Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
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J Cardiovasc Magn Reson · Dec 2014
Right ventricular adaptation to pulmonary pressure load in patients with chronic thromboembolic pulmonary hypertension before and after successful pulmonary endarterectomy--a cardiovascular magnetic resonance study.
The aim of the study was to characterize RV adaptation to varying loading conditions in patients with chronic thromboembolic hypertension (CTEPH) before and after pulmonary endarterectomy (PEA). Nearly 4% of patients with pulmonary embolism develop CTEPH. PEA offers a cure with excellent outcome. By use of cardiovascular magnetic resonance (CMR) combined with hemodynamic measurements pulmonary arterial elastance (Ea-pulm_i), end-systolic right ventricular elastance (Ees-RV_i) and ventriculo-arterial coupling (Ea-pulm_i/Ees-RV_i) can be studied before and after PEA. ⋯ RV function is largely determined by afterload and returns to normal once afterload is normalized. This is paralleled by a significant improvement of CMR indices of right ventricular remodelling.
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J Cardiovasc Magn Reson · Oct 2014
Dual echo positive contrast bSSFP for real-time visualization of passive devices during magnetic resonance guided cardiovascular catheterization.
Cardiovascular magnetic resonance (CMR) guided cardiovascular catheterizations can potentially reduce ionizing radiation exposure and enable new interventions. Commercially available paramagnetic X-Ray devices create a small signal void in CMR images, which is ambiguous and insufficient to guide catheterization procedures. This work aims to improve real-time CMR of off-the-shelf X-Ray devices by developing a real-time positive contrast sequence with color overlay of the device onto anatomy. ⋯ The ability to effectively visualize commercially available X-Ray devices during CMR-guided cardiovascular catheterizations, combined with safe low-SAR pulse sequences, could potentially expedite the clinical translation of interventional CMR.
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J Cardiovasc Magn Reson · Oct 2014
Prediction of long-term segmental and global functional recovery of hibernating myocardium after revascularisation based on low dose dobutamine and late gadolinium enhancement cardiovascular magnetic resonance.
This study sought to evaluate the relation between long-term segmental and global functional outcome after revascularisation in patients with chronic ischaemic left ventricular dysfunction (LVD) and baseline markers of viability: late gadolinium enhancement (LGE) transmurality and contractile reserve (CR). ⋯ In patients with chronic ischaemic LVD, improvement of dysfunctional but viable myocardium can be considerably delayed. Both the likelihood and the time course of functional improvement are related to the LGE, CR and the degree of contractile dysfunction at baseline. At 35 ± 6 months after revascularisation, patients with ≥55% of viable segments from all dysfunctional and revascularised segments significantly improve LVEF and experience reverse LV remodelling. A combination of LDD-CMR and LGE-CMR is a simple and powerful tool for identifying which patients with impaired LV function will benefit from revascularisation.
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J Cardiovasc Magn Reson · Sep 2014
Comparative StudyHigh resolution 3D diffusion cardiovascular magnetic resonance of carotid vessel wall to detect lipid core without contrast media.
Without the need of contrast media, diffusion-weighted imaging (DWI) has shown great promise for accurate detection of lipid-rich necrotic core (LRNC), a well-known feature of vulnerable plaques. However, limited resolution and poor image quality in vivo with conventional single-shot diffusion-weighted echo planar imaging (SS-DWEPI) has hindered its clinical application. The aim of this work is to develop a diffusion-prepared turbo-spin-echo (DP-TSE) technique for carotid plaque characterization with 3D high resolution and improved image quality. ⋯ Diffusion-prepared CMR allows, for the first time, 3D DWI of the carotid arterial wall in vivo with high spatial resolution and improved image quality over SS-DWEPI. It can potentially detect LRNC without the use of contrast agents, allowing plaque characterization in patients with renal insufficiency.
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J Cardiovasc Magn Reson · Aug 2014
Quantification of left atrial strain and strain rate using Cardiovascular Magnetic Resonance myocardial feature tracking: a feasibility study.
Cardiovascular Magnetic Resonance myocardial feature tracking (CMR-FT) is a quantitative technique tracking tissue voxel motion on standard steady-state free precession (SSFP) cine images to assess ventricular myocardial deformation. The importance of left atrial (LA) deformation assessment is increasingly recognized and can be assessed with echocardiographic speckle tracking. However atrial deformation quantification has never previously been demonstrated with CMR. We sought to determine the feasibility and reproducibility of CMR-FT for quantitative derivation of LA strain and strain rate (SR) myocardial mechanics. ⋯ CMR-FT based atrial performance analysis reliably quantifies LA longitudinal strain and SR from standard SSFP cine images and discriminates between patients with impaired left ventricular relaxation and healthy controls. CMR-FT derived atrial deformation quantification seems a promising novel approach for the study of atrial performance and physiology in health and disease states.