Abstract 10958: Identification of Right Ventricular Myocardial Infarction With Late Gadolinium Enhancement in Chronic Ischemic Heart Disease: Comparison With Pathological Findings

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yan Chaowu ◽  
Li Li ◽  
Fang Wei ◽  
Li Hua ◽  
Wang Yang
Keyword(s):  
Myocardial Infarction ◽  
Heart Disease ◽  
Late Gadolinium Enhancement ◽  
Ischemic Heart Disease ◽  
Ischemic Heart ◽  
Pathological Findings ◽  
Chronic Ischemic Heart Disease ◽  
Gadolinium Enhancement ◽  
Right Ventricular Myocardial Infarction ◽  
Replacement Fibrosis

Introduction: Late gadolinium enhancement (LGE) has the potential to become an excellent technique in the diagnosis of right ventricular myocardial infarction (RVMI). However, the gold standard, pathological findings from patients, is still unavailable to validate the true value of LGE. Hypothesis: We hypothesized that LGE might correspond with histological infarction in RVMI. Methods: 36 transplant candidates (35 M /1F) with chronic ischemic heart disease were studied prospectively with LGE. According to the 12-segment-model, the pathological findings of RV were compared with the previous in vivo LGE after heart transplantation. Results: Histological RVMI was detected in 7 patients, and corresponded with all LGE segments (n=23) and 2 non-LGE segments. A generalize linear mix effect model showed non-significant difference (P=0.152) between the results of LGE and histological infraction. In identifying the RV segments with histological infarction, sensitivity and specificity of LGE was 92.0% (95%CI 74.0% to 99.0%) and 100% (95%CI 99.9% to 100.0%), respectively. Furthermore, RV segments without LGE mainly included two pathological patterns: histologically normal myocardium (n=372) or the admixture of viable myocardium and scattered replacement fibrosis (n=35). In the non-LGE RV segments, wall motion abnormality was associated with volume fraction of collagen (11.4±6.5% vs 4.3±2.2%, P<0.001) and the presence of ischemia (96.4% vs 1.7%, P<0.001). Conclusions: The RV segments with LGE corresponded closely with histological infarction in ischemic heart disease. However, RV segments without LGE might be histologically normal myocardium or intermixed with scattered replacement fibrosis. Further studies are required to evaluate the significance of scattered replacement fibrosis in the non-LGE segments.

scholarly journals Correlations of Serum Magnesium and Potassium in Acute Myocardial Infarction, Chronic Ischemic Heart Disease and Normal Healthy Volunteers of Bangladesh

2013 ◽  
Vol 3 (2) ◽  
pp. 50-56
Author(s):  
MBK Choudhury ◽  
MM Hossain ◽  
M Akhtaruzzaman ◽  
MM Jamal Uddin ◽  
MS Rahman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Healthy Volunteers ◽  
Serum Magnesium ◽  
Ischemic Heart ◽  
Diagnostic Tools ◽  
Strong Positive Correlation ◽  
Chronic Ischemic Heart Disease

Magnesium (Mg) and potassium (K) are the major intracellular cations whose presence in the serum are low, but minor changes of those may show a remarkable change in the various body functions specially in the heart. The study was designed to find out the correlation between serum Mg and K in acute myocardial infarction (AMI), chronic ischemic heart disease (CIHD) and normal healthy volunteers. It was carried out over a period of 18 months in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU) in collaboration with Department of Cardiology, Sir Salimullah Medical College & Mitford Hospital (SSMC & MH) and Atomic Energy Center, Dhaka. A total of 101 subjects were included in which 32 subjects were AMI, 34 CIHD and 35 normal healthy volunteers. Serum glucose and serum creatinine were estimated to exclude diabetes and renal dystrophies. Estimation of serum CK-MB and ECG tracing were done as diagnostic tools of AMI and to categories the subjects into various groups. Serum Mg was estimated by Atomic absorption spectrophotometer and serum K by Ion sensitive electrode. The present study shows that there is a strong positive correlation of serum Mg and K in AMI, CIHD and healthy control subjects (r = 0.566, p<0.01 level). So it is suggested to estimate and supplement both Mg and K in IHD patients for their better management. DOI: http://dx.doi.org/10.3329/bjmb.v3i2.13812 Bangladesh J Med Biochem 2010; 3(2): 50-56

scholarly journals Comparison of Serum Magnesium and Potassium in Acute Myocardial Infarction and Chronic Ischemic Heart Disease

2012 ◽  
Vol 17 (1) ◽  
pp. 33-36
Author(s):  
MBK Choudhury ◽  
MS Rahman ◽  
MM Hassan ◽  
R Begum ◽  
N Hoque ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Serum Magnesium ◽  
Serum Glucose ◽  
Ischemic Heart ◽  
Cardiac Complications ◽  
Chronic Ischemic Heart Disease ◽  
Group I

The comparative study has been designed to estimate serum magnesium (Mg) and potassium (K) in patients with acute myocardial infarction (AMI) and chronic ischemic heart disease (CIHD). A total 61 subjects were selected and were divided as group-I (30 subjects of AMI) and group-II (31 subjects of CIHD). Laboratory investigations were done for estimation of serum glucose and serum creatinine to exclude the diabetes mellitus and renal disease. Serum Mg was estimated by atomic absorption spectrophotometer and serum K by ion selective electrode. This study showed that Mg and K level in serum is significantly lower in patients with AMI than that of CIHD subjects. Findings of the study suggested that significantly reduced serum level of Mg and K persists in AMI than those of CIHD, which may be the cause of further cardiac complications. So it may be recommended for estimation and supplementation of Mg and K in both the cases of AMI and CIHD patients for better management. DOI: http://dx.doi.org/10.3329/jdnmch.v17i1.12190 J. Dhaka National Med. Coll. Hos. 2011; 17 (01): 33-36

scholarly journals Effective Study: Development and Application of a Question‐Driven, Time‐Effective Cardiac Magnetic Resonance Scanning Protocol

2021 ◽  
Author(s):  
Camilla Torlasco ◽  
Silvia Castelletti ◽  
Davide Soranna ◽  
Valentina Volpato ◽  
Stefano Figliozzi ◽  
...  
Keyword(s):  
Heart Disease ◽  
Cardiac Magnetic Resonance ◽  
Late Gadolinium Enhancement ◽  
Magnetic Resonance ◽  
Ischemic Heart Disease ◽  
Tissue Characterization ◽  
Ischemic Heart ◽  
Gadolinium Enhancement ◽  
Scanning Time ◽  
Stress Cmr

Background Long scanning times impede cardiac magnetic resonance (CMR) clinical uptake. A “one‐size‐fits‐all” shortened, focused protocol (eg, only function and late‐gadolinium enhancement) reduces scanning time and costs, but provides less information. We developed 2 question‐driven CMR and stress‐CMR protocols, including tailored advanced tissue characterization, and tested their effectiveness in reducing scanning time while retaining the diagnostic performances of standard protocols. Methods and Results Eighty three consecutive patients with cardiomyopathy or ischemic heart disease underwent the tailored CMR. Each scan consisted of standard cines, late‐gadolinium enhancement imaging, native T1‐mapping, and extracellular volume. Fat/edema modules, right ventricle cine, and in‐line quantitative perfusion mapping were performed as clinically required. Workflow was optimized to avoid gaps. Time target was <30 minutes for a CMR and <35 minutes for a stress‐CMR. CMR was considered impactful when its results drove changes in diagnosis or management. Advanced tissue characterization was considered impactful when it changed the confidence level in the diagnosis. The quality of the images was assessed. A control group of 137 patients was identified among scans performed before February 2020. Compared with standard protocols, the average scan duration dropped by >30% (CMR: from 42±8 to 28±6 minutes; stress‐CMR: from 50±10 to 34±6 minutes, both P <0.0001). Independent on the protocol, CMR was impactful in ≈60% cases, and advanced tissue characterization was impactful in >45% of cases. Quality grading was similar between the 2 protocols. Tailored protocols did not require additional staff. Conclusions Tailored CMR and stress‐CMR protocols including advanced tissue characterization are accurate and time‐effective for cardiomyopathies and ischemic heart disease.

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