Use of Cardiac Magnetic Resonance and Echocardiography in Population-Based Studies

Marwick, Thomas H.; Neubauer, Stefan; Petersen, Steffen E.

doi:10.1161/circimaging.113.000498

Cited by 34 publications

(31 citation statements)

References 52 publications

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“…Similar to transthoracic echocardiography (TTE), cMRI is non-invasive, but offers higher resolution, more precise measurements, and greater reproducibility than TTE. 38 , 39 In clinical practice, tricuspid annular plane systolic excursion, right ventricular fractional area change, systolic velocity, and RV global strain are recommended in follow-up visits for patients with PAH. Although optimal timing is currently unknown, structural changes to the heart can be observed using cMRI or TTE within 4–6 months.…”

Section: Discussionmentioning

confidence: 99%

Bosentan‐based, treat‐to‐target therapy in patients with pulmonary arterial hypertension: results from the COMPASS‐3 study

et al. 2018

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The phase 4 COMPASS-3 study evaluated whether a singular endpoint produces clinically meaningful outcomes in patients with pulmonary arterial hypertension (PAH). The relationship between cardiac magnetic resonance imaging (cMRI)-derived parameters and right heart catheterization (RHC) measurements was also examined. In COMPASS-3 (ClinicalTrials.gov NCT00433329), 100 patients with PAH received bosentan monotherapy for 16 weeks. Patients continued monotherapy if their 6-min walk distance (6MWD) was !380 m, or otherwise received add-on sildenafil for an additional 12 weeks. 6MWD, RHC, and cMRI were performed at baseline, week 16, and week 28 (6MWD and cMRI). Baseline median 6MWD was 274 m and 82% of patients had WHO Functional Class III/IV. At week 16, 17% (n ¼ 16) of remaining patients achieved the 6MWD threshold and 78 (83%) did not. In the intention-to-treat population, median 6MWD increased significantly relative to baseline (week 16 ¼ 308 m; week 28 ¼ 327 m; P < 0.001). At week 28, 9/16 (monotherapy) and 15/76 (20%; add-on sildenafil) patients met the target threshold. Baseline cMRI-derived and RHC-derived parameters showed moderate-to-strong correlations (e.g. right to left ventricular end-diastolic ratio [RVEDV:LVEDV] correlated strongly with pulmonary vascular resistance [r ¼ þ0.729, P < 0.0001]). cMRI-derived parameters predicted clinical worsening/decline (e.g. week 16 RVEDV:LVDEV [P ¼ 0.0172]). Time to clinical worsening/decline did not differ between patients based on 6MWD threshold achievement. No unexpected safety events were reported. A substantial proportion of patients failed to achieve the goal of 380 m, regardless of treatment. Several cMRI parameters predicted clinical worsening/ decline and its non-invasive nature further supports its use in future clinical trials.

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Section: Discussionmentioning

confidence: 99%

Bosentan‐based, treat‐to‐target therapy in patients with pulmonary arterial hypertension: results from the COMPASS‐3 study

et al. 2018

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“…Imaging with novel techniques can reduce follow-up times. Presently surrogate endpoints for HF outcomes are unreliable or lacking [ 214 ]. Novel surrogates of CR will take time to secure a front line role in clinical trials.…”

Section: Novel Imaging and Clinical Trialsmentioning

confidence: 99%

Cardiac Imaging in Heart Failure with Comorbidities

Wong¹,

Chen²,

Iyngkaran

2016

CCR

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Imaging modalities stand at the frontiers for progress in congestive heart failure (CHF) screening, risk stratification and monitoring. Advancements in echocardiography (ECHO) and Magnetic Resonance Imaging (MRI) have allowed for improved tissue characterizations, cardiac motion analysis, and cardiac performance analysis under stress. Common cardiac comorbidities such as hypertension, metabolic syndromes and chronic renal failure contribute to cardiac remodeling, sharing similar pathophysiological mechanisms starting with interstitial changes, structural changes and finally clinical CHF. These imaging techniques can potentially detect changes earlier. Such information could have clinical benefits for screening, planning preventive therapies and risk stratifying patients. Imaging reports have often focused on traditional measures without factoring these novel parameters. This review is aimed at providing a synopsis on how we can use this information to assess and monitor improvements for CHF with comorbidities.

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“…While CMR is not as widely used as echocardiograms, its utility is rapidly growing in cardiac research studies as an attractive modality. CMR is more reproducible than echocardiography (29), and CMR has been shown to be superior to echocardiography to identify cardiotoxicity in cancer survivors (30). Furthermore, CMR is not affected by acoustic window or geometric assumptions, and it is less dependent upon operator skills than echocardiography.…”

Section: Introductionmentioning

confidence: 99%

A Pilot Study of Cardiac MRI in Breast Cancer Survivors After Cardiotoxic Chemotherapy and Three-Dimensional Conformal Radiotherapy

et al. 2020

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Purpose/Objectives: Node-positive breast cancer patients often receive chemotherapy and regional nodal irradiation. The cardiotoxic effects of these treatments, however, may offset some of the survival benefit. Cardiac magnetic resonance (CMR) is an emerging modality to assess cardiac injury. This is a pilot trial assessing cardiac damage using CMR in patients who received anthracycline-based chemotherapy and three-dimensional conformal radiotherapy (3DCRT) regional nodal irradiation using heart constraints. Materials and Methods: Node-positive breast cancer patients (2000-2008) treated with anthracycline-based chemotherapy and 3DCRT regional nodal irradiation (including the internal mammary chain nodes) with heart ventricular constraints (V25 < 10%) were invited to participate. Cardiac tissues were contoured and analyzed separately for whole heart (pericardium) and for combined ventricles and left atrium (myocardium). CMR obtained ventricular function/dimensions, late gadolinium enhancement (LGE), global longitudinal strain (GLS), and extracellular volume fraction (ECV) as measures of cardiac injury and/or early fibrosis. CMR parameters were correlated with dose-volume constraints using Spearman correlations. Results: Fifteen left-sided and five right-sided patients underwent CMR. Median diagnosis age was 50 (32-77). No patients had baseline cardiac disease before regional nodal irradiation. Median time after 3DCRT was 8.3 years (5.2-14.4). Median left-sided mean heart dose (MHD) was 4.8 Gy (1.1-11.2) and V25 was 5.7% (0-12%). Median left ventricular ejection fraction (LVEF) was 63%. No abnormal LGE was observed.

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Use of Cardiac Magnetic Resonance and Echocardiography in Population-Based Studies

Cited by 34 publications

References 52 publications

Bosentan‐based, treat‐to‐target therapy in patients with pulmonary arterial hypertension: results from the COMPASS‐3 study

Bosentan‐based, treat‐to‐target therapy in patients with pulmonary arterial hypertension: results from the COMPASS‐3 study

Cardiac Imaging in Heart Failure with Comorbidities

A Pilot Study of Cardiac MRI in Breast Cancer Survivors After Cardiotoxic Chemotherapy and Three-Dimensional Conformal Radiotherapy

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