Regional assessment of wall curvature and wall stress in left ventricle with magnetic resonance imaging

1999 ◽  
Vol 277 (3) ◽  
pp. H901-H910 ◽  
Author(s):  
Philippe Balzer ◽  
Alain Furber ◽  
Stéphane Delépine ◽  
Frédéric Rouleau ◽  
Franck Lethimonnier ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Left Ventricle ◽  
Wall Stress ◽  
Left Ventricular ◽  
Cine Mri ◽  
Short Axis ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Systolic Wall Stress

Left ventricular functional abnormalities are associated with regional increases of wall stress and modifications of wall curvature. This study describes the integration of the short-axis and long-axis wall curvatures for determining peak systolic wall stress. Quantification was realized with cine magnetic resonance imaging (MRI) from the location of the endocardial and epicardial borders of the left ventricle on pairs of consecutive short-axis sections. Fifteen normal volunteers were subjected to cine MRI, and different methods of calculating peak systolic wall stress were compared. A short-axis analysis showed a 55 ± 13% increase of the circumferential mean of the peak systolic wall stress between apical and basal sections. Regarding the curvature, no significant increase of wall stress was observed except on the septal wall (31 ± 18%). Short-axis studies proved to be insufficient for determining the regional variations of left ventricular wall stress and for providing normal reference values for the location of abnormal regions in patients.

Relation of B-type natriuretic peptide to left ventricular wall stress as assessed by cardiac magnetic resonance imaging in patients with dilated cardiomyopathy

2007 ◽  
Vol 85 (8) ◽  
pp. 790-799 ◽  
Author(s):  
P. Alter ◽  
H. Rupp ◽  
M.B. Rominger ◽  
A. Vollrath ◽  
F. Czerny ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Wall Stress ◽  
Left Ventricular ◽  
Ventricular Wall ◽  
Resonance Imaging ◽  
Sphere Model ◽  
Lv Mass ◽  
Systolic Wall Stress

Ventricular loading conditions are crucial determinants of cardiac function and prognosis in heart failure. B-type natriuretic peptide (BNP) is mainly stored in the ventricular myocardium and is released in response to an increased ventricular filling pressure. We examined, therefore, the hypothesis that BNP serum concentrations are related to ventricular wall stress. Cardiac magnetic resonance imaging (MRI) was used to assess left ventricular (LV) mass and cardiac function of 29 patients with dilated cardiomyopathy and 5 controls. Left ventricular wall stress was calculated by using a thick-walled sphere model, and BNP was assessed by immunoassay. LV mass (r = 0.73, p < 0.001) and both LV end-diastolic (r = 0.54, p = 0.001) and end-systolic wall stress (r = 0.66, p < 0.001) were positively correlated with end-diastolic volume. LV end-systolic wall stress was negatively related to LV ejection fraction (EF), whereas end-diastolic wall stress was not related to LVEF. BNP concentration correlated positively with LV end-diastolic wall stress (r = 0.50, p = 0.002). Analysis of variance revealed LV end-diastolic wall stress as the only independent hemodynamic parameter influencing BNP (p < 0.001). The present approach using a thick-walled sphere model permits determination of mechanical wall stress in a clinical routine setting using standard cardiac MRI protocols. A correlation of BNP concentration with calculated LV stress was observed in vivo. Measurement of BNP seems to be sufficient to assess cardiac loading conditions. Other relations of BNP with various hemodynamic parameters (e.g., EF) appear to be secondary. Since an increased wall stress is associated with cardiac dilatation, early diagnosis and treatment could potentially prevent worsening of the outcome.

scholarly journals Magnetic resonance imaging accurately estimates LV mass in a transgenic mouse model of cardiac hypertrophy

1998 ◽  
Vol 274 (2) ◽  
pp. H679-H683 ◽  
Author(s):  
Fatima Franco ◽  
Susan K. Dubois ◽  
Ronald M. Peshock ◽  
Ralph V. Shohet
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cardiac Hypertrophy ◽  
Cine Mri ◽  
Short Axis ◽  
Wild Type ◽  
Resonance Imaging ◽  
Cardiac Phenotype ◽  
Lv Mass ◽  
Magnetic Resonance Imaging Mri

Transgenic mice with a dysfunctional guanylyl cyclase A gene (GCA −/−) are unable to transduce the signals from atrial naturetic peptide and develop hypertension and cardiac hypertrophy. Magnetic resonance imaging (MRI) was performed to assess cardiac hypertrophy in these animals, using wild-type siblings as controls. Anesthetized mice were studied by gated multislice, multiphase cine MRI at 1.5 T. Simpson’s rule was used to estimate left ventricle (LV) mass and volumes from short-axis images. Correlation between LV mass evaluated by MRI and at necropsy was excellent, with LVnecropsy = 1.04 × LVMRI + 4.69 mg ( r 2 = 0.95). By MRI, GCA −/− LV mass was significantly different when compared with isogenic controls [GCA −/−, 226 ± 43 mg ( n = 14) vs. controls, 156 ± 14 mg ( n = 10); P < 0.0001]. LV volumes and ejection fraction in the two groups were not significantly different. MRI provides an accurate means for the noninvasive assessment of murine cardiac phenotype and may be useful in following the effects of genetic modification.

scholarly journals P240 Thebesian veins draining to the left ventricle mimicking left ventricular non-compaction

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
K Durrer-Ariyakuddy ◽  
B W De Boeck ◽  
F Cuculi ◽  
R Kobza ◽  
S F Staempfli
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Left Ventricle ◽  
Color Doppler ◽  
Left Ventricular ◽  
Short Axis ◽  
Resonance Imaging ◽  
T Wave ◽  
Color Doppler Flow ◽  
Thebesian Veins

Abstract Description We report about a 59-year old asymptomatic woman initially presented with lateral T-wave inversions in a routine ECG. Echocardiography suggested isolated left ventricular non-compaction (LVNC). An additional cardiac magnetic resonance imaging (cMRI) showed positive diagnostic criteria for LVNC. Six years later a diagnostic coronary angiogram revealed by a coincidence extensive shunting from the left coronary arteries to the left ventricle through Thebesian veins (sinusoids). Finally color Doppler flow confirmed that the irregular anatomy of the LV was not a result of incomplete LV compaction but due to the coronary anomaly. Initial work up A 59-year old asymptomatic woman presented with lateral T-wave inversions in a routine ECG. Echocardiography suggested isolated left ventricular non-compaction (LVNC) with deep recesses and a systolic non-compacted to compacted ratio in short axis of &gt;2. To confirm the diagnosis cardiac magnetic resonance imaging (cMRI) was performed. Quality was not optimal due to premature contractions and insufficient breath-hold, but positive diagnostic criteria for LVNC (as described by Petersen, Left ventricular non-compaction: insights from cardiovascular magnetic resonance imaging. JACC, 2005 July 5;46(1):101-5) were reported (Figure 1A). Diagnosis and Management Six years later, the patient was referred to our institution for catheter ablation of a suspected paroxysmal supraventricular tachycardia causing palpitations. Since the patient also complained about recurrent chest pain, a coronary angiogram was performed in the same session and revealed a chronic total occlusion of the right coronary artery. However, also extensive shunting from the left coronary arteries to the left ventricle through Thebesian veins (sinusoids) was observed (Figure 1B, arrows). Follow-up In light of this new finding, echocardiography was repeated and color Doppler flow revealed diastolic filling of the recesses not from the LV cavity but from the coronary system, confirming that the irregular anatomy of the LV was not a result of incomplete LV compaction but due to the coronary anomaly (Figure 1C, apical short axis view, upper panel color Doppler in diastole, lower panel color M-mode). To exclude concurrent LVNC a cardiac CT was performed, confirming that the recesses, which initially led to the diagnosis of LVNC, exhibited diastolic flow from the coronary system (Figure 1D). Conclusion This case exemplifies that for the diagnosis of LVNC all echocardiographic criteria as defined by Oechslin and Jenni (Left ventricular non-compaction revisited: a distinct phenotype with genetic heterogeneity. EHJ, 2011 June;Volume 32, Issue 12, Pages 1446–1456) need to be fulfilled – including color Doppler assessment of flow in the recesses. Consequently, it illustrates that cMRI alone is not sufficient for the diagnosis of LVNC but both echocardiographic and cMRI criteria need to be applied. Abstract P240 Figure.

scholarly journals Semiotics of apical hypertrophic cardiomyopathy in magnetic resonance Imaging

2020 ◽  
Vol 19 (2) ◽  
pp. 18-23
Author(s):  
I. E. Obramenko
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hypertrophic Cardiomyopathy ◽  
Magnetic Resonance ◽  
Left Ventricle ◽  
Heart Diseases ◽  
Fibrous Tissue ◽  
Left Ventricular ◽  
Left Ventricular Cavity ◽  
Resonance Imaging ◽  
Apical Hypertrophic Cardiomyopathy

Introduction. About 0.2 % of the adult population all over the world suffers from hypertrophic cardiomyopathy. Early and timely diagnosis of the apical form of hypertrophic cardiomyopathy remains an urgent medical problem, since the disease has a wide variability of clinical manifestations and often occurs asymptomatic or with symptoms of other heart diseases. Magnetic resonance imaging is an informative method of radiation diagnosis of hypertrophic cardiomyopathy. The aim is improving of radiology diagnostics in applying to the apical form of hypertrophic cardiomyopathy. Materials and methods. 98 patients with apical hypertrophic cardiomyopathy aged 19 to 76 years were еxamined. There were 48 men and 50 women. All subjects were examined by a cardiologist, all patients underwent electrocardiography and echocardiography, 45 patients underwent magnetic resonance imaging (MRI) of the heart. Results. In our study 13 patients had MRI determined the isolated form of apical form of hypertrophic cardiomyopathy, 32 had combined one. 42.2% of the patients with symmetrical hypertrophy of all apical segments had sawtoothed configuration of the LV revealed by MRI. The symptom of left ventricular cavity obliteration was determined in 19 patients. The symptom of LV cavity sequestration was determined in 5 subjects. 5 patients had an aneurysm on the top of the left ventricle, 1 – on the top of the right ventricle. Signs of left ventricular outflow tract obstruction were visualized in 2 patients, intraventricular obstruction at the level of the middle segments of the left ventricle was determined in 5 cases. Akinesis and hypokinesis were detected in areas of fibrous changes (n=21) or in areas of cardiosclerosis (n=2). In 17.8 % of subjects identified non-compacted myocardium, in 3 cases it was combined with apical form of hypertrophic cardiomyopathy. With contrast enhancement in 29 patients, foci (n=22) or zones (n=7) of pathological accumulation of contrast agent were determined, which indicated the replacement of myocardium with fibrous tissue.

scholarly journals Congenital diverticulum of the left ventricle – diagnosis with echocardiography, ventriculography and magnetic resonance imaging: clinical case

2020 ◽  
Vol 26 (3) ◽  
pp. 74-82
Author(s):  
Gloria Adam ◽  
Ina Tsareva ◽  
Galina Kirova ◽  
Ivo Petrov
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Left Ventricle ◽  
Clinical Symptoms ◽  
Resonance Imaging ◽  
Cardiac Wall ◽  
Invasive Method ◽  
Electrocardiographic Changes ◽  
Magnetic Resonance Imaging Mri ◽  
Myocardial Crypts

Myocardial diverticula are rare and incidental fi ndings. They are most probably congenital anomalies of the cardiac wall, mainly of the left ventricle (LV), which in the majority of the cases are associated with other anomalies – cardiac, vascular or thoraco-abdominal. The lack of specifi c clinical symptoms and electrocardiographic changes in the presence of cardiac diverticulum, make them most commonly an incidental fi nding during a diagnostic imaging examination. The diagnosis of LV diverticulum can be made with echocardiography, left ventriculography, computed tomography or magnetic-resonance imaging (MRI). Among all, MRI gives the best morphologic assessment of the ventricular wall, the location and the relation of the diverticulum to surrounding structures and its dynamic behaviour during systole and diastole. MRI can rule out infl ammatory, traumatic and ischemic cardiac pathology, and cardiomyopathy, and thus differentiate the diverticulum from another entity – myocardial crypts, pathologically formed focal aneurysm or pseudoaneurysm of the LV. Therefore, MRI is the preferred non-invasive method for evaluating the cardiac wall in detail and helps to differentiate and defi nitively diagnose congenital cardiac diverticulum, which in most cases does not require therapeutic intervention.

scholarly journals Open-Source Routines for Building Personalized Left Ventricular Models From Cardiac Magnetic Resonance Imaging Data

2019 ◽  
Vol 142 (2) ◽  
Author(s):  
Thien-Khoi N. Phung ◽  
Christopher D. Waters ◽  
Jeffrey W. Holmes
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Geometric Model ◽  
Left Ventricular ◽  
Patient Specific ◽  
Imaging Data ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Data ◽  
Multiple Imaging ◽  
Magnetic Resonance Imaging Mri

Abstract Creating patient-specific models of the heart is a promising approach for predicting outcomes in response to congenital malformations, injury, or disease, as well as an important tool for developing and customizing therapies. However, integrating multimodal imaging data to construct patient-specific models is a nontrivial task. Here, we propose an approach that employs a prolate spheroidal coordinate system to interpolate information from multiple imaging datasets and map those data onto a single geometric model of the left ventricle (LV). We demonstrate the mapping of the location and transmural extent of postinfarction scar segmented from late gadolinium enhancement (LGE) magnetic resonance imaging (MRI), as well as mechanical activation calculated from displacement encoding with stimulated echoes (DENSE) MRI. As a supplement to this paper, we provide MATLAB and Python versions of the routines employed here for download from SimTK.

scholarly journals P713 An incidental finding of a completely thrombosed left ventricular pseudoaneurysm: what is the next step?

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Istratoaie ◽  
A Iliescu ◽  
S Manole ◽  
R Beyer ◽  
D Tudoreanu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Left Ventricle ◽  
Cardiac Magnetic Resonance Imaging ◽  
Multimodality Imaging ◽  
Left Ventricular ◽  
Resonance Imaging ◽  
Left Ventricular Pseudoaneurysm

Abstract Introduction Left ventricular pseudoaneurysm is a rare complication of myocardial infarction. It is the result of ventricular rupture contained by the pericardial adhesions or thrombus. Although echocardiography is suitable as the initial method for diagnosis, multimodality imaging is often required in order to further characterize the pseudoaneurysm morphology and to plan the treatment. Case report A 56-year-old male patient with an old inferior myocardial infarction treated conservatively 6 years ago, was admitted in our department for atypical left laterothoracic pain. Three months before he had the same symptoms and an unexplained paracardiac mass was incidentally diagnosed by transthoracic echocardiography. At that time, he was evaluated by coronary angiography which showed no epicardial coronary artery stenosis. During admission, the ECG showed sinus rhythm, inferior myocardial scarring and right bundle branch block. The laboratory tests revealed cardiac enzymes within normal range, increased D-dimeri and elevated inflammatory markers. The echocardiography showed a nondilated left ventricle (LV) with preserved ejection fraction and akinesia of the inferolateral(IL) LV wall. Attached to the basal IL LV wall, an extensive mass was documented with an echogenic appearance and no color Doppler flow, suggesting a thrombosed pseudoaneurysm. A contrast enhanced computed tomography (CT) scan confirmed the diagnosis, but it was not able to establish whether the pseudoaneurysm was partially or completely thrombosed. For a more accurate morphologic and tissue characterization, a cardiac magnetic resonance imaging(CMR) was subsequently performed, that confirmed the presence of a completely thrombosed pseudoaneurysm, measuring 82x38mm. In this case, a conservative approach was initially suggested by the completely thrombosed chronic pseudoaneurysm (older than 3months and with no Doppler color flow). However, according to the literature a surgical approach should be considered when the pseudoaneurysm dimension is larger than 3 cm. Since the patient refused the surgical intervention, medical treatment was initiated with anticoagulants due to the high embolic risk, betablockers and angiotensin-receptor antagonists to maintain the blood pressure less than 120/80mmHg. At 1 month, his condition was stable. He will be reevaluated in 3 months, to monitor the possible pseudoaneurysm expansion. According to our knowledge, this is the first case of a completely thrombosed pseudoaneurysm described in the literature. Its echocardiographic, CT and CMR appearance is important for the differential diagnosis of all paracardiac masses (tumors, hiatus hernias, etc). Conclusion Completely thrombosed left ventricle pseudoaneurysm remains a challenging diagnosis since its echocardiographic appearance is atypical. Cardiac magnetic resonance imaging has a higher diagnostic yield and can provide important information that may influence the course of treatment. Abstract P713 Figure. LV Pseudoaneurysm-multimodality imaging

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