T1 and T2 mapping in the identification of acute myocardial injury in patients with NSTEMI

2018 ◽  
Vol 123 (12) ◽  
pp. 926-934 ◽  
Author(s):  
Carlo Tessa ◽  
Jacopo Del Meglio ◽  
Alessio Lilli ◽  
Stefano Diciotti ◽  
Luca Salvatori ◽  
...  
Keyword(s):  
Myocardial Injury ◽  
T2 Mapping ◽  
Acute Myocardial Injury ◽  
T1 And T2

scholarly journals Myocardial injury detected by T1 and T2 mapping on CMR predicts subsequent cancer therapy–related cardiac dysfunction in patients with breast cancer treated by epirubicin-based chemotherapy or left-sided RT

2021 ◽  
Author(s):  
Enver Tahir ◽  
Manuella Azar ◽  
Sahar Shihada ◽  
Katharina Seiffert ◽  
Yvonne Goy ◽  
...  
Keyword(s):  
Cancer Therapy ◽  
Cardiac Dysfunction ◽  
Myocardial Injury ◽  
T2 Mapping ◽  
Relaxation Times ◽  
Left Ventricular ◽  
Early Prediction ◽  
Good Sensitivity ◽  
Combined Use ◽  
T1 And T2

Abstract Objectives Cancer therapy-related cardiac dysfunction (CTRCD) is a relevant clinical problem and needs early prediction. This study aimed to analyze myocardial injury using serial laboratory and cardiac magnetic resonance imaging (CMR) parameters after epirubicin-based chemotherapy compared with left-sided radiotherapy and to study their value for early prediction of CTRCD. Methods Sixty-six consecutive women (53 ± 13 years) including n = 39 with epirubicin-based chemotherapy and n = 27 with left-sided radiotherapy were prospectively studied by 3 T CMR including left ventricular (LV) mass and volumes for ejection fraction (LVEF), as well as feature-tracking with global longitudinal strain (GLS) and T1/T2 mapping. CMR was performed at baseline, at therapy completion (follow-up 1, FU1), and after 13 ± 2 months (FU2). CTRCD was defined as LVEF decline of at least 10% to < 55% or a > 15% GLS change at FU2. Results T1 and T2 increased at FU1 after epirubicin-based chemotherapy, but not after left-sided radiotherapy. CTRCD occurred in 20% of patients after epirubicin-based chemotherapy and in 4% after left-sided radiotherapy. T1 at FU1 was the best single parameter to predict CTRCD with an area under the curve (AUC) of 0.712 (CI 0.587–0.816, p = 0.005) with excellent sensitivity (100%, 66–100%), but low specificity (44%, 31–58%). Combined use of increased T1 and LVEF ≤ 60% at FU1 improved AUC to 0.810 (0.695–0.896) resulting in good sensitivity (78%, 44–95%) and specificity (84%, 72–92%). Conclusion Only epirubicin-based chemotherapy, but not left-sided radiotherapy, resulted in increased T1/T2 myocardial relaxation times as a marker of myocardial injury. Combined use of CMR parameters may allow an early prediction of subsequent CTCRD. Key Points • Myocardial T1 and T2 relaxation times increased at FU1 after epirubicin-based chemotherapy, but not after left-sided radiotherapy. • Cancer therapy–related cardiac dysfunction (CTRCD) occurred in 20% of patients after epirubicin-based chemotherapy and in 4% after left-sided radiotherapy. • Combined use of increased T1 and reduced LVEF had an AUC of 0.810 (0.695–0.896) to predict CTRCD with good sensitivity (78%, 44–95%) and specificity (84%, 72–92%).

scholarly journals T1 and T2 mapping CMR to quantify focal myocardial injury in patients with myocarditis

2015 ◽  
Vol 17 (Suppl 1) ◽  
pp. O90 ◽  
Author(s):  
Ulf K Radunski ◽  
Sebastian Bohnen ◽  
Gunnar Lund ◽  
Dennis Säring ◽  
Christian Stehning ◽  
...  
Keyword(s):  
Myocardial Injury ◽  
T2 Mapping ◽  
T1 And T2

scholarly journals Visualizing myocardial injury from elective cardioversion with CMR

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
K Fischer ◽  
C Riecker ◽  
S Overney ◽  
M Stucki ◽  
H Tanner ◽  
...  
Keyword(s):  
Myocardial Injury ◽  
Systolic Function ◽  
T2 Mapping ◽  
Extracellular Volume ◽  
Left Ventricular ◽  
Diffuse Fibrosis ◽  
Lv Function ◽  
Chronic Injury ◽  
The Third ◽  
Myocardial Area

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): European Association of Cardiothoracic Anaesthesiologists Research Grant Background Despite everyday use of electrical interventions in cardiovascular care, the extent and type of concomitant myocardial injury is not fully understood. Current literature disagrees about the question whether and how cardioversion or defibrillation damage the myocardium, especially when serologic markers are used. Such markers are not always cardiac-specific, nor diagnostic for type and region of myocardial injury. These limitations may be overcome by parametric T1 and T2 mapping. We aimed to investigate whether the acute and long-term impact of electrical cardioversion on myocardial structure and function is detectable using CMR imaging. Methods Patients scheduled for elective cardioversion were enrolled to undergo three CMR exams (3 Tesla): on the morning prior to cardioversion to assess pre-existing injury; two to five hours after cardioversion to assess the acute response; and six to ten weeks later to investigate chronic injury. The CMR exam studied left ventricular (LV) function, T2 mapping to measure edema, and extracellular volume (ECV) from T1 maps to measure diffuse fibrosis. Both the degree of injury and proportion (%) of myocardial area affected were analysed. Results Eight patients completed the study, requiring 1-2 shocks (totalling 120-300 J biphasic energy) to achieve sinus rhythm. LV ejection fraction increased after cardioversion from 47 ± 13% to 55 ± 15% (p = 0.020), and was 52 ± 16% at the third exam (p = 0.199). Even prior to intervention, some patients showed edema (baseline T2 &gt; 40ms) afflicting 49 ± 23% of their LV myocardium. Area affected by edema expanded to 72 ± 18% after cardioversion (p = 0.002) and returned to 54 ± 24% by the third exam. T2 rose from baseline (40.4 ± 1.8ms) after cardioversion acutely to 44.1 ± 5.2ms (p = 0.028) and normalized until the late exam (40.8 ± 3.1ms). Myocardial area affected by diffuse fibrosis (ECV &gt; 30%) was 28.3 ± 9.4% at baseline and 38.8 ± 18.9% late after cardioversion (p = 0.018). Pathologic T2 increases (indicative of edema) were not observed in all patients, but individuals with higher baseline ECV also experienced greater T2 increase after cardioversion (r = 0.840, p = 0.036). Conclusion Elective cardioversion improves LV systolic function, but also aggravates myocardial edema and possibly adds to diffuse fibrosis during several weeks thereafter. Such sequelae of cardioversion were observed mainly in patients with a greater burden of pre-existing myocardial injury. More data is needed to corroborate these preliminary findings and to study whether this type of myocardial injury predicts worse outcome. Moreover, changes in CMR markers caused by electrical interventions including defibrillation, may have the potential to confound diagnostic assessments of the underlying cardiac injury. Abstract Figure

Cardiac tissue characterization with t1 and t2 mapping in anderson fabry patients: new pathophysiological concepts and early cardiac involvement

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Zanoni ◽  
V Ferrara ◽  
G Lanati ◽  
G Vitale ◽  
F Di Nicola ◽  
...  
Keyword(s):  
Cardiac Disease ◽  
Tissue Characterization ◽  
Cardiac Involvement ◽  
Late Onset ◽  
T2 Mapping ◽  
Serum Levels ◽  
Left Ventricular ◽  
Control Group ◽  
Funding Source ◽  
T1 And T2

Abstract Background Anderson Fabry (AF) disease is a X-linked lysosomal storage disorder with multiorgan involvement. Cardiac disease, mainly represented by left ventricular hypertrophy (LVH) and arrhythmias, is the most frequent cause of premature death. It is well know that specific therapy is less effective after the development of LVH and myocardial fibrosis, therefore early cardiac detection (before LVH) is important. New cardiac magnetic resonance (CMR) parametric imaging techniques (T1 and T2 maps) enable myocardial tissue changes associated with AF disease. Purpose To evaluate the relationship between CMR tissue characterization and clinical and instrumental manifestations of AF disease to find early markers of cardiac involvement. Methods 31 AF patients (9 males, mean age 49±16 years) underwent ECG, echocardiogram and contrast CMR. TnI, BNP, pro-BNP and serum lyso-Gb3 were dosed. T1 mapping was performed in a pre-contrast acquisition with the modified Look-Locker inversion recovery (MOLLI) sequences. CMR results were compared with those of 43 healthy age and gender-matched controls. Results In AF patients native septal T1 values were significantly lower compared to healthy controls (median 949 vs 991 msec, p=0.0137) and were inversely related to Lyso-Gb3 serum levels (p=0.003). Patients with LVH had lower T1 septal values in comparison with patients without LVH (892 vs 981 msec; p=0.0012). Patients with classic form had abnormal low T1 values more frequently than pts with late onset variant (78 vs 23%; p=0.038). In AF patients native septal T2 values were significantly higher compared to the control group (53 vs 49 msec; p=0.0004) and correlated with troponin I (p=0.008) and NT-pro BNP (p=0.006) serum levels. No difference was found between pts with and without LVH (53.5 vs 52.5 ms; p=0.797) and the prevalence of abnormal high T2 values was similar between patients with late onset AF and pts with classical form (53% vs 50%; p=1.000). All patients with late onset AF and high T2 values were females. Conclusions CMR T1 (low values) and T2 (high values) mapping are useful tools to detect early cardiac involvement before LVH and to better understand the pathophysiology of cardiac disease in AF patients. Subclinical tissue inflammation, detectable through T2 maps, seems to be an additional pathogenetic mechanism related to the Gb3 storage that contributes to organ damage and precedes LVH, particularly in females patients with late onset phenotype. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Sant'Orsola-Malpighi Hospital

Acute myocardial injury during cardiopulmonary bypass

1958 ◽  
Vol 56 (6) ◽  
pp. 926-928 ◽  
Author(s):  
Robert S. Fraser ◽  
Richard E. Rossall
Keyword(s):  
Cardiopulmonary Bypass ◽  
Myocardial Injury ◽  
Acute Myocardial Injury

scholarly journals Acute Myocardial Injury in a 45-year-old Female: Hypereosinophilic Syndrome

2013 ◽  
Vol 20 (1) ◽  
pp. 60-62
Author(s):  
WC Lin ◽  
YM Weng ◽  
YL Chan ◽  
H Chang ◽  
SL Huang ◽  
...  
Keyword(s):  
Myocardial Injury ◽  
Hypereosinophilic Syndrome ◽  
Acute Myocardial Injury
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