Improved diagnostic role of CMR in acute coronary syndromes and unobstructed coronary arteries: the importance of time-to-CMR

Singhal, Priyanka; Rodrigues, Jonathan; Ahmed, Nauman; Palazzuoli, Alberto; Townsend, Mandie; Nightingale, Angus K; Johnson, Tom; Strange, Julian; Baumbach, Andreas; Bucciarelli-Ducci, Chiara

doi:10.1186/1532-429x-17-s1-o87

Cited by 5 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These SA planes were then divided radially into six segments for the basal (1-6 segments) and mid-cavity (7-12 segments) slices, and four segments for the apical slice (13-16 segments), while the 17th segment is the apex itself. AHA segments were then grouped into anterior (segments n. 1, 7, 13), septal (segments n. 2, 3, 8, 9, 14), inferior (segments n. 4, 10, 15), lateral (segments n. 5,6,11,12,16), and apex (segment n. 17) [14,16,17].…”

Section: Cmr Analysismentioning

confidence: 99%

“…The clinical presentation of acute myocarditis (AM) is widely variable, ranging from a subclinical disease characterized by flu-like symptoms and atypical chest pain to an infarct-like syndrome with severe and/or recurring chest pain, electrocardiogram (ECG) pathologic changes, and elevated troponin (Tn) levels mimicking an acute myocardial infarction, or to fulminant heart failure, cardiogenic shock, and sudden death related to the new onset of arrhythmias and complete heart block [1][2][3]. In a small (7-15%) subgroup of patients presenting with an infarct-like syndrome, subsequent coronary angiography reveals normal or non-flow-limiting coronary artery disease [1][2][3][4][5][6][7][8][9]. These patients presenting with suspected acute coronary syndrome (ACS) and unobstructed coronary arteries pose a difficult clinical and diagnostic dilemma; therefore, cardiac magnetic resonance (CMR) may be particularly useful in determining the diagnosis [1][2][3][4][5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…In a small (7-15%) subgroup of patients presenting with an infarct-like syndrome, subsequent coronary angiography reveals normal or non-flow-limiting coronary artery disease [1][2][3][4][5][6][7][8][9]. These patients presenting with suspected acute coronary syndrome (ACS) and unobstructed coronary arteries pose a difficult clinical and diagnostic dilemma; therefore, cardiac magnetic resonance (CMR) may be particularly useful in determining the diagnosis [1][2][3][4][5][6][7][8][9][10][11]. CMR diagnostic criteria-original Lake Louise criteria (LLC)-for AM have been extensively validated in the literature and are commonly applied in clinical routines with high diagnostic accuracy and sensitivity [1,[10][11][12].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Infarct-like versus Non-Infarct-like Clinical Presentation of Acute Myocarditis: Comparison of Cardiac Magnetic Resonance (CMR) Findings

Capasso

Imperato

Serra³

et al. 2023

Diagnostics

View full text Add to dashboard Cite

Background: The clinical presentation of acute myocarditis (AM) is widely variable, ranging from a subclinical disease to an infarct-like syndrome. Cardiac magnetic resonance (CMR) has become the reference non-invasive diagnostic tool for suspected AM, allowing the identification of the various hallmarks of myocardial inflammation (edema, fibrosis, and hyperemia). The aim of the study was to investigate any differences in morphological, functional, and tissue characterization CMR parameters between infarct-like AM in patients with unobstructed coronary arteries and non-infarct-like AM, diagnosed according to the original Lake-Louise Criteria (LLC); Methods: We retrospectively selected 39 patients diagnosed with AM according to LLC, divided into 2 groups according to the clinical presentation: infarct-like in group 1 patients and non-infarct-like in group 2 patients. CMR morphologic, functional, and tissue characterization parameters were analyzed and compared. Results: In group 1, CMR tissue characterization parameters were mainly altereda in septal location with mesocardial myocardial involvement; in group 2, CMR tissue characterization parameters were mainly altered in a lateral location with subepicardial myocardial involvement mainly at the mid-cavity. No significant differences in morphological or functional parameters were observed between the two study groups. Conclusions: Our results showed differences in the localization and distribution of myocardial tissue damage assessed by CMR among forms of AM accompanied by an infarct-like clinical presentation compared with non-infarct-like presentations of AM. The mechanisms underlying the different preferential sites of damage observed in our study are not known, and we do not exclude the possibility of their prognostic implications.

show abstract

Section: Cmr Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Infarct-like versus Non-Infarct-like Clinical Presentation of Acute Myocarditis: Comparison of Cardiac Magnetic Resonance (CMR) Findings

Capasso

Imperato

Serra³

et al. 2023

Diagnostics

View full text Add to dashboard Cite

show abstract

“…One study showed that performing CMR imaging within 2 weeks allowed an underlying cause to be identified in a higher percentage of the study population than if CMR imaging was performed after 2 weeks (82% vs 54%, respectively). 13 While the Dutch ACS working group recommends CMR imaging within 4 weeks of presentation, 11 a stricter timeframe of performing CMR imaging within 1 week has been suggested by Ferreira et al 4 The local practice may depend on availability of imaging resources.…”

Section: Timing Of Cardiac Magnetic Resonance Imagingmentioning

confidence: 99%

Utility of cardiac magnetic resonance imaging in troponin-positive chest pain with non-obstructive coronary arteries: literature review

Lee

Chiang

et al. 2021

Hong Kong Med J

View full text Add to dashboard Cite

There is no general consensus on the investigation and subsequent management of patients presenting with acute chest pain and elevated cardiac troponin levels, but with non-obstructive coronary arteries on angiography. Recent technological advances in cardiac magnetic resonance imaging have aided in the understanding of the underlying pathophysiology, allowing accurate diagnosis, prognostic information, and guidance for management in these patients. This article reviews the evidence supporting the usefulness of cardiac magnetic resonance imaging in patients with acute chest pain and elevated cardiac troponin levels, but with non-obstructive coronary arteries, and offers insights into the role and future

show abstract

The Role of Cardiac MRI in Patients with Troponin-Positive Chest Pain and Unobstructed Coronary Arteries

Dastidar

Rodrigues

Ahmed

et al. 2015

Curr Cardiovasc Imaging Rep

Self Cite

View full text Add to dashboard Cite

Acute coronary syndrome (ACS) still remains one of the leading causes of mortality and morbidity worldwide. Seven to fifteen percent of patients presenting with ACS have unobstructed coronary artery disease (CAD) on urgent angiography. Patients with ACS and unobstructed coronary arteries represent a clinical dilemma and their diagnosis and management is quite variable in current practice. Cardiovascular magnetic resonance imaging with its unique non-invasive myocardial tissue characterization property has the potential to identify underlying etiologies and reach a final diagnosis. These include acute and chronic myocarditis, embolic/spontaneous recanalization myocardial infarction, and Tako-Tsubo cardiomyopathy, and other conditions. Establishing a final diagnosis has a direct implication on patient’s management and prognosis. In this article, we have reviewed the current evidence on the diagnostic role of cardiac magnetic resonance (CMR) in patients with ACS and unobstructed coronary arteries. We have also highlighted the potential role of CMR as a risk stratification or prognostication tool for this patient population.

show abstract

Improved diagnostic role of CMR in acute coronary syndromes and unobstructed coronary arteries: the importance of time-to-CMR

Cited by 5 publications

References 0 publications

Infarct-like versus Non-Infarct-like Clinical Presentation of Acute Myocarditis: Comparison of Cardiac Magnetic Resonance (CMR) Findings

Infarct-like versus Non-Infarct-like Clinical Presentation of Acute Myocarditis: Comparison of Cardiac Magnetic Resonance (CMR) Findings

Utility of cardiac magnetic resonance imaging in troponin-positive chest pain with non-obstructive coronary arteries: literature review

The Role of Cardiac MRI in Patients with Troponin-Positive Chest Pain and Unobstructed Coronary Arteries

Contact Info

Product

Resources

About