Mar 28, 2010
Summary of 2009 in JCMR
A summary of the papers published in JCMR in 2009 - open access of these high quality papers.
http://jcmr-online.com/content/pdf/1532-429x-12-15.pdf
Mar 25, 2010
Mininum of 2
Mar 15, 2010
More on TakoTsubo - from another source
It seems the reviews just keep coming in:
http://ang.sagepub.com/cgi/content/abstract/61/2/166
This one is from the journal Angiology.
Mar 7, 2010
Coronary and 7T: dreams yet to come true?
Initial results on in vivo human coronary MR angiography at 7 T.
van Elderen SG, Versluis MJ, Webb AG, Westenberg JJ, Doornbos J, Smith NB, de Roos A, Stuber M.
Magn Reson Med. 2009 Dec;62(6):1379-84.
Imran S. Syed, MD*,*, James F. Glockner, MD, PhD, DaLi Feng, MD*, Philip A. Araoz, MD, Matthew W. Martinez, MD*,, William D. Edwards, MD, Morie A. Gertz, MD, Angela Dispenzieri, MD, Jae K. Oh, MD*, Diego Bellavia, MD, PhD*, A. Jamil Tajik, MD||, Martha Grogan, MD*
Objectives: Our aim was to evaluate the role and mechanism of late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) in identifying cardiac amyloidosis (CA) and to investigate associations between LGE and clinical, morphologic, functional, and biochemical features.
Background: CA can be challenging to diagnose by echocardiography. Recent studies have demonstrated an emerging role for LGE-CMR.
Methods: LGE-CMR was performed in 120 patients with amyloidosis. Cardiac histology was available in 35 patients. The remaining 85 patients were divided into those with and without echocardiographic evidence of CA.
Results: Of the 35 patients with histologically verified CA, abnormal LGE was present in 34 (97%) patients and increased echocardiographic left ventricular wall thickness in 32 (91%) patients. Global transmural or subendocardial LGE (83%) was most common and was associated with greater interstitial amyloid deposition (p = 0.03). Suboptimal myocardial nulling (8%) and patchy focal LGE (6%) were also observed. LGE distribution matched the deposition pattern of interstitial amyloid. Among patients without cardiac histology, LGE was present in 86% of those with evidence of CA by echocardiography and in 47% of those without evidence of CA by echocardiography. In patients without echocardiographic evidence of CA, the presence of LGE was associated with worse clinical, electrocardiographic (ECG), and cardiac biomarker profiles. In all patients, LGE presence and pattern was associated with New York Heart Association functional class, ECG voltage, left ventricular mass index, right ventricular wall thickness, troponin-T, and B-type natriuretic peptide levels.
Conclusions: LGE is common in CA and detects interstitial expansion from amyloid deposition. Global transmural or subendocardial LGE is most common, but suboptimal myocardial nulling and focal patchy LGE are also observed. LGE-CMR may detect early cardiac abnormalities in patients with amyloidosis with normal left ventricular thickness. The presence and pattern of LGE is strongly associated with clinical, morphologic, functional, and biochemical markers of prognosis.
Key Words: amyloidosis • cardiac magnetic resonance • cardiomyopathy
J Am Coll Cardiol Img, 2010; 3:155-164
Mar 5, 2010
Cardiac MRI studies of transient left ventricular apical ballooning syndrome (takotsubo cardiomyopathy): A systematic review
International Journal of Cardiology 135 (2009) 146 – 149
Cardiac MRI studies of transient left ventricular apical ballooning syndrome (takotsubo cardiomyopathy): A systematic review
Guillaume Leurent a , b , c , d ,⁎, Antoine Larralde e , Dominique Boulmier a , b , c , d , Claire Fougerou f , Bernard Langella e , Romain Ollivier a , b , c , d , Marc Bedossa a , b , c , d , Hervé Le Breton a , b , c , d
a INSERM, U642, Rennes, F-35000, France b Université de Rennes 1, LTSI, Rennes, F-35000, France c CHU Rennes, Service de cardiologie et maladies vasculaires, Rennes, F-35000, France d INSERM, CIC-IT 804, CHU de Rennes, F-35000, France e Département d'imagerie médicale, CHU de Rennes, F-35000, France f Centre d'Investigation Clinique, INSERM 0203, F-35000, France
Abstract
Background: Since its first description in 1991, many cases of transient left ventricular apical ballooning syndrome (TLVABS) have been
described, but the use of cardiac MRI in this condition is much more recent.
Methods and results: We performed a systematic review of the present literature in the MEDLINE and EMBASE databases for relevant case
series of TLVABS (≥ 5 reported original cases, MRI analysis in the acute phase) and summarized the main results in a narrative synthesis.
Only 8 studies met the eligible criteria, counting 176 patients (women: 95%; age: 68, stress trigger: 80%). MRI assessed an improvement of
mean left ventricular ejection fraction from 39 (in the acute phase) to 64% (in the recovery phase). A right ventricular dysfunction was
reported in 38%, a myocardial oedema in 81% and an apical thrombus in 5%.
Conclusions: Although cardiac MRI is a very useful and inescapable tool in the management of TLVABS, there is no large published study
concerning this topic. A systematic and multicentric register of TLVABS studied by cardiac MRI is necessary.
Keywords: Cardiac MRI; Transient left ventricular apical ballooning syndrome; Takotsubo cardiomyopathy; Left ventricular dysfunction
© 2009 Elsevier Ireland Ltd. All rights reserved.
Received 11 February 2009; accepted 2 March 2009
Available online 28 April 2009
N Engl J Med 2009;360:1526-38.
review article
The new england journal of medicine
Medical Progress
Myocarditis
Leslie T. Cooper, Jr., M.D.
Myocarditis may present with a wide range of symptoms, ranging from mild dyspnea or chest pain that resolves without specific therapy to cardiogenic shock and death. Dilated cardiomyopathy with chronic heart failure is the major long-term sequela of myocarditis. Most often, myocarditis results from common viral infections; less commonly, specific forms of myocarditis may result from other pathogens, toxic or hypersensitivity drug reactions, giant-cell myocarditis, or sarcoidosis. The prognosis and treatment of myocarditis vary according to the cause, and clinical and hemodynamic data usually provide guidance to decide when to refer a patient to a specialist for endomyocardial biopsy. The aim of this review is to provide a practical and current approach to the evaluation and treatment of suspected myocarditis.
N Engl J Med 2009;360:1526-38.
Copyright © 2009 Massachusetts Medical Society.