Journal: European Heart Journal. Cardiovascular Imaging

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Oxford University Press

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2047-2404
2047-2412

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2014 - 201992020 - 20233
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Publications 1 - 10 of 12
  • Longitudinal strain under dobutamine stress echocardiography in patient with light chain cardiac amyloidosis
    Item type: Journal Article
    Nemchyna, Olena; Gebker, Rolf; Schönrath, Felix; et al. (2019)
    European Heart Journal. Cardiovascular Imaging
  • Multi-centre study of whole-heart dynamic 3D cardiac magnetic resonance perfusion imaging for the detection of coronary artery disease defined by fractional flow reserve: gender based analysis of diagnostic performance
    Item type: Journal Article
    Hamada, Sandra; Gotschy, Alexander; Wissmann, Lukas; et al. (2017)
    European Heart Journal. Cardiovascular Imaging
    Aims Coronary artery disease (CAD) is a leading cause of morbidity and mortality in women and non-invasive testing for CAD in women can be more challenging than in men. This study compared the diagnostic performance of whole-heart dynamic 3D cardiovascular magnetic resonance (CMR) stress perfusion imaging in female and male patients with quantitative coronary angiography (QCA) and fractional flow reserve (FFR) as reference tests. Methods and results Four hundred sixteen patients with suspected or known CAD were enrolled in five European centres. CMR imaging was performed prior to clinically indicated coronary angiography. QCA was performed in all patients and FFR in 357 of 416 patients. Whole-heart dynamic 3D CMR first-pass perfusion imaging was conducted at rest and during adenosine stress. All CMR analyses were operated by experienced investigators blinded to all clinical data. One hundred nineteen female and 297 male patients were included and successfully examined (mean age 65 ± 11 and 63 ± 11 years, respectively). FFR was performed in 106 female and 251 male patients. Sensitivity and specificity of whole-heart dynamic 3D CMR stress perfusion imaging were 89% (95% CI: 77–96) and 82% (95% CI: 70–90) in the female population and 83% (95% CI: 77–86) and 79% (95% CI: 71–86) in the male population relative to QCA (P = 0.474 and P = 0.83, P-values for comparison between genders). Sensitivity and specificity were 95% (95% CI: 82–99) and 84% (95% CI: 73–92) in the female population and 83% (95% CI: 76–89) and 82% (95% CI: 74–88) in the male population when using FFR as the reference (P = 0.134 and P = 0.936, P-values for comparison between genders). Diagnostic accuracy in females was 92% (95% CI: 85–96) and 86% (95% CI: 81–90) in males when using FFR as the reference. The prevalence of CAD as defined by FFR (<0.8) was 36% in females and 53% in males. Conclusion Whole-heart dynamic 3D CMR stress perfusion imaging has a high diagnostic accuracy for the detection of significant CAD irrespective of gender and is therefore a suitable non-invasive testing tool to detect myocardial ischaemia in both genders.
  • EACVI survey on the multi-modality imaging assessment of the right heart
    Item type: Journal Article
    Soliman-Aboumarie, Hatem; Joshi, Shruti S.; Cameli, Matteo; et al. (2022)
    European Heart Journal. Cardiovascular Imaging
    Aims The European Association of Cardiovascular Imaging (EACVI) Scientific Initiatives Committee performed a global survey to evaluate the use of different cardiac imaging modalities for the evaluation of the right heart. Methods and results Delegates from 250 EACVI registered centres were invited to participate in a survey which was also advertised on the EACVI bulletin and on social media. One hundred and thirty-eight respondents from 46 countries across the world responded to the survey. Most respondents worked in tertiary centres (79%) and echocardiography was reported as the commonest imaging modality used to assess the right ventricle (RV). The majority of survey participants (78%) included RV size and function in >90% of their echocardiographic reports. The RV basal diameter obtained from the apical four-chamber view and the tricuspid annular plane systolic excursion were the commonest parameters used for the echocardiographic assessment of RV size and function as reported by 82 and 97% respondents, respectively. Survey participants reported arrhythmogenic cardiomyopathy as the commonest condition (88%) where cardiac magentic resonance (CMR) imaging was used for right heart assessment. Only 52% respondents included RV volumetric and ejection fraction assessments routinely in their CMR reports, while 30% of respondents included these parameters only when RV pathology was suspected. Finally, 73% of the respondents reported pulmonary hypertension as the commonest condition where right heart catheterization was performed. Conclusion Echocardiography remains the most frequently used imaging modality for the evaluation of the right heart, while the use of other imaging techniques, most notably CMR, is increasing.
  • Diffuse myocardial fibrosis precedes subclinical functional myocardial impairment and provides prognostic information in systemic sclerosis
    Item type: Journal Article
    Gotschy, Alexander; Jordan, Suzana; Stoeck, Christian; et al. (2023)
    European Heart Journal. Cardiovascular Imaging
    Aims Myocardial involvement is common in patients with systemic sclerosis (SSc) and causes myocardial fibrosis and subtle ventricular dysfunction. However, the temporal onset of myocardial involvement during the progression of the disease and its prognostic value are yet unknown. We used cardiovascular magnetic resonance (CMR) to investigate subclinical functional impairment and diffuse myocardial fibrosis in patients with very early diagnosis of SSc (VEDOSS) and established SSc and examined whether this was associated with mortality. Methods and results One hundred and ten SSc patients (86 established SSc, 24 VEDOSS) and 15 healthy controls were prospectively recruited. The patients were followed-up for a median duration of 7.0 years (interquartile range 6.0-7.3 years). Study subjects underwent CMR including assessment of myocardial fibrosis [native T1 and extracellular volume (ECV)] and measurement of global longitudinal (GLS) and circumferential (GCS) myocardial strain. Native T1 values and ECV were elevated in VEDOSS and SSc patients compared with controls (P < 0.001). GLS was similar in VEDOSS and controls but significantly impaired in patients with established SSc (P < 0.001). GCS was similar over all groups (P = 0.88). There were 12 deaths during follow-up. Elevated native T1 [hazard ratio (HR) 5.8, 95% confidence interval (CI): 1.7-20.4; P = 0.006] and reduced GLS (HR 6.1, 95% CI: 1.3-29.9; P = 0.038) identified subjects with increased risk of death. Only native T1 was predictive for cardiovascular mortality (P < 0.001). Conclusion Subclinical myocardial involvement first manifests as diffuse myocardial fibrosis identified by the expansion of ECV and increased native T1 in VEDOSS patients while subtle functional impairment only occurs in established SSc. Native T1 and GLS have prognostic value for all-cause mortality in SSc patients.
  • Three-dimensional whole-heart vs. two-dimensional high-resolution perfusion-CMR: a pilot study comparing myocardial ischaemic burden
    Item type: Journal Article
    McDiarmid, Adam K.; Ripley, David P.; Mohee, Kevin; et al. (2016)
    European Heart Journal. Cardiovascular Imaging
  • Assessment of ischaemic burden in angiographic three-vessel coronary artery disease with high-resolution myocardial perfusion cardiovascular magnetic resonance imaging
    Item type: Journal Article
    Motwani, Manish; Maredia, Neil; Fairbairn, Timothy A.; et al. (2014)
    European Heart Journal. Cardiovascular Imaging
    Aims This study compared the myocardial ischaemic burden (MIB) in patients with angiographic three-vessel coronary artery disease (3VD) using high-resolution and standard-resolution myocardial perfusion cardiovascular magnetic resonance (perfusion CMR) imaging. Methods and results One hundred and five patients undergoing coronary angiography had two separate stress/rest perfusion CMR studies, one with standard-resolution (2.5 mm in-plane) and another with high-resolution (1.6 mm in-plane). Quantitative coronary angiography was used to define patients with angiographic 3VD. Perfusion CMR images were anonymized, randomly ordered and visually reported by two observers acting in consensus and blinded to all clinical and angiographic data. Perfusion was graded in each segment on a four-point scale and summed to produce a perfusion score and estimate of MIB for each patient. In patients with angiographic 3VD (n = 35), high-resolution acquisition identified more abnormal segments (7.2 ± 3.8 vs. 5.3 ± 4.0; P = 0.004) and territories (2.4 ± 0.9 vs. 1.6 ± 1.1; P = 0.002) and a higher overall perfusion score (20.1 ± 7.7 vs. 11.9 ± 9.4; P < 0.0001) per patient compared with standard-resolution. The number of segments with subendocardial ischaemia was greater with high-resolution acquisition (195 vs. 101; P < 0.0001). Hypoperfusion in all three territories was identified in 57% of 3VD patients by high-resolution compared with only 29% by standard-resolution (P = 0.04). The area-under-the-curve (AUC) for detecting angiographic 3VD using the estimated MIB was significantly greater with high-resolution than standard-resolution acquisition (AUC = 0.90 vs. 0.69; P < 0.0001). Conclusion In patients with angiographic 3VD, the ischaemic burden detected by perfusion CMR is greater with high-resolution acquisition due to better detection of subendocardial ischaemia. High-resolution perfusion CMR may therefore be preferred for risk stratification and management of this high-risk patient group.
  • P459: Inflammatory reactions of the pericardium as measured with parametric mapping CMR
    Item type: Other Conference Item
    Gastl, Mareike; Sokolska, Justyna Maria; Polacin, Malgorzata; et al. (2019)
    European Heart Journal. Cardiovascular Imaging ~ Abstract Book
    Background: Despite the improved spectrum of diagnostic tools and technical developments, diagnosis of pericardial inflammation can remain challenging. Cardiovascular magnetic resonance (CMR) is increasingly used to diagnose pericardial inflammation through the visualization of thickened pericardium, pericardial edema and contrast agent uptake. Unlike T1- and T2-weighted imaging, parametric mapping (T1 and T2 mapping) has emerged as an alternative to visualize and quantify focal and global changes of the myocardium. Purpose: To investigate the role of parametric mapping for the diagnosis of pericardial inflammation. Methods: Twelve patients with suspected or known pericardial inflammation underwent CMR at a 1.5T system including T1/T2 black blood imaging with fat suppression (SPIR), T1/T2 mapping and a 3D gradient-spoiled fast-field-echo sequence for late gadolinium enhancement (LGE). T1/T2 mapping was performed in end-diastole covering 3 short axis slices (T1: TR shortest, TE shortest, 11 images; T2-GraSE: TR 1 heartbeat, TE shortest, 9 echoes). The diagnosis of pericardial inflammation was made according to recent guidelines using LGE imaging and T1/T2 black blood. T1 and T2 measurements were pursued by manually drawing a region of interest (ROI) in the pericardium of all slices avoiding contamination by other cardiac structures, e.g. epicardial fat. Results: T1 mapping could be performed in all subjects, T2 maps could only be analysed in 5 patients. In addition to pericardial inflammation, 3 patients displayed myocardial involvement. On average, the pericardium displayed a thickness of 6.7 ± 2.0 mm. T1 values were 1394.7 ± 318.8 ms and T2 values were 149.4 ± 24.6 ms, which was above local reference and patients" myocardial values (Myocardial T1: 1031.5 ± 42.1 ms, p = 0.003; T2: 50.2 ± 1.2 ms, p = 0.001). Both, T1 and T2, did not show a correlation to the extent of the thickened pericardium. There was no correlation of T1/T2 to blood markers of inflammation and myocardial injury (CRP, troponin, CK). Conclusions: Parametric T1 and T2 mapping was able to support the diagnosis of pericardial inflammation by T1/T2-weighted and LGE imaging. Because of partial volume effects of the healthy, thin pericardium, the implementation of normal values can be hampered.
  • Effective orifice area and hemodynamic performance of the transcatheter Edwards Sapien 3 prosthesis: short-term and 1-year follow-up
    Item type: Journal Article
    Külling, Mischa; Külling, Jeremy; Wyss, Christophe; et al. (2018)
    European Heart Journal. Cardiovascular Imaging
    Aims: The Edwards Sapien 3 heart valve prosthesis (S3) is commonly used for transcatheter aortic valve implantation (TAVI) and is available in three sizes. To date no data has been published on the effective orifice area (EOA) and the hemodynamic performance of the three different S3 sizes. The aim of this study was to measure the size-specific EOA and hemodynamic performance of the S3 in short-term and 1-year follow-up. Methods and results: One hundred and thirteen consecutive patients treated by TAVI with a S3 prosthesis at the Heart Clinic Zurich between May 2014 and July 2015 were included. Clinical data were extracted from the Swiss TAVI registry. The EOA was calculated using Doppler echocardiography (peri-interventionally and at discharge) and by 3D-biplane transoesophageal echocardiography (peri-interventionally). Mean transvalvular gradients (dPmean) were additionally calculated with Doppler echocardiography at 30 days and 1 year. Results were analysed separately for the 23 mm (n = 42; 37%), 26 mm (n = 46; 41%), and 29 mm (n = 25; 22%) prostheses. At discharge, the EOAs were 1.6 ± 0.2 cm² (23 mm S3), 2.0 ± 0.2 cm² (26 mm S3), and 2.7 ± 0.2 cm² (29 mm S3), p < 0.001. The dPmeans at discharge were 10.9 ± 6.0 mmHg (23 mm S3), 10.4 ± 3.5 mmHg (26 mm S3), and 8.9 ± 2.8 mmHg (29 mm S3), p = 0.235, and did not significantly change over time within any of the S3 sizes. Conclusions: Post-TAVI, the EOAs of the three different S3 prosthesis sizes differ significantly, the transvalvular gradients, however, are comparable. Mean transvalvular gradients remain stable over time and document good prosthesis function after 1 year.
  • Right ventricular outflow tract dimensions in arrhythmogenic right ventricular cardiomyopathy/dysplasi-a multicentre study comparing echocardiography and cardiovascular magnetic resonance
    Item type: Journal Article
    Gotschy, Alexander; Saguner, Ardan M.; Niemann, Markus; et al. (2018)
    European Heart Journal. Cardiovascular Imaging
    Aims: Right ventricular outflow tract (RVOT) dilation is one of the echocardiographic criteria in the 2010 revised Task Force Criteria (TFC) of arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D). However, studies comparing cardiac magnetic resonance (CMR) and transthoracic echocardiography (TTE) suggest a lower diagnostic accuracy of TTE due to its operator dependence and limited reproducibility. The goal of this study was to compare the 2010 TFC measures of RVOT dilation with three alternative measures for improving the echocardiographic assessment of RVOT in patients with ARVC/D. Methods and results: In this multicentre study, CMR and TTE were performed in 38 patients with a definite, borderline, or possible ARVC/D diagnosis and in 10 healthy controls. Besides the echocardiographic RVOT measurements listed by the 2010 TFC, we assessed three additional end-diastolic RVOT diameters. These included the RVOT diameter defined by the parasternal long axis M-mode of the aortic sinus portion (RVOT3), that defined by the parasternal long axis M-mode of the left ventricle (RVOT4), and that obtained by the parasternal short axis view of the distal RVOT proximal to the pulmonary valve (RVOT5). RVOT4 provided the best correlation between CMR and TTE (r = 0.92, [95% confidence interval (CI): 0.84–0.96; P < 0.0001]) and enhanced diagnostic accuracy for diagnosing ARVC/D (area under the curve 0.92 [95% CI, 0.78–0.98]). Conclusion: Among all RVOT diameters examined, that defined by the parasternal long axis M-mode of the left ventricle (RVOT4) provides the best agreement between CMR and TTE and exhibits the best diagnostic accuracy for ARVC/D. This novel RVOT4 measurement carries the potential for improving the echocardiographic diagnosis of ARVC/D.
  • 2D high resolution vs. 3D whole heart myocardial perfusion cardiovascular magnetic resonance
    Item type: Journal Article
    Nazir, Muhummad Sohaib; Shome, Joy; Villa, Adriana D.M.; et al. (2022)
    European Heart Journal. Cardiovascular Imaging
    Aims Developments in myocardial perfusion cardiovascular magnetic resonance (CMR) allow improvements in spatial resolution and/or myocardial coverage. Whole heart coverage may provide the most accurate assessment of myocardial ischaemic burden, while high spatial resolution is expected to improve detection of subendocardial ischaemia. The objective of this study was to compare myocardial ischaemic burden as depicted by 2D high resolution and 3D whole heart stress myocardial perfusion in patients with coronary artery disease. Methods and results Thirty-eight patients [age 61 +/- 8 (21% female)] underwent 2D high resolution (spatial resolution 1.2 mm(2)) and 3D whole heart (in-plane spatial resolution 2.3 mm(2)) stress CMR at 3-T in randomized order. Myocardial ischaemic burden (%) was visually quantified as perfusion defect at peak stress perfusion subtracted from subendocardial myocardial scar and expressed as a percentage of the myocardium. Median myocardial ischaemic burden was significantly higher with 2D high resolution compared with 3D whole heart [16.1 (2.0-30.6) vs. 13.4 (5.2-23.2), P = 0.004]. There was excellent agreement between myocardial ischaemic burden (intraclass correlation coefficient 0.81; P < 0.0001), with mean ratio difference between 2D high resolution vs. 3D whole heart 1.28 +/- 0.67 (95% limits of agreement -0.03 to 2.59). When using a 10% threshold for a dichotomous result for presence or absence of significant ischaemia, there was moderate agreement between the methods (kappa = 0.58, P < 0.0001). Conclusion 2D high resolution and 3D whole heart myocardial perfusion stress CMR are comparable for detection of ischaemia. 2D high resolution gives higher values for myocardial ischaemic burden compared with 3D whole heart, suggesting that 2D high resolution is more sensitive for detection of ischaemia.
Publications 1 - 10 of 12