Isolated noncompaction of the left ventricular myocardium and intraventricular thrombosis detected by magnetic resonance imaging

SummaryWe report a rare case of a cardiac hydatid cyst that was incidentally found during routine work up for a redo-CABG and was picked up on echocardiography and confirmed by magnetic resonance imaging and, after successful removal, further confirmed by histopathology. The report emphasizes the importance of early and urgent surgery for such cardiac hydatid cysts whenever discovered to prevent fatal and unexpected death. Cardiac hydatidosis is a most infrequent type, in comparison with hydatidosis of the liver (65%) and lung (25%).Learning pointsHydatidosis or cystic echinococcosis is caused by infection with the metacestode stage of the tapeworm Echinococcus (family Taeniidae). The adult tapeworm is usually found in dogs or other canines; the tapeworm eggs are expelled in the animal's feces and humans become infected after ingestion of the eggs. The initial phase of primary infection is asymptomatic.Cardiac hydatidosis is extremely rare, more commonly the liver and lungs are affected.Morbidity from heart echinococcosis in men is three times higher than that in women. Solitary cysts occur in almost 60% of the cases; the most frequent location is the ventricular myocardium and they are usually subepicardially located, hence they rarely rupture in the pericardial space. The left ventricle is damaged twofold to threefold more frequently than the right one.The diagnosis of echinococcosis in heart can be divided into two steps: detection of the cyst and its identification as echinococcus. It is based on serological reactions, echocardiography, X-ray, computerized tomography, and/or magnetic resonance imaging.The most dangerous complication of cardiac echinococcosis is cyst perforation. After cyst perforation three quarters of the patients die from septic shock or embolic complications.It is very important to understand that chemotherapy may lead to cyst death, and destruction of its wall and result in cyst rupture. Therefore, no germicide must be administered before surgical removal.

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Accurate Assessment of Left Ventricular Mass by 3D-Echo: Comparison to Magnetic Resonance Imaging

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(97)85600-8 ◽

1998 ◽

Vol 31 (2) ◽

pp. 436A

Author(s):

H Kühl

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Left Ventricular Mass ◽

Left Ventricular ◽

Accurate Assessment ◽

Resonance Imaging ◽

Ventricular Mass ◽

3D Echo

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Follow-up magnetic resonance imaging of Löffler endocarditis: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytaa381 ◽

2020 ◽

Author(s):

Shinya Ito ◽

Akihiro Isotani ◽

Kyohei Yamaji ◽

Kenji Ando

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Corticosteroid Therapy ◽

Cardiac Mri ◽

High Intensity ◽

Left Ventricular ◽

Eosinophil Infiltration ◽

Resonance Imaging ◽

T2 Weighted Images

Abstract Background Löffler endocarditis is a condition characterized by cardiac infiltration of eosinophils. Cardiac magnetic resonance imaging (MRI) is a modality for the diagnosis of myocardial damage. Case summary This is the case of a 77-year-old man with acute decompensated heart failure who was admitted. Transthoracic echocardiography showed preserved left ventricular (LV) systolic function along with LV thrombi attached to the septo-apical wall and the posterior wall, consistent with Löffler endocarditis. Cardiac MRI revealed obliteration of the LV apex and partial filling of the LV cavity, as well as near circumferential subendocardial late gadolinium enhancement (LGE) in the mid- and apical segments. T2-weighted images showed a near circumferential high-intensity area of the LV subendocardial muscle in the mid- and apical segments. High-dose corticosteroids and intravenous heparin were initiated, followed by maintenance warfarin therapy. At 18 months, follow-up cardiac MRI revealed the disappearance of the LV thrombi, and a reduction of LGE, as well as high-intensity areas in the T2-weighted images. Discussion The high-intensity area of T2-weighted images indicate the presence of subendocardial oedema. Eosinophil-mediated heart damage evolves through three stages: (i) acute necrotic, (ii) thrombotic, and (iii) fibrotic stages. Since the deposition of toxic eosinophil granule proteins and eosinophil infiltration injured the endocardium, the first-line treatment for Löffler endocarditis is corticosteroid therapy. In this case, LGE in the subendocardium and the high-intensity area in the T2-weighted images were reduced at 18 months. High-intensity areas of T2-weighted images in the acute phase might indicate the possibility of therapeutic response to corticosteroid therapy.

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Effect of age and sex on fully automated deep learning assessment of left ventricular function, volumes, and contours in cardiac magnetic resonance imaging

The International Journal of Cardiovascular Imaging ◽

10.1007/s10554-021-02326-9 ◽

2021 ◽

Author(s):

Vincent Chen ◽

Alex J. Barker ◽

Rotem Golan ◽

Michael B. Scott ◽

Hyungkyu Huh ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Deep Learning ◽

Cardiac Magnetic Resonance ◽

Magnetic Resonance ◽

Left Ventricular Function ◽

Left Ventricular ◽

Learning Assessment ◽

Resonance Imaging ◽

Effect Of Age ◽

Age And Sex

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P613Cardiac magnetic resonance imaging derived left ventricular mechanical function in patients with atrial fibrillation and left atrial low voltage zones

European Heart Journal ◽

10.1093/eurheartj/ehz747.0222 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

S Ulbrich ◽

R S Schoenbauer ◽

B Kirstein ◽

J Tomala ◽

Y Huo ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Atrial Fibrillation ◽

Magnetic Resonance ◽

Stroke Volume ◽

Left Atrial ◽

Low Voltage ◽

Left Ventricular ◽

Left Ventricular Stroke Volume ◽

Resonance Imaging ◽

Ventricular Filling

Abstract Background The relation of left atrial low voltage zones (LVZ) to left ventricular function in patients undergoing pulmonary vein isolation (PVI) is not known. Objective To explore the relationship of left atrial low voltage zones (LVZ) on left ventricular function in patients with atrial fibrillation. Methods From June to Nov. 2018, 107 (mean age 67y, 70 men, 73 persistent AF) consecutive patients with symptomatic AF underwent a PVI with LVZ mapping. Before PVI the left ventricular ejection fraction (EF) and stroke volume (SV) were measured by cardiac magnetic resonance imaging (CMR). From feature-tracking of CMR-cine images left ventricular global, systolic and diastolic longitudinal strains (GLS), circumferential strains (GCS) and radial strains (GRS) were calculated. Results Of 59 patients CMR scanning in sinus rhythm was performed, LVZ were present in 24 patients. LVEF was significantly lower in patients with left atrial LVZ (62±9% vs. 55±15%) (p=0,03). Left ventricular stroke volume was significantly decreased by the extent of LVZ (94±23 vs. 72±21ml), (p=0,03). The left ventricular diastolic strains during ventricular filling (caused by atrial contraction) of GLS (r=−0,52), GCS (r=−0,65) and GRS (r=−0,65) were highly signifcantly correlated to the occurence and extent of LVZ (each p<0,001 respectively). The only systolic ventricular strain was GLS, which decreased (r=−0,3, p=0,03) by the occurance of atrial low voltage. Conclusion The active, atrial part of diastolic left ventricular filling properties is impaired by the occurrence and extent of left atrial LVZ. In patients with left atrial LVZ the left ventricular stroke volume and ejection fraction is decreased already in sinus rhythm. It seems possible that atrial mechanical dysfunction and presence of atrial low voltage maybe predicted by LV diastolic strain analysis.

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