Cardiovascular MRI for the assessment of heart failure: Focus on clinical management and prognosis

Muzzarelli, Stefano; Ordovás, Karen; Higgins, Charles B.

doi:10.1002/jmri.22433

Cited by 9 publications

(7 citation statements)

References 128 publications

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“…Cardiovascular magnetic resonance (CMR) permits non-invasive depiction of pathological changes in the myocardial structure such as fibrosis, oedema and fatty replacement of myocytes [ 10 ]. It has, thus, also been used to assess cardiac involvement in dystrophinopathies [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Myocardial late gadolinium enhancement is associated with clinical presentation in Duchenne muscular dystrophy carriers

Wexberg

Avanzini

Mascherbauer

et al. 2016

Journal of Cardiovascular Magnetic Resonance

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BackgroundDuchenne muscular dystrophy (DMD) is an X-linked recessive disease that occurs in males leading to immobility and death in early adulthood. Female carriers of DMD are generally asymptomatic, yet frequently develop dilated cardiomyopathy. This study aims to detect early cardiac manifestation in DMD using cardiovascular magnetic resonance (CMR) and to evaluate its association with clinical symptoms.MethodsClinical assessment of DMD carriers included six minutes walk tests (6MWT), blood analysis, electrocardiography, echocardiography, and CMR using FLASH sequences to detect late gadolinium enhancement (LGE). T1-mapping using the Modified Look-Locker Inversion recovery (MOLLI) sequence was performed quantify extracellular volume (ECV).ResultsOf 20 carriers (age 39.47 ± 12.96 years) 17 (89.5 %) were clinically asymptomatic. ECV was mildly elevated (29.79 ± 2.92 %) and LGE was detected in nine cases (45 %). LGE positive carriers had lower left ventricular ejection fraction in CMR (64.36 ± 5.78 vs. 56.67 ± 6.89 %, p = 0.014), higher bothCK (629.89 ± 317.48 vs. 256.18 ± 109.10 U/l, p = 0.002) and CK-MB (22.13 ± 5.25 vs. 12.11 ± 2.21 U/l, p = 0.001), as well as shorter walking distances during the 6MWT (432.44 ± 96.72 vs. 514.91 ± 66.80 m, p = 0.037). 90.9 % of subjects without LGE had normal pro-BNP, whereas in 66.7 % of those presenting LGE pro-BNP was elevated (p = 0.027). All individuals without LGE were in the NYHA class I, whereas all those in NYHA classes II and III showed positive for LGE (p = 0.066).ConclusionsMyocardial involvement shown as LGE in CMR occurs in a substantial number of DMD carriers; it is associated with clinical and morphometric signs of incipient heart failure. LGE is thus a sensitive parameter for the early diagnosis of cardiomyopathy in DMD carriers.Trial registrationClinicaltrials.gov, NCT01712152 Trial registration: October 19, 2012.First patient enrolled: September 27, 2012 (retrospectively registered).

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Section: Introductionmentioning

confidence: 99%

Myocardial late gadolinium enhancement is associated with clinical presentation in Duchenne muscular dystrophy carriers

Wexberg

Avanzini

Mascherbauer

et al. 2016

Journal of Cardiovascular Magnetic Resonance

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“…Cardiac magnetic resonance (CMR) imaging has been widely adopted in many clinical institutions to routinely diagnose patients with cardiac diseases (Ishida et al, 2009; Muzzarelli et al, 2011; Karamitsos and Myerson, 2011). CMR is non-ionising, non-invasive and provides a range of contrast mechanisms.…”

Section: Introductionmentioning

confidence: 99%

A collaborative resource to build consensus for automated left ventricular segmentation of cardiac MR images

Suinesiaputra

Cowan

Al-Agamy

et al. 2014

Medical Image Analysis

168

121

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A collaborative framework was initiated to establish a community resource of ground truth segmentations from cardiac MRI. Multi-site, multi-vendor cardiac MRI datasets comprising 95 patients (73 men, 22 women; mean age 62.73 ± 11.24 years) with coronary artery disease and prior myocardial infarction, were randomly selected from data made available by the Cardiac Atlas Project (Fonseca et al., 2011). Three semi- and two fully-automated raters segmented the left ventricular myocardium from short-axis cardiac MR images as part of a challenge introduced at the STACOM 2011 MICCAI workshop (Suinesiaputra et al., 2012). Consensus myocardium images were generated based on the Expectation-Maximization principle implemented by the STAPLE algorithm (Warfield et al., 2004). The mean sensitivity, specificity, positive predictive and negative predictive values ranged between 0.63-0.85, 0.60-0.98, 0.56-0.94 and 0.83-0.92, respectively, against the STAPLE consensus. Spatial and temporal agreement varied in different amounts for each rater. STAPLE produced high quality consensus images if the region of interest was limited to the area of discrepancy between raters. To maintain the quality of the consensus, an objective measure based on the candidate automated rater performance distribution is proposed. The consensus segmentation based on a combination of manual and automated raters were more consistent than any particular rater, even those with manual input. The consensus is expected to improve with the addition of new automated contributions. This resource is open for future contributions, and is available as a test bed for the evaluation of new segmentation algorithms, through the Cardiac Atlas Project (www.cardiacatlas.org).

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“…2,3 In the evaluation of dilated cardiomyopathies, the precise quantification of ventricular volumes and systolic function has great clinical relevance in regard to prognosis and clinical management such as ICD implantation. 4 The excellent spatial and temporal resolution of cine imaging along with myocardial strain imaging allows for accurate and detailed analysis of global and regional myocardial function. 5 Cardiac MR imaging also offers accurate and reproducible assessment of RV structure and function.…”

Section: Morphology and Functionmentioning

confidence: 99%

“…Through the use of multiple techniques such as late gadolinium enhancement imaging (LGE), native and post-contrast T1 mapping, T2-weighted imaging, and T2* imaging, the differentiation between ischemic and non-ischemic etiology can be performed as well as further differentiation of the various etiologies of non-ischemic cardiomyopathies. 4 …”

Section: Tissue Characterizationmentioning

confidence: 99%

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The case for CMR

Shaw

Kramer

2015

Journal of Nuclear Cardiology

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Cardiovascular MRI for the assessment of heart failure: Focus on clinical management and prognosis

Cited by 9 publications

References 128 publications

Myocardial late gadolinium enhancement is associated with clinical presentation in Duchenne muscular dystrophy carriers

Myocardial late gadolinium enhancement is associated with clinical presentation in Duchenne muscular dystrophy carriers

A collaborative resource to build consensus for automated left ventricular segmentation of cardiac MR images

The case for CMR

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