scholarly journals Hybrid Phase ordering with Automatic Window Selection (HybridPAWS) improves respiratory-navigator efficiency during 3D late-gadolinium enhancement CMR in patients with chronic heart failure and irregular respiratory pattern

2012 ◽  
Vol 14 (S1) ◽  
Author(s):  
Zhong Chen ◽  
Christoph Kolbitsch ◽  
Jouke Smink ◽  
James Harrison ◽  
Valentina O Puntmann ◽  
...  
Keyword(s):  
Heart Failure ◽  
Late Gadolinium Enhancement ◽  
Chronic Heart Failure ◽  
Respiratory Pattern ◽  
Gadolinium Enhancement ◽  
Respiratory Navigator ◽  
Navigator Efficiency ◽  
Phase Ordering ◽  
Window Selection

scholarly journals Hypertrophic cardiomyopathy: Prognostic value of myocardial fibrosis volume as a predictor of chronic heart failure progression

2020 ◽  
Vol 35 (2) ◽  
pp. 75-80
Author(s):  
S. S. Komissarova ◽  
E. J. Zakharova ◽  
N. M. Rineiska ◽  
I. K. Haidel
Keyword(s):  
Heart Failure ◽  
At Risk ◽  
Late Gadolinium Enhancement ◽  
Hypertrophic Cardiomyopathy ◽  
Chronic Heart Failure ◽  
Myocardial Fibrosis ◽  
Clinical Course ◽  
Gadolinium Enhancement ◽  
Patients At Risk

Determining the clinical course of disease in patients with hypertrophic cardiomyopathy (HCM) with the presence of symptoms of chronic heart failure (CHF) progression remains a complex and unresolved problem.Objective. The objective of the study was to analyze the variants of clinical course in patients with CHF due to progressive LV dysfunction and to evaluate the prognostic role of myocardial fibrosis volume according to late gadolinium enhancement cardiac magnetic resonance (CMR) as a predictor of CHF progression to NYHA FC III.Material and Methods. A comprehensive examination including cardiac echocardiography, Holter ECG monitoring, and late gadolinium enhancement CMR, was performed in 124 patients (79 men and 45 women, median age of 46 years) with HCM who were observed in Republican Scientific and Practical Centre “Cardiology”. The median follow-up was 41 months (from 25 to 58 months). The clinical endpoint was progression of CHF symptoms from NYHA FC I–II to class III requiring hospitalization.Results and Discussion. Among 124 patients with HCM, CHF progression requiring hospitalization during the follow-up period was observed in 24 patients with preserved systolic function (LV EF > 50%). The 5-year survival rate was 83% (95% CI 76.5–90.1). As a new marker aimed at identifying patients at risk of CHF progression, the volume of myocardial fibrosis was analyzed using the late gadolinium enhancement cardiac MR. The level of fibrosis, associated with the progression of heart failure, was 20%. The log-rank test and Kaplan-Meier survival curves showed statistically significant diff erences (p = 0.001) in groups with fibrosis volume less than 20% and more than 20%. Event-free survival was 95.2% (95% CI 89.9–100%) and 32.1% (95% CI 17.9–57.4%), respectively. Multivariate analysis showed that the independent factors associated with CHF progression and associated hospitalization were age over 50 years (HR 5.9; 95% CI 2.3–15.1, p < 0.001), atrial fibrillation (AF) episodes (HR 5.6; 95% CI 2.2–14.2, p < 0.001), and percentage of myocardial fibrosis volume ≥20% according to cardiac MR data (HR 23.3; 95% CI 7.3–74.8, p < 0.001).Conclusion. Based on the results of a multi-factor analysis, we identified a group of HCM patients at risk of CHF progression requiring hospitalization. These patients were over 50 years of age, had AF episodes, and a myocardial fibrosis volume ≥20%. 

scholarly journals Implications of multiple late gadolinium enhancement lesions on the frequency of left ventricular reverse remodeling and prognosis in patients with non‐ischemic cardiomyopathy

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Shingo Ota ◽  
Makoto Orii ◽  
Tsuyoshi Nishiguchi ◽  
Mao Yokoyama ◽  
Ryoko Matsushita ◽  
...  
Keyword(s):  
Heart Failure ◽  
Late Gadolinium Enhancement ◽  
Ischemic Cardiomyopathy ◽  
Left Ventricular ◽  
Reverse Remodeling ◽  
Cardiac Events ◽  
Gadolinium Enhancement ◽  
Systolic Volume ◽  
Linear Pattern ◽  
Multiple Lesions

Abstract Background Non-ischemic cardiomyopathy (NICM) is a heterogeneous disease, and its prognosis varies. Although late gadolinium enhancement (LGE)-cardiovascular magnetic resonance (CMR) demonstrates a linear pattern in the mid-wall of the septum or multiple LGE lesions in patients with NICM, the therapeutic response and prognosis of multiple LGE lesions have not been elucidated. This study aimed to investigate the frequency of left ventricular (LV) reverse remodeling (LVRR) and prognosis in patients with NICM who have multiple LGE lesions. Methods This single-center retrospective study included 101 consecutive patients with NICM who were divided into 3 groups according to LGE-CMR results: patients without LGE (no LGE group = 48 patients), patients with a typical mid-wall LGE pattern (n = 29 patients), and patients with multiple LGE lesions (n = 24 patients). LVRR was defined as an increase in LV ejection fraction (LVEF) ≥ 10 % and a final value of LVEF > 35 %, which was accompanied by a decrease in LV end-systolic volume ≥ 15 % at 12-month follow-up using echocardiography. The frequency of composite cardiac events, defined as sudden cardiac death (SCD), aborted SCD (non-fatal ventricular fibrillation, sustained ventricular tachycardia, or adequate implantable cardioverter-defibrillator therapies), and heart failure death or hospitalization for worsening heart failure, were summarized and compared between the groups. Results Among the 3 groups, the frequency of LVRR was significantly lower in the multiple lesions group than in the no LGE and mid-wall groups (no LGE vs. mid-wall vs. multiple lesions: 49 % vs. 52 % vs. 19 %, p = 0.03). There were 24 composite cardiac events among the patients: 2 in patients without LGE (hospitalization for worsening heart failure; 2), 7 in patients of the mid-wall group (SCD; 1, aborted SCD; 1 and hospitalization for worsening heart failure; 5), and 15 in patients of the multiple lesions group (SCD; 1, aborted SCD; 8 and hospitalization for worsening heart failure; 6). The multiple LGE lesions was an independent predictor of composite cardiac events (hazard ratio: 11.40 [95 % confidence intervals: 1.49−92.01], p = 0.020). Conclusions Patients with multiple LGE lesions have a higher risk of cardiac events and poorer LVRR. The LGE pattern may be useful for an improved risk stratification in patients with NICM.

Abstract 5920: Usefulness of Late Gadolinium Enhancement as Non-invasive Arrhythmic Risk Marker in Patients with Heart Failure and Systolic Dysfunction

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Alfonso Valle ◽  
Mercedes Nadal ◽  
Jordi Estornell ◽  
Nieves Martinez ◽  
Miguel Corbi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Late Gadolinium Enhancement ◽  
Risk Stratification ◽  
Systolic Dysfunction ◽  
Total Mortality ◽  
Left Ventricular ◽  
Gadolinium Enhancement ◽  
Non Invasive ◽  
Patients With Heart Failure

The identification of prognostic markers in patients with heart failure of both ischemic and non ischemic etiology is an increasing need in the era of devices therapy. Risk stratification for sudden cardiac death (SCD) remains problematic with reliance on left ventricular function which predicts total mortality rather than arrhythmic events (AE). Recently cardiac magnetic resonance was employed to predict susceptibility for malignant arrhythmias. This study sought to determine the utility of late gadolinium enhancement (LGE) to predict AE. Three hundred consecutive patients with symptomatic heart failure and systolic dysfunction of both ischemic and non ischemic cause undergoing CMR, were classified into two groups attending to the presence (n 160) or absence of LGE (n 140), and were followed prospectively during 842 days. The primary endpoint was the combined of SCD or Ventricular tachycardia (VT). 23 patients had AE (8 SCD/15 VT) during the follow-up, 19 of them presenting LGE (83%). The presence of LGE was associated to a significantly higher AE rate (11.8.% vs 2.8% p< 0.001)(figure ). Compared to patients without LGE, midwall fibrosis and an ischemic pattern of LGE predicted AE. (3% vs 5% vs 14%, p= 0.001) LGE is a new non-invasive predictor of AE in patients with heart failure and systolic dysfunction. This suggest a potential role for risk stratification and better selection of patients who needs device therapy

scholarly journals Association of left atrial pressure with late gadolinium enhancement extent in patient who underwent catheter ablation for atrial fibrillation

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Seung-Young Roh ◽  
Dae In Lee ◽  
Sung Ho Hwang ◽  
Kwang-No Lee ◽  
Yong-soo Baek ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Late Gadolinium Enhancement ◽  
Catheter Ablation ◽  
Left Atrial ◽  
Independent Predictor ◽  
Atrial Remodeling ◽  
Clinical Parameters ◽  
Gadolinium Enhancement ◽  
Cmr Imaging

Abstract Atrial remodeling with fibrosis has been well-described in patients with atrial fibrillation (AF). We hypothesized that the left atrial (LA)-late gadolinium enhancement (LGE) extent on cardiac magnetic resonance (CMR) imaging is associated with LA pressure and can be a marker for suitable candidates for non-paroxysmal AF ablation. A total of 173 AF patients with an LA-LGE area on CMR imaging were enrolled. The clinical parameters, including invasively measured LA pressure, were compared between the patients with extensive LA-LGE (E-LGE, LGE extent ≥ 20%, n = 78) and those with small LA-LGE (S-LGE, LGE extent < 20%, n = 95). The E-LGE group had higher peak LA pressures than the S-LGE group (23 versus 19 mmHg, p < 0.001). The E-LGE group had more patients with non-paroxysmal AF (non-PAF) (51% vs. 34%), heart failure (9% vs. 0%), and higher NT pro-B-type natriuretic peptide (472 vs. 265 pg/ml) (all p < 0.05). LA pressure ≥ 21 mmHg was an independent predictor of E-LGE (OR = 2.218; p = 0.019). In the paroxysmal AF (PAF) subgroup, freedom from atrial arrhythmia after catheter ablation was not different (81% vs 86%, log-rank p = 0.529). However, in the non-PAF subgroup, it was significantly higher in the S-LGE group than in the E-LGE group (81% vs 55%, log-rank p = 0.014). Increased LA pressure was related to the LA-LGE extent. LA-LGE was a good predictor of outcome after catheter ablation, but only in patients with non-PAF.

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