scholarly journals Systolic function evaluated with cardiovascular magnetic resonance imaging in HIV-infected patients

2016 ◽  
Vol 20 (2) ◽  
Author(s):  
Leonie Scholtz ◽  
André Du Plessis ◽  
Savvas Andronikou ◽  
Anelia Swart ◽  
Anton Stoltz ◽  
...  

Background: Of all areas worldwide, sub-Saharan Africa is worst affected by the HIV and/or AIDS epidemic. Cardiovascular manifestations are very common and are a powerful contributor to mortality, but often go undetected. Cardiovascular magnetic resonance (CMR) is the most reliable method of assessing cardiac function and morphology and, with this in mind, we initiated a cross-sectional study comparing CMR-determined morphological and functional parameters in asymptomatic HIV-infected patients who were not yet on treatment and early in the disease, with HIV-uninfected control patients.Objectives: To ascertain whether there were any morphological abnormalities or systolic functional impairments on CMR in untreated asymptomatic HIV-infected patients, compared with HIV-uninfected control individuals.Methods: The CMR studies were performed using a 1.5-T whole-body clinical magnetic resonance 16-channel scanner (Achieva, Philips Medical Systems, Best, The Netherlands), using a cardiac five-element phased-array receiver coil (SENSE coil). Functional assessment was performed on 36 HIV-infected patients and the findings compared with 35 HIV-uninfected control patients who were matched for age and sex.Results: There was no significant difference in systolic function between the HIV-uninfected and the HIV-infected patients. The left ventricular end diastolic mass (LVEDM) was slightly higher in the HIV-infected group, but this was statistically insignificant.Conclusion: No significant differences were found regarding the CMR systolic functional analysis and morphological parameters between the HIV-infected and the healthy volunteers.

Author(s):  
Fabian Strodka ◽  
Jana Logoteta ◽  
Roman Schuwerk ◽  
Mona Salehi Ravesh ◽  
Dominik Daniel Gabbert ◽  
...  

AbstractVentricular dysfunction is a well-known complication in single ventricle patients in Fontan circulation. As studies exclusively examining patients with a single left ventricle (SLV) are sparse, we assessed left ventricular (LV) function in SLV patients by using 2D-cardiovascular magnetic resonance (CMR) feature tracking (2D-CMR-FT) and 2D-speckle tracking echocardiography (2D-STE). 54 SLV patients (11.4, 3.1–38.1 years) and 35 age-matched controls (12.3, 6.3–25.8 years) were included. LV global longitudinal, circumferential and radial strain (GLS, GCS, GRS) and strain rate (GLSR, GCSR, GRSR) were measured using 2D-CMR-FT. LV volumes, ejection fraction (LVEF) and mass were determined from short axis images. 2D-STE was applied in patients to measure peak systolic GLS and GLSR. In a subgroup analysis, we compared double inlet left ventricle (DILV) with tricuspid atresia (TA) patients. The population consisted of 19 DILV patients, 24 TA patients and 11 patients with diverse diagnoses. 52 patients were in NYHA class I and 2 patients were in class II. Most SLV patients had a normal systolic function but median LVEF in patients was lower compared to controls (55.6% vs. 61.2%, p = 0.0001). 2D-CMR-FT demonstrated reduced GLS, GCS and GCSR values in patients compared to controls. LVEF correlated with GS values in patients (p < 0.05). There was no significant difference between GLS values from 2D-CMR-FT and 2D-STE in the patient group. LVEF, LV volumes, GS and GSR (from 2D-CMR-FT) were not significantly different between DILV and TA patients. Although most SLV patients had a preserved EF derived by CMR, our results suggest that, LV deformation and function may behave differently in SLV patients compared to healthy subjects.


2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Chengjie Gao ◽  
Yajie Gao ◽  
Jingyu Hang ◽  
Meng Wei ◽  
Jingbo Li ◽  
...  

Abstract Background A considerable number of non-ischemic dilated cardiomyopathy (NDCM) patients had been found to have normalized left ventricular (LV) size and systolic function with tailored medical treatments. Accordingly, we aimed to evaluate if strain parameters assessed by cardiovascular magnetic resonance (CMR) feature tracking (FT) analysis could predict the NDCM recovery. Methods 79 newly diagnosed NDCM patients who underwent baseline and follow-up CMR scans were enrolled. Recovery was defined as a current normalized LV size and systolic function evaluated by CMR. Results Among 79 patients, 21 (27%) were confirmed recovered at a median follow-up of 36 months. Recovered patients presented with faster heart rates (HR) and larger body surface area (BSA) at baseline (P < 0.05). Compared to unrecovered patients, recovered pateints had a higher LV apical radial strain divided by basal radial strain (RSapi/bas) and a lower standard deviation of time to peak radial strain in 16 segments of the LV (SD16-TTPRS). According to a multivariate logistic regression model, RSapi/bas (P = 0.035) and SD16-TTPRS (P = 0.012) resulted as significant predictors for differentiation of recovered from unrecovered patients. The sensitivity and specificity of RSapi/bas and SD16-TTPRS for predicting recovered conditions were 76%, 67%, and 91%, 59%, with the area under the curve of 0.75 and 0.76, respectively. Further, Kaplan Meier survival analysis showed that patients with RSapi/bas ≥ 0.95% and SD16-FTPRS ≤ 111 ms had the highest recovery rate (65%, P = 0.027). Conclusions RSapi/bas and CMR SD16-TTPRS may be used as non-invasive parameters for predicting LV recovery in NDCM. This finding may be beneficial for subsequent treatments and prognosis of NDCM patients. Registration number: ChiCTR-POC-17012586.


2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
V Puntmann ◽  
S Martin ◽  
B Vanchin ◽  
N Holm ◽  
E Giokoglu ◽  
...  

Abstract Background Long COVID (LC) is an increasingly recognized late complication of COVID-19 infection. Cardiovascular involvement has also been implicated, however, the type and extent of the underlying cardiovascular injury remains unknown. Purpose To evaluate the association between ongoing symptoms and findings with cardiovascular magnetic resonance (CMR) in consecutive patients recently recovered from COVID-19 illness. Methods Prospective observational cohort study of patients recently recovered from COVID-19 illness and no previously known cardiovascular disease were included between April 2020 and April 2021. Demographic characteristics, cardiac blood markers, and CMR imaging a minimum of 4 weeks from the diagnosis were obtained. Results Of the 389 included patients, 192 (49%) were male, the mean (±standard deviation) age was 44 (±13) years and 61 (16%) required hospitalization during the acute illness. The median (IQR) time interval between COVID-19 diagnosis and CMR was 94 (71–165) days. 298 (77%) of patients continued to experience ongoing cardiovascular symptoms (long COVID, LC), including dyspnea, palpitations, atypical chest pain and fatigue at the time of CMR at least 4 weeks after the infection. In most patients, the symptoms were only effort related 137 (46%), whereas in 98 (33%) the symptoms affected the activities of daily life; 10 (3%) had severe and debilitating symptoms at rest. Compared to those with no LC (NLC, n=91), LC patients were more commonly hospitalized, had significantly higher native T1, native T2, and showed pericardial enhancement and effusion (Figure 1). There were no differences in cardiac biomarkers, left ventricular (LV) and right ventricular ejection fraction and mass. Proportionally, men and women were similarly affected (n=144 (73%) vs. n=157 (80%), p=0.18). Previous hospitalization was associated with hypertension and ongoing detectable troponin. LC status was associated with previous hospitalization and CMR findings of raised native T1 and native T2, and in females also pericardial enhancement. Severity of symptoms were associated with increased native T1 and T2 and decreased end-diastolic volume, whereas cardiac function showed no significant difference. Conclusions In this cohort of patients recently recovered from COVID-19 infection, ongoing cardiovascular symptoms were common. The LC status was related to previous hospitalization and CMR imaging findings of myopericardial inflammation. The extent and type of cardiovascular findings was associated with the severity of symptoms. These findings indicate the need for ongoing investigation of the long-term cardiovascular consequences of COVID-19. FUNDunding Acknowledgement Type of funding sources: Foundation. Main funding source(s): The German Heart Foundation (Deutsche Herzstiftung) and Bayer AG, Leverkusen, Germany Figure 1


2021 ◽  
Author(s):  
Fabian Strodka ◽  
Jana Logoteta ◽  
Roman Schuwerk ◽  
Mona Salehi Ravesh ◽  
Dominik Daniel Gabbert ◽  
...  

Abstract Purpose Ventricular dysfunction is a well-known complication in single ventricle patients in Fontan circulation. As studies exclusively examining patients with a single left ventricle (SLV) are sparse, we assessed left ventricular (LV) function in SLV patients by using 2D-cardiovascular magnetic resonance (CMR) feature tracking (2D-CMR-FT) and 2D-speckle tracking echocardiography (2D-STE). Methods 54 SLV patients (11.4, 3.1–38.1 years) and 35 age-matched controls (12.3, 6.3–25.8 years) were included. LV global longitudinal, circumferential and radial strain (GLS, GCS, GRS) and strain rate (GLSR, GCSR, GRSR) were measured using 2D-CMR-FT. LV volumes, ejection fraction (LVEF) and mass were determined from short axis images. 2D-STE was applied in patients to measure peak systolic GLS and GLSR. In a subgroup analysis, we compared double inlet left ventricle (DILV) with tricuspid atresia (TA) patients. Results The population consisted of 19 DILV patients, 24 TA patients and 11 patients with diverse diagnoses. 52 patients were in NYHA class I and 2 patients were in class II. Median LVEF in patients was lower compared to controls (55.6% vs. 61.2%, p = 0.0001). 2D-CMR-FT demonstrated reduced GLS, GCS and GCSR values in patients compared to controls. LVEF correlated with GS values in patients (p < 0.05). There was no significant difference between GLS values from 2D-CMR-FT and 2D-STE in the patient group. LVEF, LV volumes, GS and GSR were not significantly different between DILV and TA patients. Conclusion Although most SLV patients had a preserved EF, our results suggest that, LV deformation and function may behave differently in SLV patients compared to healthy subjects.


2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Yongning Shang ◽  
Xiaochun Zhang ◽  
Liu Chen ◽  
Weiling Leng ◽  
Xiaotian Lei ◽  
...  

Background. Diabetic cardiomyopathy (DCM) is always accompanied with alteration of left ventricular structure and function. The aims of this study were to assess the structural remodelling in patients with DCM by cardiovascular magnetic resonance (CMR) and correlation of structural remodelling with severity of DCM.Methods. Twenty-five patients (53.8±8.8years, 52.0% males) with DCM and thirty-one normal healthy controls (51.9±13.6years, 45.2% males) were scanned by CMR cine to assess function and structure of left ventricular. Length of diabetic history and results of cardiac echocardiography (E′, A′, and E′/A′) were also measured.Results. Compared with normal controls group, DCM group was associated with significantly increased ratio of left ventricular mass at end diastole to end-diastolic volume (MVR) (P<0.05) and no significant difference was in mass at end diastole (P>0.05). The ratio correlated with both length of diabetic history and echocardiographic Doppler tissue imaging E′ (allP<0.05).Conclusions. CMR can be a powerful technique to assess LV remodelling, and MVR may be considered as an imaging marker to evaluate the severity of LV remodelling in patients with DCM.


2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Yongning Shang ◽  
Xiaochun Zhang ◽  
Weilling Leng ◽  
Liu Chen ◽  
Xiaotian Lei ◽  
...  

Purpose. To quantify extracellular matrix expansion with the cardiovascular magnetic resonance (CMR) T1 mapping technique and the derived extracellular volume fraction (ECV) in diabetic cardiomyopathy (DbCM) patients and to detect the relationship among ECV, duration of diabetes, and diastolic function. Materials. Thirty-eight patients with diabetic cardiomyopathy (20 males, age 54.6 ± 8.6 years) and thirty-two matched normal controls (15 males, age 51.4 ± 13.6 years) were prospectively enrolled. All of them were scanned by T1 mapping to obtain the native and postcontrast T1 values of myocardium and blood, and ECV was calculated accordingly. All patients also underwent transthoracic echocardiographic tissue Doppler imaging to assess left-ventricular diastolic function. Results. There was a significant difference in ECV between the two groups (DbCMs 30.4 ± 2.9% versus controls 27.1 ± 2.4%, P<0.001). The duration of diabetes was positively and strongly associated with ECV (R=0.539, P=0.0005). There was also a significant difference in ECV (P≤0.001) among four groups (A, controls; B, DbCM patients with duration of diabetes <5 years; C, 5–10 years; and D, >10 years). ECV was negatively associated with LV E’/A’ (R=−0.403, P=0.012). Conclusion. CMR T1 mapping can reflect myocardial extracellular matrix expansion in DbCM and can be a powerful technique for the early diagnosis of DbCM.


Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Jessica A Haffajee ◽  
Thomas H Hauser ◽  
Ralph de la Torre ◽  
Warren J Manning ◽  
Eli V Gelfand

Background : One of the goals of referring patients with chronic severe organic mitral regurgitation (MR) for corrective mitral valve surgery (MVR) is preservation of postoperative global left ventricular (LV) systolic function. Using cardiovascular magnetic resonance (CMR) methods, we have previously reported an intermediate decline in postoperative LV ejection fraction (LVEF). We hypothesized that years following successful surgical correction, there would be evidence of ongoing positive ventricular remodeling with improvement in systolic function and used quantitative CMR to prospectively test this hypothesis. Methods : Fourteen patients (50% female, 55 +/− 11.3 yrs) underwent elective MVR for severe organic MR. Quantitative CMR was performed preoperatively and at median times of 3 months and 27 months following MVR. Results : See Table . At 3 mo, postoperative LVEF declined by 27% (p<0.001) but recovered to preoperative values at 27 mo (p=NS vs. pre, p<0.001 vs. 3 mo). Twelve (86%) of 14 patients had normal LVEF 27 mo after MVR. LV end diastolic volume index (LVEDVI) declined by 32% at 3 mo (p<0.001) and by an additional 9% at 27 mo (p<0.001 vs. pre, p<0.019 vs. 3mo), with 12 (86%) of 14 patients achieving normal volumes. LV mass index (LVMI) declined by 22% at 3 mo (p<0.001) with a further decline of 17% at 27 mo (p<0.001 vs. pre, p<0.001 vs. 3 mo). All patients had normal LVMI at long-term follow-up. Conclusions : In this prospective pilot study, we demonstrate ongoing positive LV remodeling beyond the intermediate postoperative period. These changes likely reflect normalization of cardiac hemodynamics following correction of MR with decreases in ventricular volumes and mass as well as preservation of systolic function. Comparison of LV parameters preoperatively, at 3 mo, and at 27 mo following MVR


2017 ◽  
Vol 20 (1) ◽  
pp. 026 ◽  
Author(s):  
Nan Cheng ◽  
Liuquan Cheng ◽  
Rong Wang ◽  
Lin Zhang ◽  
Changqing Gao

Objective: The aim of this study was to quantify left ventricular torsion by newly applied cardiovascular magnetic resonance feature tracking (CMR-FT), and to evaluate the clinical value of the ventricular torsion as a sensitive indicator of cardiac function by comparison of preoperative and postoperative torsion.Methods: A total of 54 volunteers and 36 patients with previous myocardial infarction (MI) and LV ejection fraction (EF) between 30%-50% were screened preoperatively or postoperatively by MRI. The patients’ short axis views of the whole heart were acquired, and all patients had a scar area >75% in at least one of the anterior or inferior segments. Their apical and basal rotation values were analyzed by feature tracking, and the correlation analysis was performed for the improvement of LV torsion and ejection fraction after CABG. The intra- and inter-observer reliabilities of torsion measured by CMR-FT were assessed.Results: In normal hearts, the apex rotated counterclockwise in the systolic period with the peak rotation as 10.2 ± 4.8°, and the base rotated clockwise as the peak value was 7.0 ± 3.3°. There was a timing hiatus between the apex and base untwisting, during which period the heart recoils and its suction sets the stage for the following rapid filling period. The postoperative torsion and rotation significantly improved compared with preoperative ones. However, the traditional indicator of cardiac function, ejection fraction, didn’t show significant improvement.Conclusion: Left ventricular torsion derived from CMR-FT, which does not require specialized CMR sequences, was sensitive to patients with low ejection fraction whose cardiac function significantly improved after CABG. The rapid acquisition of this measurement has potential for the assessment of cardiac function in clinical practice. 


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ulf K. Radunski ◽  
Johannes Kluwe ◽  
Malte Klein ◽  
Antonio Galante ◽  
Gunnar K. Lund ◽  
...  

AbstractTransjugular intrahepatic portosystemic shunt (TIPS) reduces portal hypertension in patients with liver cirrhosis. The exact cardiac consequences of subsequent increase of central blood volume are unknown. Cardiovascular magnetic resonance (CMR) imaging is the method of choice for quantifying cardiac volumes and ventricular function. The aim of this study was to investigate effects of TIPS on the heart using CMR, laboratory, and imaging cardiac biomarkers. 34 consecutive patients with liver cirrhosis were evaluated for TIPS. Comprehensive CMR with native T1 mapping, transthoracic echocardiography, and laboratory biomarkers were assessed before and after TIPS insertion. Follow-up (FU) CMR was obtained in 16 patients (47%) 207 (170–245) days after TIPS. From baseline (BL) to FU, a significant increase of all indexed cardiac chamber volumes was observed (all P < 0.05). Left ventricular (LV) end-diastolic mass index increased significantly from 45 (38–51) to 65 (51–73) g/m2 (P =  < 0.01). Biventricular systolic function, NT-proBNP, high-sensitive troponin T, and native T1 time did not differ significantly from BL to FU. No patient experienced cardiac decompensation following TIPS. In conclusion, in patients without clinically significant prior heart disease, increased cardiac preload after TIPS resulted in increased volumes of all cardiac chambers and eccentric LV hypertrophy, without leading to cardiac impairment during follow-up in this selected patient population.


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