Looking for NSF

None of the readers reported cases of NSF in the recent years. Small public but very representative. Let's hope it keeps this way.

Original Articles
Regional Thicknesses and Thickening of Compacted and Trabeculated Myocardial Layers of the Normal Left Ventricle Studied by Cardiovascular Magnetic Resonance
Dana K. Dawson, DM, MRCP, DPhil, Alicia M. Maceira, MD, Vimal J. Raj, MB, BS, FRCR, Catriona Graham, MSc, BSc(hons), Dudley J. Pennell, MD, FRCP, FACC, FESC and Philip J. Kilner, MD, PhD

Abstract
Background— We used cardiovascular magnetic resonance (CMR) to study normal left ventricular (LV) trabeculation as a basis for differentiation from pathological noncompaction.

Methods and Results— The apparent end-diastolic (ED) and end-systolic (ES) thicknesses and thickening of trabeculated and compacted myocardial layers were measured in 120 volunteers using a consistent selection of basal, mid, and apical CMR short-axis slices. All had a visible trabeculated layer in 1 or more segments. The compacted but not the trabeculated layer was thicker in men than in women (P<0.01 at ED and ES). When plotted against age, the trabeculated and compacted layer thicknesses demonstrated opposite changes: an increase of the compact layer after the fourth decade at both ED and ES (P<0.05) but a decrease of the trabeculated layer. There was age-related preservation of total wall thickness at ED but an increase at ES (P<0.05). The compacted layer thickened, whereas the trabeculated layer thinned with systole, but neither change differed between sexes. With age, the most trabeculated LV segments showed significantly greater systolic thinning of trabeculated layers and, conversely, greater thickening of the compact segments (P<0.05). Total wall thickening is neither sex nor age dependent. There were no sex differences in the trabeculated/compacted ratio at ES or ED, but the ES trabeculated/compacted ratio was smaller in older (50 to 79 years) versus younger (20 to 49 years) groups (P<0.05).

Conclusions— We demonstrated age- and sex-related morphometric differences in the apparent trabeculated and compacted layer thicknesses and systolic thinning of the visible trabeculated layer that contrasts with compacted myocardial wall thickening.

Key Words:myocardiumtrabeculae, myocardium, systolic thickeningisolated noncompaction of the ventricular myocardiumcontractility.
© 2011 American Heart Association, Inc.

Cardiac Magnetic Resonance of Left Ventricular Trabeculation
The New Normal
Elizabeth M. McNally, MD, PhD and Amit R. Patel, MD

Key Words:Editorial sheart ventricle isolated noncompaction of the ventricular myocardium cardiomyopathy magnetic resonance imaging .Historically, left ventricular noncompaction (LVNC) was considered to be a rare form of cardiomyopathy; however, during the past decade, there has been a significant increase in reports of patients with LVNC. Using either echocardiography or cardiac magnetic resonance (CMR) imaging, LVNC is relatively straight forward to diagnose in individuals expressing a typical phenotype. However, the diagnosis may be challenging to make in those individuals who express more subtle phenotypes of LVNC. CMR imaging offers a more detailed examination of myocardial structure and composition compared with other imaging modalities, such as echocardiography. With more common use of CMR, there has been increased appreciation of the degree of trabeculation of the LV. The ventricle comprises 2 myocardial layers: the compact myocardium and the trabecular myocardium. During cardiac development, after heart looping, the myocardium becomes deeply trabeculated through a clonal outgrowth of embryonic cardiomyocytes. 1 After the coronary arteries form and provide a ready supply of oxygen and nutrients, the LV undergoes compaction accompanied by resolution of the deep trabeculae. Persistence of the LV trabeculae in the postnatal myocardium may be associated with cardiomyopathy, and LVNC is classified as a cardiomyopathy. 2, 3
Circulation: Cardiovascular Imaging.2011; 4: 84-86

Suggested Paper of the week: On T2* Magnetic Resonance and Cardiac Iron

Dr. John-Paul Carpenter's and cols recent publication is about measurement of myocardial iron, that is key to the clinical management of patients at risk of iron-overload cardiomyopathy, which is a major killer in transfusion-dependent patients and others with errors of iron metabolism. They observed a strong correlation between cardiovascular magnetic resonance relaxation measurements and biochemically derived tissue iron concentration in 12 postmortem human hearts from transfusion-dependent patients, leading to a clinical calibration equation. Carpenter JP. Circulation. 2011;123:1519-1528

The Extent of Left Ventricular Scar Quantified by Late Gadolinium Enhancement MRI Is Associated with Spontaneous Ventricular Arrhythmias in Patients with Coronary Artery Disease and Implantable Cardioverter Defibrillators.

This pilot study from Dr. Scott et al, suggested that the extent of myocardial scar, characterised by LGE-CMR, was significantly associated with the occurrence of spontaneous ventricular arrhythmias. Their hypothesis is that scar quantification by LGE-CMR may prove a valuable risk stratification tool for the occurrence of ventricular arrhythmias, which may have implications for patient selection for ICD therapy.

Incremental Prognostic Significance of Combined Cardiac Magnetic Resonance Imaging, Adenosine Stress Perfusion, Delayed Enhancement, and Left Ventricular Function Over Preimaging Information for the Prediction of Adverse Events

(Circulation. 2011;123:1509-1518.)

Dr. Binghan and Dr. Hachamovitch followed 908 patients with suspicion of coronary stenosis and/or ischemia and concluded that CMR analysis of ventricular volume, aortic flow, myocardial viability, and stress perfusion all add incremental value for prediction of adverse events over pre-CMR data and can be combined to further enhance prognostication. Normal combined CMR confers a low risk of subsequent cardiac events.

Every CMR information is important

An early release from Circulation shows that every bit of information on CMR assessment of ischemic patients is relevant and adds prognostic data to pre-imaging parameters.
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