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

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.

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Cardiac magnetic resonance assessment of right ventricular remodeling after anthracycline therapy

Scientific Reports ◽

10.1038/s41598-021-96630-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Thiago Ferreira de Souza ◽

Thiago Quinaglia Silva ◽

Lígia Antunes-Correa ◽

Zsofia D. Drobni ◽

Felipe Osório Costa ◽

...

Keyword(s):

Cardiac Magnetic Resonance ◽

Magnetic Resonance ◽

Right Ventricular ◽

Ventricular Remodeling ◽

Interstitial Fibrosis ◽

Systolic Dysfunction ◽

Extracellular Volume ◽

Increased Risk ◽

Tissue Characteristics ◽

A Prospective Study

AbstractThere are limited data on the effects of anthracyclines on right ventricular (RV) structure, function, and tissue characteristics. The goal of this study was to investigate the effects of anthracyclines on the RV using cardiac magnetic resonance (CMR). This was a post-hoc analysis of a prospective study of 27 breast cancer (BC) patients (51.8 ± 8.9 years) using CMR prior, and up to 3-times after anthracyclines (240 mg/m2) to measure RV volumes and mass, RV extracellular volume (ECV) and cardiomyocyte mass (CM). Before anthracyclines, LVEF (69.4 ± 3.6%) and RVEF (55.6 ± 9%) were normal. The median follow-up after anthracyclines was 399 days (IQR 310–517). The RVEF reached its nadir (46.3 ± 6.8%) after 9-months (P < 0.001). RV mass-index and RV CM decreased to 13 ± 2.8 g/m2 and 8.13 ± 2 g/m2, respectively, at 16-months after anthracyclines. The RV ECV expanded from 0.26 ± 0.07 by 0.14 (53%) to 0.40 ± 0.1 (P < 0.001). The RV ECV expansion correlated with a decrease in RV mass-index (r = −0.46; P < 0.001) and the increase in CK-MB. An RV ESV index at baseline above its median predicted an increased risk of LV dysfunction post-anthracyclines. In BC patients treated with anthracyclines, RV atrophy, systolic dysfunction, and a parallel increase of diffuse interstitial fibrosis indicate a cardiotoxic response on a similar scale as previously seen in the systemic left ventricle.

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Improving the role of echocardiography in studying the right ventricle of repaired tetralogy of Fallot patients: comparison with cardiac magnetic resonance

The International Journal of Cardiovascular Imaging ◽

10.1007/s10554-017-1249-1 ◽

2017 ◽

Vol 34 (3) ◽

pp. 399-406 ◽

Cited By ~ 3

Author(s):

Carolina D’Anna ◽

Armando Caputi ◽

Benedetta Natali ◽

Benedetta Leonardi ◽

Aurelio Secinaro ◽

...

Keyword(s):

Cardiac Magnetic Resonance ◽

Magnetic Resonance ◽

Right Ventricle ◽

Tetralogy Of Fallot ◽

Repaired Tetralogy Of Fallot ◽

The Right

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Left ventricular noncompaction—a rare cause of triad: heart failure, ventricular arrhythmias, and systemic embolic events: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02862-x ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Despina Toader ◽

Alina Paraschiv ◽

Petrișor Tudorașcu ◽

Diana Tudorașcu ◽

Constantin Bataiosu ◽

...

Keyword(s):

Heart Failure ◽

Cardiac Magnetic Resonance ◽

Magnetic Resonance ◽

Left Ventricle ◽

Ventricular Arrhythmias ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Left Ventricular Noncompaction ◽

Ventricular Noncompaction ◽

The Right

Abstract Background Left ventricular noncompaction is a rare cardiomyopathy characterized by a thin, compacted epicardial layer and a noncompacted endocardial layer, with trabeculations and recesses that communicate with the left ventricular cavity. In the advanced stage of the disease, the classical triad of heart failure, ventricular arrhythmia, and systemic embolization is common. Segments involved are the apex and mid inferior and lateral walls. The right ventricular apex may be affected as well. Case presentation A 29-year-old Caucasian male was hospitalized with dyspnea and fatigue at minimal exertion during the last months before admission. He also described a history of edema of the legs and abdominal pain in the last weeks. Physical examination revealed dyspnea, pulmonary rales, cardiomegaly, hepatomegaly, and splenomegaly. Electrocardiography showed sinus rhythm with nonspecific repolarization changes. Twenty-four-hour Holter monitoring identified ventricular tachycardia episodes with right bundle branch block morphology. Transthoracic echocardiography at admission revealed dilated left ventricle with trabeculations located predominantly at the apex but also in the apical and mid portion of lateral and inferior wall; end-systolic ratio of noncompacted to compacted layers > 2; moderate mitral regurgitation; and reduced left ventricular ejection fraction. Between apical trabeculations, multiple thrombi were found. The right ventricle had normal morphology and function. Speckle-tracking echocardiography also revealed systolic left ventricle dysfunction and solid body rotation. Abdominal echocardiography showed hepatomegaly and splenomegaly. Abdominal computed tomography was suggestive for hepatic and renal infarctions. Laboratory tests revealed high levels of N-terminal pro-brain natriuretic peptide and liver enzymes. Cardiac magnetic resonance evaluation at 1 month after discharge confirmed the diagnosis. The patient received anticoagulants, antiarrhythmics, and heart failure treatment. After 2 months, before device implantation, he presented clinical improvement, and echocardiographic evaluation did not detect thrombi in the left ventricle. Coronary angiography was within normal range. A cardioverter defibrillator was implanted for prevention of sudden cardiac death. Conclusions Left ventricular noncompaction is rare cardiomyopathy, but it should always be considered as a possible diagnosis in a patient hospitalized with heart failure, ventricular arrhythmias, and systemic embolic events. Echocardiography and cardiac magnetic resonance are essential imaging tools for diagnosis and follow-up.

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Left Atrial Geometry and Phasic Function Determined by Cardiac Magnetic Resonance Are Independent Predictors for Outcome in Non-Ischaemic Dilated Cardiomyopathy

Biomedicines ◽

10.3390/biomedicines9111653 ◽

2021 ◽

Vol 9 (11) ◽

pp. 1653

Author(s):

Bianca Olivia Cojan-Minzat ◽

Alexandru Zlibut ◽

Ioana Danuta Muresan ◽

Rares-Ilie Orzan ◽

Carmen Cionca ◽

...

Keyword(s):

Cardiac Magnetic Resonance ◽

Magnetic Resonance ◽

Dilated Cardiomyopathy ◽

Predictive Value ◽

Left Atrial ◽

Cox Proportional Hazards ◽

Lv Function ◽

Composite Outcome ◽

Chi Square ◽

Increased Risk

Left atrial (LA) geometry and phasic functions are frequently impaired in non-ischaemic dilated cardiomyopathy (NIDCM). Cardiac magnetic resonance (CMR) can accurately measure LA function and geometry parameters. We sought to investigate their prognostic role in patients with NIDCM. We prospectively examined 212 patients with NIDCM (49 ± 14.2-year-old; 73.5% males) and 106 healthy controls. LA volumes, phasic functions, geometry, and fibrosis were determined using CMR. A composite outcome (cardiac death, ventricular tachyarrhythmias, heart failure hospitalization) was ascertained over a median of 26 months. LA phasic functions, sphericity index (LASI) and late gadolinium enhancement (LA-LGE) were considerably impaired in the diseased group (p < 0.001) and significantly correlated with impaired LV function parameters (p < 0.0001). After multivariate analysis, LA volumes, LASI, LA total strain (LA-εt) and LA-LGE were associated with increased risk of composite outcome (p < 0.001). Kaplan–Meier analysis showed significantly higher risk of composite endpoint for LA volumes (all p < 0.01), LASI > 0.725 (p < 0.003), and LA-εt < 30% (p < 0.0001). Stepwise Cox proportional-hazards models demonstrated a considerable incremental predictive value which resulted by adding LASI to LA-εt (Chi-square = 10.2, p < 0.001), and afterwards LA-LGE (Chi-Square = 15.8; p < 0.0001). NIDCM patients with defective LA volumes, LASI, LA-LGE and LA-εt had a higher risk for an outcome. LA-εt, LASI and LA-LGE provided independent incremental predictive value for outcome.

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Rare Cardiac Mass Assessed by Cardiac Magnetic Resonance

Internal Medicine ◽

10.2478/inmed-2019-0096 ◽

2019 ◽

Vol 16 (6) ◽

pp. 77-79

Author(s):

Sebastian Militaru ◽

Bernhard Gerber

Keyword(s):

Cardiac Magnetic Resonance ◽

Magnetic Resonance ◽

Cardiac Involvement ◽

Specific Treatment ◽

Cardiac Mass ◽

Cardiac Complications ◽

Erdheim Chester Disease ◽

The Right ◽

Erdheim Chester ◽

Chester Disease

AbstractA 43 year old male was referred to our center for assessment of the cardiac involvement in Erdheim-Chester disease (EHD) by cardiac magnetic resonance (CMR). The patient presented with a history of bone involvement as well as retroperitoneal mass, demonstrated to consist fibrosis as well as histiocyte infiltration.The CMR examination included cine (SSFP – steady state free procession), T1 weighted (T1w) and T2 weighted (T2w) sequences, as well as late enhancement images 10 minutes after gadolinium based contrast injection (0.2 mmol/kg). The acquired images showed normal dimensions and function for both right and left cardiac chambers. However, a cardiac mass was revealed in the free wall of the right atrium and the junction with the right ventricle, with clear borders and a diameter of 2.5 cm (Image 1). The tissue was best viewed on axial sequences and was isointense on cine, T1w and T2w images and was mildly enhanced on LGE images. Consequently, the diagnosis of cardiac involvement in EHD was confirmed. The patient was started on specific treatment for EHD and 3-year CMR follow-up showed regression of cardiac involvement.Erdheim-Chester disease is a rare disorder most frequently characterized by non-Langerhans histiocytic multifocal osteosclerotic lesions, with multisystemic granulomatosis and widespread manifestations, as well as highly variable severity(1). ECD affects the cardiovascular system in 75% of patients with infiltration of the pericardium and the right atrioventricular septum being the most common presentation. Typically the mass appears isointense on T1 and T2 weighted images and has low contrast enhancement, as was the case in our patient. In approximately 60% of cases death occurs because of cardiac complications, like pericardial tamponade, myocardial infarction, cardiomyopathy or arrhythmias(2). Patients may sometimes be successfully treated with biologic therapy, interferon alpha or radiotherapy.

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

Circulation ◽

10.1161/circ.130.suppl_2.19008 ◽

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: ∆]]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: ∆]]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: ∆]]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.

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Sexual Dimorphism in Laryngeal Volumetric Measurements Using Magnetic Resonance Imaging

Ear Nose & Throat Journal ◽

10.1177/0145561319840568 ◽

2019 ◽

Vol 99 (2) ◽

pp. 132-136 ◽

Cited By ~ 1

Author(s):

Abdul-Latif Hamdan ◽

Elie Khalifee ◽

Georges Ziade ◽

Sahar Semaan

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Statistical Significance ◽

Resonance Imaging ◽

Men And Women ◽

Mean Width ◽

Significant Difference ◽

The Mean ◽

The Right ◽

Volumetric Measurements

The objective of this study is to investigate the dimensional and volumetric measurements in the thyroarytenoid (TA) muscle in men and women using magnetic resonance imaging (MRI). The hypothesis is that there is a gender-related difference in these measurements. A retrospective chart review of 76 patients who underwent MRI of the neck at the American University of Beirut Medical Center was conducted. The dimension and volume of the right and left TA muscle were measured on axial and coronal planes short tau inversion recovery images. Male and female groups were compared with respect to demographic data and MRI findings using parametric and nonparametric tests. The mean length of the thyro-arytenoid muscle in males was larger than that in females on the right (males 2.44 [0.29] cm vs females 1.70 [0.22] cm) and on the left (males 2.50 [0.28] cm vs females 1.72 [0.24] cm) reaching statistical significance ( P < .001). The mean width of the thyro-arytenoid muscle in males was larger than that in females on the right (males 0.68 [0.13] cm vs females 0.59 [0.11] cm) and on the left (males 0.68 [0.12] cm vs females 0.57 [0.12] cm) reaching statistical significance ( P < .001). The mean height of the thyro-arytenoid muscle in males was larger than that in females on the right (males 1.05 [0.21] cm vs females 0.95 [0.12] cm) and on the left (males 1.05 [0.21] cm vs females 0.95 [0.12] cm) reaching statistical significance ( P < .01 on the right and P < .05 on the left). The volume of the thyroarytenoid muscle in males was larger than that in females on the right (males 0.86 [0.25] mL vs females 0.48 [0.15] mL) and on the left (males 0.89 [0.27] mL vs females 0.48 [0.17] mL) reaching statistical significance ( P < .001). The results of this investigation clearly indicate a significant difference in these measurements between men and women.

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Comparison of the Effects of Denosumab and Alendronate on Cardiovascular and Renal Outcomes in Osteoporotic Patients

Journal of Clinical Medicine ◽

10.3390/jcm8070932 ◽

2019 ◽

Vol 8 (7) ◽

pp. 932 ◽

Cited By ~ 1

Author(s):

Tsuen-Wei Hsu ◽

Chien-Ning Hsu ◽

Shih-Wei Wang ◽

Chiang-Chi Huang ◽

Lung-Chih Li

Keyword(s):

Renal Function ◽

Kidney Injury ◽

Protective Effects ◽

Medical Organization ◽

Renal Function Decline ◽

Renal Outcomes ◽

Increased Risk ◽

Significant Difference ◽

Myocardial Infraction ◽

Cox Proportional Hazard Regression

A correlation between impaired bone metabolism, chronic kidney disease, and cardiovascular diseases (CVD) has been suggested. This study aimed to compare the effects of denosumab and alendronate, two anti-resorptive agents, on cardiovascular and renal outcomes in osteoporotic patients. Propensity score-matched cohort study comparing denosumab to alendronate users between January 2005 and December 2017 was conducted from a large medical organization in Taiwan. Risks of CVD development and renal function decline were estimated using Cox proportional hazard regression. A total 2523 patients were recruited in each group. No significant difference in cardiovascular events was found between the two groups over a 5-year study period. Stratified analysis results showed that denosumab was likely to exert protective effects against composite CVD in patients with medication possession rate ≥60% (adjusted hazard ratio (AHR), 0.74; p = 0.0493) and myocardial infraction (AHR, 0.42; p = 0.0415). Denosumab was associated with increased risk of renal function decline in male patients (AHR, 1.78; p = 0.0132), patients with renal insufficiency (AHR, 1.5; p = 0.0132), and patients with acute kidney injury during the study period (AHR, 1.53; p = 0.0154). Conclusively, denosumab may exert cardiovascular benefits in patients with good adherence but may have renal disadvantages in certain conditions and thus must be used with caution.

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Ocular Surface Disorders in Intensive Care Unit Patients

The Scientific World JOURNAL ◽

10.1155/2013/182038 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 14

Author(s):

Tuba Berra Saritas ◽

Banu Bozkurt ◽

Baris Simsek ◽

Zeynep Cakmak ◽

Mehmet Ozdemir ◽

...

Keyword(s):

Intensive Care ◽

Ocular Surface ◽

Blink Reflex ◽

Test Results ◽

Eyelid Closure ◽

Ocular Infections ◽

Increased Risk ◽

Significant Difference ◽

The Right ◽

Corneal Staining

Patients in intensive care units (ICU) are at increased risk of corneal abrasions and infectious keratitis due to poor eyelid closure, decreased blink reflex, and increased exposure to pathogenic microorganisms. The aim of this retrospective study was to evaluate the ocular surface problems in patients who stayed in ICU more than 7 days and were consulted by an ophthalmologist. There were 26 men and 14 women with a mean age of 40.1 ± 18.15 years (range 17–74 years). Conjunctiva hyperemia, mucopurulent or purulent secretion, corneal staining, and corneal filaments were observed in 56.25%, 36.25%, 15%, and 5% of the eyes, respectively. Keratitis was observed in 4 patients (10%) who were treated successfully with topical antibiotics. Mean Schirmers test results were 7.6 ± 5.7 mm/5 min (median 6.5 mm/5 min) in the right, and 7.9 ± 6.3 mm/5 min (median 7 mm/5 min) in the left eyes. Schirmers test results were <5 mm/5 min in 40% of the subjects. The parameters did not show statistically significant difference according to mechanical ventilation, sedation, and use of inotropes. As ICU patients are more susceptible to develop dry eye, keratopathy, and ocular infections, they should be consulted by an ophthalmologist for early diagnosis of ocular surface disorders.

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