1,721,131 research outputs found
Letter by Barison et al Regarding Article, "Familial Clustering of Mitral Valve Prolapse in the Community"
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Juvenile sudden cardiac death. When is post-mortem magnetic resonance imaging suitable ? Surely in ARVC/D cases
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A fast and effective method of quantifying myocardial perfusion by magnetic resonance imaging
No full textThe quantification of global myocardial blood flow (MBF) by measuring coronary sinus flow by magnetic resonance (MRI) was demonstrated to be very well correlated with positron emission tomography (PET). We proposed a new method for the quantification of regional myocardial perfusion with MRI by the integration of MBF and first pass technique. The aim of this study was to validate this new method for quantification of regional perfusion by comparing it with 13NH13-PET in swine models of myocardial infarction and in humans in resting and hyperemic conditions. MRI and 13NH3-PET was performed in 2 healthy swine, 11 swine models of myocardial infarction (5 reperfused, 6 non reperfused) and in 12 humans at rest and during hyperemia. MBF was estimated by MRI through the quantification of coronary sinus flow and left ventricular (LV) mass. The upslope of signal intensity (SI-upslope) of each myocardial segment was obtained by the first pass gadolinium technique. Regional SI-upslope was indexed by the upslope of the entire left ventricular myocardium (global upslope). Regional myocardial perfusion was estimated as the product of MBF and SI-upslope/global upslope. Regional perfusion was also estimated by 13NH3-PET. A close agreement of the MRI and PET techniques for measurement of regional myocardial perfusion was found in all myocardial segments by Bland-Altman analysis (mean difference 5.1 %; limits of agreement, -37.2-27.5 %). With the integration of the first pass technique and the measurement of global MBF by coronary sinus flow/LV mass, MRI allows direct quantification of regional myocardial perfusion
Role of tissue characterization by Cardiac Magnetic Resonance in the diagnosis of constrictive pericarditis
No full textCardiac Magnetic Resonance (CMR) allows evaluation of the functional and flow changes in pericardial constriction as well as detection of acute pericardial inflammation, fusion and thickening of pericardial layers and pericardial effusion. We sought to evaluate the diagnostic role of tissue characterization by CMR in constrictive pericarditis (CP). We performed a CMR exam in 70 patients (mean age 58 ± 16) with clinical suspicion of constrictive pericarditis and constrictive pattern at echocardiography and/or catheterization. A multiparametric CMR approach was used to evaluate the initial diagnostic suspicion. A clinical follow-up was performed in all patients for a median of 551 days. The diagnosis of CP was confirmed in 53 patients while 12 patients presented signs of predominant pericardial active inflammation suggesting a diagnosis of transient constrictive pericarditis and five presented effusive-constrictive pericarditis. Patients with a final diagnosis of CP had worse prognosis than those with transient constrictive or effusive constrictive pericarditis. The presence of myocardial late gadolinium enhancement was associated to adverse events. Results of the current study confirmed the value of CMR in the differential diagnosis of pericardial disease. A multiparametric CMR approach allowed to distinguish between active inflammation, chronic pericarditis with constriction and effusion without inflammation
The heart after idarubicin overdose. Cardiac death in a patient with acute promyelocitic leukaemia
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Implications of atrial volumes in surgical corrected Tetralogy of Fallot on clinical adverse events
No full textBackground: While left atrial (LA) size has been shown as a strong predictor of cardiovascular diseases in various studies, the role of right atrial (RA) enlargement, especially in the growing population of patients with congenital heart diseases (CHD) is largely unknown. We sought to evaluate (1) RA and LA volumes in patients with repaired Tetralogy of Fallot (TOF) and assess correlations to (2) functional parameters and (3) clinical adverse events. Methods: 169 patients with repaired TOF were enrolled following a targeted protocol for Cardiovascular magnetic resonance imaging (CMR), Cardiopulmonary exercise tests (CPET), Echocardiography and Measurement of NT-proBNP. Clinical history was assessed at enrollment and during a median Follow-up of 23 months (IQR 9–40). The primary clinical endpoint was a composite of all cause mortality, aborted sudden cardiac death and sustained VT. Prespecified secondary surrogate endpoint included worsening heart failure (NYHA III–IV), non-sustained VT and sustained supraventricular tachycardia. Results: RA Systolic indexed volume (RASVi) correlated with LA Systolic indexed volume (LASVi) (r = 0.59, p 58 ml/m 2 ) had higher NT-proBNP levels, longer QRS duration, larger ventricle diameters, higher RV mass and lower peak oxygen uptake. RASVi was associated with the primary composite adverse event at univariate Cox-regression analysis (HR: 1.044, CI: 1.008–1.08, p = 0.01). Bayesian Multivariate model averaging revealed RASVi as predictor of secondary surrogate adverse outcome (HR: 1.06, CI: 1.053–1.068, Pb = 0,889). Conclusion: Among patients with repaired TOF, RA dilatation is an independent predictor for adverse clinical events. As such, routine assessment of RA volumes could be useful to further improve decision-making and management of these patients in the future
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