100 research outputs found
CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DebrillAtor ThErapy international registry: Design and rationale of the DERIVATE study
No full textImplantable cardioverter defibrillator (ICD) represents the most valuable sudden cardiac death (SCD) prophylactic strategy in patients with heart failure and severely reduced left ventricular ejection fraction (LVEF). To date, it is still unknown how to integrate the information given by cardiac magnetic resonance (CMR) into clinical and transthoracic echocardiography (TTE) work-up of non-ischemic cardiomyopathy (NICM) and ischemic cardiomyopathy (ICM) patients for accurate risk stratification
Increased extracellular volume fraction in nonischaemic dilated cardiomyopathy predicts worse outcomes independently of medical therapy
No full textMicrovascular obstruction complicating acute right ventricular myocardial infarction
No full textThis case history describes a man with inferior myocardial infarction (MI) with right-ventricular involvement, treated with a right coronary artery stent. Magnetic resonance showed akinesia of left-ventricular inferior and inferolateral walls and right-ventricular inferior free wall with an impairment of global systolic function. There was late gadolinium enhancement (LGE) of left-ventricular inferior and inferolateral walls with microvascular obstruction (MVO). LGE of the right-ventricular inferior wall was seen with a hypointense core within hyperenhanced myocardium, consistent with MVO of the infarcted right-ventricular myocardium. At follow-up there was persistent akinesia of left-ventricular inferior and inferolateral walls and right-ventricular systolic dysfunction. LGE was still evident with resolution of MVO
Negative risk markers for improving prediction of heart failure: Risk stratification implementation or simply the other side of existing risk scores?
No full textA stress test to evaluate the usefulness of Akaike information criterion in short-term earthquake prediction
No full textAkaike information criterion (AIC) has been recently adopted to identify possible earthquake precursors in ionospheric total electron content (TEC). According to the authors of this methodology, their technique allows finding abrupt increases (positive breaks) in vertical TEC rate of change 25–80 min before the occurrence of large earthquakes, highlighting a promising implication of AIC method in Mw > 8 earthquakes alert strategies. Due to the relevance of this matter, a lively scientific debate ensued from these results. In this study, we carefully evaluate AIC method potentiality in searching earthquake TEC precursory signatures. We first investigate the dependence of the detected breaks number on the adjustable AIC method parameters. Then, we show that breaks occurrence clusters around specific local times and around moderate and high solar and geomagnetic activity. The outcome of this study is that AIC method is not concretely usable for issuing large earthquakes alerts.Published211532A. Fisica dell'alta atmosferaJCR Journa
Multi-Modality Imaging in Dilated Cardiomyopathy: With a Focus on the Role of Cardiac Magnetic Resonance
No full textHeart failure (HF) is recognized as a leading cause of morbidity and mortality worldwide. Dilated cardiomyopathy (DCM) is a common phenotype in patients presenting with HF. Timely diagnosis, appropriate identification of the underlying cause, individualized risk stratification, and prediction of clinical response to treatment have improved the prognosis of DCM over the last few decades. In this article, we reviewed the current evidence on available imaging techniques used for DCM patients. In this direction, we evaluated appropriate scenarios for the implementation of echocardiography, nuclear imaging, and cardiac computed tomography, and we focused on the primordial role that cardiac magnetic resonance (CMR) holds in the diagnosis, prognosis, and tailoring of therapeutic options in this population of special clinical interest. We explored the predictive value of CMR toward left ventricular reverse remodeling and prediction of sudden cardiac death, thus guiding the decisions for device therapy. Principles underpinning the use of state-of-the-art CMR techniques such as parametric mapping and feature-tracking strain analysis are also provided, along with expectations for the anticipated future advances in this field. We also attempted to correlate the evidence with clinical practice, with the intent to address questions on selecting the optimal imaging method for different indications and clinical needs. Overall, we recommend a comprehensive assessment of DCM patients at baseline and at follow-up intervals depending on the clinical status, with the addition of CMR as a second-line modality to other imaging techniques. We also provide an algorithm to guide the detailed imaging approach of the patient with DCM. We expect that future guidelines will upgrade their clinical recommendations for the utilization of CMR in DCM, which is expected to further improve the quality of care and the outcomes. This review provides an up-to-date perspective on the imaging of dilated cardiomyopathy patients and will be of clinical value to training doctors and physicians involved in the area of heart failure. © Copyright © 2020 Mitropoulou, Georgiopoulos, Figliozzi, Klettas, Nicoli and Masci
Myocardial fibrosis in isolated left ventricular non-compaction and its relation to disease severity
No full textAims The aim of the present study was to evaluate the prevalence and extent of myocardial fibrosis in patients with isolated left ventricular non-compaction (LVNC) and to determine its relation to clinical status and LV systolic function. Methods and results The cardiac magnetic resonance imaging (MRI) database of our institution was searched for all patients with a first diagnosis of isolated LVNC. The diagnosis of isolated LVNC was based on the presence of standard cardiac MRI and clinical criteria. For each patient, cine and contrast-enhanced cardiac MR images were analysed to evaluate LV systolic function and the prevalence and extent of late gadolinium enhancement (LGE), a surrogate of myocardial fibrosis. A total of 42 patients (mean age 46 ± 20 years, 62% male) were identified. Late gadolinium enhancement was observed in 23 (55%) patients with isolated LVNC, occupying 4.8 ± 6.7% of the LV mass. Both the presence and extent of LGE were significantly related to the number of abnormal clinical features (i.e. symptomatic status, resting electrocardiogram abnormalities, and 24 h Holter monitoring abnormalities; P <, 0.001 and P = 0.001, respectively). Similarly, LGE was more prevalent and extensive in patients with LV ejection fraction (EF),<50% compared with patients with LVEF ≥50% (90 vs. 23%; P <, 0.001 and 8.9 ± 7.6 vs. 1.1 ± 2.4%; P <, 0.001, respectively). At multivariate analysis, both the presence and extent of LV LGE were independently related to LVEF (β = -0.63; P <, 0.001 and β = -0.62; P <, 0.001, respectively). Conclusion Myocardial fibrosis is related to clinical disease severity and LV systolic dysfunction in isolated LVNC. © 2010 The Author
A concealed carcinoid cardiac metastasis uncovered by comprehensive cardiovascular magnetic resonance-based tissue characterization: A case report
No full textBackground: Cardiac metastases of carcinoid tumours are extremely rare, and their diagnosis poses a significant challenge. A variety of techniques has been reported in the literature for this purpose, ranging from echocardiogram to the Indium-111 Octreotide, positron emission tomography using specific tracers, and biopsy. Occasionally, the diagnosis is only made post-mortem. Recently, CMR (cardiovascular magnetic resonance) has been added to the diagnostic toolkit. This case report describes the CMR sequences that can be used to characterize cardiac metastases of carcinoid tumours. Case summary: A 55-year-old woman with an antecedent history of resected carcinoid tumour of the ileocecal junction underwent whole-body In-111 Octreoscan single-photon emission computed tomography in the context of her follow-up. This raised the suspicion of pericardial involvement, which prompted a CMR study. Comprehensive CMR findings were consistent with isolated carcinoid tumour metastasis embedded within the anterior papillary muscle. We describe the CMR sequences that were used to characterize the metastasis. Discussion: The rarity of cardiac metastasis of carcinoid tumour makes its diagnosis challenging and warrants a high level of clinical suspicion. Cardiovascular magnetic resonance imaging proves to be an indispensable tool in the tissue characterization of such tumours. © 2020 The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology
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