The international journal of cardiovascular imaging
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Int J Cardiovasc Imaging · Apr 2011
Comparative StudyAssessment of left ventricular myocardial scar in infiltrative and non-ischemic cardiac diseases by free breathing three dimensional phase sensitive inversion recovery (PSIR) TurboFLASH.
The purpose of this study was to compare a navigator gated free breathing 3D Phase Sensitive Inversion Recovery (PSIR) TurboFLASH to an established 2D PSIR TurboFLASH method for detecting myocardial late gadolinium hyperenhanced lesions caused by infiltrative and non-ischemic cardiomyopathy. Under an IRB approved protocol; patients with suspected non-ischemic infiltrative myocardial heart disease were examined on a 1.5T MR scanner for late enhancement after the administration of gadolinium using a segmented 2D PSIR TurboFLASH sequence followed by a navigator-gated 3D PSIR TurboFLASH sequence. Two independent readers analyzed image quality using a four point Likert scale for qualitative analysis (0 = poor, non diagnostic; 1 = fair, diagnostic may be impaired; 2 = good, some artifacts but not interfering in diagnostics, 3 = excellent, no artifacts) and also reported presence or absence of scar. ⋯ Larger numbers of hyperenhanced scars were detected with 3D PSIR (200) compared to 2D PSIR (167) and scar volume were significant larger in 3D PSIR (p = 0.004). The mean scar volume over all cases was 49.95 cm(3) for 2D PSIR and 70.02 cm(3) for 3D PSIR. The navigator gated free breathing 3D PSIR approach is a suitable method for detecting myocardial late gadolinium hyperenhanced lesions caused by non-ischemic cardiomyopathy due to its complete isotropic coverage of the left ventricle, improving detection of scar lesions compared to 2D PSIR imaging.
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Int J Cardiovasc Imaging · Apr 2011
Occlusion of Fontan fenestrations using Amplatzer septal occluder.
The objective of the study is to assess efficacy and safety of the Amplatzer septal device for percutaneous occlusion of Fontan fenestration. Fenestration improves postoperative outcomes in children undergoing Fontan repair. Many of these fenestrations close spontaneously; persistent fenestrations ultimately cause desaturation and can be a potential cause of paradoxical embolism. ⋯ The Amplatzer septal occluder device is effective in closing both Fontan fenestrations. Longer single or dual anti-platelet therapy may be considered to prevent thrombotic events. Long-term outpatients follow up with transthoracic echocardiographic monitoring for systemic venous congestion or thrombosis is warranted.
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Int J Cardiovasc Imaging · Apr 2011
Midregional pro-atrial natriuretic peptide: a novel marker of myocardial fibrosis in patients with hypertrophic cardiomyopathy.
We aimed to determine the diagnostic performance of biomarkers in predicting myocardial fibrosis assessed by late gadolinium enhancement (LGE) cardiovascular magnetic resonance imaging (CMR) in patients with hypertrophic cardiomyopathy (HCM). LGE CMR was performed in 40 consecutive patients with HCM. Left and right ventricular parameters, as well as the extent of LGE were determined and correlated to the plasma levels of midregional pro-atrial natriuretic peptide (MR-proANP), midregional pro-adrenomedullin (MR-proADM), carboxy-terminal pro-endothelin-1 (CT-proET-1), carboxy-terminal pro-vasopressin (CT-proAVP), matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1) and interleukin-8 (IL-8). ⋯ The odds ratio was 1.268 (95% confidence interval 1.066-1.508). The sensitivity of MR-proANP at a cut-off value of 207 pmol/L was 69%, the specificity 94%, the positive predictive value 90% and the negative predictive value 80%. The results imply that MR-proANP serves as a novel marker of myocardial fibrosis assessed by LGE CMR in patients with HCM.