Cardiac Magnetic Resonance Imaging for the Interventional Cardiologist

Figtree, Gemma A.; Lønborg, Jacob; Grieve, Stuart M.; Ward, Michael R.; Bhindi, Ravinay

doi:10.1016/j.jcin.2010.09.026

Cited by 9 publications

(3 citation statements)

References 100 publications

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“…Considering that most patients with severe AS are elderly, and eGFR has a natural decline with age, this presents significant implications to anatomical screening in prospective patients with iodine contrast reliant methods. CMR has the potential for accurate haemodynamic measurements of the cardiovascular system [8,[46][47][48]. However, this is not standard practice and significant heterogeneity exists in the algorithms used to calculate transvalvular aortic gradients.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of aortic stenosis using cardiovascular magnetic resonance: a systematic review & meta-analysis

Woldendorp

Bannon

Grieve

2020

Journal of Cardiovascular Magnetic Resonance

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Background As the average age of patients with severe aortic stenosis (AS) who receive procedural intervention continue to age, the need for non-invasive modalities that provide accurate diagnosis and operative planning is increasingly important. Advances in cardiovascular magnetic resonance (CMR) over the past two decades mean it is able to provide haemodynamic data at the aortic valve, along with high fidelity anatomical imaging. Methods Electronic databases were searched for studies comparing CMR to transthoracic echocardiography (TTE) and transoesophageal echocardiography (TEE) in the diagnosis of AS. Studies were included only if direct comparison was made on matched patients, and if diagnosis was primarily through measurement of aortic valve area (AVA). Results Twenty-three relevant, prospective articles were included in the meta-analysis, totalling 1040 individual patients. There was no significant difference in AVA measured as by CMR compared to TEE. CMR measurements of AVA size were larger compared to TTE by an average of 10.7% (absolute difference: + 0.14cm2, 95% CI 0.07–0.21, p < 0.001). Reliability was high for both inter- and intra-observer measurements (0.03cm2 +/− 0.04 and 0.02cm2 +/− 0.01, respectively). Conclusions Our analysis demonstrates the equivalence of AVA measurements using CMR compared to those obtained using TEE. CMR demonstrated a small but significantly larger AVA than TTE. However, this can be attributed to known errors in derivation of left ventricular outflow tract size as measured by TTE. By offering additional anatomical assessment, CMR is warranted as a primary tool in the assessment and workup of patients with severe AS who are candidates for surgical or transcatheter intervention.

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Section: Discussionmentioning

confidence: 99%

Evaluation of aortic stenosis using cardiovascular magnetic resonance: a systematic review & meta-analysis

Woldendorp

Bannon

Grieve

2020

Journal of Cardiovascular Magnetic Resonance

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“…CMR allows for accurate assessment of cardiac function and comprehensive tissue characterisation. Functional CMR images assess ventricular volumes, function and focal wall motion abnormalities; T2 weighted black blood images can be used to identify oedema and the presence of active inflammation; and delayed gadolinium enhancement images detect scarring with great accuracy [7]. New emerging pre- and postcontrast T1 mapping CMR techniques may provide information regarding interstitial fibrosis and extracellular matrix volume [8].…”

Section: Discussionmentioning

confidence: 99%

Utility of cardiac magnetic resonance in assessing right-sided heart failure in sarcoidosis

et al. 2013

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BackgroundCardiac involvement in sarcoidosis is associated with a poor prognosis. In patients with right sided heart failure, differentiating between cor-pulmonale, or cardiac sarcoidosis has important implications to management.Case presentationWe present the case of a patient with severe but stable pulmonary sarcoidosis and new onset right sided heart failure despite only mild elevations of pulmonary artery pressure. CMR demonstration of extensive right ventricular fibrosis with associated dilatation and hypokinesis was a key finding for prognosis and management of the patient.ConclusionCardiac magnetic resonance (CMR) is the preferred investigation in the diagnosis of cardiac sarcoidosis, allowing assessment of myocardial inflammation and fibrosis, as well as function, in a manner not matched by other technologies.

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“…Cardiovascular Magnetic Resonance Imaging (CMR) is a non-invasive imaging modality with the ability to characterize myocardium, as well as to accurately measure cardiac and vascular function [19]. A specific advantage of CMR that is especially relevant to this study is the ability to detect focal fibrosis and silent myocardial infarction (MI) through the use of late gadolinium enhancement (LGE) [20].…”

Section: Introductionmentioning

confidence: 99%

Regular Cocaine Use Is Associated with Increased Systolic Blood Pressure, Aortic Stiffness and Left Ventricular Mass in Young Otherwise Healthy Individuals

et al. 2014

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BackgroundThe cardiovascular impact of cocaine use in otherwise healthy individuals who consider themselves ‘social’ users is not well established.Methods/ResultsTwenty regular cocaine users and 20 control subjects were recruited by word-of-mouth. Cardiovascular magnetic resonance was performed to assess cardiac and vascular structure and function. Cocaine users had higher systolic blood pressure compared to non-users (134±11 vs 126±11 mmHg, p = 0.036), a finding independent of age, body surface area, smoking and alcohol consumption. Cocaine use was associated with increased arterial stiffness - reflected by reduced aortic compliance (1.3±0.2 vs 1.7±0.5 cm2×10−2.mmHg−1, p = 0.004), decreased distensibility (3.8±0.9 vs 5.1±1.4 mmHg−1.10−3, p = 0.001), increased stiffness index (2.6±0.6 vs 2.1±0.6, p = 0.005), and higher pulse wave velocity (5.1±0.6 vs 4.4±0.6 m.s−1, p = 0.001). This change in aortic stiffness was independent of vessel wall thickness. Left ventricular mass was 18% higher in cocaine users (124±25 vs 105±16 g, p = 0.01), a finding that was independent of body surface area, and left atrial diameter was larger in the user group than controls (3.8±0.6 vs 3.5±0.3 cm, p = 0.04). The increased left ventricular mass, systolic blood pressure and vascular stiffness measures were all associated with duration and/or frequency of cocaine use. No late gadolinium enhancement or segmental wall motion abnormalities were seen in any of the subjects.ConclusionsCompared with the non-user control cohort, cocaine users had increased aortic stiffness and systolic blood pressure, associated with greater left ventricular mass. These measures are all well known risk factors for premature cardiovascular events, highlighting the dangers of cocaine use, even in a ‘social’ setting, and have important public health implications.

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Cardiac Magnetic Resonance Imaging for the Interventional Cardiologist

Cited by 9 publications

References 100 publications

Evaluation of aortic stenosis using cardiovascular magnetic resonance: a systematic review & meta-analysis

Evaluation of aortic stenosis using cardiovascular magnetic resonance: a systematic review & meta-analysis

Utility of cardiac magnetic resonance in assessing right-sided heart failure in sarcoidosis

Regular Cocaine Use Is Associated with Increased Systolic Blood Pressure, Aortic Stiffness and Left Ventricular Mass in Young Otherwise Healthy Individuals

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