Ventricular septal defect (VSD) is a congenital heart disease that accounts for up to 40% of all congenital cardiac malformations. VSD is a connection between right and left ventricle, through the ventricular septum. Echocardiography and magnetic resonance imaging (MRI) help identify this entity. This case presents a 12-year-old male diagnosed with a small muscular apical VSD of 3 mm in diameter, at echocardiography. Cardiac MRI using first-pass perfusion sequence, combining the right plane of acquisition with a short bolus of contrast material, clearly confirmed the presence of VSD.
Proton magnetic resonance spectroscopy (1H-MRS) can detect and quantify lipid accumulation in specific myocardial or peri-myocardial districts. Thirty-three patients (20M/13F; BMI 26±4 kg/m2; 64±10 years) with suspect of CV diseases underwent 1.5-T 1H-MRS using a water-suppressed chemical-shift imaging sequence to quantify the lipid profile of SEP, epicardial (EAT), pericardial (PAT), and subcutaneous (SAT) adipose tissues. The integral of the lipid peaks at 0.9, 1.3, 2.0, 5.3 ppm was measured as percentage over the total amount of lipids (Table). A subgroup of 15 subjects were identified as HG (12 impaired-fasting-glucose and 3 diabetics: 121±26 mg/dL). Bulk methylene (1.3 ppm) of SEP was higher in HG vs. other patients (P=0.047). In HG patients, SEP was positively correlated to glucose, visceral fat, C-reactive protein (Spearman ρ>0.63, P<0.018); EAT was positively correlated to visceral fat, age, body weight, and inversely to muscular-, fat free-, bone mass (Pearson ρ<|0.53|, P>0.039). In all subjects, the main lipid peaks correlated with metabolic parameters.1H-MRS allowed to measure lipid peaks in different adipose compartments with cardiometabolic relevance. SEP resulted a myocardial site associated with biomarkers of secondary heart events in pre/diabetic patients at higher risk of CV episodes. High SEP fat may be proposed as a marker of future CV events. Disclosure R. Codella: None. G. Di Leo: None. M. Zanardo: None. S. Schiaffino: Speaker's Bureau; Self; General Electric. S.D. Fabiano: None. C.B. Monti: None. M. Codari: None. L. Luzi: Consultant; Self; McKinsey & Company. Research Support; Self; Allergan, Gelesis, SunStar Inc. Speaker's Bureau; Self; A. Menarini Diagnostics, AstraZeneca, Eli Lilly and Company, GlaxoSmithKline plc., Menarini Group, Novartis AG, Novo Nordisk Inc., Sunstar Foundation. F. Sardanelli: None.
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