Journal: Journal of the American College of Cardiology. Cardiovascular Imaging

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Elsevier

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ISSN

1936-878X
1876-7591

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2015 - 201912020 - 20234
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Publications 1 - 5 of 5
  • Hyperpolarized Metabolic and Parametric CMR Imaging of Longitudinal Metabolic-Structural Changes in Experimental Chronic Infarction
    Item type: Journal Article
    Fuetterer, Maximilian; Traechtler, Julia; Busch, Julia; et al. (2022)
    Journal of the American College of Cardiology. Cardiovascular Imaging
    Background: Prolonged ischemia and myocardial infarction are followed by a series of dynamic processes that determine the fate of the affected myocardium toward recovery or necrosis. Metabolic adaptions are considered to play a vital role in the recovery of salvageable myocardium in the context of stunned and hibernating myocardium. Objectives: The potential of hyperpolarized pyruvate cardiac magnetic resonance (CMR) alongside functional and parametric CMR as a tool to study the complex metabolic-structural interplay in a longitudinal study of chronic myocardial infarction in an experimental pig model is investigated. Methods: Metabolic imaging using hyperpolarized [1-13C] pyruvate and proton-based CMR including cine, T1/T2 relaxometry, dynamic contrast-enhanced, and late gadolinium enhanced imaging were performed on clinical 3.0-T and 1.5-T MR systems before infarction and at 6 days and 5 and 9 weeks postinfarction in a longitudinal study design. Chronic myocardial infarction in pigs was induced using catheter-based occlusion and compared with healthy controls. Results: Metabolic image data revealed temporarily elevated lactate-to-bicarbonate ratios at day 6 in the infarcted relative to remote myocardium. The temporal changes of lactate-to-bicarbonate ratios were found to correlate with changes in T2 and impaired local contractility. Assessment of pyruvate dehydrogenase flux via the hyperpolarized [13C] bicarbonate signal revealed recovery of aerobic cellular respiration in the hibernating myocardium, which correlated with recovery of local radial strain. Conclusions: This study demonstrates the potential of hyperpolarized CMR to longitudinally detect metabolic changes after cardiac infarction over days to weeks. Viable myocardium in the area at risk was identified based on restored pyruvate dehydrogenase flux.
  • Pathophysiology of LV Remodeling Following STEMI: A Longitudinal Diffusion Tensor CMR Study
    Item type: Journal Article
    Das, Arka; Kelly, Christopher; Teh, Irvin; et al. (2023)
    Journal of the American College of Cardiology. Cardiovascular Imaging
    Background: Adverse LV remodeling post–ST-segment elevation myocardial infarction (STEMI) is associated with a poor prognosis, but the underlying mechanisms are not fully understood. Diffusion tensor (DT)-cardiac magnetic resonance (CMR) allows in vivo characterization of myocardial architecture and provides unique mechanistic insight into pathophysiologic changes following myocardial infarction. Objectives: This study evaluated the potential associations between DT-CMR performed soon after STEMI and long-term adverse left ventricular (LV) remodeling following STEMI. Methods: A total of 100 patients with STEMI underwent CMR at 5 days and 12 months post-reperfusion. The protocol included DT-CMR for assessing fractional anisotropy (FA), secondary eigenvector angle (E2A) and helix angle (HA), cine imaging for assessing LV volumes, and late gadolinium enhancement for calculating infarct and microvascular obstruction size. Adverse remodeling was defined as a 20% increase in LV end-diastolic volume at 12 months. Results: A total of 32 patients experienced adverse remodeling at 12 months. Compared with patients without adverse remodeling, they had lower FA (0.23 ± 0.03 vs 0.27 ± 0.04; P < 0.001), lower E2A (37 ± 6° vs 51 ± 7°; P < 0.001), and, on HA maps, a lower proportion of myocytes with right-handed orientation (RHM) (8% ± 5% vs 17% ± 9%; P < 0.001) in their acutely infarcted myocardium. On multivariable logistic regression analysis, infarct FA (odds ratio [OR]: <0.01; P = 0.014) and E2A (OR: 0.77; P = 0.001) were independent predictors of adverse LV remodeling after adjusting for left ventricular ejection fraction (LVEF) and infarct size. There were no significant changes in infarct FA, E2A, or RHM between the 2 scans. Conclusions: Extensive cardiomyocyte disorganization (evidenced by low FA), acute loss of sheetlet angularity (evidenced by low E2A), and a greater loss of organization among cardiomyocytes with RHM, corresponding to the subendocardium, can be detected within 5 days post-STEMI. These changes persist post-injury, and low FA and E2A are independently associated with long-term adverse remodeling.
  • Are We There Yet?: The Road to Routine Rapid CMR Imaging
    Item type: Other Journal Item
    Plein, Sven; Kozerke, Sebastian (2021)
    Journal of the American College of Cardiology. Cardiovascular Imaging
  • Tako-Tsubo Cardiomyopathy: A Heart Stressed Out of Energy?
    Item type: Other Journal Item
    Dawson, Dana K.; Neil, Christopher J.; Henning, Anke; et al. (2015)
    Journal of the American College of Cardiology. Cardiovascular Imaging
  • Computed Tomography and Fluoroscopic Angiography in Management of Left Ventricular Assist Device Outflow Graft Obstruction
    Item type: Journal Article
    Wamala, Isaac; Kneissler, Simon; Kaufmann, Friedrich; et al. (2020)
    Journal of the American College of Cardiology. Cardiovascular Imaging
Publications 1 - 5 of 5