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Cardiac magnetic resonance imaging:Which information is useful for the arrhythmologist?

World Journal of Cardiology 2017年第10期9卷 773-786页

作者： Elia De Maria Annachiara Aldrovandi Ambra Borghi Letizia Modonesi Stefano Cappelli Cardiology Unit Ramazzini Hospital41012 Carpi(Modena)Italy

Cardiac magnetic resonance(CMR) is a non-invasive,nonionizing,diagnostic technique that uses magnetic fields,radio waves and field gradients to generate images with high spatial and temporal resolution.After administration of contrast media(e.g.,gadolinium chelate),it is also possible to acquire late images,which make possible the identification and quantification of myocardial areas with scar/fibrosis(late gadolinium enhancement,LGE).CMR is currently a useful instrument in clinical cardiovascular practice for the assessment of several pathological conditions,including ischemic and nonischemic cardiomyopathies and congenital heart disease.In recent years,its field of application has also extended to arrhythmology,both in diagnostic and prognostic evaluation of arrhythmic risk and in therapeutic decisionmaking.In this review,we discuss the possible useful applications of CMR for the arrhythmologist.It is possible to identify three main fields of application of CMR in this context:(1) arrhythmic and sudden cardiac death risk stratification in different heart diseases;(2) decisionmaking in cardiac resynchronization therapy device implantation,presence and extent of myocardial fibrosis for left ventricular lead placement and cardiac venous anatomy; and(3) substrate identification for guiding ablation of complex arrhythmias(atrial fibrillation and ventricular tachycardias).

关键词：心脏的磁性的回声脱离突然的心脏的死亡心脏的再同步治疗没有节奏的风险层化

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Patient selection for transcatheter aortic valve replacement:A combined clinical and multimodality imaging approach

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World Journal of Cardiology 2017年第3期9卷 212-229页

作者： Rosangela Cocchia Antonello D’Andrea Marianna Conte Massimo Cavallaro Lucia Riegler Rodolfo Citro Cesare Sirignano Massimo Imbriaco Maurizio Cappelli Giovanni Gregorio Raffaele Calabrò Eduardo Bossone Department of Cardiology and Cardiac Surgery San Giovanni di Dio Hospital00733 SalernItaly Integrated Diagnostic Cardiology Second University of NaplesAORN“dei Colli”Monaldi Hospital80121 NaplesItaly Institute of Biostructure and Bioimaging National Research Council 80121 NaplesItaly Department of Advanced Biomedical Sciences University Federico II80121 NaplesItaly Department of Cardiology San Luca HospitalVallo della Lucania00733 SalernItaly

Transcatheter aortic valve replacement(TAVR) has been validated as a new therapy for patients affected by severe symptomatic aortic stenosis who are not eligible for surgical intervention because of major contraindication or high operative risk. Patient selection for TAVR should be based not only on accurate assessment of aortic stenosis morphology, but also on several clinical and functional data. Multi-Imaging modalities should be preferred for assessing the anatomy and the dimensions of the aortic valve and annulus before TAVR. Ultrasounds represent the first line tool in evaluation of this patients giving detailed anatomic description of aortic valve complex and allowing estimating with enough reliability the hemodynamic entity of valvular stenosis. Angiography should be used to assess coronary involvement and plan a revascularization strategy before the implant. Multislice computed tomography play a central role as it can give anatomical details in order to choice the best fitting prosthesis, evaluate the morphology of the access path and detect other relevant comorbidities. Cardiovascular magnetic resonance and positron emission tomography are emergent modality helpful in aortic stenosis evaluation. The aim of this review is to give an overview onTAVR clinical and technical aspects essential for adequate selection.

关键词：大动脉的狭窄 Doppler echocardiography 心脏的计算断层摄影术二维的紧张三维的 echocardiography 心脏的磁性的回声 Transcatheter 大动脉的阀门代替

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Clinical applications of feature-tracking cardiac magnetic resonance imaging

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World Journal of Cardiology 2018年第11期10卷 210-221页

作者： Daniele Muser Simon A Castro Pasquale Santangeli Gaetano Nucifora Cardiovascular Division Hospital of the University of Pennsylvania Philadelphia PA 19104 United States Cardiothoracic Department University Hospital of Udine Udine 33100 Italy NorthWest Cardiac Imaging Centre Wythenshawe Hospital Manchester University NHS Foundation Trust Manchester M23 9LT United Kingdom Flinders University Bedford Park Adelaide 5042 South Australia Australia

Cardiovascular diseases represent the leading cause of mortality and morbidity in the western world. Assessment of cardiac function is pivotal for early diag-nosis of primitive myocardial disorders, identification of cardiac involvement in systemic diseases, detection of drug-related cardiac toxicity as well as risk stratification and monitor of treatment effects in patients with heart failure of various etiology. Determination of ejection fraction with different imaging modalities currently represents the gold standard for evaluation of cardiac function. However, in the last few years, cardiovascular magnetic resonance feature tracking techniques has emerged as a more accurate tool for quantitative evalu-ation of cardiovascular function with several parameters including strain, strain-rate, torsion and mechanical dispersion. This imaging modality allows precise quantification of ventricular and atrial mechanics by directly evaluating myocardial fiber deformation. The purpose of this article is to review the basic principles, current clinical applications and future perspectives of cardiovascular magnetic resonance myocardial feature tracking, highlighting its prognostic implications.

关键词：左室的喷射部分心脏的磁性的回声心血管的疾病种类追踪特征

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Cutting edge clinical applications in cardiovascular magnetic resonance

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World Journal of Radiology 2017年第1期9卷 1-4页

作者： Carlo N De Cecco Giuseppe Muscogiuri Akos Varga-Szemes U Joseph Schoepf Department of Radiology and Radiological Science Medical University of South Carolina Department of Imaging Bambino Gesù-Children’s Hospital IRCCS Department of Clinical and Molecular Medicine University of Rome 'Sapienza' Division of Cardiology Department of MedicineMedical University of South Carolina

Today, the use of cardiovascular magnetic resonance(CMR) is widespread in clinical practice. The increased need to evaluate of subtle myocardial changes, coronary artery anatomy, and hemodynamic assessment has prompted the development of novel CMR techniques including T1 and T2 mapping, non-contrast angiography and four dimensional(4D) flow. T1 mapping is suitable for diagnosing pathologies affecting extracellular volume such as myocarditis, diffuse myocardial fibrosis and amyloidosis, and is a promising diagnostic tool for patients with iron overload and Fabry disease. T2 mapping is useful in depicting acute myocardial edema and estimating the amount of salvageable myocardium following an ischemic event. Novel angiography techniques, such as the selfnavigated whole-heart or the quiescent-interval singleshot sequence, enable the visualization of the great vessels and coronary artery anatomy without the use of contrast material. The 4D flow technique overcomes the limitations of standard phase-contrast imaging and allows for the assessment of cardiovascular hemodynamics in the great arteries and flow patterns in the cardiac chambers. In conclusion, the future of CMR is heading toward a more reliable quantitative assessment of the myocardium, an improved non-contrast visualization of the coronary artery anatomy, and a more accurate evaluation of the cardiac hemodynamics.

关键词：心脏的磁性的回声印射的 T1 磁性的回声 angiography 印射的 T2 四维的流动

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