Diagnostic Value of Gadolinium Delayed Enhancement Combined with Longitudinal Relaxation Time Quantitative Imaging for Myocardial Amyloidosis

2021 ◽  
Vol 11 (7) ◽  
pp. 1929-1938
Author(s):  
Shen Bing ◽  
Hou Bo ◽  
Zhang Shibin

This article is based on the use of GE combined with longitudinal lag time to quantify cardiac MRI screening for amyloidosis autologous thousand-cell transplantation, combined with clinical routine risk stratification, method for risk assessment of patients with amyloidosis and monitor the patient’s evaluation of the efficacy after treatment. Cardiac involvement with systemic amyloidosis is of great significance for both treatment and prognosis assessment, and is essential for quantitative and qualitative diagnosis or objectively providing prognostic value. In summary, myocardial amyloidosis needs to be studied before heart failure. It is recommended that patients undergo routine cardiac MRI examination to comprehensively evaluate cardiac morphology, function, risk stratification, prognosis, and treatment guidance. Diagnosis based on a single modality has been replaced by a comprehensive multi-modality method, and there is sufficient evidence to show the potential value of cardiac. However, with the continuous improvement of quality and value in the medical field, the field of cardiac will inevitably develop. The predicted and baseline indexes of myocardial strain predicted cardiac remission were 0.96 and 0.79, respectively. When the predictive value of clinical routine indicators and cardiac indicators is analyzed using blood response as the evaluation standard, the reduction in end-diastolic volume/body surface area (P = 0.031) can predict complete haematological remission. Folded cross-validation test shows that the end-diastolic volume/body surface area reduction and the baseline index IgG combined with myocardial strain predict AUC of complete blood remission of 0.78 and 0.76, respectively. This study will also continue to follow up and increase the sample size to verify the current conclusions.

Author(s):  
Niek H. Prakken ◽  
Birgitta K. Velthuis ◽  
Arco J. Teske ◽  
Arend Mosterd ◽  
Willem P. Mali ◽  
...  

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2707-2707
Author(s):  
Mark A. Westwood ◽  
Lisa J. Anderson ◽  
Alicia M. Maceira ◽  
Emma Prescott ◽  
John B. Porter ◽  
...  

Abstract Repeated blood transfusions in Thalassemia Major (TM) may lead to myocardial iron accumulation and death. Left ventricular (LV) function is commonly used to assess for iron overload, however, the reference range in TM for these variables in the absence of myocardial iron loading is not known. We used cardiovascular magnetic resonance (CMR) in 205 TM patients and studied those (N=81) with normal myocardial T2* measurements (T2*>20ms) and by inference without excess myocardial iron. Resting LV volumes and function normalized to body surface area were compared with 40 age and gender matched healthy controls. All LV parameters were significantly different (p<0.05) in TM patients (see tables 1 and 2). The lower limit for ejection fraction was higher in TM (males 59 vs 55%, females 63 vs 59%, both P<0.001). The upper limit for end-diastolic volume index was higher in TM (males 152 vs 105 mL/m2, females 121 vs 99 mL/m2, both P<0.05). In TM the cardiac output index (P<0.001) was increased. In conclusion, at rest TM patients with normal myocardial T2* values and no excess myocardial iron loading have a hyperdynamic circulation and substantially different values for LV parameters compared with controls. Significant misdiagnosis of cardiomyopathy will result from comparison of TM patients with normal ranges. LV Parameters Normalized to Body Surface Area in Males. TM Patients (Mean±SD) Controls (Mean±SD) LV parameters normalized to body surface area for males with mean and standard deviations divided into TM patients with no myocardial iron loading and non-anemic age matched controls. The ejection fraction is not indexed to body surface area as it does not vary significantly with body habitus. LVEDVI - left ventricular end-diastolic volume index, LVESVI - left ventricular end-systolic volume index, LVSVI - left ventricular stroke volume index, LVEF - left ventricular ejection fraction, LVMI - left ventricular mass index, CO - cardiac output, COI cardiac output index. LVEDVI (mL/m 2 ) 97.2±27.2 84.1±10.5 LVESVI (mL/m 2 ) 23.1±5.2 29.6±6.1 LVSVI (mL/m 2 ) 70.8±15.8 54.4±7.1 LVEF 71.0±6.1 64.9±5.0 LVMI (g/m 2 ) 84.6±20.3 75.0±8.4 CO (L/min) 9.8±3.2 6.8±1.5 COI (L/min/m 2 ) 5.7±1.9 3.5±0.7 LV Parameters Normailzed to Body Surface Area in Females TM Patients (Mean±SD) Controls (Mean±SD) LV parameters normalized to body surface area for females with mean and standard deviations divided into TM patients with no myocardial iron loading and non-anemic age matched controls. The ejection fraction is not indexed to body surface area as it does not vary significantly with body habitus. LVEDVI - left ventricular end-diastolic volume index, LVESVI - left ventricular end-systolic volume index, LVSVI - left ventricular stroke volume index, LVEF - left ventricular ejection fraction, LVMI - left ventricular mass index, CO - cardiac output, COI cardiac output index. LVEDVI (mL/m 2 ) 87.4±16.6 79.4±9.8 LVESVI (mL/m 2 ) 20.8±7.3 26.1±4.7 LVSVI (mL/m 2 ) 66.5±12.4 53.3±7.3 LVEF 75.1±5.9 67.1±4.3 LVMI (g/m 2 ) 69.9±17.3 61.9±7.9 CO (L/min) 8.2±2.0 5.8±1.6 COI (L/min/m 2 ) 5.2±1.3 3.4±0.8


1996 ◽  
Vol 76 (05) ◽  
pp. 682-688 ◽  
Author(s):  
Jos P J Wester ◽  
Harold W de Valk ◽  
Karel H Nieuwenhuis ◽  
Catherine B Brouwer ◽  
Yolanda van der Graaf ◽  
...  

Summary Objective: Identification of risk factors for bleeding and prospective evaluation of two bleeding risk scores in the treatment of acute venous thromboembolism. Design: Secondary analysis of a prospective, randomized, assessor-blind, multicenter clinical trial. Setting: One university and 2 regional teaching hospitals. Patients: 188 patients treated with heparin or danaparoid for acute venous thromboembolism. Measurements: The presenting clinical features, the doses of the drugs, and the anticoagulant responses were analyzed using univariate and multivariate logistic regression analysis in order to evaluate prognostic factors for bleeding. In addition, the recently developed Utrecht bleeding risk score and Landefeld bleeding risk index were evaluated prospectively. Results: Major bleeding occurred in 4 patients (2.1%) and minor bleeding in 101 patients (53.7%). For all (major and minor combined) bleeding, body surface area ≤2 m2 (odds ratio 2.3, 95% Cl 1.2-4.4; p = 0.01), and malignancy (odds ratio 2.4, 95% Cl 1.1-4.9; p = 0.02) were confirmed to be independent risk factors. An increased treatment-related risk of bleeding was observed in patients treated with high doses of heparin, independent of the concomitant activated partial thromboplastin time ratios. Both bleeding risk scores had low diagnostic value for bleeding in this sample of mainly minor bleeders. Conclusions: A small body surface area and malignancy were associated with a higher frequency of bleeding. The bleeding risk scores merely offer the clinician a general estimation of the risk of bleeding. In patients with a small body surface area or in patients with malignancy, it may be of interest to study whether limited dose reduction of the anticoagulant drug may cause less bleeding without affecting efficacy.


Author(s):  
Shirazu I. ◽  
Theophilus. A. Sackey ◽  
Elvis K. Tiburu ◽  
Mensah Y. B. ◽  
Forson A.

The relationship between body height and body weight has been described by using various terms. Notable among them is the body mass index, body surface area, body shape index and body surface index. In clinical setting the first descriptive parameter is the BMI scale, which provides information about whether an individual body weight is proportionate to the body height. Since the development of BMI, two other body parameters have been developed in an attempt to determine the relationship between body height and weight. These are the body surface area (BSA) and body surface index (BSI). Generally, these body parameters are described as clinical health indicators that described how healthy an individual body response to the other internal organs. The aim of the study is to discuss the use of BSI as a better clinical health indicator for preclinical assessment of body-organ/tissue relationship. Hence organ health condition as against other body composition. In addition the study is `also to determine the best body parameter the best predict other parameters for clinical application. The model parameters are presented as; modeled height and weight; modelled BSI and BSA, BSI and BMI and modeled BSA and BMI. The models are presented as clinical application software for comfortable working process and designed as GUI and CAD for use in clinical application.


2015 ◽  
Vol 18 (3) ◽  
pp. 098
Author(s):  
Cem Arıtürk ◽  
Serpil Ustalar Özgen ◽  
Behiç Danışan ◽  
Hasan Karabulut ◽  
Fevzi Toraman

<p class="p1"><span class="s1"><strong>Background:</strong> The inspiratory oxygen fraction (FiO<sub>2</sub>) is usually set between 60% and 100% during conventional extracorporeal circulation (ECC). However, this strategy causes partial oxygen pressure (PaO<sub>2</sub>) to reach hyperoxemic levels (&gt;180 mmHg). During anesthetic management of cardiothoracic surgery it is important to keep PaO<sub>2</sub> levels between 80-180 mmHg. The aim of this study was to assess whether adjusting FiO<sub>2</sub> levels in accordance with body temperature and body surface area (BSA) during ECC is an effective method for maintaining normoxemic PaO<sub>2</sub> during cardiac surgery.</span></p><p class="p1"><span class="s1"><strong>Methods:</strong> After approval from the Ethics Committee of the University of Acıbadem, informed consent was given from 60 patients. FiO<sub>2</sub> adjustment strategies applied to the patients in the groups were as follows: FiO<sub>2</sub> levels were set as 0.21 × BSA during hypothermia and 0.21 × BSA + 10 during rewarming in Group I; 0.18 × BSA during hypothermia and 0.18 × BSA + 15 during rewarming in Group II; and 0.18 × BSA during hypothermia and variable with body temperature during rewarming in Group III. Arterial blood gas values and hemodynamic parameters were recorded before ECC (T1); at the 10th minute of cross clamp (T2); when the esophageal temperature (OT) reached 34°C (T3); when OT reached 36°C (T4); and just before the cessation of ECC (T5).</span></p><p class="p1"><span class="s1"><strong>Results:</strong> Mean PaO<sub>2</sub> was significantly higher in Group I than in Group II at T2 and T3 (<em>P</em> = .0001 and <em>P</em> = .0001, respectively); in Group I than in Group III at T1 (<em>P</em> = .02); and in Group II than in Group III at T2, T3, and T4 <br /> (<em>P</em> = .0001 for all). </span></p><p class="p1"><span class="s1"><strong>Conclusion: </strong>Adjustment of FiO<sub>2</sub> according to BSA rather than keeping it at a constant level is more appropriate for keeping PaO<sub>2</sub> between safe level limits. However, since oxygen consumption of cells vary with body temperature, it would be appropriate to set FiO<sub>2</sub> levels in concordance with the body temperature in the <br /> rewarming period.</span></p>


2014 ◽  
Vol 5 (1) ◽  
pp. 54 ◽  
Author(s):  
CHEN Guiying ◽  
LIU Jiongyu ◽  
DAI Qiang ◽  
JIANG Jianping

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