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  • Ovid Technologies (Wolters Kluwer Health)  (6)
  • 1
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    Online Resource
    Aortic Stiffness and Interstitial Myocardial Fibrosis by Native T1 Are Independently Associated With Left Ventricular Remodeling in Patients With Dilated Cardiomyopathy
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Hypertension Vol. 64, No. 4 ( 2014-10), p. 762-768
    Details
    In: Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 64, No. 4 ( 2014-10), p. 762-768
    Abstract: Increased aortic stiffness is related to increased ventricular stiffness and remodeling. Myocardial fibrosis is the pathophysiological hallmark of failing heart. We investigated the relationship between noninvasive imaging markers of myocardial fibrosis, native T1, and late gadolinium enhancement, respectively, and aortic stiffness in ventricular remodeling. Consecutive patients with known dilated cardiomyopathy (n=173) underwent assessment of cardiac volumes and function, T1 mapping, scar imaging, and pulse wave velocity, a measure of aortic stiffness. Asymptomatic healthy volunteers served as controls (n=47). Controls and patients showed an increase in pulse wave velocity with age, which was accelerated in the presence of cardiovascular disease. On the contrary, native T1 increased with age in patients, but not in controls. Pulse wave velocity was associated with native T1 in the presence of disease, but not in health. Native T1 showed a strong relationship with markers of structural and functional left ventricular remodeling and diastolic impairment. Ischemic and nonischemic pathophysiology of ventricular remodeling showed a similar slope of relationship between pulse wave velocity and native T1. However, in nonischemic patients, increase in pulse wave velocity was associated with greater increase in native T1. Aortic stiffness is related to age, and this process is accelerated in the presence of disease. On the contrary, increase in interstitial myocardial fibrosis is associated with age in the presence of disease. Patients with ischemic and nonischemic dilated cardiomyopathy have a similar relationship between native T1 and pulse wave velocity, which is stronger in the latter group.
    Type of Medium: Online Resource
    ISSN: 0194-911X , 1524-4563
    URL: Article
    DOI: 10.1161/HYPERTENSIONAHA.114.03928
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 2094210-2
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  • 2
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    Online Resource
    Comprehensive Cardiac Magnetic Resonance for Short‐Term Follow‐Up in Acute Myocarditis
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Journal of the American Heart Association Vol. 5, No. 7 ( 2016-07-06)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 5, No. 7 ( 2016-07-06)
    Abstract: Cardiac magnetic resonance ( CMR ) can detect inflammatory myocardial alterations in patients suspected of having acute myocarditis. There is limited information regarding the degree of normalization of CMR parameters during the course of the disease and the time window during which quantitative CMR should be most reasonably implemented for diagnostic work‐up. Methods and Results Twenty‐four patients with suspected acute myocarditis and 45 control subjects underwent CMR . Initial CMR was performed 2.6±1.9 days after admission. Myocarditis patients underwent CMR follow‐up after 2.4±0.6, 5.5±1.3, and 16.2±9.9 weeks. The CMR protocol included assessment of standard Lake Louise criteria, T1 relaxation times, extracellular volume fraction, and T2 relaxation times. Group differences between myocarditis patients and control subjects were highest in the acute stage of the disease ( P 〈 0.001 for all parameters). There was a significant and consistent decrease in all inflammatory CMR parameters over the course of the disease ( P 〈 0.01 for all parameters). Myocardial T1 and T2 relaxation times—indicative of myocardial edema—were the only single parameters showing significant differences between myocarditis patients and control subjects on 5.5±1.3‐week follow‐up (T1: 986.5±44.4 ms versus 965.1±28.1 ms, P =0.022; T2: 55.5±3.2 ms versus 52.6±2.6 ms; P =0.001). Conclusions In patients with acute myocarditis, CMR markers of myocardial inflammation demonstrated a rapid and continuous decrease over several follow‐up examinations. CMR diagnosis of myocarditis should therefore be attempted at an early stage of the disease. Myocardial T1 and T2 relaxation times were the only parameters of active inflammation/edema that could discriminate between myocarditis patients and control subjects even at a convalescent stage of the disease.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.116.003603
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 2653953-6
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  • 3
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    Online Resource
    Abstract 15154: T1-mapping and Outcomes in Non-ischemic Cardiomyopathies- An Investigator-led Multicenter Observational Longitudinal Study
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Circulation Vol. 132, No. suppl_3 ( 2015-11-10)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 132, No. suppl_3 ( 2015-11-10)
    Abstract: Introduction: Nonischemic cardiomyopathy (NICM) is a recognised cause of poor clinical outcome. NICM is characterised by intrinsic myocardial impairment, which is driven by interstitial myocardial fibrosis in a considerable majority of NICM. The lack of accurate and noninvasive characterisation of interstitial myocardial fibrosis limits recognition of disease and effective clinical management in NICM. Hypothesis: T1 mapping by CMR is a novel non-invasive imaging application with a recognized potential to significantly improve the management of patients with NICM, supporting characterization of interstitial myocardial disease, assessment of severity of disease, risk stratification as well as development of targeted therapies. Comparative prognostic relevance of T1-mapping parameters in subjects with NICM for adverse outcome is unknown. Methods: an investigator-led multicenter observational longitudinal study in patients with NICM. We standardized imaging acquisition based on the modified Look-Locker sequence (MOLLI) (3(3)3(3)5) and post-processing approach of T1 mapping, and transferred the methodology to several other centres. We determined reference ranges for T1 mapping values and provided proof of concept studies in NICM in discrimination between health and disease. The primary endpoint was all-cause mortality. Results: 805 consecutive patients (mean age (years) 50±16; males: n=499, 62%) with NICM underwent contrast-enhanced CMR with T1-mapping. During a median follow-up period of 17 months (range 36 months), we observed a total of 26 deaths (18 cardiac). Native T1, ECV and extent of LGE were strongly associated with an increased likelihood of all-cause mortality (p 〈 0.001). In multivariate analyses, native T1 was the sole independent predictor of all-cause and cardiac mortality, over and above ECV and LGE. Native T1 was also superior in correctly classifying subjects and adverse events over a 17-months period. Conclusions. In patients with NICM, non-invasive measures of interstitial myocardial fibrosis are useful in prediction of outcome. Native T1 is an independent predictor over and above conventional markers of risk, providing a basis for a novel algorithm of risk stratification in NICM.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.132.suppl_3.15154
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
    detail.hit.zdb_id: 1466401-X
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  • 4
    Online Resource
    Online Resource
    Interrelations of Epicardial Fat Volume, Left Ventricular T1-Relaxation Times and Myocardial Strain in Hypertensive Patients : A Cardiac Magnetic Resonance Study
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Journal of Thoracic Imaging Vol. 32, No. 3 ( 2017-05), p. 169-175
    Details
    In: Journal of Thoracic Imaging, Ovid Technologies (Wolters Kluwer Health), Vol. 32, No. 3 ( 2017-05), p. 169-175
    Abstract: This cardiac magnetic resonance study was performed to assess myocardial fibrosis by evaluating T1-relaxation time (T1), to measure left ventricular (LV) strain, and to determine epicardial fat volume (EFV) in hypertensive patients with no history of cardiovascular (CV) events and to relate the results to the presence of coronary atherosclerotic artery disease (CAD) in these patients. Materials and Methods: A total of 123 subjects were examined at 1.5 T. Of them, 98 were hypertensive patients (58 men; mean age, 62.9±10.7 y; body mass index, 29.0±5.6 kg/m 2 ) and 25 were controls without CV risk factors or disease (13 men; 60.1±10.7 y; 28.1±5.4 kg/m 2 ). All patients had a well-treated blood pressure. In the hypertensive group, 56 patients had no CAD, whereas 42 patients had CAD. T1 was assessed by a modified Look-Locker inversion recovery sequence. Longitudinal and circumferential peak systolic strain (LS; CS) was determined with dedicated cardiac magnetic resonance software (feature tracking). EFV (normalized to the body surface area) was assessed by a 3D Dixon sequence. Results: T1 (ms) and EFV (mL/m 2 ) were higher and CS and LS (%) were lower in hypertensive patients compared with those in nonhypertensive controls ( P 〈 0.05), independent of the presence of CAD (controls: T1=967.2±16.9, LS=−25.2±4.6, CS=−28.7±5.0, EFV=58.2±21.1; hypertensive patients overall: T1=991.3±45.5, LS=−21.0±4.5, CS=−25.0±5.9, EFV=71.1±25.3; hypertensive patients without CAD: T1=991.6±48.4, LS=−21.0±4.7, CS=−24.6±6.3, EFV=71.3±26.6; hypertensive patients with CAD: T1=986.7±39.2, LS=−21.1±4.3, CS=−25.5±5.4, EFV=70.9±23.6). There were no significant differences between hypertensive patients with and those without CAD and between patients grouped according to the number of vessels affected (0-vessel disease, 1-vessel disease, 2-vessel disease, or 3-vessel disease). Conclusions: Hypertension is associated with signs of myocardial fibrosis and an impaired LV contractility despite a normal LV ejection fraction, as well as with an increased EFV. However, CAD, in the absence of previous pathologies with consecutive myocardial ischemic damage, did not additionally affect these parameters.
    Type of Medium: Online Resource
    ISSN: 0883-5993
    URL: Article
    DOI: 10.1097/RTI.0000000000000264
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 2048799-X
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  • 5
    Online Resource
    Online Resource
    Incidental Cardiac Findings in Non–Electrocardiogram-gated Thoracic Computed Tomography of Intensive Care Unit Patients: Assessment of Prevalence and Underreporting
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Journal of Thoracic Imaging Vol. 33, No. 3 ( 2018-05), p. 168-175
    Details
    In: Journal of Thoracic Imaging, Ovid Technologies (Wolters Kluwer Health), Vol. 33, No. 3 ( 2018-05), p. 168-175
    Abstract: Cardiac findings frequently remain unreported on non–electrocardiogram (ECG)-gated computed tomography (CT). Although the clinical relevance of such findings may be limited in a general patient population, they may have significant impact in intensive care patients. Thus, the purpose of this study was to evaluate the prevalence, underreporting, and clinical relevance of incidental cardiac findings in intensive care unit (ICU) patients. Materials and Methods: Non–ECG-gated chest CT examinations of ICU patients were retrospectively analyzed for incidental cardiac findings. The findings were classified into 3 categories (A to C): category A findings, which carry potential for risk to life; category B findings, which have a potential for significant morbidity; category C findings, which have a possible effect on prognosis. Results: A total of 500 patients who underwent non–ECG-gated thoracic CT examinations were included. Of the 500 patients, 403 presented with 1443 cardiac findings. Of all cardiac findings, 37% were described in the initial written report. Sixty category A findings were detected, of which 48% were not mentioned in the report. Six hundred forty category B findings were detected, of which 77% were not described in the report. The remaining 743 findings were classified as category C, 55% of which were not reported in the report. Conclusions: The prevalence as well as the rate of underreporting of incidental cardiac findings in non–ECG-gated chest CT of ICU patients is very high. The results of this study underscore the importance of dedicated training for assessment of cardiac structures and conditions, which may be detected on non–ECG-gated chest CT.
    Type of Medium: Online Resource
    ISSN: 0883-5993
    URL: Article
    DOI: 10.1097/RTI.0000000000000309
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2048799-X
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  • 6
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    Comprehensive Cardiac Magnetic Resonance for Assessment of Cardiac Involvement in Myotonic Muscular Dystrophy Type 1 and 2 Without Known Cardiovascular Disease
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Circulation: Cardiovascular Imaging Vol. 12, No. 6 ( 2019-06)
    Details
    In: Circulation: Cardiovascular Imaging, Ovid Technologies (Wolters Kluwer Health), Vol. 12, No. 6 ( 2019-06)
    Type of Medium: Online Resource
    ISSN: 1941-9651 , 1942-0080
    URL: Article
    DOI: 10.1161/CIRCIMAGING.119.009100
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2440475-5
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