The Prognostic Impact of Myocardial Late Gadolinium Enhancement

Panovský, Roman; Pleva, Martin; Feitová, Věra; Kružliak, Peter; Meluzı́n, Jaroslav; Kincl, Vladimír

doi:10.1097/crd.0000000000000002

Cited by 6 publications

(3 citation statements)

References 143 publications

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“…It is also used to assess repeatedly the stage and progression of cardiac diseases and to monitor the effect of treatment. Cardiovascular magnetic resonance using late gadolinium enhancement (LGE) provides assessment of myocardial tissue in vivo [ 299 ]. Takayasu arteritis (TA) is a chronic granulomatous vasculitis of autoimmune etiology characterized by narrowing of aorta and its main branches.…”

Section: Imaging Biomarkersmentioning

confidence: 99%

Emerging Risk Biomarkers in Cardiovascular Diseases and Disorders

2015

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Present review article highlights various cardiovascular risk prediction biomarkers by incorporating both traditional risk factors to be used as diagnostic markers and recent technologically generated diagnostic and therapeutic markers. This paper explains traditional biomarkers such as lipid profile, glucose, and hormone level and physiological biomarkers based on measurement of levels of important biomolecules such as serum ferritin, triglyceride to HDLp (high density lipoproteins) ratio, lipophorin-cholesterol ratio, lipid-lipophorin ratio, LDL cholesterol level, HDLp and apolipoprotein levels, lipophorins and LTPs ratio, sphingolipids, Omega-3 Index, and ST2 level. In addition, immunohistochemical, oxidative stress, inflammatory, anatomical, imaging, genetic, and therapeutic biomarkers have been explained in detail with their investigational specifications. Many of these biomarkers, alone or in combination, can play important role in prediction of risks, its types, and status of morbidity. As emerging risks are found to be affiliated with minor and microlevel factors and its diagnosis at an earlier stage could find CVD, hence, there is an urgent need of new more authentic, appropriate, and reliable diagnostic and therapeutic markers to confirm disease well in time to start the clinical aid to the patients. Present review aims to discuss new emerging biomarkers that could facilitate more authentic and fast diagnosis of CVDs, HF (heart failures), and various lipid abnormalities and disorders in the future.

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Section: Imaging Biomarkersmentioning

confidence: 99%

Emerging Risk Biomarkers in Cardiovascular Diseases and Disorders

2015

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“…Oedema visualization and the late gadolinium enhancement (LGE) technique provide the unique opportunity to assess myocardial tissue in vivo – it enables tissue characterization in ischemic and non-ischemic cardiomyopathies and other cardiac diseases. All these advantages can help to refine the diagnostics of patients with unclear diagnoses [10]. …”

Section: Introductionmentioning

confidence: 99%

The unique value of cardiovascular magnetic resonance in patients with suspected acute coronary syndrome and culprit-free coronary angiograms

Panovský

Borová

Pleva

et al. 2017

BMC Cardiovasc Disord

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BackgroundPatients with chest pain, elevated troponin, and unobstructed coronary disease present a clinical dilemma. The purpose of this study was to investigate the incremental diagnostic value of cardiovascular magnetic resonance (CMR) in a cohort of patients with suspected acute coronary syndrome (ACS) and unobstructed coronary arteries.ResultsData files of patients meeting the inclusion criteria in two cardiology centres were searched and analysed. The inclusion criteria included: 1) thoracic pain suspected with ACS; 2) a significant increase in the high-sensitive Troponin T value; 3) ECG changes; 4) coronary arteries without any significant stenosis; 5) a CMR examination included in the diagnostic process; 6) an uncertain diagnosis before the CMR exam; and 7) the absence of known CMR and contrast media contraindications. Special attention was paid to the benefits of CMR in determining the final diagnosis.In total, 136 patients who underwent coronary angiography for chest pain were analysed. The most frequent underlying causes were myocarditis (38%) and perimyocarditis (18%), followed by angiographically unrecognised acute myocardial infarction (18%) and Takotsubo cardiomyopathy (15%). The final diagnosis remained unclear in 6% of the patients. The contribution of CMR in determining the final diagnosis determination was crucial in 57% of the patients. In another 35% of the patients, CMR confirmed the suspicion and, only 8% of the CMR examinations did not help at all and had no influence on diagnosis or treatment.ConclusionCMR provided a powerful incremental diagnostic value in the cohort of patients with suspected ACS and unobstructed coronary arteries. CMR is highly recommended to be incorporated as an inalienable part of the diagnostic algorithms in these patients.

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“…AAS abuse has been linked with numerous toxic and hormonal effects as well as structural changes in the myocardium ( 1 , 2 ). Late gadolinium enhanced cardiovascular magnetic resonance (CMR) is an excellent non-invasive imaging tool, which allows an in-vivo characterization of the myocardial tissue ( 3 ). We present the case of a 39-year-old bodybuilder with a longstanding abuse of AAS presenting with increasing exertional dyspnoea and fatigue and showing signs of left ventricular hypertrophy in the echocardiography.…”

Section: Introductionmentioning

confidence: 99%

Myocardial Scar Detected by Cardiovascular Magnetic Resonance in a Competitive Bodybuilder With Longstanding Abuse of Anabolic Steroids

et al. 2014

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Introduction:The self-administration intake of anabolic-androgenic steroids (AAS) is a widespread practice in competitive bodybuilders. Structural changes within the myocardium following AAS abuse including hypertrophy, restricted diastolic function as well as systolic dysfunction and impaired ventricular inflow have been reported.Case Presentation:We present the case of a 39-year-old bodybuilder with a more than 20-year history of anabolic-androgenic steroids (AAS) abuse presenting with increasing exertional dyspnoea and fatigue. Diagnostic work-up of the patient’s current symptoms included a cine cardiovascular magnetic resonance (CMR). Using a T1-weighted inversion-recovery sequence 10 minutes after application of 0.1 mmol/kg gadolinium with diethylenetriaminepentaacetic acid (gadolinium DTPA), patchy midwall enhancement in the septal and posterolateral region of the left ventricle was demonstrated. This enhancement pattern is different from the enhancement pattern found in patients with ischemic heart disease.Conclusions:The present case illustrates for the first time, by CMR, myocardial scarring with severe left ventricular hypertrophy in a patient with normal coronary arteries after long lasting abuse of AAS. With that finding we could demonstrate a link between AAS abuse and the occurrence of myocardial scarring in humans. This finding may help raise awareness of the consequences of AAS use.

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The Prognostic Impact of Myocardial Late Gadolinium Enhancement

Cited by 6 publications

References 143 publications

Emerging Risk Biomarkers in Cardiovascular Diseases and Disorders

Emerging Risk Biomarkers in Cardiovascular Diseases and Disorders

The unique value of cardiovascular magnetic resonance in patients with suspected acute coronary syndrome and culprit-free coronary angiograms

Myocardial Scar Detected by Cardiovascular Magnetic Resonance in a Competitive Bodybuilder With Longstanding Abuse of Anabolic Steroids

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