scholarly journals Hepatic T2-times on cardiovascular magnetic resonance imaging reflect liver fibrosis and predict outcome in an all-comer cohort

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
K Mascherbauer ◽  
C Dona ◽  
M Koschutnik ◽  
C Nitsche ◽  
V Dannenberg ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Liver Fibrosis ◽  
Tissue Characterization ◽  
Cox Regression ◽  
Imaging Modality ◽  
Hepatic Tissue ◽  
Alcoholic Fatty Liver ◽  
Nafld Fibrosis Score ◽  
Myocardial T1

Abstract Background Non-alcoholic fatty liver disease (NAFLD) is associated with dismal outcomes in patients with cardiac disorders but infrequently assessed by cardiologists. Cardiovascular magnetic resonance (CMR) is evolving as one-stop-shop imaging modality in cardiology, allowing for non-invasive myocardial tissue characterization by T1-mapping. On standard CMR exams, hepatic tissue is also assessable on T1-maps. However, it is unknown whether hepatic T1-times are associated with 1) myocardial T1-times, 2) established NAFLD scores, and 3) outcomes in patients referred for CMR. Methods In consecutive patients undergoing CMR we assessed hepatic and myocardial T1-times, and the NAFLD Fibrosis Score (NFS). Correlation analyses were used to test the association between hepatic and myocardial T1-times as well as the NFS. We used Kaplan-Meier estimates and Cox-regression models to investigate the association between hepatic T1-times and a composite endpoint of heart failure hospitalization and cardiovascular death. Results 513 patients were included (57±18 y/o, 49% female). Hepatic T1-times were 588±98ms on average and were correlated with myocardial T1-times (r=0.42, p<0.001) and – weakly – with the NFS (r=0.11, p=0.04). Patients with severe liver fibrosis or cirrhosis (n=47) had significantly higher hepatic T1-times as compared to patients with no or mild fibrosis based on the NFS (635±197ms versus 588±80ms, p=0.02). During follow-up (100±40 months), a total of 137 (27%) events occurred. When stratified by quartiles, patients in the highest hepatic T1-time quartile (>700ms) were at higher risk for events compared to all other quartiles (log-rank, p=0.01), which was consistent across different NAFLD risk groups based on the NFS (no/mild fibrosis, indeterminant score, severe fibrosis/cirrhosis). On Cox regression analyses, higher hepatic T1-times yielded significantly higher risk estimates for events (adj. HR 1.20 [95% CI: 1.04–1.38] per 1-SD increase, p=0.01) even when adjusted for age, sex, left and right ventricular ejection fractions, and myocardial T1-times. Conclusion Hepatic T1-times assessed on standard CMR reflect severity of NAFLD and predict outcome on top of established risk factors, including myocardial T1-times, in an all-comer CMR cohort. FUNDunding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Medical University of Vienna

scholarly journals MicroRNA-29a Suppresses CD36 to Ameliorate High Fat Diet-Induced Steatohepatitis and Liver Fibrosis in Mice

Cells ◽  
2019 ◽  
Vol 8 (10) ◽  
pp. 1298 ◽  
Author(s):  
Hung-Yu Lin ◽  
Feng-Sheng Wang ◽  
Ya-Ling Yang ◽  
Ying-Hsien Huang
Keyword(s):  
Transcription Factor ◽  
Liver Fibrosis ◽  
High Fat Diet ◽  
Critical Role ◽  
Luciferase Reporter ◽  
Hepatic Tissue ◽  
Wild Type ◽  
High Fat ◽  
Alcoholic Fatty Liver ◽  
Mesenchymal Transition

MicroRNA-29 (miR-29) has been shown to play a critical role in reducing inflammation and fibrosis following liver injury. Non-alcoholic fatty liver disease (NAFLD) occurs when fat is deposited (steatosis) in the liver due to causes other than excessive alcohol use and is associated with liver fibrosis. In this study, we asked whether miR-29a could reduce experimental high fat diet (HFD)-induced obesity and liver fibrosis in mice. We performed systematical expression analyses of miR-29a transgenic mice (miR-29aTg mice) and wild-type littermates subjected to HFD-induced NAFLD. The results demonstrated that increased miR-29a not only alleviated HFD-induced body weight gain but also subcutaneous, visceral, and intestinal fat accumulation and hepatocellular steatosis in mice. Furthermore, hepatic tissue in the miR-29aTg mice displayed a weak fibrotic matrix concomitant with low fibrotic collagen1α1 expression within the affected tissues compared to the wild-type (WT) mice fed the HFD diet. Increased miR-29a signaling also resulted in the downregulation of expression of the epithelial mesenchymal transition-executing transcription factor snail, mesenchymal markers vimentin, and such pro-inflammation markers as il6 and mcp1 within the liver tissue. Meanwhile, miR-29aTg-HFD mice exhibited significantly lower levels of peroxisome proliferator-activated receptor γ (PPARγ), mitochondrial transcription factor A TFAM, and mitochondria DNA content in the liver than the WT-HFD mice. An in vitro luciferase reporter assay further confirmed that miR-29a mimic transfection reduced fatty acid translocase CD36 expression in HepG2 cells. Conclusion: Our data provide new insights that miR-29a can improve HDF-induced obesity, hepatocellular steatosis, and fibrosis, as well as highlight the role of miR-29a in regulation of NAFLD.

scholarly journals Identification and Assessment of Anderson-Fabry Disease by Cardiovascular Magnetic Resonance Noncontrast Myocardial T1 Mapping

2013 ◽  
Vol 6 (3) ◽  
pp. 392-398 ◽  
Author(s):  
Daniel M. Sado ◽  
Steven K. White ◽  
Stefan K. Piechnik ◽  
Sanjay M. Banypersad ◽  
Thomas Treibel ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Fabry Disease ◽  
T1 Mapping ◽  
Myocardial T1

Cardiac Pseudotumor: Tissue Characterization by Cardiovascular Magnetic Resonance

2003 ◽  
Vol 5 (3) ◽  
pp. 497-500 ◽  
Author(s):  
James C. C. Moon ◽  
Mary N. Sheppard ◽  
G. Lloyd ◽  
Nikhil R. Patel ◽  
Dudley J. Pennell ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Tissue Characterization

scholarly journals Accuracy of proton magnetic resonance for diagnosing non-alcoholic steatohepatitis: a meta-analysis

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Tae-Hoon Kim ◽  
Chang-Won Jeong ◽  
Hong Young Jun ◽  
ChungSub Lee ◽  
SiHyeong Noh ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Imaging Modality ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Methods ◽  
Likelihood Ratios ◽  
Alcoholic Fatty Liver ◽  
Noninvasive Diagnostics ◽  
Alcoholic Steatohepatitis

Abstract Liver biopsy is the reference standard test to differentiate between non-alcoholic steatohepatitis (NASH) and simple steatosis (SS) in non-alcoholic fatty liver disease (NAFLD), but noninvasive diagnostics are warranted. The diagnostic accuracy in NASH using MR imaging modality have not yet been clearly identified. This study was assessed the accuracy of magnetic resonance imaging (MRI) method for diagnosing NASH. Data were extracted from research articles obtained after a literature search from multiple electronic databases. Random-effects meta-analyses were performed to obtain overall effect size of the area under the receiver operating characteristic(ROC) curve, sensitivity, specificity, likelihood ratios(LR), diagnostic odds ratio(DOR) of MRI method in detecting histopathologically-proven SS(or non-NASH) and NASH. Seven studies were analyzed 485 patients, which included 207 SS and 278 NASH. The pooled sensitivity was 87.4% (95% CI, 76.4–95.3) and specificity was 74.3% (95% CI, 62.4–84.6). Pooled positive LR was 2.59 (95% CI, 1.96–3.42) and negative LR was 0.17 (95% CI, 0.07–0.38). DOR was 21.57 (95% CI, 7.27–63.99). The area under the curve of summary ROC was 0.89. Our meta-analysis shows that the MRI-based diagnostic methods are valuable additions in detecting NASH.

scholarly journals Towards Replacing Late Gadolinium Enhancement with Artificial Intelligence Virtual Native Enhancement for Gadolinium-Free Cardiovascular Magnetic Resonance Tissue Characterization in Hypertrophic Cardiomyopathy

Circulation ◽  
2021 ◽  
Author(s):  
Qiang Zhang ◽  
Matthew K. Burrage ◽  
Elena Lukaschuk ◽  
Mayooran Shanmuganathan ◽  
Iulia A. Popescu ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Cardiovascular Magnetic Resonance ◽  
Deep Learning ◽  
Late Gadolinium Enhancement ◽  
Hypertrophic Cardiomyopathy ◽  
Magnetic Resonance ◽  
Image Quality ◽  
Tissue Characterization ◽  
Wilcoxon Test ◽  
Gadolinium Enhancement

Background: Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging is the gold standard for non-invasive myocardial tissue characterization, but requires intravenous contrast agent administration. It is highly desired to develop a contrast-agent-free technology to replace LGE for faster and cheaper CMR scans. Methods: A CMR Virtual Native Enhancement (VNE) imaging technology was developed using artificial intelligence. The deep learning model for generating VNE uses multiple streams of convolutional neural networks to exploit and enhance the existing signals in native T1-maps (pixel-wise maps of tissue T1 relaxation times) and cine imaging of cardiac structure and function, presenting them as LGE-equivalent images. The VNE generator was trained using generative adversarial networks. This technology was first developed on CMR datasets from the multi-center Hypertrophic Cardiomyopathy Registry (HCMR), using HCM as an exemplar. The datasets were randomized into two independent groups for deep learning training and testing. The test data of VNE and LGE were scored and contoured by experienced human operators to assess image quality, visuospatial agreement and myocardial lesion burden quantification. Image quality was compared using nonparametric Wilcoxon test. Intra- and inter-observer agreement was analyzed using intraclass correlation coefficients (ICC). Lesion quantification by VNE and LGE were compared using linear regression and ICC. Results: 1348 HCM patients provided 4093 triplets of matched T1-maps, cines, and LGE datasets. After randomization and data quality control, 2695 datasets were used for VNE method development, and 345 for independent testing. VNE had significantly better image quality than LGE, as assessed by 4 operators (n=345 datasets, p<0.001, Wilcoxon test). VNE revealed characteristic HCM lesions in high visuospatial agreement with LGE. In 121 patients (n=326 datasets), VNE correlated with LGE in detecting and quantifying both hyper-intensity myocardial lesions (r=0.77-0.79, ICC=0.77-0.87; p<0.001) and intermediate-intensity lesions (r=0.70-0.76, ICC=0.82-0.85; p<0.001). The native CMR images (cine plus T1-map) required for VNE can be acquired within 15 minutes. Producing a VNE image takes less than one second. Conclusions: VNE is a new CMR technology that resembles conventional LGE, without the need for contrast administration. VNE achieved high agreement with LGE in the distribution and quantification of lesions, with significantly better image quality.

scholarly journals NAFLD fibrosis score is correlated with PCSK9 and improves outcome prediction of PCSK9 in patients with chest pain: a cohort study

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Jia Peng ◽  
Ming-Ming Liu ◽  
Jing-Lu Jin ◽  
Ye-Xuan Cao ◽  
Yuan-Lin Guo ◽  
...  
Keyword(s):  
Chest Pain ◽  
Cardiovascular Events ◽  
Cox Regression ◽  
Linear Regression Analysis ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Fibrosis Score ◽  
Alcoholic Fatty Liver ◽  
Nafld Fibrosis Score

Abstract Background The risk of liver fibrosis in non-alcoholic fatty liver disease (NAFLD) can be easily evaluated by noninvasive scoring systems, of which the NAFLD fibrosis score (NFS) is the most commonly used. Proprotein convertase subtilisin/kexin type 9 (PCSK9), a new predictor of cardiovascular events, has been reported to be associated with cardiovascular outcomes and NAFLD. However, the relationship of NFS with PCSK9 and their prognostic abilities in cardiovascular risks are unknown. Methods A total of 2008 hospitalized subjects who had chest pain without lipid-lowering therapy were consecutively included. Baseline clinical data were collected, and the NFS was calculated. The circulating PCSK9 concentration was determined by enzyme immunoassay. The major adverse cardiovascular event (MACE) occurrences were recorded in the follow-up period. Associations of PCSK9 concentration with NFS were examined. All of the participants were categorized into three groups according to NFS levels and were further stratified by PCSK9 tertiles to evaluate the MACEs. Results 158 (7.87%) MACEs were observed during a mean of 3.2 years of follow-up. NFS levels were independently related to higher PCSK9 levels according to multivariable linear regression analysis. Furthermore, elevated PCSK9 and NFS concentrations were respectively associated with increased MACE incidence in multivariable Cox regression models. When combining NFS status with PCSK9 tertiles as a stratifying factor, patients with intermediate-high NFS and high PCSK9 levels had higher risks of events than those with low NFS and low PCSK9 levels. Conclusions This study revealed for the first time that NFS is positively related to PCSK9 and that the combination of NFS and PCSK9 greatly increased the risk of MACEs in patients with chest pain, providing a potential link between NFS and PCSK9 for predicting cardiovascular events.

scholarly journals Society for Cardiovascular Magnetic Resonance (SCMR) recommended CMR protocols for scanning patients with active or convalescent phase COVID-19 infection

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Sebastian Kelle ◽  
Chiara Bucciarelli-Ducci ◽  
Robert M. Judd ◽  
Raymond Y. Kwong ◽  
Orlando Simonetti ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Cardiac Function ◽  
Tissue Characterization ◽  
Clinical Indication ◽  
Myocardial Tissue ◽  
Clinical Question ◽  
Convalescent Phase ◽  
Myocardial Tissue Characterization

Abstract The aim of this document is to provide specific recommendations on the use of cardiovascular magnetic resonance (CMR) protocols in the era of the COVID-19 pandemic. In patients without COVID-19, standard CMR protocols should be used based on clinical indication as usual. Protocols used in patients who have known / suspected active COVID-19 or post COVID-19 should be performed based on the specific clinical question with an emphasis on cardiac function and myocardial tissue characterization. Short and dedicated protocols are recommended.

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