Imaging Methods: Magnetic Resonance Imaging

Thomas, Katharine; Fotaki, Anastasia; Botnar, René M.; Ferreira, Vanessa M.

doi:10.1161/circimaging.122.014068

Cited by 13 publications

(8 citation statements)

References 106 publications

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“…The accuracy, reproducibility, and versatility of cardiovascular magnetic resonance (CMR) imaging make it a valuable phenotyping tool for patients with MD. 7 , 8 Beyond reference standard volumetric quantification of cardiac chamber structure and contractile function, CMR imaging provides unique insights into myocardial health across the spectrum of diffuse through regional replacement fibrosis. The versatile delivery of these markers without limitation from poor imaging windows, a common challenge for ultrasound‐based assessments in patients with MD attributable to scoliosis, obesity, and lung disease, 9 , 10 , 11 offers strong potential for CMR imaging to deliver personalized phenotype‐driven risk modeling in this population.…”

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confidence: 99%

Prognostic Utility of Cardiovascular Magnetic Resonance–Based Phenotyping in Patients With Muscular Dystrophy

Kashyap,

Nikhanj,

Labib

et al. 2023

JAHA

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Background The prognostic utility of cardiovascular magnetic resonance imaging, including strain analysis and tissue characterization, has not been comprehensively investigated in adult patients with muscular dystrophy. Methods and Results We prospectively enrolled 148 patients with dystrophinopathies (including heterozygotes), limb‐girdle muscular dystrophy, and type 1 myotonic dystrophy (median age, 36.0 [interquartile range, 23.0–50.0] years; 51 [34.5%] women) over 7.7 years in addition to an age‐ and sex–matched healthy control cohort (n=50). Cardiovascular magnetic resonance markers, including 3‐dimensional strain and fibrosis, were assessed for their respective association with major adverse cardiac events. Our results showed that markers of contractile performance were reduced across all muscular dystrophy groups. In particular, the dystrophinopathies cohort experienced reduced left ventricular (LV) ejection fraction and high burden of replacement fibrosis. Patients with type 1 myotonic dystrophy showed a 26.8% relative reduction in LV mass with corresponding reduction in chamber volumes. Eighty‐two major adverse cardiac events occurred over a median follow‐up of 5.2 years. Although LV ejection fraction was significantly associated with major adverse cardiac events (adjusted hazard ratio [aHR], 3.0 [95% CI, 1.4–6.4]) after adjusting for covariates, peak 3‐dimensional strain amplitude demonstrated greater predictive value (minimum principal amplitude: aHR, 5.5 [95% CI, 2.5–11.9]; maximum principal amplitude: aHR, 3.3 [95% CI, 1.6–6.8]; circumferential amplitude: aHR, 3.4 [95% CI, 1.6–7.2]; longitudinal amplitude: aHR, 3.4 [95% CI, 1.7–6.9]; and radial strain amplitude: aHR, 3.0 [95% CI, 1.4–6.1]). Minimum principal strain yielded incremental prognostic value beyond LV ejection fraction for association with major adverse cardiac events (change in χ 2 =13.8; P <0.001). Conclusions Cardiac dysfunction is observed across all muscular dystrophy subtypes; however, the subtypes demonstrate distinct phenotypic profiles. Myocardial deformation analysis highlights unique markers of principal strain that improve risk assessment over other strain markers, LV ejection fraction, and late gadolinium enhancement in this vulnerable patient population.

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confidence: 99%

Prognostic Utility of Cardiovascular Magnetic Resonance–Based Phenotyping in Patients With Muscular Dystrophy

Kashyap,

Nikhanj,

Labib

et al. 2023

JAHA

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“…The median level of Tn (ng/L) on admission was 19.3 (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27), and this increased significantly on day 3 (214) and decreased on day 7, though the values remained higher than those observed on admission (39). According to the cut-off point established for myocardial damage, only one patient met the myocardial damage criteria on admission.…”

Section: Cardiac Biomarkersmentioning

confidence: 93%

A Multicentric Observational Study to Determine Myocardial Injury in Severe Community-Acquired Pneumonia (sCAP)

Martin-Loeches,

Maggi,

Diaz

et al. 2023

Antibiotics

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Background: Severe community-acquired pneumonia (sCAP) is the most frequent admission for acute respiratory failure in intensive care medicine. Observational studies have found a correlation between patients who were admitted with CAP and the development of cardiovascular events. The risk of acute myocardial damage in patients with CAP is particularly high within the first 30 days of hospitalization. Research design and methods: Multicenter prospective cohort analysis conducted in consecutive patients admitted to an ICU with microbiologically confirmed diagnoses of sCAP. The aim was to determine any structural cardiac damage detected by advanced imagining techniques (cardiac MRI) and cardiac biomarkers in patients with sCAP. The patients were stratified, according to their etiology, into pneumococcal or not-pneumococcal sCAP. The primary outcome was cardiac damage at day 5 and 7 of clinical presentation. Results: A total of 23 patients were consecutively and prospectively enrolled for two winter periods. No significant differences were observed between the median troponin when comparing the pneumococcal vs. non-pneumococcal. The incidence of myocardial damage was numerically higher in the pneumococcal subgroup (70% vs. 50%, p = 0.61) on day 5 and on day 7 (53% vs. 40%, p = 0.81) but did not achieve significance. Confirming a correlation between the biomarkers of cell damage and the biomarkers of myocardial damage, only a positive and significant correlation was observed between h-FABP and DNA on day 1 (r = 0.74; p < 0.01) and day 3 (r = 0.83; p < 0.010). Twenty cardiac MRIs were performed on the 23 patients (87%). No presence of fibrosis was observed in any of the studies carried out within the first 15 days of admission. Conclusions: No significant myocardial damage was found in patients with sCAP independent of the bacterial etiology in accordance with biomarker alterations (Troponin and/or h-FABP) or cardiac MRI. Using cardiac MRI, we could not find any presence of myocardial fibrosis within the first 15 days of admission.

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“…To achieve this purpose, cine steady-state free procession (SSFP) sequences, T1-weighted and T2-weighted black-blook (T1-BB and T2-BB) sequences, T1 and T2 mapping, and late gadolinium enhancement (LGE) sequences are used. Identifying these alterations is essential for the diagnosis, prognosis, and management of major cardiac pathologies such as ischemic heart disease, non-ischemic cardiomyopathies, and myocarditis [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Cardiac Magnetic Resonance and Cardiac Implantable Electronic Devices: Are They Truly Still “Enemies”?

Fogante,

Volpato,

Esposto Pirani

et al. 2024

Medicina

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The application of cardiac magnetic resonance (CMR) imaging in clinical practice has grown due to technological advancements and expanded clinical indications, highlighting its superior capabilities when compared to echocardiography for the assessment of myocardial tissue. Similarly, the utilization of implantable cardiac electronic devices (CIEDs) has significantly increased in cardiac arrhythmia management, and the requirements of CMR examinations in patients with CIEDs has become more common. However, this type of exam often presents challenges due to safety concerns and image artifacts. Until a few years ago, the presence of CIED was considered an absolute contraindication to CMR. To address these challenges, various technical improvements in CIED technology, like the reduction of the ferromagnetic components, and in CMR examinations, such as the introduction of new sequences, have been developed. Moreover, a rigorous protocol involving multidisciplinary collaboration is recommended for safe CMR examinations in patients with CIEDs, emphasizing risk assessment, careful monitoring during CMR, and post-scan device evaluation. Alternative methods to CMR, such as computed tomography coronary angiography with tissue characterization techniques like dual-energy and photon-counting, offer alternative potential solutions, although their diagnostic accuracy and availability do limit their use. Despite technological advancements, close collaboration and specialized staff training remain crucial for obtaining safe diagnostic CMR images in patients with CIEDs, thus justifying the presence of specialized centers that are equipped to handle these type of exams.

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Imaging Methods: Magnetic Resonance Imaging

Cited by 13 publications

References 106 publications

Prognostic Utility of Cardiovascular Magnetic Resonance–Based Phenotyping in Patients With Muscular Dystrophy

Prognostic Utility of Cardiovascular Magnetic Resonance–Based Phenotyping in Patients With Muscular Dystrophy

A Multicentric Observational Study to Determine Myocardial Injury in Severe Community-Acquired Pneumonia (sCAP)

Cardiac Magnetic Resonance and Cardiac Implantable Electronic Devices: Are They Truly Still “Enemies”?

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