scholarly journals Cardiac MRI Assessment of Nonischemic Myocardial Inflammation: State of the Art Review and Update on Myocarditis Associated with COVID-19 Vaccination

2021 ◽  
Vol 3 (6) ◽  
Author(s):  
Felipe Sanchez Tijmes ◽  
Paaladinesh Thavendiranathan ◽  
Jacob A. Udell ◽  
Michael Seidman ◽  
Kate Hanneman
2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
V Kovalenko ◽  
E Nesukay ◽  
S Cherniuk ◽  
R Kirichenko ◽  
A Kozliuk ◽  
...  

Abstract Background Myocardial inflammatory and fibrotic changes are the most frequent and significant causes of ventricular rhythm disorders that could result in development of life threatening arrythmias and increase the risk of sudden cardiac death, especially in young patients with inflammatory cardiomyopathy (ICM). The purpose – to estimate association of myocardial inflammation and fibrosis with development of ventricular arrythmias in patients with ICM during 12-months of follow-up. Material and methods The study was performed on 70 patients with ICM, average age was (35,2±2,7) years. Initially all patients had cardiomegaly with reduced left ventricular (LV) ejection fraction - <40% and absolute value of longitudinal global systolic strain <9,0%. By 24-hour ECG monitoring we studied frequency of ventricular premature beats (VPB) and incidence of non-sustained ventricular tachycardia (NSVT) paroxysms. All patients underwent for cardiac MRI with evaluation of early T1- and T2-weighted images for the detection of inflammatory changes and T1-weighted delayed images for detection of myocardial fibrosis. Results of cardiac MRI were estimated by Lake Louise criteria and also we performed quantification of segments involved according to standard 17-segment LV model. Initial examination was carried out within the 1st month from the clinical onset of disease and subsequent evaluation of studied parameters was performed after 12 months of follow-up. Results After 12 months of follow-up average frequency of VPB reduced to (1,42±0,14) % from (2,32±0,27) % on initial examination (p<0,01), similarly reduced the incidence of NSVT paroxysms – to 11,4% after 12 months from 28,6% initially. Mean quantity of LV segments, affected by inflammatory process and characterized by presence of edema and/or hyperemia, reduced to (2,12±0,22) segm. after 12 months of follow up from (6,12±0,71) segm. on the 1st month (p<0,01). Also we observed increase of LV segments amount with the presence of delayed enhancement which indicates myocardial fibrosis – from (2,04±0,21) segm. on initial examination to (4,79±0,38) segm. after 12 months (p<0,01). Using binary regression analysis we defined that initial presence of inflammatory lesions in ≥5,0 LV segments was associated with frequent VPB (≥1,0%) and NSVT paroxysms. Wherein, after 12 months presence of inflammatory lesions had no association with ventricular rhythm disorders but the same relation was observed between the presence of delayed enhancement in ≥4,0 LV segments and frequent VPB (≥1,0%) as also with NSVT paroxysms. Conclusion At the time of clinical onset of inflammatory cardiomyopathy ventricular rhythm disorders (particularly VPB and NSVT paroxysms) were associated with larger quantity of LV segments involved into inflammatory process. After 12 months of follow-up ventricular rhythm disorders were associated predominantly with the presence of fibrotic lesions in several (≥4,0) segments of LV. Funding Acknowledgement Type of funding source: None


2019 ◽  
Vol 49 (7) ◽  
pp. e122-e131 ◽  
Author(s):  
Michael P. Gannon ◽  
Ebe Schaub ◽  
Cindy L. Grines ◽  
Shahryar G. Saba

Heart ◽  
2012 ◽  
Vol 98 (17) ◽  
pp. 1278-1284 ◽  
Author(s):  
Christopher Neil ◽  
Thanh Ha Nguyen ◽  
Angela Kucia ◽  
Benjamin Crouch ◽  
Aaron Sverdlov ◽  
...  

2015 ◽  
Vol 194 ◽  
pp. 44-49 ◽  
Author(s):  
Constantin Lapa ◽  
Theresa Reiter ◽  
Xiang Li ◽  
Rudolf A. Werner ◽  
Samuel Samnick ◽  
...  

2020 ◽  
Vol 52 (3) ◽  
pp. 930-938 ◽  
Author(s):  
Haojie Li ◽  
Hui Zhu ◽  
Zhaoxia Yang ◽  
Dazhong Tang ◽  
Lu Huang ◽  
...  

2019 ◽  
Author(s):  
Toby Pillinger ◽  
Emanuele F. Osimo ◽  
Antonio de Marvao ◽  
Alaine Berry ◽  
Thomas Whitehurst ◽  
...  

AbstractCardiovascular disease (CVD) is a major cause of excess mortality in schizophrenia. Preclinical evidence shows antipsychotics can cause myocardial fibrosis and myocardial inflammation in murine models, but it is not known if this is the case in patients. We therefore set out to determine if there is evidence of cardiac fibrosis and/or inflammation using cardiac MRI in medicated patients with schizophrenia compared with matched healthy controls. 31 participants (14 patients and 17 controls) underwent cardiac MRI assessing myocardial markers of fibrosis/inflammation, indexed by native myocardial T1 time, and cardiac structure (left ventricular (LV) mass) and function (left/right ventricular end-diastolic and end-systolic volumes, stroke volumes, and ejection fractions). Participants were physically fit, and matched for age, gender, smoking, blood pressure, BMI, HbA1c, ethnicity, and physical activity. Compared with controls, native myocardial T1 was significantly longer in patients with schizophrenia (effect size, d=0.89; p=0.02). Patients had significantly lower LV mass, and lower left/right ventricular end-diastolic and stroke volumes (effect sizes, d=0.86-1.08; all p-values <0.05). There were no significant differences in left/right end-systolic volumes and ejection fractions between groups (p>0.05). These results suggest an early diffuse fibro-inflammatory myocardial process in patients that is independent of established CVD-risk factors and could contribute to the excess cardiovascular mortality associated with schizophrenia. Future studies are required to determine if this is due to antipsychotic treatment or is intrinsic to schizophrenia.


2020 ◽  
Vol 6 (7) ◽  
pp. 65 ◽  
Author(s):  
Sulaiman Vesal ◽  
Andreas Maier ◽  
Nishant Ravikumar

Cardiac magnetic resonance (CMR) imaging is used widely for morphological assessment and diagnosis of various cardiovascular diseases. Deep learning approaches based on 3D fully convolutional networks (FCNs), have improved state-of-the-art segmentation performance in CMR images. However, previous methods have employed several pre-processing steps and have focused primarily on segmenting low-resolutions images. A crucial step in any automatic segmentation approach is to first localize the cardiac structure of interest within the MRI volume, to reduce false positives and computational complexity. In this paper, we propose two strategies for localizing and segmenting the heart ventricles and myocardium, termed multi-stage and end-to-end, using a 3D convolutional neural network. Our method consists of an encoder–decoder network that is first trained to predict a coarse localized density map of the target structure at a low resolution. Subsequently, a second similar network employs this coarse density map to crop the image at a higher resolution, and consequently, segment the target structure. For the latter, the same two-stage architecture is trained end-to-end. The 3D U-Net with some architectural changes (referred to as 3D DR-UNet) was used as the base architecture in this framework for both the multi-stage and end-to-end strategies. Moreover, we investigate whether the incorporation of coarse features improves the segmentation. We evaluate the two proposed segmentation strategies on two cardiac MRI datasets, namely, the Automatic Cardiac Segmentation Challenge (ACDC) STACOM 2017, and Left Atrium Segmentation Challenge (LASC) STACOM 2018. Extensive experiments and comparisons with other state-of-the-art methods indicate that the proposed multi-stage framework consistently outperforms the rest in terms of several segmentation metrics. The experimental results highlight the robustness of the proposed approach, and its ability to generate accurate high-resolution segmentations, despite the presence of varying degrees of pathology-induced changes to cardiac morphology and image appearance, low contrast, and noise in the CMR volumes.


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