The international journal of cardiovascular imaging
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Int J Cardiovasc Imaging · Oct 2014
Comparative StudyReproducibility of area at risk assessment in acute myocardial infarction by T1- and T2-mapping sequences in cardiac magnetic resonance imaging in comparison to Tc99m-sestamibi SPECT.
Area at risk (AAR) is an important parameter for the assessment of the salvage area after revascularization in acute myocardial infarction (AMI). By combining AAR assessment by T2-weighted imaging and scar quantification by late gadolinium enhancement imaging cardiovascular magnetic resonance (CMR) offers a promising alternative to the "classical" modality of Tc99m-sestamibi single photon emission tomography (SPECT). Current T2 weighted sequences for edema imaging in CMR are limited by low contrast to noise ratios and motion artifacts. ⋯ AAR assessed by SPECT measured 41.6 ± 20.7 %LV. Correlation analysis revealed best correlation with SPECT for T2-MAP at a T2-threshold of 60 ms (ms) (slope = 0.99, Pearson's r = 0.94), and for MOLLI at T1-threshold of 1,075 ms (slope 0.86, r = 0.91, Pearson's r = 0.45). For the assessment of AAR in AMI, the novel T2-mapping technique correlates best with SPECT size, T1-mapping with MOLLI and standard T2-weighted imaging showed similar good correlations.
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Int J Cardiovasc Imaging · Oct 2014
Evaluation of right ventricle functions and serotonin levels during headache attacks in migraine patients with aura.
Several studies suggested that headache attacks and its frequency were mainly responsible for increased cardiovascular (CV) disease and mortality in patients with migraine with aura (MWA). Elevated serotonin level has been found to play a role in migraine attacks. Serotonin was best studied within the CV system for its role in the development of pulmonary hypertension, which had negative impact on right ventricular (RV) functions. ⋯ Thirty-one patients (58.4 %) had low-frequency attack. Patients with high-frequency attacks had increased serotonin levels (p 0.040) and decreased RV-free-ST, RV-free-STR-S, RV-free-STR-E and RV-free-STR-E/A ratio values during HAP when compared to low-frequency group (p 0.026, p 0.029, p 0.037 and p 0.019 respectively). This study demonstrated that migraine attacks, especially at higher frequencies, could have negative impact on RV systolic functions in MWA patients.
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Int J Cardiovasc Imaging · Oct 2014
Prognostic significance of dilated inferior vena cava in advanced decompensated heart failure.
Dilated inferior vena cava (IVC) is prevalent among patients with heart failure (HF), but whether its presence predicts worsening renal function (WRF) or adverse outcomes is unclear. This cohort study analyzed patients with left ventricular ejection fraction <40 % and repeated hospitalizations (≥2 times) for HF between August 2009 and August 2011. The study endpoints were death and HF re-hospitalization. ⋯ In Cox regression model, the risk of combined end-points was increased in patients with aging, elevated blood urine nitrogen, IVC >21 mm, and WRF. When adjusted for confounding factors, IVC >21 mm [hazard ratio (HR) 3.73, 95 % confidence interval (CI) 1.66-8.34] and WRF (HR 2.68, 95 % CI 1.07-6.75) were significant predictors for adverse outcomes. In patients with advanced decompensated HF, dilated IVC (>21 mm) predicted the development of WRF and could be a predictor for adverse outcomes.
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Int J Cardiovasc Imaging · Oct 2014
Evaluation of global circumferential strain as prognostic marker after administration of β-blockers for dilated cardiomyopathy.
The use of β-blockers has improved the prognosis of dilated cardiomyopathy (DCM) and the appearance of left ventricular (LV) reverse remodeling is generally thought to result in a more favorable prognosis. While there are many prognostic predictors, not all of them are applicable to individual patients. Global circumferential strain (GCS) was identified as a powerful prognostic marker, which appears to be a better parameter than LV global function for patients with depressed left ventricular (LV) ejection fraction. ⋯ An important finding of multivariate logistic regression analysis was that GCS was the best independent predictor of LV reverse remodeling (OR 7.692; 95 % CI 2.292-25.82; p = 0.001). It should be noted that only 1.3 ± 0.4 min per patient was needed to analyze GCS. In conclusions, GCS could result in further improvements in predicting LV reverse remodeling after β-blocker administration, and have clinical implications for better management in daily clinical practice.
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Int J Cardiovasc Imaging · Oct 2014
Assessment of right ventricular geometry and mechanics in chronic obstructive pulmonary disease patients living at high altitude.
Degree of increase in pulmonary artery pressure (PAP) and adaptive responses in right ventricular morphology and mechanics play an important role in the prognosis of chronic obstructive pulmonary disease (COPD) patients. Three dimensional echocardiography and deformation imaging are recent advancements in echocardiography that allow more through assessment of right ventricle. We aimed to investigate right ventricular geometry and mechanics in a stable COPD population living at moderately high altitude. ⋯ Only mean PAP and body surface area were found as independent predictors for 6MWT distance. Increased PAP and reduced right ventricular contractility were found in COPD patients living at moderately high altitude, although right ventricular volumes were normal. Similar findings can be expected in other COPD patients with high PAP, since these findings probably represents the effect of increased PAP on right ventricular mechanics.