Abstract 226: Impact of Reporting Cardiac Magnetic Resonance Examination Duration on the Total Scan Time: A Tertiary Academic Health Care Hospital Experience

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Manavjot S Sidhu ◽  
Heidi Lumish ◽  
Shanmugam Uthamalingam ◽  
Leif-Christopher Engel ◽  
Mannudeep Kalra ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Wilcoxon Test ◽  
Care Hospital ◽  
Diagnostic Quality ◽  
Scan Time ◽  
Two Samples ◽  
Significant Difference ◽  
Simple Step ◽  
Time Allotment

Background: The core components of a quality improvement (QI) program focus on consistent, high-quality service delivery. We report our experience with a QI program focused on cardiac magnetic resonance (CMR) examination duration reduction. Methods: Department policy for the scan time allotment for a clinical CMR examination was reviewed. Medical records of all patients who underwent CMR examination from January 2010 to December 2010 were reviewed. Scan duration from time of the initial to the final image acquisition was recorded. An intervention was implemented from January 2011 to September 2011 to report the scan durations weekly to all CMR physicians. Monthly comparisons were performed between the 2010 and 2011 exams. No changes were made in department protocols. Results: The allotted time for a CMR examination was 90 minutes. From January to September 2010, the mean (±SD) scan duration for CMR examinations was 105 (± 32) minutes, as compared with a mean of 87 (±21) minutes for the same months in 2011. Comparison between the 2010 and 2011 scan durations using a Wilcoxon test indicated a significant difference between the two samples (p<0.05; Figure 1). The percentage of all scans exceeding 120 minutes in duration decreased from 27.4% (n=529) in 2010 to 5.3% (n=451) in 2011. The indications for CMR examinations were found to be similar between 2011 and 2010 (p<0.05). All exams were reported to be of diagnostic quality. Conclusions: The simple step of publicly reporting weekly scan durations to house staff and attending physicians resulted in significant reduction in CMR scan durations, with preserved diagnostic quality. We propose that increased awareness led to higher efficiency.

Abstract 19008: Is Cold Pressor Cardiac Magnetic Resonance Imaging Testing Useful for Detection of Coronary Endothelial Dysfunction?

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Sherwin Dela Cruz ◽  
Janet Wei ◽  
Chrisandra Shufelt ◽  
Puja Mehta ◽  
Andre Rogatko ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Endothelial Dysfunction ◽  
Cardiac Magnetic Resonance Imaging ◽  
Myocardial Perfusion Reserve ◽  
Cold Pressor ◽  
Resonance Imaging ◽  
Significant Difference ◽  
Coronary Endothelial Dysfunction

Background: Coronary endothelial dysfunction is typically assessed by invasive coronary reactivity testing (CRT) to measure coronary blood flow ([[Unable to Display Character: &#8710;]]CBF) and diameter responses to acetylcholine (Ach). We evaluated if cold pressor testing (CPT) during noninvasive cardiac magnetic resonance imaging (CMRI) measurement of myocardial perfusion reserve index (MPRI) reflects invasive measurements with Ach and CPT in subjects suspected of having endothelial dysfunction. Methods: CRT was performed in 137 symptomatic women using incremental infusions of Ach in the left coronary artery for 3 minutes and with CPT using ice pack on their hand and forearm for 2 minutes. Quantitative coronary angiography was performed 5 mm distal to the Doppler wire positioned in the proximal left anterior descending artery. In 132 women, [[Unable to Display Character: &#8710;]]CBF was calculated from average peak velocity and vessel cross sectional area. Invasive CPT could not be completed on 4 women. All women underwent CPT CMRI (1.5 T) to measure MPRI as a ratio of stress and rest upslopes of the whole myocardium. Five definitions of normal invasive CPT and Ach diameter response (dilation > 0, 5, 10, 15 or 20%) were compared to two abnormal definitions (≤ 0 or - 5%) of endothelial function. Normal [[Unable to Display Character: &#8710;]]CBF was defined as ≤ 50%. We used Wilcoxon Two-Sample statistical test to compare MPRI in each group. Results: CPT MPRI was significantly different in those with normal versus abnormal invasive Ach when Ach diameter response was defined as ≥ 20% or < - 5 % (p=0.04), though not with other thresholds (Table). Conclusion: Noninvasive CPT CMRI may not be useful for detection of endothelial dysfunction in symptomatic women as no significant difference in MPRI was found in those with normal and abnormal invasive CRT. However, there may be a role for CPT MPRI in detecting endothelial dysfunction at higher thresholds of normal diameter response. Additional investigation will evaluate CPT CMRI and cardiovascular outcomes.

scholarly journals Autologous Right Auricular Versus PTFE Cavopulmonary Lateral Tunnel: Influence of Surgical Technique on Arrhythmias

2019 ◽  
Vol 10 (6) ◽  
pp. 686-693
Author(s):  
Sara C. Arrigoni ◽  
Freek van den Heuvel ◽  
Tineke P. Willems ◽  
Nic J.G.M. Veeger ◽  
Paul Schoof ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Growth Potential ◽  
Risk Indicators ◽  
Lateral Tunnel ◽  
Increased Risk ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Cox Proportional Hazard Regression ◽  
The Right

Background: To compare the incidence of arrhythmias and the overall survival at long-term follow-up of the right auricular baffle technique (RA) versus Gore-Tex® (GT) baffle as intra-atrial cavopulmonary lateral tunnel, as well as the Nakata index and tunnel dimensions on cardiac magnetic resonance. Methods: Data were retrospectively collected. Serial 24-hour Holter recordings and cardiac magnetic resonance findings of the two groups were compared. Results: There was no significant difference in the estimated freedom from arrhythmias (87% at 10 years and 78% at 15 years vs 80% at 10 years and 70% at 15 years in RA and GT, respectively; P = .44) nor cumulative survival (86% at 10 years and 84% at 15 years vs 97% at 10 years and 81% at 15 years in RA and GT, respectively; P = .8). Also, no difference between the groups was observed in the Nakata index. The tunnel dimensions on cardiac magnetic resonance were significantly wider in the RA group. In reference to other potential risk indicators, using Cox proportional hazard regression analysis, only age (5 years or older at the time of total cavopulmonary connection) was associated with an increased risk for both arrhythmia and mortality. Conclusions: This study demonstrated that there was no difference in freedom from arrhythmias, Nakata index, or survival between the two groups. This study confirmed the growth potential of the right auricular tunnel. However, the growth of the tunnel did not influence the incidence of arrhythmias.

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.

Abstract 2124: Accuracy of T2-weighted Cardiac Magnetic Resonance in Detecting Myocardial Edema in Acute Myocardial Infarction is Strongly Influenced by Microvascular Obstruction.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Yoko Mikami ◽  
Hajime Sakuma ◽  
Motonori Nagata ◽  
Nanaka Ishida ◽  
Tairo Kurita ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Signal Intensity ◽  
Microvascular Obstruction ◽  
Myocardial Edema ◽  
High Signal ◽  
Black Blood ◽  
Significant Difference

Background: High signal intensity (SI) on T2-weighted Cardiac Magnetic Resonance (CMR) indicates infarct-associated myocardial edema in patients with acute myocardial infarction (MI). However, erythrocytes leaking from capillaries in infarct tissue may result in reduced signal on T2W CMR due to T2 shortening. The purpose of this study was to determine if detection of myocardial edema with T2-weighted CMR is influenced by microvascular obstruction (MO- ). Methods: Thirty-seven patients underwent black blood T2 weighted MRI with a spectral presaturation with inversion recovery fat saturation method, rest perfusion MRI and late gadolinium enhanced (LGE) MRI 5.4±3.1 days after onsets. The presence and transmural extent of LGE and MO were analyzed based on a 16-segment model. The relative SI compared with remote normal myocardium was determined in the infarction and peri-infarction zones on T2 weighted MRI, by using the mean + 2SD of the SI in normal segments as a threshold. Results: LGE was observed in 37 (100%) of 37 patients and MO in 19 (51%) of 37 patients. The SI in LGE segments without MO and the SI in periinfarct zones were significantly higher than those in normal segments (relative SI 1.84±0.5, p<0.001 and 1.69±0.18, p<0.001, respectively). However, no significant difference was found between the SI in MO segments and the SI in normal segments (relative SI 1.12±0.24, p=N.S.). The sensitivity of T2 weighted MRI for detecting edema in acute MI was 95% (73/77) in the LGE segments without MO, but was reduced to 30% (22/73) in the segments with MO. Myocardial edema was completely missed on T2 weighted MRI in 2 patients with severe MO. Conclusions: Although T2-weighted CMR is highly sensitive in detecting myocardial edema in the segments without MO, reduced T2 signal intensity in MO segments can be an important pitfall in characterizing the area of the acute event.

scholarly journals P364 The first prospective study of non-compaction cardiomyopathy patients with preserved ejection fraction using cardiac magnetic resonance feature tracking

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Kiss ◽  
A Szucs ◽  
A Furak ◽  
Z S Gregor ◽  
M Horvath ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Ejection Fraction ◽  
Feature Tracking ◽  
Longitudinal Strain ◽  
Apical Part ◽  
Left Ventricular ◽  
Functional Parameters ◽  
Significant Difference

Abstract Feature tracking (FT) is a new cardiac magnetic resonance (CMR) technique for strain measurement to reveal changes e.g. in noncompaction cardiomyopathy (NCMP) patients with good ejection fraction (EF). Our aim was to describe, first in the literature, the functional and CMR-FT strain values of NCMP patients with good EF and to compare them with their previous scans taken 4 years ago. At the Heart and Vascular Center of Semmelweis University 6743 CMR examinations were done between 2009-2015 and 232 NCMP patients were diagnosed. We followed up 27 patients, who had a previous examination at least 4 years ago, had no co-morbidities and whoes EF were above 50% (mean age: 37 ± 14.4 years, 18 males, mean follow up: 5.7 ± 1.5 years). Their parameters were compared to a matched control (C) group. The Medis Suite software was used for analysis, the MedCalc software for statistics, (p &lt; 0.05). We compared the patient’s previous (PREV) and recent (REC) functional parameters but did not find significant changes. Comparing the global longitudinal and global circumferential strains (GLS, GCS) and rotation (R) no difference was found between the PREV and the REC values. The GCS showed significant difference between NCMP and C groups (-30.2 ± 5.0 vs -35.9 ± 4.5; p &lt; 0.0001). We compared the segmental longitudinal and circumferential strain values of PREV vs. REC groups and NCMP vs C groups and found significant differences just in a few segments. The left ventricular (LV) apical part’s mean longitudinal strain value showed significant decrease on the REC scans compared to the PREV (PREV vs REC: -24.4 ± 7.7 vs -20.6 ± 5.1%; p &lt; 0.05) and a non-significant decrease compared to the C (C vs REC: -22.8 ± 7.5 vs -20.6 ± 5.1%; p= n.s.). The ratio of the average longitudinal strain value of the apical and basal part of the left ventricle was significantly smaller in the REC group compared to the PREV but did not differ from the C subjects ( PREV vs. REC: 1.5 ± 0.8 vs 1.0 ±0.3; C vs REC: 1.5 ± 0.3 vs 1.2 ± 0.5; p &lt; 0.05) We did not find worsening in the functional parameters of NCMP patients with good EF by the end of the follow up period. However, subclinical changes can be detected in the affected apical part of LV when using FT suggesting the need for follow up.

scholarly journals The value of the sagittal-oblique MRI technique for injuries of the anterior cruciate ligament in the knee

2013 ◽  
Vol 47 (1) ◽  
pp. 19-25 ◽  
Author(s):  
Dragoslav Nenezić ◽  
Igor Kocijancic
Keyword(s):  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Soft Tissues ◽  
Cruciate Ligament ◽  
Partial Rupture ◽  
Complete Rupture ◽  
Scan Time ◽  
Lower Accuracy ◽  
Significant Difference ◽  
Anterior Cruciate

Abstract Background. Complete rupture of the anterior cruciate ligament (ACL) does not represent a diagnostic problem for the standard magnetic resonance (MR) protocol of the knee. Lower accuracy of the standard MR protocol for partial rupture of the ACL can be improved by using additional, dedicated MR techniques. The study goal was to draw a comparison between sagittal-oblique MR technique of ACL imaging versus flexion MR technique of ACL imaging and, versus ACL imaging obtained with standard MR protocol of the knee. Patients and methods. In this prospective study we included 149 patients who were referred to magnetic resonance imaging (MRI) examination due to knee soft tissues trauma during 12 months period. MRI signs of ACL trauma, especially detection of partial tears, number of slices per technique showing the whole ACL, duration of applied additional protocols, and reproducibility of examination were analysed. Results. Accuracy of standard MRI protocol of the knee comparing to both additional techniques is identical in detection of a complete ACL rupture. Presentations of the partial ruptures of ACL using flexion technique and sagittaloblique technique were more sensitive (p<0.001) than presentation using standard MR protocol. There was no statistically significant difference between MRI detection of the ruptured ACL between additional techniques (p> 0.65). Sagittal-oblique technique provides a higher number of MRI slices showing the whole course of the ACL and requires a shorter scan time compared to flexion technique (p<0.001). Conclusions. Both additional techniques (flexion and sagittal-oblique) are just as precise as the standard MR protocol for the evaluation of a complete rupture of the ACL, so they should be used in cases of suspicion of partial rupture of the ACL. Our study showed sagittal-oblique technique was superior, because it did not depend on patient’s ability to exactly repeat the same external rotation if standard MR protocol was used or to repeat exactly the same flexion in flexion MR technique in further MR examinations. Sagittal-oblique technique does not require the patient’s knee to be repositioned, which makes this technique faster. We propose this technique in addition to the standard MR protocol for detection of partial ACL tears.

Comparison of 2- and 3-Dimensional Shoulder Ultrasound to Magnetic Resonance Imaging in a Community Hospital for the Detection of Supraspinatus Rotator Cuff Tears with Improved Worktime Room Efficiency

2012 ◽  
Vol 63 (3) ◽  
pp. 170-176 ◽  
Author(s):  
Steven Co ◽  
Sonny Bhalla ◽  
Kevin Rowan ◽  
Sven Aippersbach ◽  
Simon Bicknell
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rotator Cuff ◽  
Wilcoxon Test ◽  
Rotator Cuff Tears ◽  
Resonance Imaging ◽  
3 Dimensional ◽  
Significant Difference ◽  
The Mean ◽  
2D And 3D

Purpose The purpose of this study was to evaluate whether 3-dimensional (3D) volumetric acquisition of shoulder ultrasound (US) data for supraspinatus rotator cuff tears is as sensitive when compared with conventional 2-dimensional (2D) US and routine magnetic resonance imaging (MRI), and whether there is improved workroom time efficiency when using the 3D technique compared with the 2D technique. Methods In this prospective study, 39 shoulders underwent US and MRI examination of their rotator cuff to confirm the accuracy of both the 2D and 3D techniques. The difference in sensitivities was compared by using confidence interval analysis. The mean times required to obtain the 2D and 3D US data and to review the scans were compared by using a 1-tailed Wilcoxon test. Results Sensitivity and specificity of 2D US in detecting supraspinatus full- and partial-thickness tears was 100% and 96%, and 80% and 100%, respectively, and similar values were obtained with 3D US at 100% and 100%, and 90% and 96.6%, respectively. Analysis of the confidence limits of the sensitivities showed no significant difference. The mean time (± SD) of the overall 2D examination of the shoulder, including interpretation was 10.02 ± 3.28 minutes, whereas, for the 3D examination, it was 7.08 ± 0.35 minutes. Comparison between the 2 cohorts when using a 1-tailed Wilcoxon test showed a statistically significant difference ( P < .05). Conclusion 3D US of the shoulder is as accurate as 2D US when compared with MRI for the diagnosis of full- and partial-thickness supraspinatus rotator cuff tears, and 3D US examination significantly reduced the time between the initial scan and the radiologist interpretation, ultimately improving workplace efficiency.

Morphological three-dimensional analysis of papillary muscles in borderline left ventricles

2017 ◽  
Vol 27 (7) ◽  
pp. 1369-1376
Author(s):  
Mari N. Velasco Forte ◽  
Mohamed Nassar ◽  
Nick Byrne ◽  
Miguel Silva Vieira ◽  
Israel V. Pérez ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Left Ventricle ◽  
Papillary Muscle ◽  
Three Dimensional ◽  
Papillary Muscles ◽  
Biventricular Repair ◽  
Muscle Morphology ◽  
Significant Difference ◽  
Surgical Options

AbstractObjectiveMitral valve anatomy has a significant impact on potential surgical options for patients with hypoplastic or borderline left ventricle. Papillary muscle morphology is a major component regarding this aspect. The purpose of this study was to use cardiac magnetic resonance to describe the differences in papillary muscle anatomy between normal, borderline, and hypoplastic left ventricles.MethodsWe carried out a retrospective, observational cardiac magnetic resonance study of children (median age 5.36 years) with normal (n=30), borderline (n=22), or hypoplastic (n=13) left ventricles. Borderline and hypoplastic cases had undergone an initial hybrid procedure. Morphological features of the papillary muscles, location, and arrangement were analysed and compared across groups.ResultsAll normal ventricles had two papillary muscles with narrow pedicles; however, 18% of borderline and 46% of hypoplastic cases had a single papillary muscle, usually the inferomedial type. In addition, in borderline or hypoplastic ventricles, the supporting pedicle occasionally displayed a wide insertion along the ventricular wall. The length ratio of the superolateral support was significantly different between groups (normal: 0.46±0.08; borderline: 0.39±0.07; hypoplastic: 0.36±0.1; p=0.009). No significant difference, however, was found when analysing the inferomedial type (0.42±0.09; 0.38±0.07; 0.39±0.22, p=0.39). The angle subtended between supports was also similar among groups (113°±17°; 111°±51° and 114°±57°; p=0.99). A total of eight children with borderline left ventricle underwent biventricular repair. There were no significant differentiating features for papillary muscle morphology in this subgroup.ConclusionsThe superolateral support can be shorter or absent in borderline or hypoplastic left ventricle cases. The papillary muscle pedicles in these patients often show a broad insertion. These changes have important implications on surgical options and should be described routinely.

scholarly journals 2849. Gut Microbiota Differences at the Time of Medical Intensive Care Unit (MICU) Admission Are Associated with Acquisition of Multi-drug-Resistant Organisms (MDROs) Among Patients Not Already Colonized with an MDRO

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S71-S72
Author(s):  
Christine Bassis ◽  
Anna Seekatz ◽  
Thelma E Dangana ◽  
Teppei Shimasaki ◽  
Rachel D Yelin ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Acute Care Hospital ◽  
Wilcoxon Test ◽  
Sequence Difference ◽  
P Value ◽  
Rrna Gene ◽  
Care Hospital ◽  
Clinical Predictors ◽  
Operational Taxonomic Units ◽  
Significant Difference

Abstract Background Among hospitalized patients, underlying variation in gut microbiota may confer differential risk for gut MDRO acquisition. Methods Rectal swab samples were collected from patients ≤2 days of MICU admission and then daily in the 27-bed MICU of an acute care hospital in Chicago, IL over 1 year. Patients were screened for MDRO colonization by selective culture (see Figure 1 for MDRO types); those with ≥2 swabs and MICU stays ≥3 days were studied. Bacterial 16S rRNA gene amplicon sequences were used for microbiota analysis. Medical records were reviewed. Results In preliminary analysis, 2,480 samples were collected from 627 patients who acquired 170 MDROs (Figure 1). Debilitation, co-morbidities, and certain medical devices were associated with MDRO acquisition, though admission MDRO status was not (table). While no interactions were detected between admission MDRO status and clinical predictors of MDRO acquisition, there were significant differences in gut microbiota composition at the time of MICU admission between patients colonized with an MDRO on admission and those not colonized (P < 0.001, using analysis of molecular variance (AMOVA) on distances). Therefore, we stratified our analysis by admission MDRO colonization status. For patients MDRO-colonized at admission, there were no significant differences in microbiota of patients who later did or did not acquire a new MDRO (AMOVA P-value = 0.32). For patients not MDRO-colonized on admission, there was a significant difference in microbiota of patients who later acquired an MDRO and those who did not (AMOVA P-value: 0.026). Differentially abundant operational taxonomic units (OTUs, based on 3% sequence difference) included OTUs classified as Anaerococcus and as other Clostridiales (higher in patients who remained uncolonized) and as Enterococcus (higher in patients who acquired an MDRO) (Figure 2). Diversity was also higher in patients who remained uncolonized (Wilcoxon test P-value: 0.035) (Figure 3). Conclusion Among patients not already colonized with an MDRO on admission, we identified gut microbiota differences associated with MDRO acquisition that could help explain patient-level variation in MDRO colonization resistance. Disclosures All Authors: No reported Disclosures.

scholarly journals Cardiac Magnetic Resonance Tissue-Tracking and Parametric Mapping in Characterizing Takotsubo Syndrome: A Pilot Study

2021 ◽  
Author(s):  
Riccardo Cau ◽  
Pierpaolo Bassareo ◽  
Valeria Cherchi ◽  
Roberta Montisci ◽  
Martino Deidda ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Pilot Study ◽  
Magnetic Resonance ◽  
T2 Mapping ◽  
Myocardial Strain ◽  
Control Group ◽  
Healthy Controls ◽  
Parametric Mapping ◽  
Tissue Tracking ◽  
Significant Difference

Abstract Aims: The aims of our pilot study were to evaluate the application of cardiac magnetic resonance tissue tracking (CMR-TT) and tissue mapping in characterizing TS.Methods: Two groups were retrospectively enrolled: patients with apical ballooning TS (n=19) and healthy controls (n=10). We assessed global and regional bi-ventricular function, including longitudinal (LS), circumferential (CS), and radial strain (RS) analysis. Tissue characterization by T1, T2 mapping, and LGE was performed as well to detect the possible presence of myocardial injuries. Results: LS was reduced in patients with TS compared to healthy controls. LS dysfunction was detected mainly at mid- and apical cavity (p=0.001 for both). Again, basal RS was higher in TS patients compared to the control group. No other statistically significant differences in myocardial strain were detected. TS patients had higher T1 and T2 values, with greater involvement of the LV apex compared with controls. In a multivariate analysis, there was a statistically significant difference between TS and controls regarding parametric mapping and myocardial strain after controlling for gender and age. T1-native and T2 mapping proved to have an excellent performance in differentiating TS patients from controls (AUCs of 0.94 and 0.96, respectively)Conclusion: Our study suggests that myocardial strain impairment and parametric mappings could help in refining the evaluation of TS patients.

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