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

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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 *** 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 *** recent years,its field of application has also extended to arrhythmology,both in diagnostic and prognostic evaluation of arrhythmic risk and in therapeutic *** this review,we discuss the possible useful applications of CMR for the *** 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： cardiac magnetic resonance Ablation Sudden cardiac death cardiac resynchronization therapy Arrhythmic risk stratification

Value of cardiac magnetic resonance on the risk stratification of cardiomyopathies

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World Journal of Cardiology 2023年第10期15卷 487-499页

作者： Rafael Vidal-Perez Mariana Brandao Wael Zaher Ruben Casado-Arroyo Alberto Bouzas-Mosquera Ricardo Fontes-Carvalho Jose Manuel Vazquez-Rodriguez Servicio de Cardiologia Unidad de Imagen y Funcion CardiacaComplexo Hospitalario Universitario A Coruña Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares(CIBERCV)A Coruna 15006GaliciaSpain Department of Cardiology Centro Hospitalar de Vila Nova de Gaia/EspinhoVila Nova de Gaia 4434-502Portugal Department of Cardiology Hôpital ErasmeUniversite Libre de BruxellesBrussels 1070BrusselsBelgium Cardiovascular R&D Centre-UnIC@RISE Department of Surgery and PhysiologyFaculty of Medicine of the University of PortoPorto 4200-319Portugal Servicio de Cardiología Complexo Hospitalario Universitario A CoruñaA Coruña 15006A CoruñaSpain

Cardiomyopathies represent a diverse group of heart muscle diseases with varying etiologies,presenting a diagnostic challenge due to their heterogeneous *** evaluation using cardiac imaging techniques is impera-tive as symptoms can evolve over *** imaging approaches are pivotal for accurate diagnosis,treatment planning,and optimizing prognostic *** these,cardiovascular magnetic resonance(CMR)stands out for its ability to provide precise anatomical and functional *** manuscript ex-plores the significant contributions of CMR in the diagnosis and management of patients with cardiomyopathies,with special attention to risk ***’s high spatial resolution and tissue characterization capabilities enable early detec-tion and differentiation of various cardiomyopathy ***,it offers valuable insights into myocardial fibrosis,tissue viability,and left ven-tricular function,crucial parameters for risk stratification and predicting adverse cardiac *** integrating CMR into clinical practice,clinicians can tailor patient-specific treatment plans,implement timely interventions,and optimize long-term *** non-invasive nature of CMR reduces the need for invasive procedures,minimizing patient *** review highlights the vital role of CMR in monitoring disease progression,guiding treatment decisions,and identifying potential complications in patients with *** utilization of CMR has significantly advanced our understanding and management of these complex cardiac conditions,leading to improved patient outcomes and a more personalized approach to care.

关键词： cardiac magnetic resonance Cardiomyopathies Prognosis Dilated cardiomyopathy Hypertrophic cardiomyopathy Restrictive cardiomyopathy

Association of electrocardiographic markers with myocardial fibrosis as assessed by cardiac magnetic resonance in different clinical settings

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World Journal of Cardiology 2022年第9期14卷 483-495页

作者： George Bazoukis Sebastian Garcia-Zamora GökselÇinier Sharen Lee Enes Elvin Gul JesúsÁlvarez-García Gabi Miana Mertİlker Hayıroğlu Gary Tse Tong Liu Adrian Baranchuk Department of Cardiology Larnaca General HospitalLarnaca 6036Cyprus Department of Basic and Clinical Sciences University of Nicosia Medical SchoolNicosia 2414Cyprus Department of Cardiology Delta ClinicSanta Fe 341Argentina Department of Cardiology Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research CenterIstanbul 34668Turkey Cardiovascular Analytics Group Laboratory of Cardiovascular PhysiologyHong Kong 999077China Division of cardiac Electrophysiology Madinah Cardiac CentreMadinah 42351Saudi Arabia Department of Cardiology Ramon y Cajal University HospitalMadrid 28034Spain Telehealth Center of Hospital das Clínicas Hong Kong 999077China Kent and Medway Medical School CanterburyCanterbury CT27FSUnited Kingdom Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease Department of CardiologyTianjin Institute of CardiologySecond Hospital of TianjinTianjin Medical UniversityTianjin 300211China Department of Cardiology The Second Hospital of Tianjin Medical UniversityTianjin 300211China Department of Cardiology Queen's UniversityOntario K7L 3N6Canada

BACKGROUND cardiac magnetic resonance(CMR)is a unique tool for non-invasive tissue characterization,especially for identifying *** To present the existing data regarding the association of electrocardiographic(ECG)markers with myocardial fibrosis identified by CMR-late gadolinium enhancement(LGE).METHODS A systematic search was performed for identifying the relevant studies in Medline and Cochrane databases through February *** addition,we conducted a relevant search by Reference Citation Analysis(RCA)(https://***).RESULTS A total of 32 studies were *** hypertrophic cardiomyopathy(HCM),fragmented QRS(fQRS)is related to the presence and extent of myocardial *** and abnormal Q waves are associated with LGE in ischemic cardiomyopathy patients,while fQRS has also been related to fibrosis in *** score,abnormal Q waves,and notched QRS have also been associated with *** abnormalities as reflected by increased Tp-Te,negative Twaves,and higher QT dispersion are related to myocardial fibrosis in HCM *** patients with Duchenne muscular dystrophy,a significant correlation between fQRS and the amount of myocardial fibrosis as assessed by LGE-CMR was *** atrial fibrillation patients,advanced inter-atrial block is defined as P-wave duration≥120 ms,and biphasic morphology in inferior leads is related to left atrial *** Myocardial fibrosis,a reliable marker of prognosis in a broad spectrum of cardiovascular diseases,can be easily understood with an easily applicable ***,more data is needed on a specific disease basis to study the association of ECG markers and myocardial fibrosis as depicted by CMR.

关键词： Myocardial fibrosis Late gadolinium enhancement Electrocardiogram cardiac magnetic resonance

Associations of Infarct Size and Regional Myocardial Function Examined by cardiac magnetic resonance Feature Tracking Strain Analysis with the Infarct Location in Patients with Acute ST-Segment Elevation Myocardial Infarction

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Chinese Medical Sciences Journal 2022年第4期37卷 309-319页

作者： Jianing Cui Yanan Zhao Wei Wang Tao Li Department of Radiology The First Medical CenterChinese People’s Liberation Army General HospitalBeijing 100853China

Objective To quantitatively evaluate the associations of infarct size,regional myocardial function examined by cardiac magnetic resonance feature tracking(CMR-FT)strain analysis with infarct location in patients with ST-segment elevation myocardial infarction(STEMI)treated by primary percutaneous coronary *** cardiac magnetic resonance images were retrospectively analyzed in 95 consecutive STEMI patients with successful *** patients were divided into the anterior wall myocardial infarction(AWMI)and nonanterior wall myocardial infarction(NAWMI)*** characteristics were assessed by late gadolinium *** and regional strains and associated strain rates in the radial,circumferential and longitudinal directions were assessed by CMR-FT based on standard cine *** associations of infarct size,regional myocardial function examined by CMR-FT strain analysis with infarct location in STEMI patients were evaluated by the Spearman or *** There were 44 patients in the AWMI group and 51 in the NAWMI *** extent of left ventricular enhanced mass was significantly larger in patients with AWMI compared with the NAWMI group(24.47±11.89,21.06±12.08%LV;t=3.928,P=0.008).In infarct zone analysis,strains in the radial,circumferential and longitudinal directions were remarkably declined in the AWMI group compared with the NAWMI group(z=-20.873,-20.918,-10.357,all P<0.001).The volume(end-systolic volume index),total enhanced mass and extent of enhanced mass of the left ventricular were correlated best with infarct zone strain in the AWMI group(all P<0.001).Conclusion In STEMI patients treated by percutaneous coronary intervention,myocardial damage is more extensive and regional myocardial function in the infarct zone is lower in the AWMI group compared with the NAWMI group.

关键词： cardiac magnetic resonance acute myocardial infarction left ventricular tissue tracking myocardial strain

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： Left ventricular ejection fraction cardiac magnetic resonance Cardiovascular disease Strain Feature-tracking

Comparison of 2D and 4D Flow MRI Measurements for Hemodynamic Evaluation of the Fontan Palliation

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Congenital Heart Disease 2023年第6期18卷 627-638页

作者： Elisa Listo Nicola Martini Stefano Salvadori Elisa Valenti Nicola Stagnaro Gianluca Trocchio Chiara Marrone Alberto Clemente Francesca Raimondi Pierluigi Festa Lamia Ait Ali Department of Radiology IRCCS Istituto Giannina GasliniGenovaItaly U.O.C.Bioingegneria Gabriele Monasterio CNR-Tuscany FoundationPisaItaly Institute of Clinical Physiology CNR PisaItaly Cardiology Unit IRCCS Istituto Giannina GasliniGenovaItaly Pediatric Cardiology and GUCH Unit Massa Gabriele Monasterio CNR-Tuscany FoundationMassaItaly Gabriele Monasterio CNR-Tuscany Foundation PisaItaly Department of Cardiology Azienda Ospedaliero-Universitaria MeyerFlorenceItaly Institute of Clinical Physiology CNR MassaItaly

Background:The assessment of Fontan circuit’sﬂow is traditionally evaluated by multiple through-plane phase-contrast MRI acquisitions(2Dﬂow),while recently,a single volumetric 4D-ﬂow MRI acquisition is emerging as a comprehensive tool for the hemodynamic evaluation in congenital heart ***:To compare 2D and 4D-ﬂow MRI measurements in patients after Fontan palliation and to evaluate parameters affecting potential ***:39 patients after Fontan palliation(23 males,age 22±11 years)who underwent cardiac MRI with 2D and 4D-ﬂow MRI acquisition were included in the *** all patients,bloodﬂow quantiﬁcation in the Fontan circuit and aorta by 2Dﬂow and by 4Dﬂow MRI acquisition blinding to the 2D results was *** agreement between 2D and 4D-ﬂow MRI was calculated as the intraclass correlation coefﬁcient(ICC).The mean absolute differences between 4D and 2Dﬂows were analyzed using linear regression ***:4D-ﬂow MRI acquisition time was slightly lower than 2D(7.6±1.8 min vs.9.4±3.3 min,p=0.03).Flow was slightly predominant in the right pulmonary artery(58%of total pulmonaryﬂow).Conduit/tunnel-pul-monary arteriesﬂow accounted for 60%of the Fontan *** between 2D and 4D was overall good-to-excellent from ICC:0.81795%CI:0.637–0.907 to 0.93295%CI:0.866–*** was no signiﬁcant inﬂu-ence of evaluated parameters on the agreement on 4D and 2Dﬂ***:4D-ﬂow MRI represents a valid tool in Fontan’sﬂow quantiﬁ*** larger studies are needed to conﬁrm our results and to evaluate the impact of advanced 4D-ﬂow MRI parameters on the prognostic stratiﬁcation in patients after Fontan palliation.

关键词： Fontan palliation fontanﬂows 4Dﬂow MRI 2Dﬂow MRI cardiac magnetic resonance

Epicardial adipose tissue in obesity with heart failure with preserved ejection fraction: Cardiovascular magnetic resonance biomarker study

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World Journal of Cardiology 2024年第3期16卷 149-160页

作者： Ju-Wei Shao Bing-Hua Chen Kamil Abu-Shaban Ahmad Baiyasi Lian-Ming Wu Jing Ma Department of Radiology The Affiliated Hospital of Yunnan UniversityKunming 650021Yunnan ProvinceChina Department of Radiology Ren Ji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200127China Department of Radiology University of Toledo College of MedicineToledoOH 43623United States Department of Radiology Wayne State University School of MedicineDetroitMI 48201United States Department of Endocrinology Ren Ji HospitalShanghai Jiao Tong University School of MedicineShanghai 200127China

BACKGROUND Obesity has become a serious public health issue,significantly elevating the risk of various *** is a well-established contributor to Heart failure with preserved ejection fraction(HFpEF).Evaluating HFpEF in obesity is *** adipose tissue(EAT)has emerged as a valuable tool for validating prognostic biomarkers and guiding treatment ***,assessing EAT is of paramount *** magnetic resonance(CMR)imaging is acknowledged as the gold standard for analyzing cardiac function and *** hope to use CMR to assess EAT as a bioimaging marker to evaluate HFpEF in obese *** To assess the diagnostic utility of CMR for evaluating heart failure with preserved ejection fraction[HFpEF;left ventricular(LV)ejection fraction≥50%]by measuring the epicardial adipose tissue(EAT)volumes and EAT mass in obese *** Sixty-two obese patients were divided into two groups for a case-control study based on whether or not they had heart failure with *** two groups were defined as HFpEF+and HFpEF-.LV geometry,global systolic function,EAT volumes and EAT mass of all subjects were obtained using cine magnetic resonance *** Forty-five patients of HFpEF-group and seventeen patients of HFpEF+group were *** mass index(g/m2)of HFpEF+group was higher than HFpEF-group(P<0.05).In HFpEF+group,EAT volumes,EAT volume index,EAT mass,EAT mass index and the ratio of EAT/[left atrial(LA)left-right(LR)diameter]were higher compared to HFpEF-group(P<0.05).In multivariate analysis,Higher EAT/LA LR diameter ratio was associated with higher odds ratio of *** EAT/LA LR diameter ratio is highly associated with HFpEF in obese *** is plausible that there may be utility in CMR for assessing obese patients for HFpEF using EAT/LA LR diameter ratio as a diagnostic *** prospective studies,are needed to validate these proof-of-concept findings.

关键词： Heart failure with preserved ejection fraction Epicardial adipose tissue Obesity cardiac magnetic resonance

Multimodality imaging in apical hypertrophic cardiomyopathy

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World Journal of Cardiology 2014年第9期6卷 916-923页

作者： Rosario Parisi Francesca Mirabella Gioel Gabrio Secco Rossella Fattori Interventional Cardiology AO Ospedali Riuniti Marche Nord

Apical hypertrophic cardiomyopathy(AHCM) is a relatively rare morphologic variant of HCM in which the hypertrophy of myocardium is localized to the left ventricular apex. Symptoms of AHCM might vary from none to others mimic coronary artery disease including acute coronary syndrome, thus resulting in inappropriate hospitalization. Transthoracic echocardiography is the firstline imaging technique for the diagnosis of hypertrophic cardiomyopathies. However, when the hypertrophy of the myocardium is localized in the ventricular apex might results in missed diagnosis. Aim of this paper is to review the different imaging techniques used for the diagnosis of AHCM and their role in the detection and comprehension of this uncommon disease.

关键词： Apical hypertrophic cardiomyopathy Imaging techniques cardiac magnetic resonance Trans-thoracic echocardiography Multidetector computed tomography

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： Aortic stenosis Doppler echocardiography cardiac computed tomography Two-dimensional strain Three dimensional echocardiography cardiac magnetic resonance Transcatheter aortic valve replacement