1,721,092 research outputs found
Dilated cardiomyopathy
No full textDilated cardiomyopathy (DCM) is defined by the presence of LV dilatation and systolic dysfunction in the absence of significant CAD or an abnormal loading condition sufficient to cause global systolic impairment. The causes of DCM can be classified as genetic and nongenetic. Echocardiography, Cardiovascular Magnetic Resonance (CMR), nuclear imaging (SPECT and PET),
and cardiac CT are valuable tools for the diagnosis and stratification of DCM patients. Specifically, the chapter is about the role of cardiovascular imaging in the diagnostic algorhythm of dilated cardiomyopathy including indication of scan protocol and report
Heart and Brain:Complex Relationships for Left Ventricular Dysfunction
No full textPurpose of Review: This review summarizes the evidence for the established vascular/hypoperfusion model and explores the new hypothesis that configures the heart/brain axis as an organ system where similar pathogenic mechanisms exploit physiological and pathological changes. Recent Findings: Although associated by common risk factors, similar epidemiological stratification and common triggers (including inflammation, oxidative stress, and hypoxia), heart failure and Alzheimer’s disease have been, for long time, viewed as pathogenically separate illnesses. The silos began to be broken down with the awareness that vascular dysfunction, and loss of cardiac perfusion pump power, trigger biochemical changes, contributing to the typical hallmark of Alzheimer’s disease (AD)—the accumulation of Aβ plaques and hyperphosphorylated Tau tangles. Compromised blood flow to the brain becomes the paradigm for the “heart-to-head” connection. Compelling evidence of common genetic variants, biochemical characteristics, and the accumulation of Aβ outside the brain suggests a common pathogenesis for heart failure (HF) and AD. These new findings represent just the beginning of the understanding the complex connection between AD and HF requiring further studies and interdisciplinary approaches. Summary: Altogether, the current evidence briefly summarized in this review, highlight a closer and complex relationship between heart failure and Alzheimer’s that goes beyond the vascular/perfusion hypothesis. Genetic and biochemical evidence begin to suggest common pathogenic mechanisms between the two diseases involving a systemic defect in the folding of protein or a seeding at distance of the misfolded proteins from one organ to the other.</p
A pipeline for developing deep learning prognostic prediction models in cardiac magnetic resonance image analysis
Full text linkPatients and healthcare professionals require clinical prediction models to accurately guide healthcare decisions, although an awareness of the limitations of regression-based models has recently increased. Deep learning (DL) has emerged as a promising alternative to traditional regression-based models, due to its ability to effectively analyse heterogeneous types of data, ranging from numerical variables to medical images. Building a DL model presents various challenges, including conceptualizing the clinical problem, selecting appropriate variables and model architecture, and providing explainability. We propose a four-step pipeline for developing DL-based prediction models for cardiac magnetic resonance image analysis. This framework aims to support researchers in exploring DL application across the broad spectrum of cardiology, with a specific focus on advancement in arrhythmic risk prediction. The field of cardiomyopathy faces challenges when assessing arrhythmic risk due to the low accuracy of the current prediction models. Research efforts have focused on developing DL models able to predict major arrhythmic events in dilated cardiomyopathy. While the initial results are promising, further tests are needed before translating these models into clinical practice
Myocardial signal intensity decay after gadolinium injection: a fast and effective method for the diagnosis of cardiac amyloidosis
No full textLate Gadolinium Enhancement (LGE) pattern of cardiac amyloidosis (CA) at cardiac magnetic resonance (CMR) examination is absent in approximately 30% of patients. We tested whether the evaluation of myocardial gadolinium signal intensity (SI) decay (SID) has a higher diagnostic accuracy for CA. CMR was performed in 59 patients with systemic AL amyloidosis (36 males, 69 ± 10 years, mean ± SD), and 20 age/sex-matched healthy controls. LGE images were acquired every minute up to 8 min after gadolinium injection (time of inversion 250 ms). SI regions of interest were plotted in SI/time curves for endocardial (Endo) and epicardial layer of interventricular septum, cavity, and skeletal muscle as reference. SID (a negative exponential function described by the parameter TSID) was expressed as number of heart beats (HB) from each ROI. The typical LGE pattern for CA was detected in 42 patients (Ty-LGE), while 17 showed either absent LGE or an atypical pattern (ATy-LGE). A definite CA diagnosis was confirmed in all Ty-LGE patients and in 10/17 ATy-LGE patients. At ROC analysis Endo-TSID was the most accurate parameter to distinguish Ty-LGE and ATy-LGE patients from controls. A 269 HB threshold (mean + 2 SD Endo-TSID measured in controls) identified 51/52 patients with definite CA diagnosis, with 98% sensitivity, 93% specificity, and 96% diagnostic accuracy. A direct relation was found between the extracellular volume and Endo-TSID in CA patients (r 0.72, 95% CI 0.37-089, p < 0.001). the analysis of myocardial SID after gadolinium injection improves the accuracy of CMR for CA diagnosis
Implementing the risk stratification in STEMI by cardiovascular magnetic resonance: An academic exercise or real benefit?
No full textstatus: Publishe
Prognostic significance of myocardial extracellular volume fraction in nonischaemic dilated cardiomyopathy
No full textIn nonischaemic dilated cardiomyopathy (NICM), replacement myocardial fibrosis as detected by late gadolinium enhancement (LGE) at cardiovascular magnetic resonance (CMR) is associated with poor prognosis. We investigated the as-yet unexplored prognostic significance of interstitial fibrosis in NICM, using T1-mapping CMR
Galectin-3 and myocardial fibrosis in nonischemic dilated cardiomyopathy
No full textLeft ventricular (LV) fibrosis, assessed by late gadolinium enhancement (LGE) at cardiac magnetic resonance imaging (MRI), is a marker of LV remodeling, and holds prognostic value in nonischemic dilated cardiomyopathy (NICM). Galectin-3 has been shown to participate in tissue fibrogenesis and to be a prognosticator in heart failure. Our aim was to investigate the relationships between galectin-3 circulating level and myocardial fibrosis at MRI in patients with NICM
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