CMR coronary angiography: rarely done

Looks like the last papers are still away from mainstream clinical application according to our readers.

Prognosis and money saving

In an editorial in JACC by Dr. Hundley commenting on two prognostic papers (use of CMR in patients with PVCs with LBBB and patients with chest pain undergoing dobutamine stress CMR) the author mentions how quality research papers on large populations should guide the best use of CV imaging. The two papers represent advances in these directions although they do not directly look at cost-benefit ratios.

Korosoglou G, Elhmidi Y, Steen H, et al. Prognostic value of high-dose dobutamine stress magnetic resonance imaging in 1,493 consecutive patients: assessment of myocardial wall motion and perfusion. J Am Coll Cardiol 2010;56:1225–34.

Aquaro GD, Pingitore A, Strata E, Di Bella G, Molinaro S, Lombardi M. Cardiac magnetic resonance predicts outcome in patients with premature ventricular complexes of left bundle branch block morphology. J Am Coll Cardiol 2010;56:1235– 43.

3 Important reviews

This week 3 important reviews were published:

1. Iron Overload Cardiomyopathy Better Understanding of an Increasing Disorder.

Gujja P, Rosing DR, Tripodi DJ, Shizukuda Y. J Am Coll Cardiol. 2010 Sep 21;56(13):1001-1012.

2. Ischaemic heart disease assessment by cardiovascular magnetic resonance imaging.

Raj V, Agrawal SK. Postgrad Med J. 2010 Sep;86(1019):532-40.

3. Cardiovascular magnetic resonance evaluation of the patient with known or suspected coronary artery disease.

Schmid M, Daniel WG, Achenbach S. Heart. 2010 Oct;96(19):1586-92.

Follow the links to see the abstracts.

ANEURISMA DE PARED LATERAL UN HALLAZGO NO TAN FRECUENTE EN PACIENTES CHAGASICOS

Bertolasi y col, describen que el aneurisma ventricular apical izquierdo de la enfermedad de Chagas, que es característico y único de la miocardiopatía asociada con esta dolencia, presenta una incidencia del 60 al 65% en las diferentes series, vale decir una incidencia mayor que la del aneurisma de la cardiopatía isquemica(del 20 al 25%). En ambas entidades se observa la misma frecuencia de aparición de complicaciones relacionadas con la presencia del aneurisma ventricular: muerte súbita, arritmias ventriculares malignas y tromboembolismo pulmonar y sistémico.
La literatura revela que la localizacion más frecuente corresponde al ápice del ventrículo, si bien el aneurisma ha sido descrito en el septum interventricular y en las paredes posterior, inferior y apicoseptal de dicho ventrículo. Esta lesion ha sido hallada aislada en el 66,6% de los casos y asociada con un aneurisma en el ventrículo derecho en el 33,3%.
Mostramos un caso de un paciente chagasico, masculino de 70 años de edad, campesino, rescatado de muerte súbita y que posteriormente fue a implante de desfibrilador, que mostro a través de la RM un aneurisma de pared lateral, con fibrosis importante,revelando claramente el origen de las arritmias que desencadenaron el evento.
DRS JOAQUIN CANABAL, RAMON AGUILAR Y FLORANGEL MARTINEZ.
UNIDAD DE IMAGENES DEL CENTRO CLINICO VALENTINA CANABAL.BARQUISIMETO.VENEZUELA

New SCMR-LAC Newsletter

Just released.

Link here.

Fat in ARVD/C: let it go...

Most respondents do not regularly look for fat infiltration in ARVD/C. This is line with the recent guidelines in where CMR can aid in the diagnosis. It is a rather strange feeling to see that since the search for fat in ARVD/C was initially the most thought of use of CMR in the past. What a long way since then it has been.

CMR in Ischemic Cardiomyopathy Review

Just out in Heart by A M Beek et al. The authors describe not only the already known use of CMR for viability but new concepts on use of CMR for indications of ICD/CRT, grey zone and reconstructive surgery.

Heart. 2010 Sep;96(18):1494-501. Link here.