Abstract 3574: Unsuspected Left Ventricular Wall Motion Abnormalities Identified by Cardiovascular Magnetic Resonance in a Free-Living Population: Lessons from the Framingham Heart Study

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Connie W Tsao ◽  
Philimon Gona ◽  
Carol J Salton ◽  
Peter G Danias ◽  
Susan Blease ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Framingham Heart Study ◽  
Wall Motion ◽  
Left Ventricular ◽  
Short Axis ◽  
Free Living ◽  
Heart Study ◽  
History Of ◽  
Wall Motion Abnormalities

INTRODUCTION: Resting left ventricular (LV) wall motion abnormalities (WMAs) are associated with significant morbidity and mortality. We hypothesized that unsuspected resting WMAs would be present in a healthy population and applied cardiovascular magnetic resonance (CMR) to characterize the prevalence of these in a free-living population. METHODS: 1794 subjects in the Framingham Heart Study Offspring Cohort (844M, 65±9 yrs) underwent cine CMR in short-axis, 2-ch, and 4-ch planes. Wall motion was scored using a standard 17-segment model with a 5-point scale. Global and regional (Ant, Sept, Inf, Lat) wall motion score indices (WMSI=wall motion score/# segments) were calculated with a WMSI>1 considered abnormal. LV ejection fraction (EF) and mass index (LVMI) were measured from the short axis stack. Adjudicated clinical events [CE; a history of coronary heart disease (CHD) or congestive heart failure (CHF)] were assessed. RESULTS: WMAs were present in 143 subjects. Compared to subjects with no prior CE, those with CE (n=157) had greater prevalence of WMA (Global, 34% vs 6%; Ant, 16% vs 2%; Sept, 18% vs 3%; Inf, 28% vs 4%; Lat, 27% vs 3%; all p<0.0001) and higher Framingham Risk Score (FRS) (11±3 vs 7±4, p<0.0001). In subjects with CE, WMA was associated with higher LVMI (70±14 g/m 2 vs 59±14 g/m 2 , p<0.0001) and lower EF (53±11% vs 69±6%, p<0.0001), but not age, blood pressure (BP), or FRS. Among 1637 subjects with no CE, 90 (5.5%) had a WMA. In these subjects, WMA was associated with greater age, BP, FRS, and LVMI, and lower EF (TABLE ). In the entire (n=1794) cohort, WMAs were more prevalent in men than in women (40% vs 19% with CE; 9% vs 3% without CE, respectively, both p<0.0001). CONCLUSIONS: In this closely followed free-living population, 5.5% of subjects have WMAs despite the absence of CE. WMAs were associated with other parameters of cardiovascular risk. The presence of WMAs among subjects without history of CHD or CHF may identify those at risk for adverse cardiovascular events.

scholarly journals Endogenous T1ρ cardiovascular magnetic resonance in hypertrophic cardiomyopathy

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Elizabeth W. Thompson ◽  
Srikant Kamesh Iyer ◽  
Michael P. Solomon ◽  
Zhaohuan Li ◽  
Qiang Zhang ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Hypertrophic Cardiomyopathy ◽  
Magnetic Resonance ◽  
Extracellular Volume ◽  
Relaxation Times ◽  
Left Ventricular ◽  
Cardiomyocyte Hypertrophy ◽  
Short Axis ◽  
Spearman's Rho ◽  
Spearman’S Rho

Abstract Background Hypertrophic cardiomyopathy (HCM) is characterized by increased left ventricular wall thickness, cardiomyocyte hypertrophy, and fibrosis. Adverse cardiac risk characterization has been performed using late gadolinium enhancement (LGE), native T1, and extracellular volume (ECV). Relaxation time constants are affected by background field inhomogeneity. T1ρ utilizes a spin-lock pulse to decrease the effect of unwanted relaxation. The objective of this study was to study T1ρ as compared to T1, ECV, and LGE in HCM patients. Methods HCM patients were recruited as part of the Novel Markers of Prognosis in Hypertrophic Cardiomyopathy study, and healthy controls were matched for comparison. In addition to cardiac functional imaging, subjects underwent T1 and T1ρ cardiovascular magnetic resonance imaging at short-axis positions at 1.5T. Subjects received gadolinium and underwent LGE imaging 15–20 min after injection covering the entire heart. Corresponding basal and mid short axis LGE slices were selected for comparison with T1 and T1ρ. Full-width half-maximum thresholding was used to determine the percent enhancement area in each LGE-positive slice by LGE, T1, and T1ρ. Two clinicians independently reviewed LGE images for presence or absence of enhancement. If in agreement, the image was labeled positive (LGE + +) or negative (LGE −−); otherwise, the image was labeled equivocal (LGE + −). Results In 40 HCM patients and 10 controls, T1 percent enhancement area (Spearman’s rho = 0.61, p < 1e-5) and T1ρ percent enhancement area (Spearman’s rho = 0.48, p < 0.001e-3) correlated with LGE percent enhancement area. T1 and T1ρ percent enhancement areas were also correlated (Spearman’s rho = 0.28, p = 0.047). For both T1 and T1ρ, HCM patients demonstrated significantly longer relaxation times compared to controls in each LGE category (p < 0.001 for all). HCM patients also showed significantly higher ECV compared to controls in each LGE category (p < 0.01 for all), and LGE −− slices had lower ECV than LGE + + (p = 0.01). Conclusions Hyperenhancement areas as measured by T1ρ and LGE are moderately correlated. T1, T1ρ, and ECV were elevated in HCM patients compared to controls, irrespective of the presence of LGE. These findings warrant additional studies to investigate the prognostic utility of T1ρ imaging in the evaluation of HCM patients.

Abstract 3117: Subclinical Aortic Atherosclerosis by Cardiovascular Magnetic Resonance Imaging Predicts Increased Cardiovascular Morbidity and Mortality in an Initially Healthy Cohort: The Framingham Heart Study

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Michael L Chuang ◽  
Philimon Gona ◽  
Farouc A Jaffer ◽  
Carol J Salton ◽  
Kraig V Kissinger ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Framingham Heart Study ◽  
Plaque Burden ◽  
Rank Test ◽  
Black Blood ◽  
Aortic Atherosclerosis ◽  
Heart Study ◽  
Cardiovascular Morbidity And Mortality

INTRODUCTION: We sought to determine whether subclinical aortic atherosclerosis, detected noninvasively using cardiovascular magnetic resonance (CMR), predicts major adverse cardiovascular events (MACE) in adults without history or clinical manifestation of cardiovascular disease (CVD). METHODS: 318 Framingham Heart Study (FHS) Offspring cohort members (60±9 yrs, 51% women) underwent CMR in 1998–1999. Subjects were free of clinical CVD and were recruited from equal strata of age, sex and quintile of Framingham Coronary Risk score (FCRS), with double sampling of the top quintile. CMR of the descending aorta on a 1.5-T system used an ECG-triggered black-blood T2W TSE sequence with 1.03 × 0.64 × 5-mm 3 voxels, 10-mm gap. Aortic-lumen and plaque areas were hand-traced. MACE included CV death, myocardial infarction (MI), stroke or new heart failure (HF). A Cox proportional hazards model adjusted for FCRS was used to determine hazard ratio (HR) for MACE for the (within-sexes) quartile of subjects with greatest plaque burden (Q4) vs other subjects (Q1–3). Log-rank test was used to compare survival. RESULTS: CMR aortic atherosclerosis was identified in 38% of women and 41% of men. Over median 5.2-yr follow up, 38 MACE (4 deaths, 14 MIs, 12 strokes, 8 HF) occurred among 31 subjects. Greater plaque burden (Q4) was associated with 2.75-fold greater hazard of MACE (95% CI 1.33 – 5.69, p=0.007). The Figure shows Kaplan-Meier survival, log-rank p=0.0009. CONCLUSIONS: In a free-living population without history of cardiovascular disease, CMR evidence of subclinical aortic atherosclerosis was a predictor of 5-year MACE, even after adjustment for traditional cardiovascular risk factors.

scholarly journals Magnetic Resonance Detects Structural Heart Disease in Patients with Frequent Ventricular Ectopy and Normal Echocardiographic Findings

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1505
Author(s):  
Raffaele Scorza ◽  
Anders Jansson ◽  
Peder Sörensson ◽  
Mårten Rosenqvist ◽  
Viveka Frykman
Keyword(s):  
Magnetic Resonance ◽  
Right Ventricular ◽  
Wall Motion ◽  
Regional Wall Motion ◽  
Left Ventricular ◽  
Ventricular Ectopy ◽  
Premature Ventricular Contractions ◽  
Regional Wall ◽  
Regional Wall Motion Abnormalities ◽  
Wall Motion Abnormalities

The prognosis of patients with ventricular ectopy and a normal heart, as evaluated by echocardiography, is virtually unknown. Cardiac magnetic resonance (CMR) can detect focal ventricular anomalies that could act as a possible site of origin for premature ventricular contractions (PVCs). The aim of this study was to investigate the presence of cardiac anomalies in patients with normal findings at echocardiogram. Methods: Fifty-one consecutive patients (23 women, 28 men, mean age 59 years) with very high PVC burden (>10,000 PVC/day) and normal findings at standard echocardiography and exercise test were examined with CMR. The outcome was pathologic findings, defined as impaired ejection fraction, regional wall motion abnormalities, abnormal ventricular volume, myocardial edema and fibrosis. Results: Sixteen out of 51 patients (32%) had structural ventricular abnormalities at CMR. In five patients CMR showed impairment of the left ventricular and/or right ventricular systolic function, and six patients had a dilated left and/or right ventricle. Regional wall motion abnormalities were seen in six patients and fibrosis in four. No patient had CMR signs of edema or met CMR criteria for arrhythmogenic right ventricular cardiomyopathy. Five patients had extra-ventricular findings (enlarged atria in three cases, enlarged thoracic aorta in one case and pericardial effusion in one case). Conclusions: In this study 16 out of 51 patients with a high PVC burden and normal findings at echocardiography showed signs of pathology in the ventricles with CMR. These findings indicate that CMR should be considered in evaluating patients with a high PVC burden and a normal standard investigation.

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