scholarly journals Automated Quantitative Stress Perfusion Cardiac Magnetic Resonance in Pediatric Patients

2021 ◽  
Vol 9 ◽  
Author(s):  
Cian M. Scannell ◽  
Hadeer Hasaneen ◽  
Gerald Greil ◽  
Tarique Hussain ◽  
Reza Razavi ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Pediatric Patients ◽  
Heart Diseases ◽  
Stress Perfusion ◽  
Coronary Perfusion ◽  
Cardiac Events ◽  
Large Aneurysm ◽  
Quantitative Stress ◽  
Perfusion Cmr

Background: Myocardial ischemia occurs in pediatrics, as a result of both congenital and acquired heart diseases, and can lead to further adverse cardiac events if untreated. The aim of this work is to assess the feasibility of fully automated, high resolution, quantitative stress myocardial perfusion cardiac magnetic resonance (CMR) in a cohort of pediatric patients and to evaluate its agreement with the coronary anatomical status of the patients.Methods: Fourteen pediatric patients, with 16 scans, who underwent dual-bolus stress perfusion CMR were retrospectively analyzed. All patients also had anatomical coronary assessment with either CMR, CT, or X-ray angiography. The perfusion CMR images were automatically processed and quantified using an analysis pipeline previously developed in adults.Results: Automated perfusion quantification was successful in 15/16 cases. The coronary perfusion territories supplied by vessels affected by a medium/large aneurysm or stenosis (according to the AHA guidelines), induced by Kawasaki disease, an anomalous origin, or interarterial course had significantly reduced myocardial blood flow (MBF) (median (interquartile range), 1.26 (1.05, 1.67) ml/min/g) as compared to territories supplied by unaffected coronaries [2.57 (2.02, 2.69) ml/min/g, p < 0.001] and territories supplied by vessels with a small aneurysm [2.52 (2.45, 2.83) ml/min/g, p = 0.002].Conclusion: Automatic CMR-derived MBF quantification is feasible in pediatric patients, and the technology could be potentially used for objective non-invasive assessment of ischemia in children with congenital and acquired heart diseases.

scholarly journals Is positron emission tomography enough to rule out cardiac sarcoidosis? A case report

2021 ◽  
Vol 5 (9) ◽  
Author(s):  
Siyi Huang ◽  
Siri Kunchakarra ◽  
Ankit Rathod
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Cardiac Sarcoidosis ◽  
Premature Ventricular Contraction ◽  
Lymph Node Biopsy ◽  
Stress Perfusion ◽  
Myocardial Uptake ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Perfusion Cmr

Abstract Background Cardiac sarcoidosis (CS) is associated with poor prognosis, yet the clinical diagnosis is often challenging. Advanced cardiac imaging including cardiac magnetic resonance (CMR) and positron emission tomographic (PET) have emerged as useful modalities to diagnose CS. Case summary A 66-year-old woman presented with palpitations. A 24-h Holter monitor detected a high premature ventricular contraction burden of 25.6%. She underwent two transthoracic echocardiograms; both showed normal results. Stress perfusion CMR did not show any evidence of ischaemic aetiology; however, myocardial lesions detected by late gadolinium enhancement (LGE) imaging raised suspicion for CS. While there was no myocardial uptake of fluorodeoxyglucose (FDG) in subsequent cardiac PET, high FDG uptake was seen in hilar lymph nodes. Lymph node biopsy confirmed the diagnosis of sarcoidosis. Discussion Cardiac magnetic resonance and PET imaging are designed to evaluate different aspects CS pathophysiology. The characteristic LGE in the absence of increased FDG uptake suggested inactive CS with residual myocardial scarring.

Abstract 4191: Prognostic Significance of Normal Combined Stress, Delayed Enhancement, and Functional Cardiac Magnetic Resonance Imaging

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Scott Bingham ◽  
Rory Hachamovitch
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Prognostic Significance ◽  
Delayed Enhancement ◽  
Stress Perfusion ◽  
Cardiac Events ◽  
History Of ◽  
Artery Disease ◽  
Event Rates

Background: Combined adenosine stress perfusion (STRESS), myocardial delayed enhancement (MDE), and ventricular wall motion (WM) by cardiac magnetic resonance (CMR) is a promising approach to further risk stratification in patients with intermediate pre-test clinical cardiovascular risk. The prognosis conferred by normal (NL) STRESS, MDE, and WM CMR is unknown. Methods: 1,002 consecutive patients underwent combined CMR including STRESS by gadolinium first-pass perfusion, MDE, and cine WM for suspicion of coronary artery disease (CAD) or myocardial ischemia. 577 patients had NL STRESS, 607 had NL MDE, 544 had NL WM, and 448 had NL combined CMR. 70% had no history of CAD. Follow up was performed at a mean 31 (range 12– 62) months after CMR for cardiac death (CD) all-cause death (ACD) and non-fatal myocardial infarction (MI). Results: NL combined CMR resulted in 0.6% rate of CD per year of follow up (0.3% if no CAD history, and 1.4% with CAD history). Rates for ACD and ACD plus MI were 1.9% and 2.0%. Similar event rates were observed when each component of combined CMR was considered separately. Conclusion: Normal STRESS, MDE, and WM CMR, both singly or in combination, confer a low risk of subsequent cardiac events. Event Rate % per Year of Follow Up

scholarly journals Prognostic Value of Quantitative Stress Perfusion Cardiac Magnetic Resonance

2018 ◽  
Vol 11 (5) ◽  
pp. 686-694 ◽  
Author(s):  
Eva C. Sammut ◽  
Adriana D.M. Villa ◽  
Gabriella Di Giovine ◽  
Luke Dancy ◽  
Filippo Bosio ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Prognostic Value ◽  
Stress Perfusion ◽  
Quantitative Stress

scholarly journals Identification and prognostication of the substrate of ventricular arrhythmia with cardiac magnetic resonance (CMR) imaging in patients with normal echocardiography

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
S Younus ◽  
H Maqsood ◽  
A Gulraiz ◽  
MD Khan ◽  
R Awais
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Cardiac Magnetic Resonance ◽  
Chest Pain ◽  
Magnetic Resonance ◽  
Ventricular Arrhythmia ◽  
Heart Diseases ◽  
Sustained Ventricular Tachycardia ◽  
Structural Heart Diseases ◽  
Cmr Imaging

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): Self Introduction Malignant ventricular arrhythmia contributes to approximately half of the sudden cardiac deaths. In common practice, echocardiography is used to identify structural heart diseases that are the most frequent substrate of VA. Identification and prognostication of structural heart diseases are very important as they are the main determinant of poor prognosis of ventricular arrhythmia. Purpose : The objective of this study is to determine whether cardiac magnetic resonance (CMR) may identify structural heart disease (SHD) in patients with ventricular arrhythmia who had no pathology observed on echocardiography. Methods : A total of 864 consecutive patients were enrolled in this single-center prospective study with significant ventricular arrhythmia. VA was characterized as >1000 ventricular ectopic beats per 24 hours, non-sustained ventricular arrhythmia, sustained ventricular arrhythmia, and no pathological lesion on echocardiography. The primary endpoint was the detection of SHD with CMR. Secondary endpoints were a composite of CMR detection of SHD and abnormal findings not specific for a definite SHD diagnosis. Results : CMR studies were used to diagnose SHD in 212 patients (24.5%) and abnormal findings not specific for a definite SHD diagnosis in 153 patients (17.7%). Myocarditis (n = 84) was the more frequent disease, followed by arrhythmogenic cardiomyopathy (n = 51), ischemic heart disease (n = 32), dilated cardiomyopathy (n = 17), hypertrophic cardiomyopathy (n = 12), congenital cardiac disease (n = 08), left ventricle noncompaction (n = 5), and pericarditis (n = 3). The strongest univariate and multivariate predictors of SHD on CMR images were chest pain (odds ratios [OR]: 2.5 and 2.33, respectively) and sustained ventricular tachycardia (ORs: 2.62 and 2.21, respectively). Conclusion : Our study concludes that SHD was able to be identified on CMR imaging in a significant number of patients with malignant VA and completely normal echocardiography. Chest pain and sustained ventricular tachycardia were the two strongest predictors of positive CMR imaging results. Abstract Figure. Distribution of different SHD

scholarly journals Introduction of Cardiac Magnetic Resonance Imaging in Kosovo: First Fifty Consecutive Patients Registry Report

2021 ◽  
Vol 9 (B) ◽  
pp. 417-425
Author(s):  
Ted Trajcheski ◽  
Lulzim Brovina ◽  
Biljana Zafirova ◽  
Lada Trajceska
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Heart Valves ◽  
Heart Diseases ◽  
Imaging Modality ◽  
Gadolinium Contrast ◽  
Myocardial Perfusion Study ◽  
Imaging Tool ◽  
Gadolinium Contrast Agent ◽  
And Function

BACKGROUND: Cardiac magnetic resonance (CMR) as advanced diagnostic tool for the heart has been introduced in our institution since September 2019. AIM: We report on the first fifty consecutive patients using this imaging modality. METHODS AND MATERIALS: Strict protocol for CMR procedure, imaging quality assessment, contraindications, and informed consent were established. Patients selected for CMR were enrolled in a prospective registry. Visualizing the heart chambers, heart muscle and heart valves, resulted in acquiring complex imaging of the heart structure and function. When applicable, patients received gadolinium contrast agent for Late Gadolinium Enhancement (LGE). Adenosine was used for stress induced myocardial perfusion study. In this study, we report on the initial CMR procedures in the first 15 months. RESULTS: The age of the patients ranges from 17 to 82 and the number of male and female patients was well balanced. No absolute contraindications were met in any patient. Relative contraindications were noted but did not prevent from performing the scan. Different cardiac pathologies were encountered in the examined patients. Most common was the ischemic heart disease – 19 (38%). We had 15 (30%) out of 46 (92%) CMR procedures with LGE showing fibrotic scaring. Quality image assessment was scaled from poor to excellent. Most of the assessments were graded very good and good (46% and 48%), no poor, and very poor noted. CONCLUSION: CMR has been successfully introduced in Kosovo as excellent imaging tool for diagnosing and characterizing a nearly exhaustive spectrum of heart diseases.

Abstract 20355: Cardiac Magnetic Resonance Assessment of Absolute Myocardial Blood Flow and Myocardial Perfusion Reserve Compared With FFR in Patients With Coronary Artery Disease

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Yoshihisa Kanaji ◽  
Tetsumin Lee ◽  
Tadashi Murai ◽  
Asami Suzuki ◽  
Junji Matsuda ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Blood Flow ◽  
Cardiac Magnetic Resonance ◽  
Coronary Artery ◽  
Magnetic Resonance ◽  
Myocardial Perfusion Reserve ◽  
Perfusion Reserve ◽  
Artery Disease ◽  
Perfusion Cmr ◽  
Ischemic Segment

Background: The diagnostic value of absolute myocardial blood flow (AMBF) obtained by cardiac magnetic resonance (CMR) quantitative measurement remains uncertain. We evaluated the subendocardial, epicardial, transmural AMBF, and myocardial perfusion reserve (MPR) derived from AMBF determined by perfusion CMR. We also assessed the relationship between CMR-derived AMBF and fractional flow reserve (FFR) in patients with coronary artery disease (CAD). Methods and Results: We investigated 38 CAD patients (mean age, 67±10 years; male, 89%, 46 vessels territories) who underwent perfusion CMR both at stress and rest, and invasive coronary angiography. FFR was measured in all vessels with stenosis more than 40% by QCA. FFR<0.8 was considered hemodynamically significant stenosis. Patients with previous revascularization and/or myocardial infarction, and with renal dysfunction were excluded. We perform quantitative analysis of the transmural, subendocardial and epicardial AMBF, and MPR at mid-ventricular level. AMBF distributed in the wide range both subendocardium and subepicardium. At stress, AMBF was significantly increased in all of the subendocardial, epicardial, and transmural layers of the ischemic segment at adenosine-induced hyperemia from rest AMBF. (At rest: subendocardial 245±122 ml/100g/min, epicardial 124 [75-233] ml/100g/min, transmural 172 [102-261] ml/100mg/min. At stress: subendocardial 380 [156-517] ml/100g/min, epicardial 275 [158-502] ml/100g/mintransmural 287 [152-456] ml/100g/min.) There was a significant relationship between transmural AMBF and FFR, transmural MPR and FFR values, with r = 0.33 (p = 0.028), r=0.39 (p=0.007). The transmural MPR<2.47 threshold yielded a sensitivity of 0.92 (95% confidence interval: 0.77 to 0.99) and a specificity of 0.71 (0.44-0.90) to detect coronary ischemia with a FFR <0.8, and an area under the ROC curve (AUC) of 0.77 (0.62 to 0.88) for vessel-based analysis. Subendocardial AMBF and MPR gradually decreased with decreasing FFR at ischemic segment, but it was not significant. Conclusions: The quantitative analysis of transmural AMBF and myocardial MPR on perfusion cardiac magnetic resonance may predicts hemodynamically significant CAD as defined by FFR.

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