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Oct 22, 2009

Feasibility of Cardiovascular Magnetic Resonance to Assess the Orifice Area of Aortic Bioprostheses
Florian von Knobelsdorff-Brenkenhoff, MD; André Rudolph, MD; Ralf Wassmuth, MD; Steffen Bohl, MD; Eva Elina Buschmann, MD; Hassan Abdel-Aty, MD; Rainer Dietz, MD and Jeanette Schulz-Menger, MD
From the Franz-Volhard-Klinik for Cardiology, HELIOS Klinikum Berlin Buch, University Medicine Berlin, Charité Campus Buch, Berlin, Germany.
Background— Prosthetic orifice area, usually calculated by transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE), provides important information regarding the hemodynamic performance of aortic bioprostheses. However, both TTE and TEE have limitations; therefore accurate and reproducible determination of the orifice area often remains a challenge. The present study aimed to investigate the feasibility of cardiovascular magnetic resonance (CMR) to assess the orifice areas of aortic bioprostheses.
Methods and Results— CMR planimetry of the orifice area was performed in 65 patients (43/22 stented/stentless prostheses; mean time since implantation, 3.1±2.8 years; mean orifice area [TTE], 1.70±0.43 cm2; 62 normally functioning prostheses, 2 severe stenoses, and 1 severe regurgitation) in an imaging plane perpendicular to the transprosthetic flow using steady-state free-precession cine imaging under breath-hold conditions on a 1.5-T MR system. CMR results were compared with TTE (continuity equation, n=65) and TEE (planimetry, n=31). CMR planimetry was readily feasible in 80.0%; feasible with limitation in 15.4% because of stent, flow, and sternal wire artifacts; and impossible in 4.6% because of flow artifacts. Correlations of the orifice areas by CMR with TTE (r=0.82) and CMR with TEE (r=0.92) were significant. The average difference between the methods was –0.02±0.24 cm2 (TTE) and 0.05±0.15 cm2 (TEE). Agreement was present for stented and stentless devices and independent of orifice size. Intraobserver and interobserver variabilities of CMR planimetry were 6.7±5.4% and 11.5±7.8%.
Conclusions— The assessment of aortic bioprostheses with normal orifice areas by CMR is technically feasible and provides orifice areas with a close correlation to echocardiography and low observer dependency.
Key Words: imaging • MRI • echocardiography • valves • surgery
Circulation: Cardiovascular Imaging. 2009;2:397-404
Early Electrocardiographic Findings and MR Imaging-Verified Microvascular Injury and Myocardial Infarct Size
Robin Nijveldt, MD, PhD*,,*, Pieter A. van der Vleuten, MD, Alexander Hirsch, MD,, Aernout M. Beek, MD*, René A. Tio, MD, PhD, Jan G.P. Tijssen, PhD, Jan J. Piek, MD, PhD, Albert C. van Rossum, MD, PhD*,, Felix Zijlstra, MD, PhD
* Department of Cardiology, VU University Medical Center, Amsterdam, the NetherlandsInteruniversity Cardiology Institute of the Netherlands, Utrecht, the NetherlandsDepartment of Cardiology, University Medical Center Groningen, Groningen, the NetherlandsAcademic Medical Center, Amsterdam, the Netherlands

Objectives: This study investigated early electrocardiographic findings in relation to left ventricular (LV) function, extent and size of infarction, and microvascular injury in patients with acute myocardial infarction (MI) treated with percutaneous coronary intervention (PCI).
Background: The electrocardiogram (ECG) is the most used and simplest clinical method to evaluate the risk for patients immediately after reperfusion therapy for acute MI. ST-segment resolution and residual ST-segment elevation have been used for prognosis in acute MI, whereas Q waves are related to outcome in chronic MI. We hypothesized that the combination of these electrocardiographic measures early after primary PCI would enhance risk stratification.
Methods: We prospectively included 180 patients with a first acute ST-segment elevation MI to assess ST-segment resolution, residual ST-segment elevation, and number of Q waves using the 12-lead ECG acquired on admission and 1 h after successful PCI. The ECG findings were related to LV function, infarction size and transmurality, and microvascular injury as assessed with cine and gadolinium-enhanced cardiac magnetic resonance 4 ± 2 days after reperfusion therapy.
Results: Residual ST-segment elevation (β = –2.00, p = 0.004) and the number of Q waves (β = –1.66, p = 0.005) were independent ECG predictors of LV ejection fraction. Although the number of Q waves was the only independent predictor of infarct size (β = 2.01, p < 0.001) and transmural extent of infarction (β = 0.60, p < 0.001), residual ST-segment elevation was the only independent predictor of microvascular injury (odds ratio: 19.1, 95% confidence interval: 2.4 to 154, p = 0.005) in multivariable analyses. The ST-segment resolution was neither associated with LV function, infarct size, or transmurality indexes, nor with microvascular injury in multivariable analysis.
Conclusions: In patients after successful coronary intervention for acute MI, residual ST-segment elevation and the number of Q waves on the post-procedural ECG offer valuable complementary information on prediction of myocardial function and necrosis and its microvascular status.
Key Words: electrocardiography • cardiac magnetic resonance • myocardial infarction • left ventricular function
Am Coll Cardiol Img, 2009; 2:1187-1194.

Oct 21, 2009

Oct 12, 2009

New SCMR-LAC Newsletter is out


Please download the PDF (118KB, virus-free double checked) at:

http://www.sendspace.com/file/4essdg


Juliano

CCT: Neutral/Positive for CMR



The results of the poll show a neutral/positive effect of CCT on CMR. In our case in Campinas, there was an increase in 20-30% in CMR after CCT. Not due to the fact that we have to check the functional aspects of lesions detected on CCT but to a general interest in advanced imaging as a whole. I still believe that both modalities help each other but the future will tell if that is really true.

CMR Reviews in Portuguese

From the Revista da SOCESP latest edition. The full PDF of the journal can be downloaded from:

http://www.socesp.org.br/revistasocesp/edicoes/volume19/pdf/v19_revista_n3.pdf


Juliano

Oct 11, 2009

Top Ten Articles in JCMR in 2009 - Free


Check out here: http://jcmr-online.com/mostviewedbyyear

Top 10 most accessed articles for last 30 days / past year / all time
1.
Accesses
3879 Review
Society for Cardiovascular Magnetic Resonance guidelines for reporting cardiovascular magnetic resonance examinations
W Gregory Hundley, David Bluemke, Jan G Bogaert, Matthias G Friedrich, Charles B Higgins, Mark A Lawson, Michael V McConnell, Subha V Raman, Albert C van Rossum, Scott Flamm, Christopher M Kramer, Eike Nagel, Stefan Neubauer
Journal of Cardiovascular Magnetic Resonance 2009, 11:5 (3 March 2009)
[Abstract] [Full Text] [PDF] [PubMed] [Related articles]

2.
Accesses
3656 Review
Role of cardiovascular magnetic resonance imaging in arrhythmogenic right ventricular dysplasia
Aditya Jain, Harikrishna Tandri, Hugh Calkins, David A Bluemke
Journal of Cardiovascular Magnetic Resonance 2008, 10:32 (20 June 2008)
[Abstract] [Full Text] [PDF] [PubMed] [Related articles]

3.
Accesses
3269 Review
Standardized cardiovascular magnetic resonance imaging (CMR) protocols, society for cardiovascular magnetic resonance: board of trustees task force on standardized protocols
Christopher M Kramer, Jorg Barkhausen, Scott D Flamm, Raymond J Kim, Eike Nagel
Journal of Cardiovascular Magnetic Resonance 2008, 10:35 (7 July 2008)
[Abstract] [Full Text] [PDF] [PubMed] [Related articles] [Cited on BioMed Central]

4.
Accesses
2837 Review
Cardiovascular magnetic resonance in pericardial diseases
Jan Bogaert, Marco Francone
Journal of Cardiovascular Magnetic Resonance 2009, 11:14 (4 May 2009)
[Abstract] [Full Text] [PDF] [PubMed] [Related articles] [Cited on BioMed Central]

5.
Accesses
2574 Review
Towards comprehensive assessment of mitral regurgitation using cardiovascular magnetic resonance
KM John Chan, Ricardo Wage, Karen Symmonds, Shelley Rahman-Haley, Raad H Mohiaddin, David N Firmin, John R Pepper, Dudley J Pennell, Philip J Kilner
Journal of Cardiovascular Magnetic Resonance 2008, 10:61 (22 December 2008)
[Abstract] [Full Text] [PDF] [PubMed] [Related articles] [Cited on BioMed Central]

6.
Accesses
2411 Review
Interventional cardiovascular magnetic resonance: still tantalizing
Kanishka Ratnayaka, Anthony Z Faranesh, Michael A Guttman, Ozgur Kocaturk, Christina E Saikus, Robert J Lederman
Journal of Cardiovascular Magnetic Resonance 2008, 10:62 (29 December 2008)
[Abstract] [Full Text] [PDF] [PubMed] [Related articles]

7.
Accesses
2322 Research
Normal values for aortic diameters in children and adolescents – assessment in vivo by contrast-enhanced CMR-angiography
Thomas Kaiser, Christian J Kellenberger, Manuela Albisetti, Eva Bergsträsser, Emanuela R Valsangiacomo Buechel
Journal of Cardiovascular Magnetic Resonance 2008, 10:56 (5 December 2008)
[Abstract] [Full Text] [PDF] [PubMed] [Related articles]

8.
Accesses
2305 Review
Myocardial first-pass perfusion cardiovascular magnetic resonance: history, theory, and current state of the art
Bernhard L Gerber, Subha V Raman, Krishna Nayak, Frederick H Epstein, Pedro Ferreira, Leon Axel, Dara L Kraitchman
Journal of Cardiovascular Magnetic Resonance 2008, 10:18 (28 April 2008)
[Abstract] [Full Text] [PDF] [PubMed] [Related articles] [Cited on BioMed Central]

9.
Accesses
2282 Research
Cardiovascular Magnetic Resonance and prognosis in cardiac amyloidosis
Alicia M Maceira, Sanjay K Prasad, Philip N Hawkins, Michael Roughton, Dudley J Pennell
Journal of Cardiovascular Magnetic Resonance 2008, 10:54 (25 November 2008)
[Abstract] [Full Text] [PDF] [PubMed] [Related articles] [Cited on BioMed Central]

10.
Accesses
2160 Research
Combined magnetic resonance coronary artery imaging, myocardial perfusion and late gadolinium enhancement in patients with suspected coronary artery disease
Christoph Klein, Rolf Gebker, Thomas Kokocinski, Stephan Dreysse, Bernhard Schnackenburg, Eckart Fleck, Eike Nagel
Journal of Cardiovascular Magnetic Resonance 2008, 10:45 (17 October 2008)
[Abstract] [Full Text] [PDF] [PubMed] [Related articles]

Oct 4, 2009

3rd SMCR-LAC Meeting


Don't miss: Puebla, Mexico. October 29 to November 2nd during the XXVI Congreso Nacional de Cardiologia de Mexico.

More information: http://www.congresocardiologia.org/start.asp

SCMR 2010 Regional Scholarship


US$1.500,00 + free registration to the meeting. ONE AWARD JUST FOR LATIN AMERICA as long as:

- you are a SCMR member
- you have an accepted oral or poster abstract for the meeting

Read the full information on

http://www.scmr.org/assets/files/meetings/SCMR_2010/SCMR%20Regional%20Scholarship%20Prog%20Description%20Website.pdf

There are no excuses not to apply!


Juliano