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Mar 25, 2010

Mininum of 2


Parallel imaging is used by most of the responders with a factor of 2. With new hardware with 64-128 channels coming this year, these factors should at least double with the respective advantages that come with this.

Juliano

Mar 7, 2010

Coronary and 7T: dreams yet to come true?

3T is definitely hitting the clinical spots right now but 7T? And doing coronary imaging??? That is certainly a major break in hardware for the future of the modality:

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.
Role of Cardiac Magnetic Resonance Imaging in the Detection of Cardiac Amyloidosis

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.

From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.

cooper.leslie@mayo.edu.

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.