The role of cardiovascular magnetic resonance in heart failure

Rajappan, Kim; Bellenger, Nicholas G.; Anderson, Lisa; Pennell, Dudley J.

doi:10.1016/s1388-9842(00)00096-9

Cited by 48 publications

(24 citation statements)

References 112 publications

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“…22 To the best of our knowledge, this study is the first comparison of the effects of single-pill antihypertensive combination therapies on LVH regression. Using highly reproducible CMR methodology, 23 we found significant reduction of LVMI by both A/B and HCTZ/B treatments, with a mean difference between treatment arms of 3.5 g/m 2 (4.5%) that fell short of the hypothesized difference of 8.0 g/m 2 and was not statistically significant. Previous studies have compared antihypertensive monotherapies to each other, to placebo, or to no treatment, mostly using echocardiography.…”

Section: Discussionmentioning

confidence: 68%

Magnetic Resonance Imaging Left Ventricular Mass Reduction With Fixed-Dose Angiotensin-Converting Enzyme Inhibitor–Based Regimens in Patients With High-Risk Hypertension

et al. 2009

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Section: Discussionmentioning

confidence: 68%

Magnetic Resonance Imaging Left Ventricular Mass Reduction With Fixed-Dose Angiotensin-Converting Enzyme Inhibitor–Based Regimens in Patients With High-Risk Hypertension

et al. 2009

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“…We have assessed cardiac function using MRI and tagging. [5][6][7] MRI provides a "1-shop" method for assessing not only cardiac morphology and function but also epicardial and visceral fat mass during the same session. MRI tagging, which directly measures intramural circumferential myocardial shortening, is a highly accurate method for direct quantification of regional systolic function, allowing one to reveal small, otherwise undetectable functional abnormalities of the myocardium.…”

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confidence: 99%

Early Hypertension Is Associated With Reduced Regional Cardiac Function, Insulin Resistance, Epicardial, and Visceral Fat

et al. 2008

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Abstract-Mild-to-moderate hypertension is often associated with insulin resistance and visceral adiposity. Whether these metabolic abnormalities have an independent impact on regional cardiac function is not known. The goal of this study was to investigate the effects of increased blood pressure, insulin resistance, and ectopic fat accumulation on the changes in peak systolic circumferential strain. Thirty-five male subjects (age: 47Ϯ1 years; body mass index: 28.4Ϯ0.6 kg . m Ϫ2 ; meanϮSEM) included 13 with normal blood pressure (BP: 113Ϯ5/67Ϯ2 mm Hg), 13 with prehypertension (BP: 130Ϯ1/76Ϯ2 mm Hg), and 9 newly diagnosed with essential hypertension (BP: 150Ϯ2/94Ϯ2 mm Hg) who underwent cardiac magnetic resonance tissue tagging (MRI) and MRI quantitation of abdominal visceral and epicardial fat. Glucose tolerance, on oral glucose tolerance test, and insulin resistance were assessed along with the serum lipid profile. All of the subjects had normal glucose tolerance, left-and right-ventricular volumes, and ejection fraction. Across the BP groups, left ventricular mass tended to increase, and circumferential shortening was progressively reduced at basal, midheart, and apical segments (on average, from Ϫ17.0Ϯ0.5% in normal blood pressure to Ϫ15.2Ϯ0.7% in prehypertension to Ϫ13.6Ϯ0.8% in those newly diagnosed with essential hypertension; Pϭ0.004). Reduced circumferential strain was significantly associated with raised BP independent of age (rϭ0.41; Pϭ0.01) and with epicardial and visceral fat, serum triglycerides, and insulin resistance independent of age and BP. In conclusion, regional left ventricular function is already reduced at the early stages of hypertension despite the normal global cardiac function. Insulin resistance, dyslipidemia, and ectopic fat accumulation are associated with reduced regional systolic function. T he mechanisms of cardiovascular damage in hypertension are still partially unclear; in particular, it is not known what role the metabolic changes frequently associated with high blood pressure (ie, insulin resistance, dyslipidemia, glucose intolerance, and ectopic fat accumulation) may play. Mild increases in blood pressure are recognized as a risk factor for myocardial infarction and coronary artery disease. 1 For this reason, in 2003, the Joint National Committee on High Blood Pressure identified "prehypertension" as a new category of blood pressure in adults 2 : prehypertensive (pre-HT) individuals carry a higher risk (Յ3-fold) of developing hypertension and cardiovascular disease in comparison with normotensive (NT) subjects. 3 We have shown recently that ectopic fat accumulation in visceral and epicardial areas is a characteristic feature of essential hypertension 4 ; the consequences, however, for cardiac morphology and function have not been investigated. We have assessed cardiac function using MRI and tagging. [5][6][7] MRI provides a "1-shop" method for assessing not only cardiac morphology and function but also epicardial and visceral fat mass during the same session. MRI tagging, whi...

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“…Clinical decisions (i.e., medical vs. interventional therapy) frequently rely on being able to differentiate reversible from irreversible or acute from chronic myocardial injury and knowing the extent of myocardial injury (14), so that unnecessary invasive procedures may be prevented. Currently, myocardial injury characterization by MRI is most commonly performed using T2-weighted and contrast-enhanced imaging (15), where substantial differences be- It also requires extended imaging times and is restricted in its accuracy for precise quantification of myocardial scar tissue.…”

Section: Discussionmentioning

confidence: 99%

Quantitative evaluation of ischemic myocardial scar tissue by unenhanced T1 mapping using 3.0 Tesla MR scanner

Okur

Kantarcı

Kizrak³

et al. 2014

Diagn Interv Radiol

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Original Article PURPOSE We aimed to use a noninvasive method for quantifying T1 values of chronic myocardial infarction scar by cardiac magnetic resonance imaging (MRI), and determine its diagnostic performance. MATERIALS AND METHODSWe performed cardiac MRI on 29 consecutive patients with known coronary artery disease (CAD) on 3.0 Tesla MRI scanner. An unenhanced T1 mapping technique was used to calculate T1 relaxation time of myocardial scar tissue, and its diagnostic performance was evaluated. Chronic scar tissue was identified by delayed contrast-enhancement (DE) MRI and T2-weighted images. Sensitivity, specificity, and accuracy values were calculated for T1 mapping using DE images as the gold standard. RESULTSFour hundred and forty-two segments were analyzed in 26 patients. While myocardial chronic scar was demonstrated in 45 segments on DE images, T1 mapping MRI showed a chronic scar area in 54 segments. T1 relaxation time was higher in chronic scar tissue, compared with remote areas (1314±98 ms vs. 1099±90 ms, P < 0.001). Therefore, increased T1 values were shown in areas of myocardium colocalized with areas of DE and normal signal on T2-weighted images. There was a significant correlation between T1 mapping and DE images in evaluation of myocardial wall injury extent (P < 0.05). We calculated sensitivity, specificity, and accuracy as 95.5%, 97%, and 96%, respectively. CONCLUSIONThe results of the present study reveal that T1 mapping MRI combined with T2-weighted images might be a feasible imaging modality for detecting chronic myocardial infarction scar tissue.

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The role of cardiovascular magnetic resonance in heart failure

Cited by 48 publications

References 112 publications

Magnetic Resonance Imaging Left Ventricular Mass Reduction With Fixed-Dose Angiotensin-Converting Enzyme Inhibitor–Based Regimens in Patients With High-Risk Hypertension

Magnetic Resonance Imaging Left Ventricular Mass Reduction With Fixed-Dose Angiotensin-Converting Enzyme Inhibitor–Based Regimens in Patients With High-Risk Hypertension

Early Hypertension Is Associated With Reduced Regional Cardiac Function, Insulin Resistance, Epicardial, and Visceral Fat

Quantitative evaluation of ischemic myocardial scar tissue by unenhanced T1 mapping using 3.0 Tesla MR scanner

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