P749Dynamic of cardiac magnetic resonance imaging parameters in patients with non-ischemic cardiomyopathies after endomyocardial stem cell transplantation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Kurlianskaya ◽  
O Polonetsky ◽  
T Denisevich ◽  
O Shatova ◽  
T Osmolovskaya ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Stem Cell ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Ejection Fraction ◽  
Cardiac Magnetic Resonance Imaging ◽  
Extracellular Volume ◽  
Idiopathic Dilated Cardiomyopathy ◽  
Resonance Imaging ◽  
Lv Ejection Fraction

Abstract Background Autologous mesenchymal stem cell (MSC) transplantation can be considered as an alternative method of end-staged chronical heart failure treatment in patients with Non-ischemic Cardiomyopathies (NICMP). About 2/3 NICMP are determined by previous myocarditis, transformed in inflammatory cardiomyopathy (ICM), while only 1/3 of NICMP cases are associated with idiopathic dilated cardiomyopathy (DCM). Application of MSC therapy in different groups of NICMP patients is not sufficiently studied. Purpose The purpose of the study was to compare cardiac magnetic resonance imaging (cMRI) parameters in the left ventricle (LV) segments of myocardium in patients with DCM and ICM before and after autologous MSC transplantation. Methods The study covered 15 patients with DCM (mean age 45.8±3.1 years; 4 females, 11 males; LV ejection fraction (EF) <40%) and 15 patients with ICM (mean age 46.0±3.6 years; 5 females, 10 males; LV EF <40%). All patients underwent cMRI, endomyocardial injections of 0.2 ml autologous MSC culture (CD105+, CD90+, CD73+ cells) into akinetic and hypokinetic myocardial segments. In total we have analysed 228 segments of NICMP patients. Results In patients with ICM we found significant decrease in extracellular volume (ECV) within 6 months after primary examination (from 32 [28; 36]% to 27 [25; 30]%, p=0,007). As a result, ICM patients had lower ECV than DCM patients 6 months after MSC transplantation 27 [26; 29] % and 31 [29; 32]% respectively (p=0,001). Patients with ICM demonstrated an increase in LV systolic myocardial segment thickness (SMST) 6 months after MSC injections (5.91 [5.74; 6.15] mm – baseline vs. 6.67 [6.60; 6.82] mm – 6 months later, p≤0,010) with a bigger increase 12 months after MSC injection (9.58 [9.47; 9.73] mm, p≤0,010). In ICM patients LV SMST was significantly higher than in DCM patients 12 months after MSC transplantation (9.58 [9.47; 9.73] mm vs. 7.38 [7.29; 7.61] mm, p=0.032). ICM patients showed an increase in LV ejection fraction (EF) within 6 months after MSC therapy (from 20 [17; 24]% to 27 [17; 32]%, p=0.043). Conclusions Endomyocardial MSC transplantation showed better results in ICM patients compared to DCM patients. It led to a significant decrease in ECV within 12 months in contrast to DCM patients. ICM patients also demonstrated significant increase of LV SMST and LV EF within 6 months after MSC therapy.

scholarly journals Using proximity extension proteomics assay to identify biomarkers associated with infarct size and ejection fraction after ST-elevation myocardial infarction

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Moman A. Mohammad ◽  
Sasha Koul ◽  
Anna Egerstedt ◽  
J. Gustav Smith ◽  
Marko Noc ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Ejection Fraction ◽  
Infarct Size ◽  
Cardiac Magnetic Resonance Imaging ◽  
Resonance Imaging ◽  
St Elevation ◽  
Inflammatory Proteins

Abstract Plasma concentrations of many cardiovascular and inflammatory proteins are altered after ST-elevation myocardial infarction (STEMI) and may provide prognostic information. We conducted a large-scale proteomic analysis in patients with STEMI, correlating protein levels to infarct size and left ventricular ejection fraction (LVEF) determined with cardiac magnetic resonance imaging. We analysed 131 cardiovascular and inflammatory proteins using a multiplex proximity extension assay and blood samples obtained at baseline, 6, 24, and 96 h from the randomised clinical trial CHILL-MI. Cardiac magnetic resonance imaging data at 4 ± 2 days and 6 months were available as per trial protocol. Using a linear regression model with bootstrap resampling and false discovery rate adjustment we identified five proteins (ST2, interleukin-6, pentraxin-3, interleukin-10, renin, and myoglobin) with elevated values corresponding to larger infarct size or worse LVEF and four proteins (TNF-related apoptosis-inducing ligand, TNF-related activation induced cytokine, interleukin-16, and cystatin B) with values inversely related to LVEF and infarct size, concluding that among 131 circulating inflammatory and cardiovascular proteins in the acute and sub-acute phase of STEMI, nine showed a relationship with infarct size and LVEF post-STEMI, with IL-6 and ST2 exhibiting the strongest association.

scholarly journals Measurement of Ejection Fraction by Cardiac Magnetic Resonance Imaging and Echocardiography to Monitor Doxorubicin-Induced Cardiotoxicity

2019 ◽  
Vol 29 (01) ◽  
pp. 045-051 ◽  
Author(s):  
Tahir Tak ◽  
Camilla M. Jaekel ◽  
Shahyar M. Gharacholou ◽  
Marshall W. Dworak ◽  
Scott A. Marshall
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Ejection Fraction ◽  
Cardiac Magnetic Resonance Imaging ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Resonance Imaging ◽  
Significant Difference

AbstractDoxorubicin is a standard treatment option for breast cancer, lymphoma, and leukemia, but its benefits are limited by its potential for cardiotoxicity. The primary objective of this study was to compare cardiac magnetic resonance imaging (CMRI) versus echocardiography (ECHO) to detect a reduction in left ventricular ejection function, suggestive of doxorubicin cardiotoxicity. We studied eligible patients who were 18 years or older, who had breast cancer or lymphoma, and who were offered treatment with doxorubicin with curative intent dosing of 240 to 300 mg/m2 body surface area between March 1, 2009 and October 31, 2013. Patients underwent baseline CMRI and ECHO. Both imaging studies were repeated after four cycles of treatment. Ejection fraction (EF) calculated by both methods was compared and analyzed with the inferential statistical Student's t test. Twenty-eight eligible patients were enrolled. Two patients stopped participating in the study before undergoing baseline CMRI; 26 patients underwent baseline ECHO and CMRI. Eight of those 26 patients declined posttreatment studies, so the final study population was 18 patients. There was a significant difference in EF pre- and posttreatment in the CMRI group (p = 0.009) versus the ECHO group that showed no significant differences in EF (p = NS). It appears that CMRI is superior to ECHO for detecting doxorubicin-induced reductions in cardiac systolic function. However, ECHO is less expensive and more convenient for patients because of its noninvasive character and bedside practicality. A larger study is needed to confirm these findings.

P4659Left ventricular thrombus and arterial embolism in patients with noncompaction cardiomyopathy - Prognostic value of cardiac magnetic resonance imaging

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
B Schneider ◽  
T H Huemme ◽  
J Schwab ◽  
B Gerecke ◽  
U Desch ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Ejection Fraction ◽  
Prognostic Value ◽  
Resonance Imaging ◽  
Noncompaction Cardiomyopathy ◽  
Lv Ejection Fraction

Abstract Background Left ventricular noncompaction cardiomyopathy (LVNC) is characterized by an increased number of LV trabeculations with deep intertrabecular recesses. This abnormality is associated with heart failure, arrhythmias and arterial embolic events (AE). At present, it is unknown if AE is mainly due to blood stasis within the intertrabecular recesses, reduced LV ejection fraction or concomitant atrial fibrillation. LVNC is usually diagnosed by echocardiography but cardiac magnetic resonance imaging (CMRI) has evolved as an alternative method. This study assessed the prognostic value of CMRI for arterial embolic events in patients (pts) with LVNC. Methods 34 consecutive pts (19m, 15f, age 53±16) with LVNC underwent cine and contrast-enhanced CMRI with a 1.5 T scanner. LV diameter, volume, ejection fraction, and ratio of noncompacted to compacted myocardium (NC/C) were determined, and in 32 pts presence and localization of late gadolinium enhancement (LGE) was assessed. Clinical and CMRI findings were compared in pts with and without LV thrombus and/or AE. Results Overall, 20 pts (59%) were in heart failure NYHA III or IV, 14 (41%) had left bundle branch block (LBBB), 7 (21%) paroxysmal atrial fibrillation and 6 (19%) ventricular tachycardia (VT). By CMRI, LV diameter in end-diastole (66±8 mm), end-systole (53±10 mm), end-diastolic (229±69 ml) and end-systolic volume (150±68 ml) were enlarged and ejection fraction (36±14%) was reduced. The NC/C ratio was 3.2±1.4 in end-diastole and 2.6±1.4 in end-systole. One pt had right ventricular involvement with a thrombus. LGE was seen in 9/32 pts (28%) in the compacted myocardial layer (n=6), in the noncompacted trabecular layer (n=6) and within the papillary muscles (n=3). LGE was present in 3 areas in 1 and in 2 areas in 4 pts. In 3 pts (9%) a thrombus was seen within the trabecular layer which resolved under anticoagulation, and 6 additional pts (18%) without detectable thrombus experienced AE (transient ischemic attack n=1, stroke n=5). Thrombus and/or AE were not associated with age, sex, NYHA class, larger left atrial or LV diameter, LV volume, LBBB or documented VT. Atrial fibrillation (2/9 vs 5/25 pts, p=ns), LV ejection fraction (33±13% vs 38±15%, p=ns) and the NC/C ratio in end-diastole (median 3.2 vs 3) or end-systole (both median 2.6, p=ns) were similar. Thrombus and/or AE occurred mainly in pts with LGE (6/9 vs 2/23 pts, p=0.002). Conclusion In LVNC, evaluation by CMRI and demonstration of LGE in the compacted or noncompacted myocardium identifies patients at high risk for thrombus formation and/or arterial embolic events, warranting anticoagulation.

Advantages of Cardiac Magnetic Resonance Imaging for Severe Pectus Excavatum Assessment in Children

2017 ◽  
Vol 28 (01) ◽  
pp. 034-038 ◽  
Author(s):  
Paloma Triana Junco ◽  
Monserrat Bret ◽  
Manuel Gomez Cervantes ◽  
Martha Muñoz Romo ◽  
Javier Jimenez Gomez ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Ejection Fraction ◽  
Right Ventricle ◽  
Cardiac Function ◽  
Cardiac Magnetic Resonance Imaging ◽  
Pectus Excavatum ◽  
Resonance Imaging ◽  
Right Ventricle Ejection Fraction

Aim Cardiac function can be impaired in patients with pectus excavatum (PE) due to anatomic and dynamic compression of the heart. Efforts for radiation dose reduction in imaging techniques have allowed cardiac magnetic resonance imaging (c-MRI) to play a major role in PE assessment. The aim of our study is to describe the findings of c-MRI 18 months after we changed the PE assessment protocol from chest computed tomography to c-MRI. Patients and Methods Since mid-2015 all patients with severe PE (suspected Haller's index > 3.2) were assessed with inspiratory and expiratory c-MRI. A retrospective analysis of these patients was performed evaluating the following parameters: (1) Radiologic PE indexes (Haller's, correction and asymmetry indexes; and sternal rotation) and (2) cardiac function (including left and right ventricle ejection fraction). Results A total of 20 patients met the inclusion criteria. Dynamic imaging showed a significant difference during inspiration and expiration of the Haller's index 3.85 (range: 3.17–7.3) versus 5.10 (range: 3.85–10.8) (p < 0.05), and correction index (26.86% vs. 36.84%, respectively, p < 0.05). The sternal rotation was 14.5 (range: 0–36). c-MRI analysis disclosed a right ventricle ejection fraction of 50.3%. (normal range: 61% [54–71%]). Echocardiographic imaging underestimated the functional repercussion of PE in all patients. Conclusion Initial results show that PE assessment by c-MRI allows a radiation-free image of the chest wall deformity during the entire breathing process. Also, it permitted the evaluation of the influence of sternum impingement on cardiac function. These findings allowed us a careful surgical evaluation and preoperative planning.

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