scholarly journals Exercise cardiac magnetic resonance imaging: a feasibility study and meta-analysis

2018 ◽  
Vol 315 (4) ◽  
pp. R638-R645 ◽  
Author(s):  
Rhys I. Beaudry ◽  
T. Jake Samuel ◽  
Jing Wang ◽  
Wesley J. Tucker ◽  
Mark J. Haykowsky ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Ejection Fraction ◽  
Stroke Volume ◽  
Cardiac Mri ◽  
Meta Analysis ◽  
Left Ventricular ◽  
Resonance Imaging ◽  
Cardiac Stress ◽  
Response To Exercise

Cardiac stress testing improves detection and risk assessment of heart disease. Magnetic resonance imaging (MRI) is the clinical gold-standard for assessing cardiac morphology and function at rest; however, exercise MRI has not been widely adapted for cardiac assessment because of imaging and device limitations. Commercially available magnetic resonance ergometers, together with improved imaging sequences, have overcome many previous limitations, making cardiac stress MRI more feasible. Here, we aimed to demonstrate clinical feasibility and establish the normative, healthy response to supine exercise MRI. Eight young, healthy subjects underwent rest and exercise cinematic imaging to measure left ventricular volumes and ejection fraction. To establish the normative, healthy response to exercise MRI we performed a comprehensive literature review and meta-analysis of existing exercise cardiac MRI studies. Results were pooled using a random effects model to define the left ventricular ejection fraction, end-diastolic, end-systolic, and stroke volume responses. Our proof-of-concept data showed a marked increase in cardiac index with exercise, secondary to an increase in both heart rate and stroke volume. The change in stroke volume was driven by a reduction in end-systolic volume, with no change in end-diastolic volume. These findings were entirely consistent with 17 previous exercise MRI studies (226 individual records), despite differences in imaging approach, ergometer, or exercise type. Taken together, the data herein demonstrate that exercise cardiac MRI is clinically feasible, using commercially available exercise equipment and vendor-provided product sequences and establish the normative, healthy response to exercise MRI.

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

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.

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

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.

scholarly journals Correlation between Echocardiography and MRI in Volumetric Analysis of Dilated Cardiomyopathy - A Cross-Sectional Study from Puttaparthi, Andhra Pradesh

2021 ◽  
Vol 8 (19) ◽  
pp. 1391-1396
Author(s):  
Kushal Singh ◽  
Anshita Singh ◽  
Piyush Piyush
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Stroke Volume ◽  
Dilated Cardiomyopathy ◽  
Cardiac Mri ◽  
Andhra Pradesh ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Resonance Imaging ◽  
Cross Sectional

BACKGROUND Echocardiography is considered as a traditional approach to clinically study dilated cardiomyopathy. Because of poor apical visibility, however, volumetric calculations are difficult to ascertain. In calculating left ventricle volumes and ejection fractions, magnetic resonance (MR) imaging has shown to be more accurate than echocardiography. Due to conflicting literature, the present study was conducted to diagnose dilated cardiomyopathy using 2 D - echocardiography and correlate these echocardiographic findings with magnetic resonance imaging (MRI). METHODS This observational cross-sectional study was conducted in the Department of Radio-diagnosis and Imaging, Sri Sathya Sai Institute of Higher Medical sciences, Puttaparthi, Andhra Pradesh, Pin 515134. The study group consisted of consecutive patients who had clinical suspicion of dilated cardiomyopathy. A total of 40 patients underwent both 2 D - echo and cardiac MRI on the same day. All patients underwent 2 - D echo which was performed at the frame rate of 40 - 80 frames per second in the left lateral decubitus position to obtain standard 2, 3, and 4 chambers as well as short axis views (GE Vingmed Vivid 7 Dimensions, Horton, Norway: 2.5 MHz transducer). MRI was performed on a 1.5 T scanner (Mangnetom Aera, Siemens, Erlangen, Germany). For patient monitoring and cardiac synchronization, 3 - lead electrocardiography was used. RESULTS In the present study, in comparison to reference standard (cardiac MRI), 2 D - echocardiography showed significant and systematic underestimation of enddiastolic volume (EDV), end-systolic volume (ESV) and stroke volume (SV). Good correlation between 2 D - echo and cardiac MRI was noted for end-diastolic volume (r = 0.89), stroke volume (r = 0.60) and ejection fraction (r = 0.75). CONCLUSIONS In summary, magnetic resonance imaging is an accurate, non-invasive, safe and advanced modality for evaluation of global left ventricular function and myocardial scarring. 2 D - echocardiography can be used for screening of the patients with clinically suspected dilated cardiac myopathy (DCM) and their follow up. KEYWORDS Echocardiography, MRI, Cardiomyopathy

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.

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