enrolled. Different features of LV papillary muscles were considered: supernumerary muscles, papillary thickness, the attachment, late gadolinium enhancement (LGE). Dark-Paps was defined as end-systolic signal hypointensity of both papillary muscles in early post-contrast cine CMR images. Mitral valve prolapse, mitral annular disjunction (MAD), and myocardial LGE were considered. RESULTS Dark-Paps was found in 79 (20%) patients and was more frequent in females. It was associated with higher prevalence of mitral valve prolapse and MAD. During a median follow-up of 2534 days, 22 hard cardiac events occurred. At Kaplan-Meier curve analysis, patients with Dark-Paps were at higher risk of events than those without (p < 0.0001). Dark-Paps was significantly associated with hard cardiac events in all the multivariate models. Dark-Paps improved prognostic estimation when added to NSVT (p = 0.0006), to LGE (p = 0.005) and to a model including NSVT+LGE (p = 0.014). Dark-Paps allowed a significant net reclassification when added to NSVT (NRI 0.30, p = 0.03), to LGE (NRI 0.25, p = 0.04), and to NSVT + LGE (NRI 0.32, p = 0.02). CONCLUSIONS In LV papillary muscles, Dark-Paps is a novel prognostic marker in patients with ventricular arrhythmias and preserved ejection fraction. KEY POINTS • Papillary muscle abnormalities are seen in patients with ventricular arrhythmias and preserved left ventricular ejection fraction. • Early post-contrast hypointensity of papillary muscles in end-systolic cine images (Dark-Paps) is a novel prognostic marker in patients with ventricular arrhythmias and preserved ejection fraction. • Dark-Paps had an additive prognostic role over late gadolinium enhancement and non-sustained ventricular tachycardia.
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Affiliation(s)
- Giovanni Donato Aquaro
- Academic Radiology Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Via Savi, 10, 56126, Pisa, Italy.
| | - Carmelo De Gori
- Academic Radiology Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Via Savi, 10, 56126, Pisa, Italy
| | | | - Roberto Licordari
- Clinical and Experimental Department of Medicine, University of Messina, Messina, Italy
| | | | | | | | - Matteo Parollo
- Academic Radiology Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Via Savi, 10, 56126, Pisa, Italy
| | | | | | | | - Lorenzo Faggioni
- Academic Radiology Unit, Department of Translational research and of new technology in medicine and Surgery, University of Pisa, Pisa, Italy
| | - Dania Cioni
- Academic Radiology Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Via Savi, 10, 56126, Pisa, Italy
| | | | - Gianluca Di Bella
- Clinical and Experimental Department of Medicine, University of Messina, Messina, Italy
| | - Emanuele Neri
- Academic Radiology Unit, Department of Translational research and of new technology in medicine and Surgery, University of Pisa, Pisa, Italy
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13
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Leali M, Aimo A, Ricci G, Torri F, Todiere G, Vergaro G, Grigoratos C, Giannoni A, Aquaro GD, Siciliano G, Emdin M, Passino C, Barison A. Cardiac magnetic resonance findings and prognosis in type 1 myotonic dystrophy. J Cardiovasc Med (Hagerstown) 2023; 24:340-347. [PMID: 37129928 DOI: 10.2459/jcm.0000000000001476] [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] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Cardiac involvement is a major determinant of prognosis in type 1 myotonic dystrophy (DM1), but limited information is available about myocardial remodeling and tissue changes. The aim of the study was to investigate cardiac magnetic resonance (CMR) findings and their prognostic significance in DM1. METHODS We retrospectively identified all DM1 patients referred from a neurology unit to our CMR laboratory from 2009 to 2020. RESULTS Thirty-four patients were included (aged 45 ± 12, 62% male individuals) and compared with 68 age-matched and gender-matched healthy volunteers (43 male individuals, age 48 ± 15 years). At CMR, biventricular and biatrial volumes were significantly smaller (all P < 0.05), as was left ventricular mass (P < 0.001); left ventricular ejection fraction (LVEF) and right ventricular ejection fraction (RVEF) were significantly lower (all P < 0.01). Five (15%) patients had a LVEF less than 50% and four (12%) a RVEF less than 50%. Nine patients (26%) showed mid-wall late gadolinium enhancement (LGE; 5 ± 2% of LVM), and 14 (41%) fatty infiltration. Native T1 in the interventricular septum (1041 ± 53 ms) was higher than for healthy controls (1017 ± 28 ms) and approached the upper reference limit (1089 ms); the extracellular volume was slightly increased (33 ± 2%, reference <30%). Over 3.7 years (2.0-5.0), 6 (18%) patients died of extracardiac causes, 5 (15%) underwent device implantation; 5 of 21 (24%) developed repetitive ventricular ectopic beats (VEBs) on Holter monitoring. LGE mass was associated with the occurrence of repetitive VEBs (P = 0.002). Lower LV stroke volume (P = 0.017), lower RVEF (P = 0.016), a higher LVMi/LVEDVI ratio (P = 0.016), fatty infiltration (P = 0.04), and LGE extent (P < 0.001) were associated with death. CONCLUSION DM1 patients display structural and functional cardiac abnormalities, with variable degrees of cardiac muscle hypotrophy, fibrosis, and fatty infiltration. Such changes, as evaluated by CMR, seem to be associated with the development of ventricular arrhythmias and a worse outcome.
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Affiliation(s)
- Marco Leali
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
| | - Alberto Aimo
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Fondazione Toscana Gabriele Monasterio
| | - Giulia Ricci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Francesca Torri
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giancarlo Todiere
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
| | - Giuseppe Vergaro
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Fondazione Toscana Gabriele Monasterio
| | | | - Alberto Giannoni
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Fondazione Toscana Gabriele Monasterio
| | | | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Michele Emdin
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Fondazione Toscana Gabriele Monasterio
| | - Claudio Passino
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Fondazione Toscana Gabriele Monasterio
| | - Andrea Barison
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna
- Fondazione Toscana Gabriele Monasterio
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14
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Licordari R, Trimarchi G, Teresi L, Restelli D, Lofrumento F, Perna A, Campisi M, de Gregorio C, Grimaldi P, Calabrò D, Costa F, Versace AG, Micari A, Aquaro GD, Di Bella G. Cardiac Magnetic Resonance in HCM Phenocopies: From Diagnosis to Risk Stratification and Therapeutic Management. J Clin Med 2023; 12:jcm12103481. [PMID: 37240587 DOI: 10.3390/jcm12103481] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 03/12/2023] [Revised: 05/06/2023] [Accepted: 05/13/2023] [Indexed: 05/28/2023] Open
Abstract
Hypertrophic cardiomyopathy (HCM) is a genetic heart disease characterized by the thickening of the heart muscle, which can lead to symptoms such as chest pain, shortness of breath, and an increased risk of sudden cardiac death. However, not all patients with HCM have the same underlying genetic mutations, and some have conditions that resemble HCM but have different genetic or pathophysiological mechanisms, referred to as phenocopies. Cardiac magnetic resonance (CMR) imaging has emerged as a powerful tool for the non-invasive assessment of HCM and its phenocopies. CMR can accurately quantify the extent and distribution of hypertrophy, assess the presence and severity of myocardial fibrosis, and detect associated abnormalities. In the context of phenocopies, CMR can aid in the differentiation between HCM and other diseases that present with HCM-like features, such as cardiac amyloidosis (CA), Anderson-Fabry disease (AFD), and mitochondrial cardiomyopathies. CMR can provide important diagnostic and prognostic information that can guide clinical decision-making and management strategies. This review aims to describe the available evidence of the role of CMR in the assessment of hypertrophic phenotype and its diagnostic and prognostic implications.
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Affiliation(s)
- Roberto Licordari
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, 98100 Messina, Italy
| | - Giancarlo Trimarchi
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy
| | - Lucio Teresi
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy
| | - Davide Restelli
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy
| | - Francesca Lofrumento
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy
| | - Alessia Perna
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy
| | - Mariapaola Campisi
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, 98100 Messina, Italy
| | - Cesare de Gregorio
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy
| | - Patrizia Grimaldi
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy
| | - Danila Calabrò
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy
| | - Francesco Costa
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, 98100 Messina, Italy
| | | | - Antonio Micari
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, 98100 Messina, Italy
| | - Giovanni Donato Aquaro
- Academic Radiology Unit, Department of Surgical Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Gianluca Di Bella
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy
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Aquaro GD, Guidi B, Emdin M, Pucci A, Chiti E, Santurro A, Scopetti M, Biondi F, Maiese A, Turillazzi E, Camastra G, Faggioni L, Cioni D, Fineschi V, Neri E, Di Paolo M. Correction: Aquaro et al. Post-Mortem Cardiac Magnetic Resonance in Explanted Heart of Patients with Sudden Death. Int. J. Environ. Res. Public Health 2022, 19, 13395. Int J Environ Res Public Health 2023; 20:ijerph20095734. [PMID: 37174275 PMCID: PMC10178492 DOI: 10.3390/ijerph20095734] [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] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 11/30/2022] [Indexed: 05/15/2023]
Abstract
The authors wish to make the following corrections to this paper [...].
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Affiliation(s)
| | | | - Michele Emdin
- Fondazione Toscana G. Monasterio, 56124 Pisa, Italy
- Scuola Superiore Sant'Anna, 56127 Pisa, Italy
| | - Angela Pucci
- Department of Surgical, Clinical and Molecular Pathology and of Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Enrica Chiti
- Department of Surgical, Clinical and Molecular Pathology and of Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Alessandro Santurro
- Department of Medicine, Surgery and Dentistry-Scuola Medica Salernitana, University of Salerno, 84084 Fisciano, Italy
| | - Matteo Scopetti
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, 00189 Rome, Italy
| | - Federico Biondi
- Cardiology Department, University of Trieste, 34127 Trieste, Italy
| | - Aniello Maiese
- UO Medicina Legale, University of Pisa, 56126 Pisa, Italy
| | | | | | | | - Dania Cioni
- Academic Radiology, University of Pisa, 56126 Pisa, Italy
| | - Vittorio Fineschi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Emanuele Neri
- Academic Radiology, University of Pisa, 56126 Pisa, Italy
| | - Marco Di Paolo
- UO Medicina Legale, University of Pisa, 56126 Pisa, Italy
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Aquaro GD, De Gori C, Faggioni L, Parisella ML, Cioni D, Lencioni R, Neri E. Diagnostic and prognostic role of late gadolinium enhancement in cardiomyopathies. Eur Heart J Suppl 2023; 25:C130-C136. [PMID: 37125322 PMCID: PMC10132607 DOI: 10.1093/eurheartjsupp/suad015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Late gadolinium enhancement (LGE) is the most relevant tool of cardiac magnetic resonance for tissue characterization, and it plays a pivotal role for diagnostic and prognostic assessment of cardiomyopathies. The pattern of presentation of LGE allows differential diagnosis between ischaemic and non-ischaemic heart disease with high diagnostic accuracy, and among different cardiomyopathies, specific presentation of LGE may help to make a diagnosis. Late gadolinium enhancement may be caused by conditions that significantly increase the interstitial space or, less frequently, that slow down Gd exit, like myocardial fibrosis. In chronic myocardial infarction, hypertrophic cardiomyopathies (HCM), dilated cardiomyopathy, Fabry disease, and other conditions, LGE is a marker of myocardial fibrosis, but also in patients with acute myocarditis where LGE may be also explained by the increase of interstitial space caused by interstitial oedema or by tissue infiltration of inflammatory cells. In cardiac amyloidosis, LGE represents myocardial fibrosis but the interstitial overload of amyloid proteins should also be considered as a potential cause of LGE. The identification of the pattern of presentation of LGE is also very important. In the ischaemic pattern, LGE always involves the subendocardial layer with more or less transmural extent, it is confluent, and every single scar should be located in the territory of one coronary artery. In the non-ischaemic pattern, LGE does not fulfil the previous criteria, being midwall, subepicardial, or mixed, not necessarily confluent or confined to a territory of one coronary artery. For cardiomyopathies, the exact pattern of non-ischaemic LGE is important. Quantitative analysis of LGE is required in some specific conditions as in HCM. Magnetic resonance imaging with LGE technique should be performed in every patient with suspect of cardiomyopathy. The lack of standardization of pulse sequence and mostly of quantification methods is the main limitation of LGE technique.
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Affiliation(s)
| | - Carmelo De Gori
- Academic Radiology, University of Pisa, Via Savi 10, 56126 Pisa, Italy
| | - Lorenzo Faggioni
- Academic Radiology, University of Pisa, Via Savi 10, 56126 Pisa, Italy
| | | | - Dania Cioni
- Academic Radiology, University of Pisa, Via Savi 10, 56126 Pisa, Italy
| | - Riccardo Lencioni
- Academic Radiology, University of Pisa, Via Savi 10, 56126 Pisa, Italy
| | - Emanuele Neri
- Academic Radiology, University of Pisa, Via Savi 10, 56126 Pisa, Italy
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17
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Ghanbari F, Joyce T, Lorenzoni V, Guaricci AI, Pavon AG, Fusini L, Andreini D, Rabbat MG, Aquaro GD, Abete R, Bogaert J, Camastra G, Carigi S, Carrabba N, Casavecchia G, Censi S, Cicala G, De Cecco CN, De Lazzari M, Di Giovine G, Di Roma M, Focardi M, Gaibazzi N, Gismondi A, Gravina M, Lanzillo C, Lombardi M, Lozano-Torres J, Masi A, Moro C, Muscogiuri G, Nese A, Pradella S, Sbarbati S, Schoepf UJ, Valentini A, Crelier G, Masci PG, Pontone G, Kozerke S, Schwitter J. AI Cardiac MRI Scar Analysis Aids Prediction of Major Arrhythmic Events in the Multicenter DERIVATE Registry. Radiology 2023; 307:e222239. [PMID: 36943075 DOI: 10.1148/radiol.222239] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Background Scar burden with late gadolinium enhancement (LGE) cardiac MRI (CMR) predicts arrhythmic events in patients with postinfarction in single-center studies. However, LGE analysis requires experienced human observers, is time consuming, and introduces variability. Purpose To test whether postinfarct scar with LGE CMR can be quantified fully automatically by machines and to compare the ability of LGE CMR scar analyzed by humans and machines to predict arrhythmic events. Materials and Methods This study is a retrospective analysis of the multicenter, multivendor CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DebrillAtor ThErapy (DERIVATE) registry. Patients with chronic heart failure, echocardiographic left ventricular ejection fraction (LVEF) of less than 50%, and LGE CMR were recruited (from January 2015 through December 2020). In the current study, only patients with ischemic cardiomyopathy were included. Quantification of total, dense, and nondense scars was carried out by two experienced readers or a Ternaus network, trained and tested with LGE images of 515 and 246 patients, respectively. Univariable and multivariable Cox analyses were used to assess patient and cardiac characteristics associated with a major adverse cardiac event (MACE). Area under the receiver operating characteristic curve (AUC) was used to compare model performances. Results In 761 patients (mean age, 65 years ± 11, 671 men), 83 MACEs occurred. With use of the testing group, univariable Cox-analysis found New York Heart Association class, left ventricle volume and/or function parameters (by echocardiography or CMR), guideline criterion (LVEF of ≤35% and New York Heart Association class II or III), and LGE scar analyzed by humans or the machine-learning algorithm as predictors of MACE. Machine-based dense or total scar conferred incremental value over the guideline criterion for the association with MACE (AUC: 0.68 vs 0.63, P = .02 and AUC: 0.67 vs 0.63, P = .01, respectively). Modeling with competing risks yielded for dense and total scar (AUC: 0.67 vs 0.61, P = .01 and AUC: 0.66 vs 0.61, P = .005, respectively). Conclusion In this analysis of the multicenter CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DebrillAtor ThErapy (DERIVATE) registry, fully automatic machine learning-based late gadolinium enhancement analysis reliably quantifies myocardial scar mass and improves the current prediction model that uses guideline-based risk criteria for implantable cardioverter defibrillator implantation. ClinicalTrials.gov registration no.: NCT03352648 Published under a CC BY 4.0 license. Supplemental material is available for this article.
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Affiliation(s)
- Fahime Ghanbari
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Thomas Joyce
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Valentina Lorenzoni
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Andrea I Guaricci
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Anna-Giulia Pavon
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Laura Fusini
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Daniele Andreini
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Mark G Rabbat
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Giovanni Donato Aquaro
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Raffaele Abete
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Jan Bogaert
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Giovanni Camastra
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Samuela Carigi
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Nazario Carrabba
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Grazia Casavecchia
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Stefano Censi
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Gloria Cicala
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Carlo N De Cecco
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Manuel De Lazzari
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Gabriella Di Giovine
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Mauro Di Roma
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Marta Focardi
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Nicola Gaibazzi
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Annalaura Gismondi
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Matteo Gravina
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Chiara Lanzillo
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Massimo Lombardi
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Jordi Lozano-Torres
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Ambra Masi
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Claudio Moro
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Giuseppe Muscogiuri
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Alberto Nese
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Silvia Pradella
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Stefano Sbarbati
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - U Joseph Schoepf
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Adele Valentini
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Gérard Crelier
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Pier Giorgio Masci
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Gianluca Pontone
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Sebastian Kozerke
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
| | - Juerg Schwitter
- From the Cardiovascular Department, CMR Center, University Hospital Lausanne-CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (F.G., A.G.P., J.S.); Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland (F.G., J.S.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (T.J., S.K.); Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy (A.I.G.); Centro Cardiologico Monzino IRCCS, Milan, Italy (L.F., D.A., G.P.); Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy (L.F.); Loyola University of Chicago, Chicago, Ill (M.G.R.); Edward Hines Jr. VA Hospital, Hines, Ill (M.G.R.); U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy (G.D.A.); Department of Cardiology, Policlinico di Monza, Monza, Italy (R.A., G.D.G.); Department of Radiology, University Hospital Leuven, Leuven, Belgium (J.B.); Cardiac Department, Vannini Hospital Rome, Rome, Italy (G. Camastra); Department of Cardiology, Infermi Hospital, Rimini, Italy (S. Carigi); Cardiovascular and Thoracic Department, Careggi Hospital, Florence, Italy (N.C.); Department of Medical and Surgical Sciences (G. Casavecchia), Department of Radiology (M.G.), University of Foggia, Foggia, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (S. Censi); Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy (G. Cicala); Division of Cardiothoracic Imaging, Department of Radiology and Biomedical Informatics, Emory University, Atlanta, Ga (C.N.D.C.); Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Medical School, Padova, Italy (M.D.L.); Radiology Department, Policlinico Casilino, Rome, Italy (M.D.R.); Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (M.F., A.G.); Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy (N.G.); Cardiology Department, Policlinico Casilino, Rome, Italy (C.L.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (M.L.); Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain (J.L.T.); Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain (J.L.T.); De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (A.M.); Department of Cardiology, ASST Brianza, Desio, Italy (C.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); University Milano Bicocca, Milan, Italy (G.M.); Dipartimento Neuro-Cardiovascolare, Ospedale Ca' Foncello Treviso, Treviso, Italy (A.N.); Department of Radiology, Careggi Hospital, Florence, Italy (A.P.); Radiology Department, Vannini Hospital Rome, Rome, Italy (S.S.); Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (U.J.S.); Department of Radiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy (A.V.); GyroTools, Winterthur, Switzerland (G. Crelier); and School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK (P.G.M.)
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Figliozzi S, Georgiopoulos G, Lopes PM, Bauer KB, Moura-Ferreira S, Tondi L, Mushtaq S, Censi S, Pavon AG, Bassi I, Servato ML, Teske AJ, Biondi F, Filomena D, Pica S, Torlasco C, Muraru D, Monney P, Quattrocchi G, Maestrini V, Agati L, Monti L, Pedrotti P, Vandenberk B, Squeri A, Lombardi M, Ferreira AM, Schwitter J, Aquaro GD, Chiribiri A, Rodríguez Palomares JF, Yilmaz A, Andreini D, Florian A, Leiner T, Abecasis J, Badano LP, Bogaert J, Masci PG. Myocardial Fibrosis at Cardiac MRI Helps Predict Adverse Clinical Outcome in Patients with Mitral Valve Prolapse. Radiology 2023; 306:112-121. [PMID: 36098639 DOI: 10.1148/radiol.220454] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Patients with mitral valve prolapse (MVP) may develop adverse outcomes even in the absence of mitral regurgitation or left ventricular (LV) dysfunction. Purpose To investigate the prognostic value of mitral annulus disjunction (MAD) and myocardial fibrosis at late gadolinium enhancement (LGE) cardiac MRI in patients with MVP without moderate-to-severe mitral regurgitation or LV dysfunction. Materials and Methods In this longitudinal retrospective study, 118 144 cardiac MRI studies were evaluated between October 2007 and June 2020 at 15 European tertiary medical centers. Follow-up was from the date of cardiac MRI examination to June 2020; the minimum and maximum follow-up intervals were 6 months and 156 months, respectively. Patients were excluded if at least one of the following conditions was present: cardiomyopathy, LV ejection fraction less than 40%, ischemic heart disease, congenital heart disease, inflammatory heart disease, moderate or worse mitral regurgitation, participation in competitive sport, or electrocardiogram suggestive of channelopathies. In the remainder, cardiac MRI studies were reanalyzed, and patients were included if they were aged 18 years or older, MVP was diagnosed at cardiac MRI, and clinical information and electrocardiogram monitoring were available within 3 months from cardiac MRI examination. The end point was a composite of adverse outcomes: sustained ventricular tachycardia (VT), sudden cardiac death (SCD), or unexplained syncope. Multivariable Cox regression analysis was performed. Results A total of 474 patients (mean age, 47 years ± 16 [SD]; 244 women) were included. Over a median follow-up of 3.3 years, 18 patients (4%) reached the study end point. LGE presence (hazard ratio, 4.2 [95% CI: 1.5, 11.9]; P = .006) and extent (hazard ratio, 1.2 per 1% increase [95% CI: 1.1, 1.4]; P = .006), but not MAD presence (P = .89), were associated with clinical outcome. LGE presence had incremental prognostic value over MVP severity and sustained VT and aborted SCD at baseline (area under the receiver operating characteristic curve, 0.70 vs 0.62; P = .03). Conclusion In contrast to mitral annulus disjunction, myocardial fibrosis determined according to late gadolinium enhancement at cardiac MRI was associated with adverse outcome in patients with mitral valve prolapse without moderate-to-severe mitral regurgitation or left ventricular dysfunction. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Gerber in this issue.
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Affiliation(s)
- Stefano Figliozzi
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Georgios Georgiopoulos
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Pedro M Lopes
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Klemens B Bauer
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Sara Moura-Ferreira
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Lara Tondi
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Saima Mushtaq
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Stefano Censi
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Anna Giulia Pavon
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Ilaria Bassi
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Maria Luz Servato
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Arco J Teske
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Federico Biondi
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Domenico Filomena
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Silvia Pica
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Camilla Torlasco
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Denisa Muraru
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Pierre Monney
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Giuseppina Quattrocchi
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Viviana Maestrini
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Luciano Agati
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Lorenzo Monti
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Patrizia Pedrotti
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Bert Vandenberk
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Angelo Squeri
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Massimo Lombardi
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - António M Ferreira
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Juerg Schwitter
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Giovanni Donato Aquaro
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Amedeo Chiribiri
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - José F Rodríguez Palomares
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Ali Yilmaz
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Daniele Andreini
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Anca Florian
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Tim Leiner
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - João Abecasis
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Luigi Paolo Badano
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Jan Bogaert
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Pier-Giorgio Masci
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
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Trimarchi G, Di Bella G, Pizzino F, Donato Aquaro G, Luppino G, Manganaro R, Petersen C, Zito C, Carerj S, Pingitore A. 409 PROGNOSTIC VALUE OF TENTING AREA ASSESSED BY CMR IN PATIENTS WITH ISCHEMIC MITRAL REGURGITATION. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.245] [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] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Objectives
Mitral regurgitation (MR) due to complications of coronary artery disease is defined as ischemic mitral regurgitation (IMR) and, in the chronic phase after myocardial infarction (MI), it has a negative prognostic value, independently of baseline patient characteristics and degree of left ventricular (LV) dysfunction. In this context, we aimed to determine the additive prognostic role of morphological parameters, assessed by cardiac magnetic resonance (CMR), in patients with ischemic mitral regurgitation (IMR).
Methods
250 patients were recruited with diagnosis of IMR, and they were divided into two groups: those with cardiac death (or appropriate ICD shocks) event at 10 years follow-up (35 patients) and those without cardiac death event (215 patients). All patients underwent CMR imaging for the assessment of left ventricular (LV) ejection fraction (EF), end-diastolic (EDV) and end-systolic volume (ESV), tenting area, tenting height, interpapillary muscles displacement and late gadolinium enhancement (LGE). Echocardiography was performed to assess MR.
Results
The average age of the entire sample is 64±10 years, with no significant differences between the two groups (63.2 ±10 vs 68 ±9). For what regards the echocardiographic parameters, there are no statistically significant differences in LVEDV, LVESV, SIV and PP; whereas telesystolic diameter (52 ±7 vs 42 ±9; p < 0,0001), telediastolic diameter (61 ±4 vs 56 ±7; p = 0,003), the EROA (0.3 ±0.09 vs 0.25 ±0.6; p < 0,0001) and left atrial volume (46±19 ml/m2 vs 38.7±11ml/m2 p= 0,0001) are greater in the event group. According to MRI data, patients in the event group, have significantly higher values of LVEDV (155 ±38 ml/m2 vs 111.09 ±38 ml/m2; p<0,001), LVESV (114.04 ±36.8 ml/m2 vs 70 ± 38; p<0,001), sphericity index (0.53 ±0.2 vs 0.44 ±0.1; p<0,001), WMSI (2 ±0.3 vs 1.75 ±0.61, p=0,02), interpapillary distance (20 ±4 vs 18.4 ±6; p<0,001) and posteromedial papillary muscle LGE (33% vs 16%; 0,03). Also, LVEF (28.2 ±9.03% vs 40.42 ±14.9%; p<0,001) is more impaired in the cardiac death event group. There is statistically significant difference between the two groups for what concerns the tenting area (3.7 ±1.4 cm2 vs 2.6 ±0.8cm2; p<0,001) and the tenting height (13 ±2.3 vs 10.5 ±2.6; p<0,001) which are higher in patients with cardiac death event. In the univariate analysis, parameters that were significantly associated with a worst prognosis are: the severe extent of mitral regurgitation (HR 4,886; 95% CI 2,198-10,861), the tenting area (HR 1,009; 95% CI 1,006-1,013), the tenting height (HR 1,295; 95% CI 1,131-1,482; p<0.05), the PISA radius (HR 1,329; 95% CI 1,083-1,631; p<0.05) the EROA (HR 511,636; 95% CI 6,932-37763,8; p<0.05), LGE PAP PM (HR 2,169; 95% CI 1,025-4,589; p<0.05) and VTDi (HR 1,012; 95% CI 1,005-1,018; p<0.05). In the multivariate analysis it appears that tenting area is an independent predictor (HR 1.009 IC (1.00–1.016) p<0.05) of negative prognosis.
Conclusions
Increased tenting area, assessed by CMR, has independent negative prognostic value in patients with ischemic mitral regurgitation. This finding suggests that local remodeling, which occurs in ischemic cardiomyopathy, influences the severity and the prognosis of IMR, underscoring that anatomical compromission has a preeminent role in influencing outcomes in these patients, better than functional parameters.
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Affiliation(s)
- Giancarlo Trimarchi
- Clinical And Experimental Department Of Medicine, University Of Messina , Messina , Italy
| | - Gianluca Di Bella
- Clinical And Experimental Department Of Medicine, University Of Messina , Messina , Italy
| | - Fausto Pizzino
- Fondazione Toscana G. Monasterio , Pisa , Italy ; , Scuola Superiore Sant’anna, Pisa , Italy
- Institute Of Life Sciences , Pisa , Italy ; , Scuola Superiore Sant’anna, Pisa , Italy
| | | | - Giovanni Luppino
- Clinical And Experimental Department Of Medicine, University Of Messina , Messina , Italy
| | - Roberta Manganaro
- Clinical And Experimental Department Of Medicine, University Of Messina , Messina , Italy
| | | | - Concetta Zito
- Clinical And Experimental Department Of Medicine, University Of Messina , Messina , Italy
| | - Scipione Carerj
- Clinical And Experimental Department Of Medicine, University Of Messina , Messina , Italy
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20
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Aimo A, Burchielli S, Aquaro GD, Barison A, Musetti V, Masotti S, Pucci A, Galvez-monton C, Martinez-falguera D, Passino C, Emdin M, Bayes-genis A. 269 EFFECTS OF COLCHICINE TREATMENT AFTER MYOCARDIAL INFARCTION ON TOP OF STANDARD THERAPY: EVIDENCE FROM A PRECLINICAL STUDY. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.493] [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] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Background
An intense inflammatory and fibrotic response after myocardial infarction (MI) may lead to scar expansion and left ventricular (LV) remodeling, increasing the risk for ventricular arrhythmias and heart failure. Colchicine is an anti-inflammatory drug that has been reported to improve the outcome of patients with MI; its effects on LV remodeling have not been specifically investigated. We aimed to characterize the effects of the anti-inflammatory drug colchicine in an animal model of reperfused MI.
Methods
In 4-month-old pigs, MI was induced by occluding the LAD artery through an angioplasty balloon for 90 minutes. Pigs surviving MI induction were randomized in a 1:1 fashion to 2 arms:
The pigs underwent a first CMR scan 72 hours after MI induction, and another CMR at day 30. The pigs were then sacrificed the day after the second CMR. The primary efficacy endpoint was LGE mass (as a percentage of LV mass).
Results
The infarcted area at 72 hours (expressed as absolute mass or as a percentage of the LV mass) and the changes over 1 month did not differ significantly between pigs on colchicine plus standard therapy vs. those on standard therapy alone. When assessing the extent of fibrosis on the explanted hearts (as a percentage of the tissue sample areas) there was a trend toward a lower extent of myocardial fibrosis in pigs on colchicine plus standard therapy (p=0.091). The percent differences in LV volumes, ejection fraction and mass across the two CMR scans did not reach statistical difference.
Conclusions
The results from a pig model of reperfused MI suggest that colchicine has no additional effects to standard MI therapy on MI size and LV remodeling.
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Affiliation(s)
- Alberto Aimo
- Scuola Superiore Sant’anna
- Fondazione Toscana Gabriele Monasterio
| | | | | | | | | | | | | | | | | | - Claudio Passino
- Scuola Superiore Sant’anna
- Fondazione Toscana Gabriele Monasterio
| | - Michele Emdin
- Scuola Superiore Sant’anna
- Fondazione Toscana Gabriele Monasterio
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21
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Aimo A, Burchielli S, Aquaro GD, Barison A, Musetti V, Masotti S, Pucci A, Modena M, Passino C, Emdin M. 267 EFFECTS OF PIRFENIDONE ON SCAR SIZE AND VENTRICULAR REMODELING AFTER MYOCARDIAL INFARCTION: A PRECLINICAL STUDY. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.142] [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] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Background
An intense fibrotic response after myocardial infarction (MI) may lead to scar expansion and left ventricular (LV) remodeling, increasing the risk for ventricular arrhythmias and heart failure. Pirfenidone is a drug currently approved for the treatment of idiopathic pulmonary fibrosis, and reduces LV fibrosis in patients with heart failure and preserved ejection fraction. We aimed to characterize the different profiles or protein expression in the infarct zone in rats receiving or not receiving pirfenidone on top of standard therapy for MI.
Methods
Male Wistar rats were randomized to: sham procedure (group 1; n=13), reperfused MI induced by surgical ligation of the left anterior descending artery (LAD) for 45 minutes (group 2; n=17), reperfused MI plus standard therapy (aspirin, angiotensin-converting enzyme inhibitor, beta-blocker, and also mineralocorticoid receptor antagonist [MRA]) (group 3; n=17), reperfused MI plus pirfenidone alone (group 4; n=17), reperfused MI plus standard therapy and pirfenidone (group 5; n=17). Rats surviving LAD ligation and reperfusion underwent cardiac magnetic resonance (CMR) after 72 hours and 30 days from MI, and were sacrificed the day after the second CMR exam. The primary endpoint was the change in late gadolinium enhancement (LGE) mass as a percentage of LV mass.
Results
Forty-six rats survived until the second CMR. Percent changes in LV end-diastolic and end-systolic volume (p=0.370 and 0.423, respectively), ejection fraction (p=0.236) and mass (p=0.815) did not differ significantly between rats on pirfenidone plus standard therapy compared with those receiving standard therapy alone. The decrease in LGE mass was significantly greater in rats on pirfenidone plus standard therapy vs. those on standard therapy alone: -22.0% (interquartile range, -37.1 to -5.7, range -51.1 to +37.5) vs. +1.9% (-7.7 to +12.5, range -19.8 to +56.5), p=0.029.
Conclusions
Pirfenidone had additive effects to standard therapy for MI (including an MRA) in reducing LV fibrosis in a rat model of reperfused MI, while it did not further improve LV function, volumes or mass.
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Affiliation(s)
- Alberto Aimo
- Scuola Superiore Sant’anna
- Fondazione Toscana Gabriele Monasterio
| | | | | | | | | | | | | | | | - Claudio Passino
- Scuola Superiore Sant’anna
- Fondazione Toscana Gabriele Monasterio
| | - Michele Emdin
- Scuola Superiore Sant’anna
- Fondazione Toscana Gabriele Monasterio
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22
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Aquaro GD, Guidi B, Emdin M, Pucci A, Chiti E, Santurro A, Scopetti M, Biondi F, Maiese A, Turillazzi E, Camastra G, Faggioni L, Cioni D, Fineschi V, Neri E, Di Paolo M. Post-Mortem Cardiac Magnetic Resonance in Explanted Heart of Patients with Sudden Death. Int J Environ Res Public Health 2022; 19:ijerph192013395. [PMID: 36293989 PMCID: PMC9603042 DOI: 10.3390/ijerph192013395] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 05/14/2023]
Abstract
BACKGROUND We sought to evaluate the diagnostic accuracy of post-mortem cardiac magnetic resonance (PMCMR) of explanted hearts to detect the cardiac causes of sudden death. METHODS PMCMR was performed in formalin-fixed explanted hearts of 115 cases of sudden death. Histological sampling of myocardium was performed using two different approaches: (1) guideline-based sampling; (2) guideline-based plus PMCMR-driven sampling. RESULTS Forensic diagnosis of cardiac cause of death was ascertained in 72 (63%) patients. When the guideline-driven histological sampling was used, the PMCMR interpretation matched with final forensic diagnosis in 93 out of 115 cases (81%) with sensitivity of 88% (79-95%), specificity of 65% (47-80%), PPV of 84% (78-90%), NPV of 73% (58-84%), accuracy of 81% (72-88%), and AUC of 0.77 (0.68-0.84). When a PMCMR-driven approach was added to the guideline-based one, the matching increased to 102 (89%) cases with a PMCMR sensitivity of 89% (80-94%), a specificity of 86% (67-96%), PPV of 95% (89-98%), NPV of 73% (59-83%), accuracy of 89% (81-93%), and AUC of 0.88 (0.80-0.93). CONCLUSIONS PMCMR has high accuracy to identify the cardiac cause of sudden death and may be considered a valid auxilium for forensic diagnosis. PMCMR could improve histological diagnosis in conditions with focal myocardial involvement or demonstrating signs of myocardial ischemia.
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Affiliation(s)
| | | | - Michele Emdin
- Fondazione Toscana G. Monasterio, 56124 Pisa, Italy
- Scuola Superiore Sant’Anna, 56127 Pisa, Italy
| | - Angela Pucci
- Department of Surgical, Clinical and Molecular Pathology and of Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Enrica Chiti
- Department of Surgical, Clinical and Molecular Pathology and of Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Alessandro Santurro
- Department of Medicine, Surgery and Dentistry-Scuola Medica Salernitana, University of Salerno, 84084 Fisciano, Italy
| | - Matteo Scopetti
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, 00189 Rome, Italy
| | - Federico Biondi
- Cardiology Department, University of Trieste, 34127 Trieste, Italy
| | - Aniello Maiese
- UO Medicina Legale, University of Pisa, 56126 Pisa, Italy
| | | | | | | | - Dania Cioni
- Academic Radiology, University of Pisa, 56126 Pisa, Italy
| | - Vittorio Fineschi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Emanuele Neri
- Academic Radiology, University of Pisa, 56126 Pisa, Italy
| | - Marco Di Paolo
- UO Medicina Legale, University of Pisa, 56126 Pisa, Italy
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23
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Ghionzoli N, Gismondi A, Mandoli GE, Spera L, Di Florio A, D’Ascenzi F, Cameli M, Cavigli L, Sciaccaluga C, Carbone SF, Aquaro GD, Valente S, Focardi M. Left Ventricular Mass with Delayed Enhancement as a Predictor of Major Events in Patients with Myocarditis with Preserved Ejection Fraction. J Clin Med 2022; 11:jcm11206082. [PMID: 36294403 PMCID: PMC9604807 DOI: 10.3390/jcm11206082] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Background: Cardiac Magnetic Resonance (CMR) has a key role in subjects presenting with acute myocarditis, independent from left ventricular ejection fraction; it is widely used as a non-invasive imaging test for both diagnostic and prognostic purposes. However, poor data is available about the CMR-derived prognostic parameters of acute myocarditis with preserved ejection fraction (AMpEF). The aim of this study was to investigate the role of CMR in predicting outcomes in patients followed up for AMpEF, using a composite endpoint of all-cause mortality and hospitalization for heart failure (HF). Methods: We retrospectively enrolled 61 patients with diagnosed AMpEF. All patients underwent biohumoral, echocardiographic and CMR evaluation in the acute phase. Myocarditis was confirmed by Lake–Louis criteria assessed on CMR images. Mean follow-up was 4.8 ± 0.6 years during which a composite endpoint of all-cause mortality and hospitalization for HF was investigated. Results: The population was fairly homogeneous regarding baseline clinical features. In particular, no significant differences in age and main cardiovascular risk factors were found between patients with and without events at follow-up. Seven patients met the endpoint. They had significantly higher levels of circulating neutrophils in the acute phase (76 ± 7% vs. 61 ± 11%, p = 0.014) and a higher amount of left ventricular mass with delayed enhancement (DE-LVM, 18 (14–29.5) vs. 12 (8–16) g, p = 0.028). At Cox univariate analysis, DE-LVM was the only significant predictor of endpoint, regardless of the site of inflammation. Conclusions: DE-LVM can predict the composite endpoint of all-cause mortality and hospitalization for HF in a population of patients with AMpEF, representing a new added tool for prognostic stratification.
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Affiliation(s)
- Nicolò Ghionzoli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy
| | - Annalaura Gismondi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy
| | - Giulia Elena Mandoli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy
- Correspondence:
| | - Lucia Spera
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy
| | - Alex Di Florio
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy
| | - Flavio D’Ascenzi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy
| | - Matteo Cameli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy
| | - Luna Cavigli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy
| | - Carlotta Sciaccaluga
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy
| | - Salvatore Francesco Carbone
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Viale Bracci 16, 53100 Siena, Italy
| | | | - Serafina Valente
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy
| | - Marta Focardi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy
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24
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Simonini L, Sbrana S, Foffa I, Baroni M, Catapano G, Chiappino D, Grigoratos C, Marrone C, Losi P, Mannucci F, Salvadori S, Todiere G, Valenti E, Ait-Ali L, Aquaro GD. Relationships between plasma cytokine balance and cardiac magnetic resonance imaging in long-term post-COVID follow-up: a cross-sectional preliminary study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.245] [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
COVID-19 infection can lead to a constellation of long-lasting post-infectious sequelae, including myocardial dysfunction, whose outcome is strongly affected by a fine-tuned balance between pro- and anti-inflammatory systemic immune responses. Plasma cytokines are key mediators of this immunological balance. In this preliminary study we evaluated the cross-sectional association between the circulating levels of the main pro- and anti-inflammatory cytokines and cardiac magnetic resonance (CMR) abnormalities.
Methods
71 subjects (59% female, mean age 52±14) with previous diagnosis of COVID-19 infection were enrolled at our institution for MULTICOVID protocol, comprehensive of CMR and biomarkers assessment performed >3 months and <1 year following the first negative swab test. CMR protocols consisted of conventional sequences (cine, T2-weighted imaging, and late gadolinium enhancement [LGE]) and quantitative mapping sequences (T1, T2, and extracellular volume [ECV] mapping). Plasma levels of cytokines TNF-α, IL-1β, IL-1α, IFN-α2, IL-6, IL-8, IL-13, IL-10, IL-17A, IL-18, IP-10, MIG and MCP-1 were quantified by Multiplex Immunoassays on the Luminex technology platform. Soluble cardiologic and biochemical biomarkers were measured by routine laboratory analysis.
Results
After a median of 9 (IQR 6–11) months following negative swab, CMR was normal in 48 subjects, while in 23 (32%) it revealed tissue characterization abnormalities (myocardial late enhancement and/or edema). By multivariate regression analysis (adjusted for age, sex, vaccination, severity degrees of the initial COVID disease, presence of comorbidities, smoke, time interval between COVID diagnosis and CMR assessment) the cytokine ratio TNF-α/(IL-10+IL-13) was independently associated (OR=2.89, 95% CI 1.19–7.04, p=0.02) with CMR abnormalities. Interestingly, the cumulative pro-/anti-inflammatory cytokine ratio (IL-1β+TNF-α+IFN-α2+IL-6+IL-17A+IL-8)/(IL-10+IL-13) showed a positive (OR=1.70, 95% CI: 1.04–2.75) and significant (p=0.03) association with CMR imaging aspects. Also, the ratio IFN-α2/(IL-10+IL-13), although without achieving a complete statistical significance (p=0.09), was associated positively with CMR findings.
Conclusions
The preliminary results of this cross-sectional study suggest that the systemic inflammatory environment, long-lasting unbalanced towards a prevalent cytokine-driven pro-inflammatory condition following COVID infection, could affect the development of CMR-detectable myocardial edema and fibrosis in long-term post-COVID subjects.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Tuscany Region
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Affiliation(s)
- L Simonini
- Institute of Clinical Physiology (IFC) , Pisa , Italy
| | - S Sbrana
- Institute of Clinical Physiology (IFC) , Pisa , Italy
| | - I Foffa
- Institute of Clinical Physiology (IFC) , Pisa , Italy
| | - M Baroni
- Fondazione Toscana Gabriele Monasterio , Massa , Italy
| | - G Catapano
- Fondazione Toscana Gabriele Monasterio , Pisa , Italy
| | - D Chiappino
- Fondazione Toscana Gabriele Monasterio , Massa , Italy
| | - C Grigoratos
- Fondazione Toscana Gabriele Monasterio , Pisa , Italy
| | - C Marrone
- Fondazione Toscana Gabriele Monasterio , Massa , Italy
| | - P Losi
- Institute of Clinical Physiology (IFC) , Pisa , Italy
| | - F Mannucci
- Fondazione Toscana Gabriele Monasterio , Pisa , Italy
| | - S Salvadori
- Institute of Clinical Physiology (IFC) , Pisa , Italy
| | - G Todiere
- Fondazione Toscana Gabriele Monasterio , Pisa , Italy
| | - E Valenti
- Institute of Clinical Physiology (IFC) , Pisa , Italy
| | - L Ait-Ali
- Institute of Clinical Physiology (IFC) , Pisa , Italy
| | - G D Aquaro
- Fondazione Toscana Gabriele Monasterio , Pisa , Italy
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25
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Ammirati E, Raimondi F, Piriou N, Sardo Infirri L, Mohiddin SA, Mazzanti A, Shenoy C, Cavallari UA, Imazio M, Aquaro GD, Olivotto I, Pedrotti P, Sekhri N, Van de Heyning CM, Broeckx G, Peretto G, Guttmann O, Dellegrottaglie S, Scatteia A, Gentile P, Merlo M, Goldberg RI, Reyentovich A, Sciamanna C, Klaassen S, Poller W, Trankle CR, Abbate A, Keren A, Horowitz-Cederboim S, Cadrin-Tourigny J, Tadros R, Annoni GA, Bonoldi E, Toquet C, Marteau L, Probst V, Trochu JN, Kissopoulou A, Grosu A, Kukavica D, Trancuccio A, Gil C, Tini G, Pedrazzini M, Torchio M, Sinagra G, Gimeno JR, Bernasconi D, Valsecchi MG, Klingel K, Adler ED, Camici PG, Cooper LT. Acute Myocarditis Associated With Desmosomal Gene Variants. JACC Heart Fail 2022; 10:714-727. [PMID: 36175056 DOI: 10.1016/j.jchf.2022.06.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [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: 04/29/2022] [Revised: 05/24/2022] [Accepted: 06/01/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The risk of adverse cardiovascular events in patients with acute myocarditis (AM) and desmosomal gene variants (DGV) remains unknown. OBJECTIVES The purpose of this study was to ascertain the risk of death, ventricular arrhythmias, recurrent myocarditis, and heart failure (main endpoint) in patients with AM and pathogenic or likely pathogenetic DGV. METHODS In a retrospective international study from 23 hospitals, 97 patients were included: 36 with AM and DGV (DGV[+]), 25 with AM and negative gene testing (DGV[-]), and 36 with AM without genetics testing. All patients had troponin elevation plus findings consistent with AM on histology or at cardiac magnetic resonance (CMR). In 86 patients, CMR changes in function and structure were re-assessed at follow-up. RESULTS In the DGV(+) AM group (88.9% DSP variants), median age was 24 years, 91.7% presented with chest pain, and median left ventricular ejection fraction (LVEF) was 56% on CMR (P = NS vs the other 2 groups). Kaplan-Meier curves demonstrated a higher risk of the main endpoint in DGV(+) AM compared with DGV(-) and without genetics testing patients (62.3% vs 17.5% vs 5.3% at 5 years, respectively; P < 0.0001), driven by myocarditis recurrence and ventricular arrhythmias. At follow-up CMR, a higher number of late gadolinium enhanced segments was found in DGV(+) AM. CONCLUSIONS Patients with AM and evidence of DGV have a higher incidence of adverse cardiovascular events compared with patients with AM without DGV. Further prospective studies are needed to ascertain if genetic testing might improve risk stratification of patients with AM who are considered at low risk.
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Affiliation(s)
- Enrico Ammirati
- De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy.
| | - Francesca Raimondi
- Centre de Référence Malformations Cardiaques Congénitales Complexes-M3C Hôpital Necker Enfants Malades, APHP Paris Cité, Paris, France
| | - Nicolas Piriou
- Université Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, France
| | | | - Saidi A Mohiddin
- Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom
| | - Andrea Mazzanti
- Molecular Cardiology, ICS Maugeri, IRCCS, Pavia, Italy; Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Chetan Shenoy
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Ugo A Cavallari
- Medical Genetics Unit, Department of Laboratory Medicine, Niguarda Hospital, Milano, Italy
| | - Massimo Imazio
- Cardiology, Cardiothoracic Department, "Santa Maria della Misericordia," Udine, Italy
| | | | - Iacopo Olivotto
- Cardiomyopathy Unit, Careggi University Hospital, Firenze, Italy
| | | | - Neha Sekhri
- Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom
| | | | | | - Giovanni Peretto
- IRCCS San Raffaele Hospital and Vita Salute University, Milano, Italy
| | - Oliver Guttmann
- Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom
| | | | | | - Piero Gentile
- De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy
| | - Marco Merlo
- Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy
| | - Randal I Goldberg
- The Leon H. Charney Division of Cardiology, NYU Langone Health, New York, New York, USA
| | - Alex Reyentovich
- The Leon H. Charney Division of Cardiology, NYU Langone Health, New York, New York, USA
| | - Christopher Sciamanna
- University of Illinois at Chicago, Advocate Christ Medical Center Cardiothoracic and Vascular Surgical Associates, Oak Lawn, Illinois, USA
| | - Sabine Klaassen
- Department of Paediatric Cardiology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Experimental and Clinical Research Center, a Cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Wolfgang Poller
- Department of Paediatric Cardiology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; German Centre for Cardiovascular Research, Berlin, Germany; Department of Cardiology, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Germany
| | - Cory R Trankle
- Division of Cardiology, Pauley Heart Center, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Antonio Abbate
- Division of Cardiology, Pauley Heart Center, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Andre Keren
- Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | | | - Julia Cadrin-Tourigny
- Division of Electrophysiology and Cardiovascular Genetics Center, Montreal Heart Institute, Université de Montréal, Montréal, Quebec, Canada
| | - Rafik Tadros
- Division of Electrophysiology and Cardiovascular Genetics Center, Montreal Heart Institute, Université de Montréal, Montréal, Quebec, Canada
| | | | | | - Claire Toquet
- Université Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, France; Pathology Department, CHU Nantes, Nantes University, Nantes, France
| | - Lara Marteau
- Université Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, France
| | - Vincent Probst
- Université Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, France
| | - Jean Noël Trochu
- Université Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, France
| | - Antheia Kissopoulou
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Aurelia Grosu
- Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Deni Kukavica
- Molecular Cardiology, ICS Maugeri, IRCCS, Pavia, Italy; Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Alessandro Trancuccio
- Molecular Cardiology, ICS Maugeri, IRCCS, Pavia, Italy; Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Cristina Gil
- Cardiac Department, University Hospital Virgen Arrixaca, Murcia, Spain
| | - Giacomo Tini
- Clinic of Cardiovascular Disease, Ospedale Policlinico San Martino, Università di Genova, Genova, Italy
| | - Matteo Pedrazzini
- Laboratory of Cardiovascular Genetics, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Margherita Torchio
- Laboratory of Cardiovascular Genetics, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Gianfranco Sinagra
- Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy
| | - Juan Ramón Gimeno
- Cardiac Department, University Hospital Virgen Arrixaca, Murcia, Spain
| | - Davide Bernasconi
- Bicocca Bioinformatics Biostatistics and Bioimaging (B4) Center, School of Medicine and Surgery, University of Milano-Bicocca, Bicocca, Italy
| | - Maria Grazia Valsecchi
- Bicocca Bioinformatics Biostatistics and Bioimaging (B4) Center, School of Medicine and Surgery, University of Milano-Bicocca, Bicocca, Italy
| | - Karin Klingel
- Cardiopathology, Institute for Pathology and Neuropathology, University Hospital Tübingen, Tübingen, Germany
| | - Eric D Adler
- Department of Cardiology, University of California-San Diego, San Diego, California, USA
| | - Paolo G Camici
- IRCCS San Raffaele Hospital and Vita Salute University, Milano, Italy
| | - Leslie T Cooper
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, USA.
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Di Bella G, Cappelli F, Licordari R, Piaggi P, Campisi M, Bellavia D, Minutoli F, Gentile L, Russo M, de Gregorio C, Perfetto F, Mazzeo A, Falletta C, Clemenza F, Vita G, Carerj S, Aquaro GD. Prevalence and diagnostic value of extra-left ventricle echocardiographic findings in transthyretin-related cardiac amyloidosis. Amyloid 2022; 29:197-204. [PMID: 35465808 DOI: 10.1080/13506129.2022.2064739] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Cardiac amyloidosis (CA) is cardiomyopathy with a hypertrophic phenotype characterised by diffuse deposition of anomalous fibrillar proteins in the extracellular matrix. OBJECTIVES To evaluate the prevalence and diagnostic value of extra left ventricle echocardiographic findings in patients with left ventricular (LV) hypertrophic phenotype and amyloid deposition. METHODS A group of 146 patients with LV thickness ≥15 mm were enrolled: 70 patients who received a definite diagnosis of sarcomeric hypertrophic cardiomyopathy (HCM group) and 76 patients with transthyretin cardiac amyloidosis (CA group). Echocardiographic analysis of crista terminalis (CriT), atrio-ventricular plane (AVP), mitro-aortic lamina (MAL), anterior ascending aortic wall, interatrial septum (IAS), Eustachian valve (EusV) and coumadin ridge (CouR) was performed in all patients, and these structures were compared among the two groups. RESULTS CA group showed significantly higher dimensions of CriT, IAS, CouR, AVP, MAL and IAS compared to the HCM group. The logistic analysis showed that LV EF, LV septal thickness, CriT presence, CriT area, MAL and IAS were all predictors of CA in univariate analyses. The stepwise multivariate analysis showed independent predictors of CA: CriT area, MAL and LVEF. According to areas under the receiver operating characteristic curves the best cut-off values to determine CA were identified (IAS > 9 mm, MAL > 7 mm, CriT > 9 mm2). Among these 3 independent predictors, IAS > 9 mm had the best specificity (96%) and positive predictive value (93%) in identifying CA. CONCLUSIONS evidence of extra left ventricle sites of amyloid deposition is a frequent finding in CA. In the context of hypertrophic phenocopies, an increased thickness of IAS, and/or CT and/or MAL should suggest a diagnosis of transthyretin CA.
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Affiliation(s)
- Gianluca Di Bella
- Rare Cardiac Disease Centre, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Francesco Cappelli
- Tuscan Regional Amyloid Center, Careggi University Hospital, Firenze, Italy
| | - Roberto Licordari
- Rare Cardiac Disease Centre, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Paolo Piaggi
- Department of Clinical and Experimental Medicine, Section of Endocrinology, University of Pisa, Pisa, Italy
| | - Mariapaola Campisi
- Rare Cardiac Disease Centre, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Diego Bellavia
- Division of Cardiovascular Diseases, Cardio-Thoracic Department, IRCCS-ISMETT, Palermo, Italy
| | - Fabio Minutoli
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Luca Gentile
- Rare Cardiac Disease Centre, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Massimo Russo
- Rare Cardiac Disease Centre, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Cesare de Gregorio
- Rare Cardiac Disease Centre, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Federico Perfetto
- Tuscan Regional Amyloid Center, Careggi University Hospital, Firenze, Italy
| | - Anna Mazzeo
- Rare Cardiac Disease Centre, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Calogero Falletta
- Division of Cardiovascular Diseases, Cardio-Thoracic Department, IRCCS-ISMETT, Palermo, Italy
| | - Francesco Clemenza
- Division of Cardiovascular Diseases, Cardio-Thoracic Department, IRCCS-ISMETT, Palermo, Italy
| | - Giuseppe Vita
- Rare Cardiac Disease Centre, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Scipione Carerj
- Rare Cardiac Disease Centre, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Pizzino F, Furini G, Casieri V, Mariani M, Bianchi G, Storti S, Chiappino D, Maffei S, Solinas M, Aquaro GD, Lionetti V. Late plasma exosome microRNA-21-5p depicts magnitude of reverse ventricular remodeling after early surgical repair of primary mitral valve regurgitation. Front Cardiovasc Med 2022; 9:943068. [PMID: 35966562 PMCID: PMC9373041 DOI: 10.3389/fcvm.2022.943068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/04/2022] [Indexed: 12/11/2022] Open
Abstract
Introduction Primary mitral valve regurgitation (MR) results from degeneration of mitral valve apparatus. Mechanisms leading to incomplete postoperative left ventricular (LV) reverse remodeling (Rev-Rem) despite timely and successful surgical mitral valve repair (MVR) remain unknown. Plasma exosomes (pEXOs) are smallest nanovesicles exerting early postoperative cardioprotection. We hypothesized that late plasma exosomal microRNAs (miRs) contribute to Rev-Rem during the late postoperative period. Methods Primary MR patients (n = 19; age, 45-71 years) underwent cardiac magnetic resonance imaging and blood sampling before (T0) and 6 months after (T1) MVR. The postoperative LV Rev-Rem was assessed in terms of a decrease in LV end-diastolic volume and patients were stratified into high (HiR-REM) and low (LoR-REM) LV Rev-Rem subgroups. Isolated pEXOs were quantified by nanoparticle tracking analysis. Exosomal microRNA (miR)-1, -21-5p, -133a, and -208a levels were measured by RT-qPCR. Anti-hypertrophic effects of pEXOs were tested in HL-1 cardiomyocytes cultured with angiotensin II (AngII, 1 μM for 48 h). Results Surgery zeroed out volume regurgitation in all patients. Although preoperative pEXOs were similar in both groups, pEXO levels increased after MVR in HiR-REM patients (+0.75-fold, p = 0.016), who showed lower cardiac mass index (-11%, p = 0.032). Postoperative exosomal miR-21-5p values of HiR-REM patients were higher than other groups (p < 0.05). In vitro, T1-pEXOs isolated from LoR-REM patients boosted the AngII-induced cardiomyocyte hypertrophy, but not postoperative exosomes of HiR-REM. This adaptive effect was counteracted by miR-21-5p inhibition. Summary/Conclusion High levels of miR-21-5p-enriched pEXOs during the late postoperative period depict higher LV Rev-Rem after MVR. miR-21-5p-enriched pEXOs may be helpful to predict and to treat incomplete LV Rev-Rem after successful early surgical MVR.
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Affiliation(s)
- Fausto Pizzino
- Unit of Translational Critical Care Medicine, Scuola Superiore Sant'Anna, Pisa, Italy.,Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Giulia Furini
- Unit of Translational Critical Care Medicine, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Valentina Casieri
- Unit of Translational Critical Care Medicine, Scuola Superiore Sant'Anna, Pisa, Italy
| | | | | | | | | | | | | | | | - Vincenzo Lionetti
- Unit of Translational Critical Care Medicine, Scuola Superiore Sant'Anna, Pisa, Italy.,Fondazione Toscana Gabriele Monasterio, Pisa, Italy
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28
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Ricci F, Aquaro GD, De Innocentiis C, Rossi S, Mantini C, Longo F, Khanji MY, Gallina S, Pingitore A. Exercise-induced myocardial edema in master triathletes: Insights from cardiovascular magnetic resonance imaging. Front Cardiovasc Med 2022; 9:908619. [PMID: 35983187 PMCID: PMC9378862 DOI: 10.3389/fcvm.2022.908619] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/05/2022] [Indexed: 11/17/2022] Open
Abstract
Background Strenuous exercise has been associated with functional and structural cardiac changes due to local and systemic inflammatory responses, reflecting oxidative, metabolic, hormonal, and thermal stress, even in healthy individuals. We aimed to assess changes in myocardial structure and function using cardiovascular magnetic resonance (CMR) imaging in master triathletes early after a full-distance Ironman Triathlon race. Materials and methods Ten master triathletes (age 45 ± 8 years) underwent CMR within 3 h after a full-distance Ironman Triathlon race (3.8 km swimming, 180 km cycling, and 42.2 km running) completed with a mean time of 12 ± 1 h. All the triathletes had a 30-day follow-up CMR. Cine balanced steady-state free precession, T2-short tau inversion recovery (STIR), tagging, and late gadolinium enhancement (LGE) imaging sequences were performed on a 1.5-T MR scanner. Myocardial edema was defined as a region with increased T2 signal intensity (SI) of at least two SDs above the mean of the normal myocardium. The extent of myocardial edema was expressed as the percentage of left ventricular (LV) mass. Analysis of LV strain and torsion by tissue tagging included the assessment of radial, longitudinal, and circumferential peak systolic strain, rotation, and twist. Results Compared with postrace, biventricular volumes, ejection fraction, and LV mass index remained unchanged at 30-day follow-up. Global T2 SI was significantly higher in the postrace CMR (postrace 10.5 ± 6% vs. follow-up 3.9 ± 3.8%, P = 0.004) and presented with a relative apical sparing distribution (P < 0.001) matched by reduction of radial peak systolic strain of basal segments (P = 0.003). Apical rotation and twist were significantly higher immediately after the competition compared with follow-up (P < 0.05). Conclusion Strenuous exercise in master triathletes is associated with a reversible regional increase in myocardial edema and reduction of radial peak systolic strain, both presenting with a relative apical sparing pattern.
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Affiliation(s)
- Fabrizio Ricci
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
- Department of Clinical Sciences, Clinical Research Center, Lund University, Malmö, Sweden
- *Correspondence: Fabrizio Ricci,
| | | | - Carlo De Innocentiis
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Serena Rossi
- Interventional Cath Lab, ASL 2 Abruzzo, Chieti, Italy
| | - Cesare Mantini
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | | | - Mohammed Y. Khanji
- Newham University Hospital, Barts Health NHS Trust, London, United Kingdom
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Sabina Gallina
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
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Baronti A, Gentile F, Manetti AC, Scatena A, Pellegrini S, Pucci A, Franzini M, Castiglione V, Maiese A, Giannoni A, Pistello M, Emdin M, Aquaro GD, Di Paolo M. Myocardial Infarction Following COVID-19 Vaccine Administration: Post Hoc, Ergo Propter Hoc? Viruses 2022; 14:v14081644. [PMID: 36016266 PMCID: PMC9413746 DOI: 10.3390/v14081644] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 12/13/2022] Open
Abstract
Vaccination against coronavirus disease 2019 (COVID-19) is the safest and most effective strategy for controlling the pandemic. However, some cases of acute cardiac events following vaccine administration have been reported, including myocarditis and myocardial infarction (MI). While post-vaccine myocarditis has been widely discussed, information about post-vaccine MI is scarce and heterogenous, often lacking in histopathological and pathophysiological details. We hereby present five cases (four men, mean age 64 years, range 50–76) of sudden death secondary to MI and tightly temporally related to COVID-19 vaccination. In each case, comprehensive macro- and microscopic pathological analyses were performed, including post-mortem cardiac magnetic resonance, to ascertain the cause of death. To investigate the pathophysiological determinants of MI, toxicological and tryptase analyses were performed, yielding negative results, while the absence of anti-platelet factor 4 antibodies ruled out vaccine-induced thrombotic thrombocytopenia. Finally, genetic testing disclosed that all subjects were carriers of at least one pro-thrombotic mutation. Although the presented cases do not allow us to establish any causative relation, they should foster further research to investigate the possible link between COVID-19 vaccination, pro-thrombotic genotypes, and acute cardiovascular events.
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Affiliation(s)
- Arianna Baronti
- Institute of Legal Medicine, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (A.B.); (A.C.M.); (A.S.); (A.M.); (M.D.P.)
| | - Francesco Gentile
- Fondazione Toscana G. Monasterio, 56124 Pisa, Italy; (F.G.); (V.C.); (A.G.); (G.D.A.)
| | - Alice Chiara Manetti
- Institute of Legal Medicine, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (A.B.); (A.C.M.); (A.S.); (A.M.); (M.D.P.)
| | - Andrea Scatena
- Institute of Legal Medicine, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (A.B.); (A.C.M.); (A.S.); (A.M.); (M.D.P.)
| | - Silvia Pellegrini
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy;
| | - Angela Pucci
- Department of Histopathology, University of Pisa, 56126 Pisa, Italy;
| | - Maria Franzini
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56126 Pisa, Italy;
| | - Vincenzo Castiglione
- Fondazione Toscana G. Monasterio, 56124 Pisa, Italy; (F.G.); (V.C.); (A.G.); (G.D.A.)
- Health Science Interdisciplinary Center, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
| | - Aniello Maiese
- Institute of Legal Medicine, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (A.B.); (A.C.M.); (A.S.); (A.M.); (M.D.P.)
| | - Alberto Giannoni
- Fondazione Toscana G. Monasterio, 56124 Pisa, Italy; (F.G.); (V.C.); (A.G.); (G.D.A.)
- Health Science Interdisciplinary Center, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
| | - Mauro Pistello
- Retrovirus Center and Virology Section, Department of Translational Research, University of Pisa, 56126 Pisa, Italy;
| | - Michele Emdin
- Fondazione Toscana G. Monasterio, 56124 Pisa, Italy; (F.G.); (V.C.); (A.G.); (G.D.A.)
- Health Science Interdisciplinary Center, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
- Correspondence: or
| | | | - Marco Di Paolo
- Institute of Legal Medicine, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (A.B.); (A.C.M.); (A.S.); (A.M.); (M.D.P.)
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30
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Aquaro GD, Licordari R, Todiere G, Ianni U, Dellegrotaglie S, Restivo L, Grigoratos C, Patanè F, Barison A, Micari A, Di Bella G. Incidence of acute myocarditis and pericarditis during the coronavirus disease 2019 pandemic: comparison with the prepandemic period. J Cardiovasc Med (Hagerstown) 2022; 23:447-453. [PMID: 35763765 DOI: 10.2459/jcm.0000000000001330] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Myocarditis and pericarditis have been proposed to account for a proportion of cardiac injury during SARS-CoV-2 infection. The impact of COVID-19 the pandemic on the incidence of this acute inflammatory cardiac disease was not systematically evaluated. AIM To examine the incidence and prevalence of inflammatory heart disorders prior to and during the COVID-19 pandemic. METHODS We compared the incidence and prevalence of acute inflammatory heart diseases (myocarditis, pericarditis) in the provinces of Pisa, Lucca and Livorno in two time intervals: prior to (PRECOVID, from 1 June 2018 to 31 May 2019) and during the COVID-19 pandemic (COVID, from 1 June 2020 to May 2021). RESULTS Overall 259 cases of inflammatory heart disease (myocarditis and/or pericarditis) occurred in the areas of interest. The annual incidence was of 11.3 cases per 100 000 inhabitants. Particularly, 138 cases occurred in the pre-COVID, and 121 in the COVID period. The annual incidence of inflammatory heart disease was not significantly different (12.1/100 000 in PRECOVID vs 10.3/100 000 in COVID, P = 0.22). The annual incidence of myocarditis was significantly higher in PRECOVID than in COVID, respectively 8.1/100 000/year vs. 5.9/100 000/year (P = 0.047) consisting of a net reduction of 27% of cases. Particularly the incidence of myocarditis was significantly lower in COVID than in PRECOVID in the class of age 18-24 years. Despite this, myocarditis of the COVID period had more wall motion abnormalities and greater LGE extent. The annual incidence of pericarditis was, instead, not significantly different (4.03/100 000 vs, 4.47/100 000, P = 0.61). CONCLUSION Despite a possible etiologic role of SARS-CoV-2 and an expectable increased incidence of myocarditis and pericarditis, data of this preliminary study, with a geographically limited sample size, suggest a decrease in acute myocarditis and a stable incidence of pericarditis and of myopericarditis/perimyocarditis.
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Affiliation(s)
| | - Roberto Licordari
- Department of Clinical and experimental medicine, University of Messina
| | | | - Umberto Ianni
- Institute of Cardiology, 'G. D'Annunzio' University, Chieti
| | - Santo Dellegrotaglie
- Division of Cardiology, Ospedale Medico-Chirurgico Accreditato 'Villa dei Fiori', Acerra
| | - Luca Restivo
- Division of Cardiology Cardiothoracovascular Department, University of Trieste
| | | | | | | | - Antonio Micari
- Department of Biomedical and Dental Science and of Morphological and Functional Images, University of Messina, Messina, Italy
| | - Gianluca Di Bella
- Department of Clinical and experimental medicine, University of Messina
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Ali LA, Marrone C, Martins DS, Khraiche D, Festa P, Martini N, Santoro G, Todiere G, Panaioli E, Bonnet D, Boddaert N, Aquaro GD, Raimondi F. Prognostic factors in hypertrophic cardiomyopathy in children: An MRI based study. Int J Cardiol 2022; 364:141-147. [PMID: 35718011 DOI: 10.1016/j.ijcard.2022.06.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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] [Received: 02/01/2022] [Revised: 05/07/2022] [Accepted: 06/12/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Clinical and prognostic role of cardiac magnetic resonance (CMR) in adult population with hypertrophic cardiomyopathy (HCM) have been largely assessed. We sought to investigate the role of CMR for predicting cardiovascular events in children with HCM. METHODS CMR was performed in 116 patients with HCM (37 sarcomeric mutations, 31 other mutations, mean age 10.4 ± 4.3 yrs). CMR protocol included cine imaging for evaluation of morphology and function and late gadolinium enhancement (LGE). Hard cardiac events (sustained VT, resuscitated cardiac arrest, sudden cardiac death, end-stage heart failure, heart transplant and appropriate ICD intervention) were recorded through a median follow-up of 4 (1-7) years. RESULTS During follow-up 21 heart cardiac events occurred. At maximal-rank statistic the optimal cut-point for LGE extent for predicting events was ≥2%. Syncope, non-sustained ventricular tachycardia (NSVT) and LGE extent ≥2% were independent predictors of events. At Harrel's C statistic combination of LGE extent ≥2% and syncope was the strongest model for predicting events. HR of patients with LGE extent ≥2% and no history of syncope was 3.6 (1.1-12.2) that increased to 37.6 (5.4-161) in those with LGE extent ≥2% and syncope. The median time dependent AUC of LGE extent (0.88, 95% CI 0.86-0.89) was significantly higher than that of syncope (0.63, 95% CI 0.61-0.66, p < 0.0001) and NSVT (0.52, 95% CI 0.50-0.53, p < 0.0001). CONCLUSIONS In children with HCM, LGE and syncope were independent predictors of hard cardiac events at follow-up.
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Affiliation(s)
- Lamia Ait Ali
- Institute of Clinical Physiology CNR, UO Massa and Fondazione G. Monasterio. CNR-Regione Toscana. Italy
| | | | - Duarte Saraiva Martins
- Pediatric Cardiology Department, Hospital de Santa Cruz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Diala Khraiche
- Unité médico-chirurgicale de cardiologie congénitale et pédiatrique, centre de référence des maladies cardiaques congénitales complexes - M3C, Hôpital universitaire Necker-Enfants Malades, Université de Paris, France
| | | | | | | | | | - Elena Panaioli
- Unité médico-chirurgicale de cardiologie congénitale et pédiatrique, centre de référence des maladies cardiaques congénitales complexes - M3C, Hôpital universitaire Necker-Enfants Malades, Université de Paris, France
| | - Damien Bonnet
- Unité médico-chirurgicale de cardiologie congénitale et pédiatrique, centre de référence des maladies cardiaques congénitales complexes - M3C, Hôpital universitaire Necker-Enfants Malades, Université de Paris, France
| | - Nathalie Boddaert
- Pediatric Radiology Unit, Hôpital universitaire Necker-Enfants Malades, Université de Paris, France
| | | | - Francesca Raimondi
- Unité médico-chirurgicale de cardiologie congénitale et pédiatrique, centre de référence des maladies cardiaques congénitales complexes - M3C, Hôpital universitaire Necker-Enfants Malades, Université de Paris, France and Azienda Ospedaliero Universitaria Meyer, Florence, Italy.
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Lilli A, Parollo M, Mazzocchetti L, De Sensi F, Rossi A, Notarstefano P, Santoro A, Aquaro GD, Cresti A, Lapira F, Faggioni L, Tessa C, Pauselli L, Bongiorni MG, Berruezo A, Zucchelli G. Ventricular tachycardia ablation guided or aided by scar characterization with cardiac magnetic resonance: rationale and design of VOYAGE study. BMC Cardiovasc Disord 2022; 22:169. [PMID: 35421939 PMCID: PMC9012027 DOI: 10.1186/s12872-022-02581-1] [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] [Received: 12/30/2021] [Accepted: 03/23/2022] [Indexed: 11/26/2022] Open
Abstract
Background Radiofrequency ablation has been shown to be a safe and effective treatment for scar-related ventricular arrhythmias (VA). Recent preliminary studies have shown that real time integration of late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) images with electroanatomical map (EAM) data may lead to increased procedure efficacy, efficiency, and safety. Methods VOYAGE is a prospective, randomized, multicenter controlled open label study designed to compare in terms of efficacy, efficiency, and safety a CMR aided/guided workflow to standard EAM-guided ventricular tachycardia (VT) ablation. Patients with an ICD or with ICD implantation expected within 1 month, with scar related VT, suitable for CMR and multidetector computed tomography (MDCT) will be randomized to a CMR-guided or CMR-aided approach, whereas subjects unsuitable for imaging or with image quality deemed not sufficient for postprocessing will be allocated to standard of care ablation. Primary endpoint is defined as VT recurrences (sustained or requiring appropriate ICD intervention) during 12 months follow-up, excluding the first month of blanking period. Secondary endpoints will include procedural efficiency, safety, impact on quality of life and comparison between CMR-guided and CMR-aided approaches. Patients will be evaluated at 1, 6 and 12 months. Discussion The clinical impact of real time CMR-guided/aided ablation approaches has not been thoroughly assessed yet. This study aims at defining whether such workflow results in more effective, efficient, and safer procedures. If proven to be of benefit, results from this study could be applied in large scale interventional practice. Trial registrationClinicalTrials.gov, NCT04694079, registered on January 1, 2021.
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Parollo M, Levantino M, Pucci A, Aquaro GD, Delle Donne MG, Caravelli P, Capozza P, Colli A, De Caterina R. A unique case of right ventricular myxoma concealed within a thrombus in a patient with Crohn's disease: a problem unresolved even with advanced cardiac MRI. J Cardiovasc Med (Hagerstown) 2022; 23:272-274. [PMID: 35287159 DOI: 10.2459/jcm.0000000000001301] [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)
| | | | - Angela Pucci
- U.O. Anatomia Patologica 3, Azienda Ospedaliero-Universitaria Pisana
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Sbrana F, Dal Pino B, Aquaro GD, Bigazzi F, Vergaro G, Sampietro T. Lipoprotein(a) apheresis restores coronary microcirculation in refractory angina. Rev Port Cardiol 2022; 41:437-439. [DOI: 10.1016/j.repc.2021.06.018] [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: 06/09/2021] [Accepted: 06/15/2021] [Indexed: 11/25/2022] Open
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Aquaro GD, Corsi E, Todiere G, Grigoratos C, Barison A, Barra V, Di Bella G, Emdin M, Ricci F, Pingitore A. Magnetic Resonance for Differential Diagnosis of Left Ventricular Hypertrophy: Diagnostic and Prognostic Implications. J Clin Med 2022; 11:jcm11030651. [PMID: 35160102 PMCID: PMC8836982 DOI: 10.3390/jcm11030651] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/19/2022] [Accepted: 01/26/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Left ventricular hypertrophy (LVH) may be due to different causes, ranging from benign secondary forms to severe cardiomyopathies. Transthoracic Echocardiography (TTE) and ECG are the first-level examinations for LVH diagnosis. Cardiac magnetic resonance (CMR) accurately defines LVH type, extent and severity. OBJECTIVES to evaluate the diagnostic and prognostic role of CMR in patients with TTE and/or ECG evidence of LVH. METHODS We performed CMR in 300 consecutive patients with echocardiographic and/or ECG signs of LVH. RESULTS Overall, 275 patients had TTE evidence of LVH, with initial suspicion of hypertrophic cardiomyopathy (HCM) in 132 (44%), cardiac amyloidosis in 41 (14%), hypertensive LVH in 48 (16%), aortic stenosis in 4 (1%), and undetermined LVH in 50 (16%). The initial echocardiographic diagnostic suspicion of LVH was confirmed in 172 patients (57.3%) and changed in 128 patients (42.7%, p < 0.0001): the diagnosis of HCM increased from 44% to 71% of patients; hypertensive and undetermined LVH decreased significantly (respectively to 4% and 5%). CMR allowed for a diagnosis in 41 out of 50 (82%) patients with undetermined LVH at TTE. CMR also identified HCM in 17 out of 25 patients with apparently normal echocardiography but with ECG criteria for LVH. Finally, the reclassification of the diagnosis by CMR was associated with a change in survival risk of patients: after CMR reclassification, no events occurred in patients with undetermined or hypertensive LVH. CONCLUSIONS CMR changed echocardiographic suspicion in almost half of patients with LVH. In the subgroup of patients with abnormal ECG, CMR identified LVH (particularly HCM) in 80% of patients. This study highlights the indication of CMR to better characterize the type, extent and severity of LVH detected at echocardiography and suspected with ECG.
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Affiliation(s)
- Giovanni Donato Aquaro
- Fondazione Toscana G. Monasterio, 56124 Pisa, Italy; (G.T.); (C.G.); (A.B.); (V.B.); (M.E.)
- Correspondence: ; Tel.: +39-050-315-2818; Fax: +39-050-315-2166
| | - Elisabetta Corsi
- Department of Cardiac and Thoracic medicine, Università degli studi di Pisa, 56126 Pisa, Italy;
| | - Giancarlo Todiere
- Fondazione Toscana G. Monasterio, 56124 Pisa, Italy; (G.T.); (C.G.); (A.B.); (V.B.); (M.E.)
| | - Crysanthos Grigoratos
- Fondazione Toscana G. Monasterio, 56124 Pisa, Italy; (G.T.); (C.G.); (A.B.); (V.B.); (M.E.)
| | - Andrea Barison
- Fondazione Toscana G. Monasterio, 56124 Pisa, Italy; (G.T.); (C.G.); (A.B.); (V.B.); (M.E.)
| | - Valerio Barra
- Fondazione Toscana G. Monasterio, 56124 Pisa, Italy; (G.T.); (C.G.); (A.B.); (V.B.); (M.E.)
| | - Gianluca Di Bella
- Cardiology Unit, Department of Clinical and Experimental Medicine, AOU Policlinico G. Martino, Università di Messina, 98122 Messina, Italy;
| | - Michele Emdin
- Fondazione Toscana G. Monasterio, 56124 Pisa, Italy; (G.T.); (C.G.); (A.B.); (V.B.); (M.E.)
- Institute of Life Sciences, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
| | - Fabrizio Ricci
- Department of Neuroscience, Imaging and Clinical Sciences, Institute of Radiology, SS. Annunziata Hospital of Chieti, University of Chieti, 66100 Chieti, Italy;
- Casa di Cura Villa Serena, Città Sant’Angelo, 65013 Pescara, Italy
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Negri F, Muser D, Driussi M, Sanna GD, Masè M, Cittar M, Poli S, De Bellis A, Fabris E, Puppato M, Grigoratos C, Todiere G, Aquaro GD, Sinagra G, Imazio M. Prognostic role of global longitudinal strain by feature tracking in patients with hypertrophic cardiomyopathy: The STRAIN-HCM study. Int J Cardiol 2021; 345:61-67. [PMID: 34728259 DOI: 10.1016/j.ijcard.2021.10.148] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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] [Received: 06/05/2021] [Revised: 10/07/2021] [Accepted: 10/26/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The assessment of myocardial fiber deformation with cardiac magnetic resonance feature tracking (CMR-FT) has shown to be promising in terms of prognostic information in several structural heart diseases. However, little is known about its role in hypertrophic cardiomyopathy (HCM). Aims of the present study were: 1) to assess the prognostic role of CMR-FT derived strain parameters in patients with HCM. METHODS CMR was performed in 130 consecutive HCM patients (93 males, mean age (54 ± 17 years) with an estimated 5-year risk of sudden cardiac death (SCD) <6% according to the HCM Risk-SCD calculator. 2D- and 3D-Global Radial (GRS), Longitudinal (GLS) and Circumferential (GCS) Strain was evaluated by FT analysis. The primary outcome of the study was a composite of major adverse cardiac events (MACE) including SCD, resuscitated cardiac arrest due to ventricular fibrillation (VF) or hemodynamically unstable ventricular tachycardia (VT), and hospitalization for heart failure. RESULTS After a median follow-up of 51.7 (37.1-68.8) months, 4 (3%) patients died (all of them suffered from SCD) and 36 (28%) were hospitalized for heart failure. After multivariable adjustment for clinical and imaging covariates, among all strain parameters, only GLS remained a significant independent predictor of outcome events in both the model including 2D strain (HR 1.12, 95% CI 1.03-1.23, p = 0.01) and the model including 3D strain (HR 1.14, 95% CI 1.01-1.30, p = 0.04). The addition of 2D-GLS into the model with clinical and imaging predictors resulted in a significant increase in the C-statistic (from 0.48 to 0.65, p = 0.03). CONCLUSION CMR-FT derived GLS is a powerful independent predictor of MACE in patients with HCM, incremental to common clinical and CMR risk factors including left ventricular ejection fraction and late gadolinium enhancement.
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Affiliation(s)
- Francesco Negri
- Cardiovascular Department, University Hospital, Udine, Italy.
| | - Daniele Muser
- Cardiovascular Department, University Hospital, Udine, Italy
| | - Mauro Driussi
- Cardiovascular Department, University Hospital, Udine, Italy
| | | | - Marco Masè
- Centre for Diagnosis and Management of Cardiomyopathies, University of Trieste, Italy
| | - Marco Cittar
- Centre for Diagnosis and Management of Cardiomyopathies, University of Trieste, Italy
| | - Stefano Poli
- Cardiovascular Department, University Hospital, Udine, Italy
| | - Annamaria De Bellis
- Centre for Diagnosis and Management of Cardiomyopathies, University of Trieste, Italy
| | - Enrico Fabris
- Centre for Diagnosis and Management of Cardiomyopathies, University of Trieste, Italy
| | | | | | | | | | - Gianfranco Sinagra
- Centre for Diagnosis and Management of Cardiomyopathies, University of Trieste, Italy
| | - Massimo Imazio
- Cardiovascular Department, University Hospital, Udine, Italy
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Leali M, Aimo A, Ricci G, Vergaro G, Todiere G, Grigoratos C, Aquaro GD, Siciliano G, Emdin M, Passino C, Barison A. 31 Cardiac magnetic resonance findings in patients with Type 1 myotonic dystrophy. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartj/suab132.030] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Aims
Heart disease is a major determinant of prognosis in type 1 myotonic dystrophy (DM1), second only to respiratory complications. Cardiac imaging, possibly including cardiac magnetic resonance (CMR), is recommended in patients with DM1. However, limited information is available on CMR findings and their prognostic significance in DM1.
Methods and results
We identified all patients with DM1 evaluated from 2009 to 2020 in a CMR laboratory with an established collaboration with a Neuromuscular Disorder Unit. Thirty-four patients were retrieved (21 males, aged 45 ± 12). By the time of CMR examination, 90% had neuromuscular symptoms (mean duration 17 ± 13 years), 13 (38%) had previous reports of atrioventricular block (n = 12 1st degree, n = 1 2nd degree type 1), 30 (88%) of intraventricular conduction disturbances (n = 5 left bundle branch block, n = 5 right bundle branch block, n = 3 left anterior fascicular block, n = 17 other non-specific or incomplete intraventricular conduction delay), 4 (12%) of atrial fibrillation or flutter. No patient had a device. At CMR, 5 (15%) patients had left ventricular (LV) systolic dysfunction [LV ejection fraction (LVEF) <50%] and 4 (12%) a depressed right ventricular (RV) function (RVEF <50%). Compared to age- and sex-specific reference values for our laboratory (Figure 1 left), 12 (35%) patients showed a decreased LV end-diastolic volume index (LVEDVi), 7 (21%) a decreased LV mass index (LVMi), and 29 (85%) a decreased LVMi/LVEDVi ratio. Nine (26%) patients had mid-wall late gadolinium enhancement (LGE, mean extent 4.5 ± 2.0% of LVM; n = 8 septal, n = 4 inferolateral, n = 2 inferior, n = 1 anterolateral, see Figure 1 middle), and 14 (41%) some areas of fatty infiltration (n = 9 involving the LV, n = 13 the RV). Native T1 in the interventricular septum (1,041 ± 53 ms) approached the upper reference limit (1089 ms), and the extracellular volume was slightly increased (33 ± 2%, reference values <30%). Over a median follow-up of 2.5 years (interquartile interval: 1.5–4.0), 2 (6%) patients died for infectious and respiratory complications, 5 (15%) underwent device implantation (n = 4 PM; n = 1 ICD), and 4 (12%) had a documentation of high-risk (Lown class ≥4) ventricular ectopic beats (VEBs). Among all CMR variables collected, higher values of LVMi/LVEDVi ratio emerged as univariate predictor of all-cause death (P = 0.044). At logistic regression analysis, anteroseptal wall thickness was associated with the need for device implantation (P = 0.028), while LGE mass was associated with high-risk VEBs (P = 0.026) (Figure 1 right).
Conclusions
Patients with DM1 display several structural and functional cardiac abnormalities, with variable degrees of cardiac muscle hypotrophy, fibrosis, and fatty infiltration. The possibility to predict the need for device implantation, ventricular arrhythmias, and all-cause or cardiovascular mortality should be verified in larger cohorts.
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Affiliation(s)
- Marco Leali
- Sant’Anna School of Advanced Studies, Institute of Life Sciences, Pisa, Italy
| | - Alberto Aimo
- Sant’Anna School of Advanced Studies, Institute of Life Sciences, Pisa, Italy
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Giulia Ricci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giuseppe Vergaro
- Sant’Anna School of Advanced Studies, Institute of Life Sciences, Pisa, Italy
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | | | | | | | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Michele Emdin
- Sant’Anna School of Advanced Studies, Institute of Life Sciences, Pisa, Italy
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Claudio Passino
- Sant’Anna School of Advanced Studies, Institute of Life Sciences, Pisa, Italy
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Andrea Barison
- Sant’Anna School of Advanced Studies, Institute of Life Sciences, Pisa, Italy
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
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Licordari R, Grigoratos C, Todiere G, Barison A, Di Bella G, Aquaro GD. 395 Diagnostic role of native T1 mapping compared to conventional magnetic resonance techniques in cardiac diseases: a real-life study. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartj/suab132.031] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aims
T1 mapping is a validated technique in cardiac magnetic resonance (CMR), however in real-life clinical practice its effectiveness to diagnose myocardial disease is still unclear. To compare native T1 mapping to conventional late gadolinium enhancement (LGE) and T2-STIR techniques for the evaluation of a cohort of consecutive patients undergoing CMR for the suspicion of myocardial disease.
Methods and results
CMR was performed in 323 patients, 206 males (64%), mean age 54 ± 8 years, and in 27 age- and sex-matched healthy controls. LGE, T2-STIR, and pre- and post-contrast T1 mapping were acquired as suggested by the SCMR position paper. The CMR findings of global and regional T1 mapping were compared to the respective results of LGE and T2-STIR techniques. The main baseline indications for CMR were: suspicion of ARVC in 20%; non-ischaemic DCM in 19%; HCM in 16%; chest pain without obstructive coronary artery in 14% of patients (suspicion of MINOCA, Tako-tsubo or myocarditis); other indications (amyloidosis, scleroderma, previous myocardial infarction, pericarditis, LV non-compaction) in the remaining of cases. At T2-STIR images myocardial hyperintensity suggesting oedema was found in 41 patients (27%). LGE images were positive in 206 patients (64%). Native T1 mapping was abnormal in 171 (49%). In 206 patients (64%) a matching between LGE and native T1 was found (both positive in 132 and negative in 74). T1 was also abnormal in 32 out of 41 (78%) with oedema at T2-STIR. Overall, LGE and/or T2-STIR were abnormal in 209 patients, whereas native T1 in 154(52%). Conventional techniques and T1 mapping were concordant in 208 patients (64%). Conventional techniques were abnormal in 76 (24%) of patients with negative T1 mapping. Finally, in 39 patients T1 mapping was positive despite negative conventional techniques (12%). Among these latter 39 patients, only in 18 T2-STIR were acquired based on clinical decision. Then, the percentage of cases where T1 mapping could have an additive role would range between 6% and 12%. T1 mapping was particularly able in conditions with diffuse myocardial damage as cardiac amyloidosis, scleroderma and fabry disease (additive role in 42%). On contrast, T1 mapping was less effective in cardiac disease with regional distribution of myocardial damage as myocardial infarction, HCM, myocarditis (additive role in 1%).
Conclusions
T1 mapping may give additive information in 6–12% of patient but is less effective cardiac disease presenting with regional or segmental distribution of myocardial damage. Results of the present study suggest that conventional LGE/T2-STIR and T1 mapping are complementary techniques and should be used together in every CMR examination.
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Licordari R, Grigoratos C, Todiere G, Barison A, Di Bella G, Aquaro GD. 396 Echocardiography and magnetic resonance for differential diagnosis of left ventricular hypertrofy: diagnostic and prognostic implications. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartj/suab132.032] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aims
Left ventricular hypertrophy (LVH) may be due to different causes, ranging from benign secondary forms to severe cardiomyopathies. Transthoracic Echocardiography (TTE) and ECG are the first level examination for LVH diagnosis. Cardiac magnetic resonance (CMR) defines accurately LVH type, extent and severity. To evaluate the diagnostic and prognostic role of CMR in patients with TTE and/or ECG evidence of LVH.
Methods and results
We performed CMR in 300 consecutive patients with echocardiographic and/or ECG signs of LVH. Overall, 275 patients had TTE evidence of LVH with initial suspicion of hypertrophic cardiomyopathy (HCM) in 132 (44%), cardiac amyloidosis in 41 (14%), hypertensive LVH in 48 (16%), aortic stenosis in 4 (1%), undetermined LVH in 50(16%). The initial echocardiographic diagnostic suspicion of LVH was confirmed in 172 patients (57.3%) and changed in 128 patients (42.7%, P < 0.0001): the diagnosis of HCM increased from 44% to 71% of patients; hypertensive and undetermined LVH decreased significantly (respectively, to 4% and 5%). CMR allowed a diagnosis in 41 out of 50 (82%) with undetermined LVH at TTE. CMR also identified HCM in 17 out of 25 patients with apparently normal echo but with ECG criteria for LVH. Finally, the reclassification of the diagnosis by CMR was associated with a change of survival risk of patients: after CMR reclassification no events occurred in patients with undetermined or hypertensive LVH.
Conclusions
CMR changed echocardiographic suspicion in almost half of patients with LVH. In the subgroup of patient with abnormal ECG, CMR identified LVH (particularly HCM) in 80% of patients. This study highlights the indication of CMR to better characterize the type, extent, and severity of LVH detected at echocardiography and suspected with ECG.
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Restelli D, Licordari R, Piaggi P, Carerj S, Santoro D, Arcadi V, Aquaro GD, Pingitore A, Di Bella G. 609 Prognostic role of renal function in patients with previous myocardial infarction. A study with cardiac magnetic resonance. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartj/suab140.048] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aims
There is not strong evidence in literature about the impact of renal function on the prognosis of patients with ischaemic cardiomyopathy. Thus, the aim of the study was to investigate mild renal impairment [estimated glomerular filtration rate (eGFR): 60–89 ml/min] as an independent prognostic factor in patients with history of myocardial infarction (MI).
Methods and results
We studied 339 consecutive patients (65 ± 13 years old, female 13%) from 2001 and 2012 with previous MI. Patients with eGFR <60 ml/min were excluded. We performed cardiac magnetic resonance (CMR) in all patients to quantify left ventricular ejection fraction (LVEF), volumes, and wall motion score index (WMSI), and to measure the infarction extent by late gadolinium enhancement (LGE). Renal function was estimated by creatinine value with Cockcroft–Gault formula and patients were divided according to normal (≥90 ml/min) and reduced (60–89 ml/min) eGFR. Patients with normal eGFR were 106 (31%, 56.9 ± 10.5 years old), 233 (69%, 66.1 ± 9.9 years old) had renal impairment. During follow-up (median 3.5 years), cardiac events (cardiac death or appropriate intra-cardiac defibrillator shock) occurred in 28/233 (12%) of patients with eGFR <90 ml/min and in 4/106 (4%) of patients with eGFR ≥90 ml/min (P < 0.05). Furthermore, survival curve showed a significantly worst prognosis in patients with renal impairment (P < 0.03). In the group of patients with ejection fraction (EF) < 35% (121 patients), cardiac events were observed only in patients with eGFR <90 ml/min (23/99, 23%, P < 0.05). At multivariate stepwise analysis, age >65 years old, eGFR <90 ml/min and WMSI >1.7 turned out to be independent predictor of cardiac events (P < 0.05).
Conclusions
In patients with previous MI, a mild renal impairment (eGFR between 60 and 89 ml/min) was an independent predictor of prognosis, especially if combined with left ventricular disfunction.
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Affiliation(s)
- Davide Restelli
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Roberto Licordari
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Paolo Piaggi
- Department of Energy and Systems Engineering, University of Pisa, Pisa, Italy
| | - Scipione Carerj
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Domenico Santoro
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Vittoria Arcadi
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | | | | | - Gianluca Di Bella
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Licordari R, Grigoratos C, Todiere G, Barison A, Micari A, Di Bella G, Aquaro GD. 394 Incidence and prevalence of acute myocarditis and pericarditis prior to and during COVID-19 pandemic. Eur Heart J Suppl 2021. [PMCID: PMC8689767 DOI: 10.1093/eurheartj/suab135.028] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Aims Myocarditis and pericarditis have been proposed to account for a proportion of cardiac injury during SARS-CoV-2 infection. During the COVID-19 pandemic, it is reasonable to expect an increasing trend in incidence of this acute inflammatory cardiac diseases. To examine the incidence and prevalence of inflammatory heart disorders prior to and during the COVID-19 pandemic. Methods and results This is a retrospective cohort study examining the incidence and prevalence of acute inflammatory heart diseases (myocarditis, pericarditis) in provinces of Pisa, Lucca and Livorno (total population of 11421285 inhabitants) in two time-intervals: (i) prior to (PRECOVID, from 1 June 2018 to 31 May 2019) and (ii) during the COVID-19 pandemic (COVID, from 1 June 2020 to May 2021). Overall 259 cases of inflammatory heart disease (myocarditis and/or pericarditis) occurred in the areas of interest. The annual incidence was of 11.3 cases per 100 000 inhabitants. Particularly, 138 cases occurred in the PRECOVID, and 121 in the COVID period. The annual incidence of inflammatory heart disease was not significantly different (12.1/100 000 in PRECOVID vs. 10.3/100 000 in COVID; P = 0.22). The annual incidence of acute myocarditis was significantly higher in PRECOVID than in the COVID: respectively, 8.1/100 000/year vs. 5.9/100 000 year (P = 0.047), consisting in a net reduction of 27% of cases. Particularly the incidence of myocarditis was significantly lower in COVID than in PRECOVID in the class of age 18–24 (P = 0.048) (Figure). The annual incidence of pericarditis was not significantly different (4.03/100 000 vs. 4.47/100 000; P = 0.61). Conclusions Despite a possible etiologic role of SARS-CoV-2 and an expectable increased incidence of myocarditis and pericarditis, data suggest a decrease of acute myocarditis and a stable incidence pericarditis and both diseases.
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Aeschlimann FA, Raimondi F, Leiner T, Aquaro GD, Saadoun D, Grotenhuis HB. Overview of imaging in adult- and childhood-onset Takayasu arteritis. J Rheumatol 2021; 49:346-357. [PMID: 34853087 DOI: 10.3899/jrheum.210368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2021] [Indexed: 11/22/2022]
Abstract
Takayasu Arteritis is an idiopathic large vessel vasculitis, that affects young adults and children and can lead to ischemia and end-organ damage. Vascular imaging is crucial for diagnosis, assessment of disease extent and management of the disease. In this article, we critically review evidence for the clinical use of the different imaging modalities conventional angiography, magnetic resonance imaging, computed tomography, Doppler ultrasound and 18fluorodeoxyglucose positron emission tomography. We thereby focus on their clinical applicability, challenges and specific use in children.
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Affiliation(s)
- Florence A Aeschlimann
- Pediatric Immunology, Hematology and Rheumatology Unit, Hôpital Necker - Enfants Malades, Paris, France and Division of Pediatrics, Kantonsspital Winterthur, Winterthur, Switzerland; Unité Médicochirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de Référence des Maladies Cardiaques Congénitales Complexes - M3C, Hôpital Universitaire Necker Enfants-Malades, Paris, France; Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands; Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, F-75013, Paris, France, Centre National de Références Maladies Autoimmunes Systémiques Rares, Centre National de Références Maladies Autoinflammatoires et Amylose Inflammatoire; Inflammation-Immunopathology-Biotherapy Department (DMU 3iD); INSERM 959, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France; Division of Pediatric Cardiology, Department of Pediatrics, Wilhelmina Children's Hospital, University of Utrecht, The Netherlands. Conflicts of interest. The authors declare no conflicts of interest. Address correspondence to Florence A Aeschlimann, MD MPH, Pediatric Immunology, Hematology and Rheumatology Unit, 149, Rue de Sèvres, F - 75743 Paris, France. E-mail:
| | - Francesca Raimondi
- Pediatric Immunology, Hematology and Rheumatology Unit, Hôpital Necker - Enfants Malades, Paris, France and Division of Pediatrics, Kantonsspital Winterthur, Winterthur, Switzerland; Unité Médicochirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de Référence des Maladies Cardiaques Congénitales Complexes - M3C, Hôpital Universitaire Necker Enfants-Malades, Paris, France; Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands; Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, F-75013, Paris, France, Centre National de Références Maladies Autoimmunes Systémiques Rares, Centre National de Références Maladies Autoinflammatoires et Amylose Inflammatoire; Inflammation-Immunopathology-Biotherapy Department (DMU 3iD); INSERM 959, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France; Division of Pediatric Cardiology, Department of Pediatrics, Wilhelmina Children's Hospital, University of Utrecht, The Netherlands. Conflicts of interest. The authors declare no conflicts of interest. Address correspondence to Florence A Aeschlimann, MD MPH, Pediatric Immunology, Hematology and Rheumatology Unit, 149, Rue de Sèvres, F - 75743 Paris, France. E-mail:
| | - Tim Leiner
- Pediatric Immunology, Hematology and Rheumatology Unit, Hôpital Necker - Enfants Malades, Paris, France and Division of Pediatrics, Kantonsspital Winterthur, Winterthur, Switzerland; Unité Médicochirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de Référence des Maladies Cardiaques Congénitales Complexes - M3C, Hôpital Universitaire Necker Enfants-Malades, Paris, France; Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands; Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, F-75013, Paris, France, Centre National de Références Maladies Autoimmunes Systémiques Rares, Centre National de Références Maladies Autoinflammatoires et Amylose Inflammatoire; Inflammation-Immunopathology-Biotherapy Department (DMU 3iD); INSERM 959, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France; Division of Pediatric Cardiology, Department of Pediatrics, Wilhelmina Children's Hospital, University of Utrecht, The Netherlands. Conflicts of interest. The authors declare no conflicts of interest. Address correspondence to Florence A Aeschlimann, MD MPH, Pediatric Immunology, Hematology and Rheumatology Unit, 149, Rue de Sèvres, F - 75743 Paris, France. E-mail:
| | - Giovanni Donato Aquaro
- Pediatric Immunology, Hematology and Rheumatology Unit, Hôpital Necker - Enfants Malades, Paris, France and Division of Pediatrics, Kantonsspital Winterthur, Winterthur, Switzerland; Unité Médicochirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de Référence des Maladies Cardiaques Congénitales Complexes - M3C, Hôpital Universitaire Necker Enfants-Malades, Paris, France; Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands; Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, F-75013, Paris, France, Centre National de Références Maladies Autoimmunes Systémiques Rares, Centre National de Références Maladies Autoinflammatoires et Amylose Inflammatoire; Inflammation-Immunopathology-Biotherapy Department (DMU 3iD); INSERM 959, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France; Division of Pediatric Cardiology, Department of Pediatrics, Wilhelmina Children's Hospital, University of Utrecht, The Netherlands. Conflicts of interest. The authors declare no conflicts of interest. Address correspondence to Florence A Aeschlimann, MD MPH, Pediatric Immunology, Hematology and Rheumatology Unit, 149, Rue de Sèvres, F - 75743 Paris, France. E-mail:
| | - David Saadoun
- Pediatric Immunology, Hematology and Rheumatology Unit, Hôpital Necker - Enfants Malades, Paris, France and Division of Pediatrics, Kantonsspital Winterthur, Winterthur, Switzerland; Unité Médicochirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de Référence des Maladies Cardiaques Congénitales Complexes - M3C, Hôpital Universitaire Necker Enfants-Malades, Paris, France; Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands; Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, F-75013, Paris, France, Centre National de Références Maladies Autoimmunes Systémiques Rares, Centre National de Références Maladies Autoinflammatoires et Amylose Inflammatoire; Inflammation-Immunopathology-Biotherapy Department (DMU 3iD); INSERM 959, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France; Division of Pediatric Cardiology, Department of Pediatrics, Wilhelmina Children's Hospital, University of Utrecht, The Netherlands. Conflicts of interest. The authors declare no conflicts of interest. Address correspondence to Florence A Aeschlimann, MD MPH, Pediatric Immunology, Hematology and Rheumatology Unit, 149, Rue de Sèvres, F - 75743 Paris, France. E-mail:
| | - Heynric B Grotenhuis
- Pediatric Immunology, Hematology and Rheumatology Unit, Hôpital Necker - Enfants Malades, Paris, France and Division of Pediatrics, Kantonsspital Winterthur, Winterthur, Switzerland; Unité Médicochirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de Référence des Maladies Cardiaques Congénitales Complexes - M3C, Hôpital Universitaire Necker Enfants-Malades, Paris, France; Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands; Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, F-75013, Paris, France, Centre National de Références Maladies Autoimmunes Systémiques Rares, Centre National de Références Maladies Autoinflammatoires et Amylose Inflammatoire; Inflammation-Immunopathology-Biotherapy Department (DMU 3iD); INSERM 959, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France; Division of Pediatric Cardiology, Department of Pediatrics, Wilhelmina Children's Hospital, University of Utrecht, The Netherlands. Conflicts of interest. The authors declare no conflicts of interest. Address correspondence to Florence A Aeschlimann, MD MPH, Pediatric Immunology, Hematology and Rheumatology Unit, 149, Rue de Sèvres, F - 75743 Paris, France. E-mail:
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Di Bella G, Aquaro GD, Bogaert J, Piaggi P, Micari A, Pizzino F, Camastra G, Carerj S, Campisi M, Bracco A, Carerj ML, Emdin M, Khandheria BK, Pingitore A. Non-transmural myocardial infarction associated with regional contractile function is an independent predictor of positive outcome: an integrated approach to myocardial viability. J Cardiovasc Magn Reson 2021; 23:121. [PMID: 34719402 PMCID: PMC8559354 DOI: 10.1186/s12968-021-00818-0] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 09/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiovascular magnetic resonance permits assessment of irreversible myocardial fibrosis and contractile function in patients with previous myocardial infarction. We aimed to assess the prognostic value of myocardial fibrotic tissue with preserved/restored contractile activity. METHODS In 730 consecutive myocardial infarction patients (64 ± 11 years), we quantified left ventricular (LV) end-diastolic (EDV) and end-systolic (ESV) volumes, ejection fraction (EF), regional wall motion (WM) (1 normal, 2 hypokinetic, 3 akinetic, 4 dyskinetic), and WM score index (WMSI), and measured the transmural (1-50 and 51-100) and global extent of the infarct scar by late gadolinium enhancement (LGE). Contractile fibrotic (CT-F) segments were identified as those showing WM-1 and WM-2 with LGE ≤ or ≥ 50%. RESULTS During follow-up (median 2.5, range 1-4.7 years), cardiac events (cardiac death or appropriate implantable defibrillator shocks) occurred in 123 patients (17%). At univariate analysis, age, LVEDV, LVESV, LVEF, WMSI, extent of LGE, segments with transmural extent > 50%, and CT-F segments were associated with cardiac events. At multivariate analysis, age > 65 years, LVEF < 30%, WMSI > 1.7, and dilated LVEDV independently predicted cardiac events, while CT-F tissue was the only independent predictor of better outcome. After adjustment for LVEF < 30% and LVEDV dilatation, the presence of CT-F tissue was associated with good prognosis. CONCLUSIONS In addition to CMR imaging parameters associated with adverse outcome (severe LV dysfunction, poor WM, and dilated EDV), the presence of fibrotic myocardium showing contractile activity in patients with previous myocardial infarction yields a beneficial effect on patient survival.
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Affiliation(s)
- Gianluca Di Bella
- Clinical and Experimental Department of Medicine, University of Messina, via Consolare Valeria 1, 98100, Messina, Italy
| | | | - Jan Bogaert
- Department of Radiology, KU Leuven - UZ Leuven, Gasthuisberg Campus. Herestraat 49, 3000, Leuven, Belgium
| | - Paolo Piaggi
- Department of Information Engineering, University of Pisa, via G. Caruso 16, 56122, Pisa, Italy
| | - Antonio Micari
- Clinical and Experimental Department of Medicine, University of Messina, via Consolare Valeria 1, 98100, Messina, Italy
| | - Fausto Pizzino
- Department of Cardiology, "Santa Maria Dei Battuti" Hospital, Conegliano - ULSS2 Marca Trevigiana, Via Brigata Bisagno 2, 31015, Conegliano, Treviso, Italy
| | - Giovanni Camastra
- Cardiac Department, Vannini Hospital Rome, via Acqua Bullicante 4, 00177, Roma, Italy
| | - Scipione Carerj
- Clinical and Experimental Department of Medicine, University of Messina, via Consolare Valeria 1, 98100, Messina, Italy
| | - Mariapaola Campisi
- Clinical and Experimental Department of Medicine, University of Messina, via Consolare Valeria 1, 98100, Messina, Italy
| | - Antonio Bracco
- Clinical and Experimental Department of Medicine, University of Messina, via Consolare Valeria 1, 98100, Messina, Italy
- Department of Cardiology, ISMETT" Hospital, via Ernesto Tricomi, 5, 90127, Palermo, Province of Palermo, Italy
| | - Maria Ludovica Carerj
- Clinical and Experimental Department of Medicine, University of Messina, via Consolare Valeria 1, 98100, Messina, Italy
| | - Michele Emdin
- Fondazione Toscana G. Monasterio, via Giuseppe Moruzzi 1, 56124, Pisa, Italy
| | - Bijoy K Khandheria
- Aurora Cardiovascular and Thoracic Services, Advocate Aurora Health, Aurora Sinai/Aurora St. Luke's Medical Centers, 2801 W. Kinnickinnic River Parkway, Ste. 880, Milwaukee, WI, 53215, USA.
| | - Alessandro Pingitore
- C.N.R. Clinical Physiology Institute, via Giuseppe Moruzzi 1, 56124, Pisa, Italy
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Di Bella G, Pizzino F, Aquaro GD, Bracco A, Manganaro R, Pasanisi E, Petersen C, Zito C, Chubuchny V, Emdin M, Khandheria BK, Carerj S, Pingitore A. CMR predictors of secondary moderate to severe mitral regurgitation and its additive prognostic role in previous myocardial infarction. J Cardiol 2021; 79:90-97. [PMID: 34493420 DOI: 10.1016/j.jjcc.2021.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 06/25/2021] [Accepted: 07/27/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND We aimed to determine predictors and the additive prognostic role of moderate to severe (MS) ischemic mitral regurgitation (MR) in myocardial infarction (MI). METHODS Four hundred twenty-two patients with previous MI underwent cardiac magnetic resonance (CMR) imaging for the assessment of left ventricular (LV) ejection fraction (EF), end-diastolic (EDV) and end-systolic volume (ESV), sphericity index, wall motion score index (WMSI), and late gadolinium enhancement (LGE). Echocardiography was performed to assess MR. RESULTS Thirty-eight had from moderate to severe MR (MS-MR group) and 384 did not (No MS-MR group). The S-MR group had higher LV volumes, sphericity index, WMSI, and LGE extent, and lower LVEF. At univariate logistic regression analysis, dilated volumes, SI >0.43, dyskinesia of inferolateral wall, papillary muscle (PM)-LGE, and LGE extent >16% were associated with MS-MR. At multivariate analysis, only SI (OR=5.7) and PM-LGE (OR=3) were independently associated with MS-MR. Considering only patients without LV dilatation, only dyskinesia in the inferolateral wall was a predictor of MS-MR (OR 34.8). Thirty cardiac events (cardiac death, appropriate implantable cardioverter-defibrillator firing, and resuscitated cardiac arrest) occurred during a median follow-up of 1,276 days. After adjusting the prognostic variables at univariate analysis by age (>65 years) and selecting those that were significant (EDV > 95 ml/m2, ESV >53 ml/m2, EF <30%, WMSI >1.65, LGE >12%, S-MR), only WMSI >1.65 and MS-MR remained an independent predictor of cardiac events. CONCLUSIONS Increased WMSI and PM-LGE in the overall population and inferolateral dyskinesia in patients without ESV dilatation are predictors of MS-MR; MS-MR and elevated WMSI have independent negative prognostic value.
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Affiliation(s)
- Gianluca Di Bella
- Clinical and Experimental Department of Medicine, University of Messina, Messina, Italy
| | - Fausto Pizzino
- Fondazione Toscana G. Monasterio, Pisa, Italy; Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | | | - Antonio Bracco
- Clinical and Experimental Department of Medicine, University of Messina, Messina, Italy
| | - Roberta Manganaro
- Clinical and Experimental Department of Medicine, University of Messina, Messina, Italy
| | | | | | - Concetta Zito
- Clinical and Experimental Department of Medicine, University of Messina, Messina, Italy
| | | | - Michele Emdin
- Fondazione Toscana G. Monasterio, Pisa, Italy; Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Bijoy K Khandheria
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, University of Wisconsin School of Medicine and Public Health; Marcus Family Fund for Echocardiography (ECHO) Research and Education, Milwaukee, WI, USA.
| | - Scipione Carerj
- Clinical and Experimental Department of Medicine, University of Messina, Messina, Italy
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Giovannetti G, Flori A, Martini N, Francischello R, Aquaro GD, Pingitore A, Frijia F. Sodium Radiofrequency Coils for Magnetic Resonance: From Design to Applications. Electronics 2021; 10:1788. [DOI: 10.3390/electronics10151788] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Sodium (23Na) is the most abundant cation present in the human body and is involved in a large number of vital body functions. In the last few years, the interest in Sodium Magnetic Resonance Imaging (23Na MRI) has considerably increased for its relevance in physiological and physiopathological aspects. Indeed, sodium MRI offers the possibility to extend the anatomical imaging information by providing additional and complementary information on physiology and cellular metabolism with the heteronuclear Magnetic Resonance Spectroscopy (MRS). Constraints are the rapidly decaying of sodium signal, the sensitivity lack due to the low sodium concentration versus 1H-MRI induce scan times not clinically acceptable and it also constitutes a challenge for sodium MRI. With the available magnetic fields for clinical MRI scanners (1.5 T, 3 T, 7 T), and the hardware capabilities such as strong gradient strengths with high slew rates and new dedicated radiofrequency (RF) sodium coils, it is possible to reach reasonable measurement times (~10–15 min) with a resolution of a few millimeters, where it has already been applied in vivo in many human organs such as the brain, cartilage, kidneys, heart, as well as in muscle and the breast. In this work, we review the different geometries and setup of sodium coils described in the available literature for different in vivo applications in human organs with clinical MR scanners, by providing details of the design, modeling and construction of the coils.
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Leali M, Aimo A, Ricci G, Vergaro G, Todiere G, Grigoratos C, Aquaro GD, Siciliano G, Emdin M, Passino C, Barison A. Cardiac magnetic resonance findings in patients with type 1 myotonic dystrophy. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.126] [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
Funding Acknowledgements
Type of funding sources: None.
Background
Heart disease is a major determinant of prognosis in type 1 myotonic dystrophy (DM1), second only to respiratory complications. Cardiac imaging, possibly including cardiac magnetic resonance (CMR), is recommended in patients with DM1. However, limited information is available on CMR findings and their prognostic significance in DM1.
Methods
We identified all patients with DM1 evaluated from 2009 to 2020 in a CMR laboratory with an established collaboration with a Neuromuscular Disorder Unit.
Results
Thirty-four patients were retrieved (21 males, aged 45 ± 12). At the time of CMR examination, 97% had neuromuscular symptoms (mean duration 16 ± 13 years), 12 (35%) presented with atrioventricular block (n = 11 1st degree, n = 1 2nd degree type 1), 15 (44%) with intraventricular conduction disturbances (n = 5 left bundle branch block, n = 5 right bundle branch block, n = 3 left anterior fascicular block, n = 2 other non-specific intraventricular conduction delay), 4 (12%) with atrial fibrillation or flutter. No patient had a device. At CMR, 5 (15%) patients had left ventricular (LV) systolic dysfunction (LV ejection fraction [LVEF] <50%) and 5 (15%) a depressed right ventricular (RV) function (RVEF <50%). Compared to age- and sex-specific reference values for our laboratory, 12 (35%) patients showed a decreased LV end-diastolic volume index (LVEDVi), 7 (21%) a decreased LV mass index (LVMi), and 29 (83%) a decreased LVMi/LVEDVi ratio. Nine (26%) patients had mid-wall late gadolinium enhancement (LGE, mean extent 4.5 ± 2.0% of LVM; n = 8 septal, n = 4 inferolateral, n = 2 inferior, n = 1 anterolateral), and 14 (40%) some areas of fatty infiltration (n = 9 involving the LV, n = 13 the RV). Native T1 in the interventricular septum (1,041 ± 53 ms) approached the upper reference limit (1,089 ms), and the extracellular volume was slightly increased (33 ± 2%, reference values <30%). Over a median follow-up of 3.3 years (interquartile interval 1.6-4.7), 2 (6%) patients died, one for infectious and respiratory complications and the other for unknown causes, 5 (15%) patients underwent pacemaker implantation for conduction disturbances, and 4 (12%) had a documentation of high-risk (Lown class ≥4) ventricular ectopic beats (VEBs). Among all CMR variables collected, higher values of LVMi/LVEDVi ratio emerged as univariate predictor of all-cause death (p = 0.044). At logistic regression analysis, anteroseptal wall thickness was associated with the need for pacemaker implantation (p = 0.028), while LGE mass was associated with high-risk VEBs (p = 0.026).
Conclusions
Patients with DM1 display several structural and functional cardiac abnormalities, with variable degrees of cardiac muscle hypotrophy, fibrosis and fatty infiltration. The possibility to predict the need for pacemaker implantation, ventricular arrhythmias and all-cause or cardiovascular mortality should be verified in larger cohorts.
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Affiliation(s)
- M Leali
- Sant"Anna School of Advanced Studies, Pisa, Italy
| | - A Aimo
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - G Ricci
- University of Pisa, Department of Clinical and Experimental Medicine, Pisa, Italy
| | - G Vergaro
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - G Todiere
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - C Grigoratos
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - GD Aquaro
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - G Siciliano
- University of Pisa, Department of Clinical and Experimental Medicine, Pisa, Italy
| | - M Emdin
- Sant"Anna School of Advanced Studies, Pisa, Italy
| | - C Passino
- Sant"Anna School of Advanced Studies, Pisa, Italy
| | - A Barison
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
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Figliozzi S, Georgiopoulos G, Aquaro GD, Bauer K, Monti L, Filomena D, Pica S, Censi S, Lopez P, Quattrocchi G, Servato ML, Schwitter J, Andreini D, Bogaert J, Masci PG. Late gadolinium enhancement predicts adverse clinical outcome in patients with mitral valve prolapse/mitral annulus disjunction. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.048] [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: 11/15/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
Mitral vAlve prolapse and disjunction by cardiac maGnetIC resonance (MA-GIC) registry
Backgroung
Mitral valve prolapse (MVP) is 2-3% prevalent in the general population with good prognosis. However, some patients develop complex ventricular arrhythmias (CVAs), sudden cardiac death (SCD), or severe mitral regurgitation (MR). Previous studies suggested that bi-leaflet involvement, mitral annulus disjunction (MAD), and myocardial fibrosis (MF) are associated with adverse outcome. Notwithstanding, these findings were limited to autopsic series or single-centre studies involving highly selected patients. Moreover, MF has been scantly investigated as predictor of clinical outcome.
Purpose
To investigate the prognostic significance of MF in an international multicentre study of MVP patients studied by cardiovascular magnetic resonance (CMR) with late gadolinium enhancement (LGE).
Methods
From October 2007 to June 2020 patients undergoing LGE-CMR were screened in 14 European centres. Inclusion criteria were: i) age > 18 years; ii) full clinical history and cardiac rhythm monitoring at baseline; iii) MVP (leaflet displacement ≥ 2 mm beyond the annulus). Exclusion criteria were: i) ischemic heart disease; ii) primary cardiomyopathy; iii) inflammatory heart disease; iv) congenital heart diseases; v) moderate-to-severe valvular heart disease. CVAs at the study outset was defined as one of the following: i) ventricular ectopic beats >10000/24h; ii) ≥ 1 episode of non-sustained ventricular tachycardia (VT); iii) sustained VT; iv) aborted SCD. Primary end-point was a composite of SCD, unexplained syncope, and mitral valve repair/replacement. Secondary end-point was a composite of SCD and unexplained syncope.
Results
Four-hundred-fifty-eight MVP patients were eventually included (46 ± 16 years old, 51% males) of whom 68% had MAD. LGE was detected in 103 (22%) of subjects with mid-wall pattern (46%) in left ventricular (LV) lateral wall (66%) as the most prevalent feature. At baseline, 37% of LGE-positive patients vs. 18% of LGE-negative individuals had CVAs (P < 0.001). SVT and/or aborted SCD were more prevalent in LGE-positive than in LGE-negative patients (9% vs 2%, P < 0.001). By multivariable Cox-regression analysis, LGE presence or extent were strong independent predictors of the primary (HR = 4.02, P = 0.003 and HR = 4.76 per 10% increase, P = 0.032, respectively) and secondary (HR = 5.39, P = 0.008 and HR = 8.78 per 10% increase, P = 0.012, respectively) endpoints after correction for major confounders including LV volumes, left atrial size and MAD presence.
Conlusion
Myocardial fibrosis by LGE is the strongest independent predictor of clinical outcome in MVP. In contrast, MAD per se does not harbinger worse prognosis.
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Affiliation(s)
- S Figliozzi
- IRCCS Istituto Auxologico Italiano, Department of Cardiovascular, Neural and Metabolic Sciences; San Luca Hospital, Milan, Italy
| | - G Georgiopoulos
- King"s College London, School of Biomedical Engineering and Imaging Sciences - St Thomas" Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - GD Aquaro
- Fondazione Toscana Gabriele Monasterio, Magnetic Resonance Unit, Pisa, Italy
| | - K Bauer
- University Hospital Muenster, Department of Cardiology, Muenster, Germany
| | - L Monti
- IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - D Filomena
- Sapienza University of Rome, Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Rome, Italy
| | - S Pica
- IRCCS Policlinico San Donato, Multimodality Cardiac Imaging Section, San Donato Milanese, Italy
| | - S Censi
- Maria Cecilia Hospital, GVM Care&Research, Cotignola, Italy
| | - P Lopez
- Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Cardiology Department, Lisboa, Portugal
| | - G Quattrocchi
- Niguarda Hospital, CardioThoraxVascular Department "De Gasperis", Milan, Italy
| | - ML Servato
- Universit Autònoma de Barcelona (UAB), Vall Hebron Hospital Institut de Recerca (VIHR) y CIBER-CV, Cardiovascular Imaging Unit, Cardiology Department at Vall Hebron Hospital, Barcelona, Spain
| | - J Schwitter
- Lausanne University Hospital, Cardiac MRI Centre, Lausanne, Switzerland
| | - D Andreini
- Centro Cardiologico Monzino, IRCCS, University of Milan, Milan, Italy
| | - J Bogaert
- Gasthuisberg University Hospital, Imaging & Pathology Department, Leuven, Belgium
| | - PG Masci
- King"s College London, School of Biomedical Engineering and Imaging Sciences - St Thomas" Hospital, London, United Kingdom of Great Britain & Northern Ireland
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Gentile P, Merlo M, Peretto G, Ammirati E, Sala S, Della Bella P, Aquaro GD, Imazio M, Potena L, Campodonico J, Foà A, Raafs A, Hazebroek M, Brambatti M, Cercek AC, Nucifora G, Shrivastava S, Huang F, Schmidt M, Muser D, Van de Heyning CM, Van Craenenbroeck E, Aoki T, Sugimura K, Shimokawa H, Cannatà A, Artico J, Porcari A, Colopi M, Perkan A, Bussani R, Barbati G, Garascia A, Cipriani M, Agostoni P, Pereira N, Heymans S, Adler ED, Camici PG, Frigerio M, Sinagra G. Post-discharge arrhythmic risk stratification of patients with acute myocarditis and life-threatening ventricular tachyarrhythmias. Eur J Heart Fail 2021; 23:2045-2054. [PMID: 34196079 DOI: 10.1002/ejhf.2288] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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] [Received: 01/23/2021] [Revised: 06/05/2021] [Accepted: 06/25/2021] [Indexed: 12/28/2022] Open
Abstract
AIMS The outcomes of patients presenting with acute myocarditis and life-threatening ventricular arrhythmias (LT-VA) are unclear. The aim of this study was to assess the incidence and predictors of recurrent major arrhythmic events (MAEs) after hospital discharge in this patient population. METHODS AND RESULTS We retrospectively analysed 156 patients (median age 44 years; 77% male) discharged with a diagnosis of acute myocarditis and LT-VA from 16 hospitals worldwide. Diagnosis of myocarditis was based on histology or the combination of increased markers of cardiac injury and cardiac magnetic resonance (CMR) Lake Louise criteria. MAEs were defined as the relapse, after discharge, of sudden cardiac death or successfully defibrillated ventricular fibrillation, or sustained ventricular tachycardia (sVT) requiring implantable cardioverter-defibrillator therapy or synchronized external cardioversion. Median follow-up was 23 months [first to third quartile (Q1-Q3) 7-60]. Fifty-eight (37.2%) patients experienced MAEs after discharge, at a median of 8 months (Q1-Q3 2.5-24.0 months; 60.3% of MAEs within the first year). At multivariable Cox analysis, variables independently associated with MAEs were presentation with sVT [hazard ratio (HR) 2.90, 95% confidence interval (CI) 1.38-6.11]; late gadolinium enhancement involving ≥2 myocardial segments (HR 4.51, 95% CI 2.39-8.53), and absence of positive short-tau inversion recovery (STIR) (HR 2.59, 95% CI 1.40-4.79) at first CMR. CONCLUSIONS Among patients discharged with a diagnosis of myocarditis and LT-VA, 37.2% had recurrences of MAEs during follow-up. Initial CMR pattern and sVT at presentation stratify the risk of arrhythmia recurrence.
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Affiliation(s)
- Piero Gentile
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy.,De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milan, Italy
| | - Marco Merlo
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy
| | - Giovanni Peretto
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital and Vita-Salute University, Milan, Italy
| | - Enrico Ammirati
- De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milan, Italy
| | - Simone Sala
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital and Vita-Salute University, Milan, Italy
| | - Paolo Della Bella
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital and Vita-Salute University, Milan, Italy
| | | | - Massimo Imazio
- Cardiology, Cardiothoracic Department, University Hospital "Santa Maria della Misericordia", ASUFC, Udine, Italy
| | - Luciano Potena
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Jeness Campodonico
- Centro Cardiologico Monzino, IRCCS, Milan, Italy.,Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
| | - Alberto Foà
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Anne Raafs
- Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands
| | - Mark Hazebroek
- Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
| | - Michela Brambatti
- Division of Cardiology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Andreja Cerne Cercek
- Department of Cardiology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Gaetano Nucifora
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia.,Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Florent Huang
- Department of Cardiology, Foch Hospital, Suresnes, France
| | - Matthieu Schmidt
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pítié-Salpêtriére Hospital, Medical Intensive Care Unit, Paris, France
| | - Daniele Muser
- Cardiothoracic Department, University Hospital, Udine, Italy
| | | | | | - Tatsuo Aoki
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | | | - Antonio Cannatà
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy.,Department of Cardiology, King's College Hospital, London, UK
| | - Jessica Artico
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy
| | - Aldostefano Porcari
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy
| | - Marzia Colopi
- Cardiology, Cardiothoracic Department, University Hospital "Santa Maria della Misericordia", ASUFC, Udine, Italy
| | - Andrea Perkan
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy
| | - Rossana Bussani
- Department of Pathological Anatomy, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy
| | - Giulia Barbati
- Biostatistics Unit, Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Andrea Garascia
- De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milan, Italy
| | - Manlio Cipriani
- De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milan, Italy
| | - Piergiuseppe Agostoni
- Centro Cardiologico Monzino, IRCCS, Milan, Italy.,Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
| | - Naveen Pereira
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Stephane Heymans
- Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
| | - Eric D Adler
- Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands
| | | | - Maria Frigerio
- De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milan, Italy
| | - Gianfranco Sinagra
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy
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49
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Francone M, Aquaro GD, Barison A, Castelletti S, de Cobelli F, de Lazzari M, Esposito A, Focardi M, di Renzi P, Indolfi C, Lanzillo C, Lovato L, Maestrini V, Mercuro G, Natale L, Mantini C, Polizzi G, Rabbat M, Secchi F, Secinaro A, di Cesare E, Pontone G. Appropriate use criteria for cardiovascular MRI: SIC - SIRM position paper Part 2 (myocarditis, pericardial disease, cardiomyopathies and valvular heart disease). J Cardiovasc Med (Hagerstown) 2021; 22:515-529. [PMID: 34076599 DOI: 10.2459/jcm.0000000000001170] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Cardiovascular magnetic resonance (CMR) has emerged as an accurate diagnostic technique for the evaluation of patients with cardiac disease in the majority of clinical settings, thanks to an established additional diagnostic and prognostic value. This document has been developed by a joined group of experts of the Italian Society of Cardiology (SIC) and Italian Society of Radiology (SIRM) to provide a summary about the current state of technology and clinical applications of CMR, to improve the clinical diagnostic pathways and to promote its inclusion in clinical practice. The writing committee consisted of members and experts of both societies in order to develop a more integrated approach in the field of cardiac imaging. This section 2 will cover myocarditis, pericardial disease, cardiomyopathies and valvular heart disease.
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Affiliation(s)
- Marco Francone
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan
| | | | | | - Silvia Castelletti
- Istituto Auxologico Italiano IRCCS, Center for the Cardiac Arrhythmias of Genetic Origin
| | - Francesco de Cobelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy Department of Radiology, IRCCS San Raffaele Scientific Institute, Milan
| | - Manuel de Lazzari
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Italy
| | - Antonio Esposito
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy Department of Radiology, IRCCS San Raffaele Scientific Institute, Milan
| | - Marta Focardi
- Department of Cardiology, Azienda Ospedaliera Universitaria Senese, Siena
| | - Paolo di Renzi
- U.O.C. Radiologia, Ospedale 'San Giovanni Calibita' Fatebenefratelli - Isola Tiberina - Rome
| | - Ciro Indolfi
- Division of Cardiology, University Magna Graecia, Italy and Mediterranea Cardiocentro, Naples
| | | | - Luigi Lovato
- Cardiovascular Radiology Unit, Department of Imaging S.Orsola-Malpighi University Hospital, Bologna
| | - Viviana Maestrini
- Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Mercuro
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari
| | - Luigi Natale
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology - Diagnostic Imaging Area
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS
- Universita ' Cattolica del Sacro Cuore, Rome
| | - Cesare Mantini
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University, Chieti
| | - Gesualdo Polizzi
- Unit of Radiodiagnostics II, University Hospital 'Policlinico-Vittorio Emanuele', Catania, Italy
| | - Mark Rabbat
- Loyola University of Chicago, Chicago
- Edward Hines Jr. VA Hospital, Hines, Illinois, USA
| | - Francesco Secchi
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese
| | - Aurelio Secinaro
- Advanced Cardiovascular Imaging Unit, Department of Imaging, Bambino Gesù Children's Hospital, Rome
| | - Ernesto di Cesare
- Department of Life, Healt and Enviromental Sciences, University of L'Aquila, L'Aquila
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50
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Masci PG, Pavon AG, Pontone G, Symons R, Lorenzoni V, Francone M, Zalewski J, Barison A, Guglielmo M, Aquaro GD, Galea N, Muscogiuri G, Muller O, Carbone I, Baggiano A, Iglesias JF, Nessler J, Andreini D, Camici PG, Claus P, de Luca L, Agati L, Janssens S, Schwitter J, Bogaert J. Early or deferred cardiovascular magnetic resonance after ST-segment-elevation myocardial infarction for effective risk stratification. Eur Heart J Cardiovasc Imaging 2021; 21:632-639. [PMID: 31326993 DOI: 10.1093/ehjci/jez179] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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] [Received: 02/05/2019] [Revised: 04/04/2019] [Accepted: 06/20/2019] [Indexed: 11/14/2022] Open
Abstract
AIMS In ST-segment-elevation myocardial infarction (STEMI), cardiovascular magnetic resonance (CMR) holds the potentiality to improve risk stratification in addition to Thrombolysis in Myocardial Infarction (TIMI) risk score. Nevertheless, the optimal timing for CMR after STEMI remains poorly defined. We aim at comparing the prognostic performance of three stratification strategies according to the timing of CMR after STEMI. METHODS AND RESULTS The population of this prospective registry-based study included 492 reperfused STEMI patients. All patients underwent post-reperfusion (median: 4 days post-STEMI) and follow-up (median: 4.8 months post-STEMI) CMR. Left ventricular (LV) volumes, function, infarct size, and microvascular obstruction extent were quantified. Primary endpoint was a composite of all-death and heart failure (HF) hospitalization. Baseline-to-follow-up percentage increase of LV end-diastolic (EDV; ΔLV-EDV) ≥20% or end-systolic volumes (ESV; ΔLV-ESV) ≥15% were tested against outcome. Three multivariate models were developed including TIMI risk score plus early post-STEMI (early-CMR) or follow-up CMR (deferred-CMR) or both CMRs parameters along with adverse LV remodelling (paired-CMRs). During a median follow-up of 8.3 years, the primary endpoint occurred in 84 patients (47 deaths; 37 HF hospitalizations). Early-CMR, deferred-CMR, and paired-CMR demonstrated similar predictive value for the primary endpoint (C-statistic: 0.726, 0.728, and 0.738, respectively; P = 0.663). ΔLV-EDV ≥20% or ΔLV-ESV ≥15% were unadjusted outcome predictors (hazard ratio: 2.020 and 2.032, respectively; P = 0.002 for both) but lost their predictive value when corrected for other covariates in paired-CMR model. CONCLUSION In STEMI patients, early-, deferred-, or paired-CMR were equivalent stratification strategies for outcome prediction. Adverse LV remodelling parameters were not independent prognosticators.
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Affiliation(s)
- Pier Giorgio Masci
- School of Biomedical Engineering & Imaging Sciences, King's College London, St Thomas' Hospital Campus, Westminster Bridge Road, London SE1 7EH, UK
| | - Anna Giulia Pavon
- Cardiology Division, Heart & Vessels Department, Center of Cardiac Magnetic Resonance, Rue du Bugnon 46, 1005 Lausanne, University Hospital, Lausanne, Switzerland
| | - Gianluca Pontone
- Centro Cardiologico Monzino, IRCCS Via Carlo Parea, 4, 20138 Milan, Italy
| | - Rolf Symons
- Radiology Department, Gasthuisberg University Hospitals, Herestraat 49, 3000 Leuven, Belgium
| | - Valentina Lorenzoni
- Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà, 24, 56127 Pisa, Italy
| | - Marco Francone
- Department of Radiological, Oncological, and Pathological Sciences, La Sapienza University, Piazzale Aldo Moro, 5, 00185 Rome, Italy
| | - Jaroslaw Zalewski
- Department of Coronary Disease, Jagiellonian University Medical College, Gołębia 24, 31-007 Kraków, Poland.,Department of Interventional Cardiology, John Paul II Hospital, Prądnicka 80, 31-202 Kraköw, Poland
| | - Andrea Barison
- Fondazione CNR-Regione Toscana 'G.Monasterio', Via Moruzzi 1, 56100 Pisa, Italy
| | - Marco Guglielmo
- Centro Cardiologico Monzino, IRCCS Via Carlo Parea, 4, 20138 Milan, Italy
| | | | - Nicola Galea
- Department of Radiological, Oncological, and Pathological Sciences, La Sapienza University, Piazzale Aldo Moro, 5, 00185 Rome, Italy
| | | | - Olivier Muller
- Cardiology Division, Heart & Vessels Department, Center of Cardiac Magnetic Resonance, Rue du Bugnon 46, 1005 Lausanne, University Hospital, Lausanne, Switzerland
| | - Iacopo Carbone
- Department of Radiological, Oncological, and Pathological Sciences, La Sapienza University, Piazzale Aldo Moro, 5, 00185 Rome, Italy
| | - Andrea Baggiano
- Radiology Department, Gasthuisberg University Hospitals, Herestraat 49, 3000 Leuven, Belgium
| | - Juan F Iglesias
- Cardiology Division, University Hospitals Geneve, Rue Gabrielle-Perret-Gentil 4, 1205 Genève, Switzerland
| | - Jadwiga Nessler
- Department of Coronary Disease, Jagiellonian University Medical College, Gołębia 24, 31-007 Kraków, Poland
| | - Daniele Andreini
- Centro Cardiologico Monzino, IRCCS Via Carlo Parea, 4, 20138 Milan, Italy
| | - Paolo G Camici
- Cardiology Division, Heart & Vessels Department, Center of Cardiac Magnetic Resonance, Rue du Bugnon 46, 1005 Lausanne, University Hospital, Lausanne, Switzerland
| | - Piet Claus
- Cardiology Department, Gasthuisberg University Hospitals, Herestraat 49, 3000 Leuven, Belgium
| | - Laura de Luca
- Cardiology Department, La Sapienza University, Piazzale Aldo Moro, 5, 00185 Rome, Italy
| | - Luciano Agati
- Cardiology Department, La Sapienza University, Piazzale Aldo Moro, 5, 00185 Rome, Italy
| | - Stefan Janssens
- Cardiology Department, Gasthuisberg University Hospitals, Herestraat 49, 3000 Leuven, Belgium
| | - Jurg Schwitter
- Cardiology Division, Heart & Vessels Department, Center of Cardiac Magnetic Resonance, Rue du Bugnon 46, 1005 Lausanne, University Hospital, Lausanne, Switzerland
| | - Jan Bogaert
- Radiology Department, Gasthuisberg University Hospitals, Herestraat 49, 3000 Leuven, Belgium
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