More than half of the respondents plan to go. Let's hope the dollar keeps cheap!
Sep 25, 2011
Sep 20, 2011
The Association of Pericardial Fat with Coronary Artery Plaque Index at MR Imaging: The Multi-Ethnic Study of Atherosclerosis (MESA)
Abstract
Purpose: To determine the relationship of pericardial fat, which secretes proinflammatory markers that have been implicated in coronary atherosclerosis, with atherosclerotic plaque in an asymptomatic population–based cohort.
Materials and Methods: In this institutional review board–approved study, all participants supplied written informed consent. One hundred eighty-three participants (89 women, 94 men; mean age, 61 years ± 9 [standard deviation]) from the community-based Multi-Ethnic Study of Atherosclerosis (MESA) were included. The coronary artery eccentricity (ratio of maximal to minimal coronary artery wall thickness) was determined by using magnetic resonance (MR) imaging and served as an index of plaque burden. The pericardial fat volume was determined by using computed tomography. Linear regression coefficient analysis was used to correlate pericardial fat volume with coronary artery wall thickness and plaque eccentricity.
Results: Pericardial fat volume correlated significantly with degree of plaque eccentricity (P < .05) in both men and women. After adjustments for body mass index (BMI) and waist circumference, traditional risk factors, C-reactive protein level, and coronary artery calcium content, the relationship between pericardial fat and plaque eccentricity remained significant in men (P < .01) but not in women. BMI and waist circumference correlated with degree of plaque eccentricity in the univariate model (P < .05) but not after adjustment for pericardial fat volume or traditional risk factors.
Conclusion: Pericardial fat volume, rather than BMI and waist circumference, was more strongly related to plaque eccentricity as a measure of coronary atherosclerotic plaque burden. The results support the proposed role of pericardial fat in association with atherosclerosis.
© RSNA, 2011
Abstract
Purpose: To determine the relationship of pericardial fat, which secretes proinflammatory markers that have been implicated in coronary atherosclerosis, with atherosclerotic plaque in an asymptomatic population–based cohort.
Materials and Methods: In this institutional review board–approved study, all participants supplied written informed consent. One hundred eighty-three participants (89 women, 94 men; mean age, 61 years ± 9 [standard deviation]) from the community-based Multi-Ethnic Study of Atherosclerosis (MESA) were included. The coronary artery eccentricity (ratio of maximal to minimal coronary artery wall thickness) was determined by using magnetic resonance (MR) imaging and served as an index of plaque burden. The pericardial fat volume was determined by using computed tomography. Linear regression coefficient analysis was used to correlate pericardial fat volume with coronary artery wall thickness and plaque eccentricity.
Results: Pericardial fat volume correlated significantly with degree of plaque eccentricity (P < .05) in both men and women. After adjustments for body mass index (BMI) and waist circumference, traditional risk factors, C-reactive protein level, and coronary artery calcium content, the relationship between pericardial fat and plaque eccentricity remained significant in men (P < .01) but not in women. BMI and waist circumference correlated with degree of plaque eccentricity in the univariate model (P < .05) but not after adjustment for pericardial fat volume or traditional risk factors.
Conclusion: Pericardial fat volume, rather than BMI and waist circumference, was more strongly related to plaque eccentricity as a measure of coronary atherosclerotic plaque burden. The results support the proposed role of pericardial fat in association with atherosclerosis.
© RSNA, 2011
Sep 19, 2011
PAPER OF THE WEEK
On improvement in ejection fraction with Iron Chelation in Thalassemia Major and the risk of future heart failure.
J Cardiovasc Magn Reson. 2011 Sep 12;13(1):45.
Prof. Pennell and his group concluded that during treatment with iron chelators for cardiac siderosis, even small increases in LVEF in TM patients are associated with a significantly reduced risk of the development of heart failure. Thus the iron chelator induced improvements in LVEF of 2.6% to 3.1% that have been observed in randomized controlled trials, are associated with risk reductions of 25.5% to 46.4% for the development of heart failure over 12 months, which is clinically meaningful.
J Cardiovasc Magn Reson. 2011 Sep 12;13(1):45.
Prof. Pennell and his group concluded that during treatment with iron chelators for cardiac siderosis, even small increases in LVEF in TM patients are associated with a significantly reduced risk of the development of heart failure. Thus the iron chelator induced improvements in LVEF of 2.6% to 3.1% that have been observed in randomized controlled trials, are associated with risk reductions of 25.5% to 46.4% for the development of heart failure over 12 months, which is clinically meaningful.
Sep 12, 2011
PAPER OF THE WEEK
Prognostic Value and Determinants of a Hypointense Infarct Core in T2-Weighted Cardiac Magnetic Resonance in Acute Reperfused ST-Elevation–Myocardial Infarction (Circulation: Cardiovascular Imaging. 2011; 4: 354-362 )
Dr. Eitel and cols, evaluated determinants and prognostic impact of a hypointense infarct core in T2-weighted CMR images, studied in patients after acute, reperfused ST-elevation–myocardial infarction and concluded that a hypointense infarct core within the area at risk of reperfused infarcted myocardium in T2-weighted CMR is closely related to infarct size, microvascular obstruction, and impaired left ventricular function, with subsequent adverse clinical outcome.
Dr. Eitel and cols, evaluated determinants and prognostic impact of a hypointense infarct core in T2-weighted CMR images, studied in patients after acute, reperfused ST-elevation–myocardial infarction and concluded that a hypointense infarct core within the area at risk of reperfused infarcted myocardium in T2-weighted CMR is closely related to infarct size, microvascular obstruction, and impaired left ventricular function, with subsequent adverse clinical outcome.
Sep 4, 2011
Study hours
Responders put a lot of hours into studying CMR. Certainly this is one of the reasons the method is keeps growing in Latin America.
Aug 21, 2011
Paper of the Week
Prognostic Value and Determinants of a Hypointense Infarct Core in T2-Weighted Cardiac Magnetic Resonance in Acute Reperfused ST-Elevation–Myocardial Infarction
Circulation: Cardiovascular Imaging. 2011; 4: 354-362
Dr. Eitel and cols evaluated determinants and prognostic impact of a hypointense infarct core in T2-weighted CMR images, studied in patients after acute, reperfused ST-elevation–myocardial infarction. and concluded that it`s is closely related to infarct size, microvascular obstruction, and impaired left ventricular function, with subsequent adverse clinical outcome.
Aug 16, 2011
Aug 8, 2011
PAPER OF THE WEEK
Value of scar imaging and inotropic reserve combination for the prediction of segmental and global left ventricular functional recovery after revascularisation (Journal of Cardiovascular Magnetic Resonance 2011, 13:35)
Dr. Glaveckaite and cols compared three cardiovascular magnetic resonance (CMR) viability parameters: inotropic reserve (IR) during low-dose dobutamine (LDD) administration, late gadolinium enhancement transmurality (LGE) and thickness of the non-contrast-enhanced myocardial rim surrounding the scar (RIM) and concluded that LDD-CMR is superior to LGE-CMR as a predictor of segmental recovery. They show that the advantage is greatest in the segments with an LGE from 26% to 75%. The RIM cut-off value of 4 mm had no superiority over the LGE cut-off value of 50% in predicting the segmental recovery. Patients with [greater than or equal to]50% of viable segments from all dysfunctional and revascularised had a tendency to improve LVEF by [greater than or equal to]5% after revascularisation.
Dr. Glaveckaite and cols compared three cardiovascular magnetic resonance (CMR) viability parameters: inotropic reserve (IR) during low-dose dobutamine (LDD) administration, late gadolinium enhancement transmurality (LGE) and thickness of the non-contrast-enhanced myocardial rim surrounding the scar (RIM) and concluded that LDD-CMR is superior to LGE-CMR as a predictor of segmental recovery. They show that the advantage is greatest in the segments with an LGE from 26% to 75%. The RIM cut-off value of 4 mm had no superiority over the LGE cut-off value of 50% in predicting the segmental recovery. Patients with [greater than or equal to]50% of viable segments from all dysfunctional and revascularised had a tendency to improve LVEF by [greater than or equal to]5% after revascularisation.
Jul 29, 2011
LA CONQUISTA.................
SIN DUDA ALGUNA RM CARDIACA ES FASCINANTE.........A NUESTROS AMIGOS ELECTROFISIOLOGOS PREMIARNOS UNA VEZ MAS........CON EL GRAN APORTE QUE ESTAN RECIBIENDO DE LA IMAGENOLOGIA CARDIACA.
Imaging of Scar in Patients with Ventricular Arrhythmias of Right Ventricular Origin: Cardiac Magnetic Resonance Versus Electroanatomic Mapping.
Santangeli P, Hamilton-Craig C, Russo AD, Pieroni M, Casella M, Pelargonio G, Biase LD, Smaldone C, Bartoletti S, Narducci ML, Tondo C, Bellocci F, Natale A.
Abstract
Imaging of Scar in Patients with RV Origin Arrhythmias: CMR Versus EAM. Introduction: Assessment of late gadolinium enhancement (LGE) at cardiac magnetic resonance is often used to detect scar in patients with arrhythmias of right ventricular (RV) origin. Recently, electroanatomic mapping (EAM) has been shown to reliably detect scars corresponding to different cardiomyopathic substrates. We compared LGE with EAM for the detection of scar in patients with arrhythmias of RV origin.
Methods and Results: Thirty-one patients with RV arrhythmias and biopsy-proven structural heart disease (18 ARVC and 13 myocarditis), and 5 with idiopathic RV outflow tract arrhythmias underwent LGE analysis and EAM with scar validation through EAM-guided endomyocardial biopsy. EAM scars were present in 23 (64%) patients (all with structural heart disease), whereas LGE was present only in 12 (33%). In 2 cases, EAM provided a false-positive diagnosis of a small scar in the basal perivalvular area. LGE correctly diagnosed EAM scar in 48% of patients, resulting in high positive (92%) but low negative (50%) predictive values. The distribution of LGE was significantly associated with the distribution of EAM scars (P < 0.001 in the free wall, P = 0.003 in the outflow tract, and P = 0.023 in the posterior/inferior wall). Presence of LGE reflected a higher extension of EAM scars (34.4 ± 16.5% vs 7.9 ± 10.1% of the RV area, P < 0.001). At receiver operating characteristic (ROC) analysis, an extension of scar ≥20% of the RV area was the best cut-off value to detect LGE (sensitivity 83%, specificity 92%). Of note, LGE missed 10 of 11 (91%) patients with EAM scars <20% of RV area.
Conclusions: LGE is significantly less sensitive than EAM in identifying RV cardiomyopathic substrates. Absence of LGE does not rule out the presence of small scars, and EAM with biopsy should be considered to increase the diagnostic yield. (J Cardiovasc Electrophysiol, Vol. pp. 1-8).
J Cardiovasc Electrophysiol. 2011 Jul 7
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