Publications
1024 results found
Rose KAM, Vera JH, Drivas P, et al., 2016, Atherosclerosis is Evident in Treated HIV-Infected Subjects With Low Cardiovascular Risk by Carotid Cardiovascular Magnetic Resonance, JAIDS-Journal of Acquired Immune Deficiency Syndromes, Vol: 71, Pages: 514-521, ISSN: 1944-7884
Objective: Premature atherosclerosis has been observed among HIV-infected individuals with high cardiovascular risk using one-dimensional ultrasound carotid intima-media thickness. We evaluated the assessment of HIV-infected individuals with low traditional cardiovascular disease risk using cardiovascular magnetic resonance, which allows three-dimensional assessment of the carotid artery wall.Methods: Carotid cardiovascular magnetic resonance was performed in 33 HIV-infected individuals (cases) (19 male, 14 female), and 35 HIV-negative controls (20 male, 15 female). Exclusion criteria included smoking, hypertension, hyperlipidemia (total cholesterol/HDL ratio > 5) or family history of premature atherosclerosis. Cases were stable on combination antiretroviral therapy with plasma HIV-1 RNA <50 copies per milliliter. Using computer modeling, the arterial wall, lumen, and total vessel volumes were calculated for a 4-cm length of each carotid artery centered on the bifurcation. The wall/outer-wall ratio (W/OW), an index of vascular thickening, was compared between the groups.Results: Cases had a median CD4 cell count of 690 cells per microliter. Mean (±SD) age and 10-year Framingham coronary risk scores were similar for cases and controls (45.2 ± 9.7 years versus 46.9 ± 11.6 years and 3.97% ± 3.9% versus 3.72% ± 3.5%, respectively). W/OW was significantly increased in cases compared with controls (36.7% versus 32.5%, P < 0.0001); this was more marked in HIV-infected females. HIV status was significantly associated with increased W/OW after adjusting for age (P < 0.0001). No significant association between antiretroviral type and W/OW was found—W/OW lowered comparing abacavir to zidovudine (P = 0.038), but statistical model fits poorly.Conclusions: In a cohort of treated HIV-infected individuals with low measurable cardiovascular risk, we have observed evidence of premature subclinical atherosclerosis.
Bucciarelli-Ducci C, Auger D, Di Mario C, et al., 2016, CMR guidance for recanalization of coronary chronic total occlusion, JACC: Cardiovascular Imaging, Vol: 9, Pages: 547-556, ISSN: 1876-7591
ObjectivesThis study explored whether cardiac magnetic resonance (CMR) could help select patients who could benefit from revascularization by identifying inducible myocardial ischemia and viability in the perfusion territory of the artery with chronic total occlusion (CTO).BackgroundThe benefit of revascularization using percutaneous coronary intervention (PCI) in CTO is controversial. CMR offers incomparable left ventricular (LV) systolic function assessment in addition to potent ischemic burden quantification and reliable myocardial viability analysis. Whether CMR guided CTO revascularization would be helpful to such patients has not yet been explored fully.MethodsA prospective study of 50 consecutive CTO patients was conducted. Of 50 patients undergoing baseline stress CMR, 32 (64%) were selected for recanalization based on the presence of significant inducible perfusion deficit and myocardial viability within the CTO arterial territory. Patients were rescanned 3 months after successful CTO recanalization.ResultsAt baseline, myocardial perfusion reserve (MPR) in the CTO territory was significantly reduced compared with the remote region (1.8 ± 0.72 vs. 2.2 ± 0.7; p = 0.01). MPR in the CTO region improved significantly after PCI (to 2.3 ± 0.9; p = 0.02 vs. baseline) with complete or near-complete resolution of CTO related perfusion defect in 90% of patients. Remote territory MPR was unchanged after PCI (2.5 ± 1.2; p = NS vs. baseline). The LV ejection fraction increased from 63 ± 13% to 67 ± 12% (p < 0.0001) and end-systolic volume decreased from 65 ± 38 to 56 ± 38 ml (p < 0.001) 3 months after CTO PCI. Importantly, despite minimal post-procedural infarction due to distal embolization and side branch occlusion in 8 of 32 patients (25%), the total Seattle Angina Questionnaire score improved from a median of 54 (range 45 to 74) at baseline to 89 (range 77 to 98) after CTO recanalization (p < 0.0001).Co
Patel HC, Rosen SD, Hayward C, et al., 2016, Renal denervation in heart failure with preserved ejection fraction (RDF-PEF): a randomised controlled trial, European Journal of Heart Failure, Vol: 18, Pages: 703-712, ISSN: 1879-0844
AimHeart failure with preserved ejection fraction (HFpEF) is associated with increased sympathetic nervous system (SNS) tone. Attenuating the SNS with renal denervation (RD) might be helpful and there are no data currently in humans with HFpEF.Methods and ResultsIn this single-centre, randomised, open-controlled study we included 25 patients with HFpEF (preserved left ventricular (LV) ejection fraction, left atrial (LA) dilatation or LV hypertrophy and raised B-type natriuretic peptide (BNP) or echocardiographic assessment of filling pressures). Patients were randomised (2:1) to RD with the Symplicity™ catheter or continuing medical therapy. The primary success criterion was not met in that there were no differences between groups at 12 months for Minnesota Living with Heart Failure Questionnaire score, peak oxygen uptake (VO2) on exercise, BNP, E/e’, LA volume index or LV mass index. A greater proportion of patients improved at three months in the RD group with respect to VO2 peak (56% vs 13%, P=0.025) and E/e’ (31% vs 13%, P=0.04). Change in estimated glomerular filtration rate was comparable between groups. Two patients required plain balloon angioplasty during the RD procedure to treat renal artery wall oedema.ConclusionThis study was terminated early due to difficulties in recruitment and was underpowered to detect whether RD improved the endpoints of: quality of life, exercise function, biomarkers and left heart remodelling. The procedure was safe in patients with HFpEF though two patients did require intra-procedure renal artery dilatation.
Auger D, Pennell DJ, 2016, Cardiac complications in thalassemia major, Annals of the New York Academy of Sciences, Vol: 1368, Pages: 56-64, ISSN: 1749-6632
The myocardium is particularly susceptible to complications from iron loading in thalassemia major. In the first years of life, severe anemia leads to high-output cardiac failure and death if not treated. The necessary supportive blood transfusions create loading of iron that cannot be naturally excreted, and this iron accumulates within tissues, including the heart. Free unbound iron catalyzes the formation of toxic hydroxyl radicals, which damage cells and cause cardiac dysfunction. Significant cardiac siderosis may present by the age of 10 and may lead to acute clinical heart failure, which must be treated urgently. Atrial fibrillation is the most frequently encountered iron-related arrhythmia. Iron chelation is effective at removing iron from the myocardium, at the expense of side effects that hamper compliance to therapy. Monitoring of myocardial iron content is mandatory for clinical management of cardiac risk. T2* cardiac magnetic resonance measures myocardial iron and is the strongest biomarker for prediction of heart failure and arrhythmic events. It has been calibrated to human myocardial tissue iron concentration and is highly reproducible across all magnetic resonance scanner vendors. As survival and patient age increases, endothelial dysfunction and diabetes may become new factors in the cardiovascular health of thalassemia patients. Promising new imaging technology and therapies could ameliorate the long-term prognosis.
Rydman R, Shiina Y, Diller G-P, et al., 2016, MORTALITY AND VT IN EBSTEIN'S ANOMALY OF THE TRICUSPID VALVE: A PROSPECTIVE CARDIOVASCULAR MAGNETIC RESONANCE STUDY, Annual Meeting of the British-Congenital-Cardiac-Association, Publisher: BMJ PUBLISHING GROUP, Pages: A27-A27, ISSN: 1355-6037
Bonello B, Shore DF, Uebing A, et al., 2016, AORTIC DILATATION IN REPAIRED TETRALOGY OF FALLOT: FEATURES, DETERMINANTS AND PROGRESSION, Annual Meeting of the British-Congenital-Cardiac-Association, Publisher: BMJ PUBLISHING GROUP, Pages: A2-A3, ISSN: 1355-6037
Heng EL, Gatzoulis MA, Uebing A, et al., 2016, EARLY CARDIAC REMODELLING AFTER PULMONARY VALVE REPLACEMENT IN PATIENTS WITH REPAIRED TETRALOGY OF FALLOT, Annual Meeting of the British-Congenital-Cardiac-Association, Publisher: BMJ PUBLISHING GROUP, Pages: A26-A26, ISSN: 1355-6037
Vassiliou VS, Patel HC, Rosen SD, et al., 2016, Left atrial dilation in patients with heart failure and preserved ejection fraction: Insights from cardiovascular magnetic resonance, International Journal of Cardiology, Vol: 210, Pages: 158-160, ISSN: 1874-1754
Auger D, Pennell DJ, 2016, Cardiac complications in thalassemia major, Annals of the New York Academy of Sciences, ISSN: 1749-6632
The myocardium is particularly susceptible to complications from iron loading in thalassemia major. In the first years of life, severe anemia leads to high-output cardiac failure and death if not treated. The necessary supportive blood transfusions create loading of iron which cannot be naturally excreted, and this iron accumulates within tissues including the heart. Free unbound iron catalyses the formation of toxic hydroxyl radicals which damage cells and cause cardiac dysfunction. Significant cardiac siderosis may present by the age of 10 and may lead to acute clinical heart failure, which must be treated urgently. Atrial fibrillation is the most frequently encountered iron related arrhythmia. Iron chelation is effective at removing iron from the myocardium at the expense of side-effects which hamper compliance to therapy. Monitoring of myocardial iron content is mandatory for clinical management of cardiac risk. T2* cardiac magnetic resonance measures myocardial iron and is the strongest biomarker for prediction of heart failure and arrhythmic events. It has been calibrated to human myocardial tissue iron concentration and is highly reproducible across all magnetic resonance scanner vendors. As survival and patient age increases, endothelial dysfunction and diabetes may become new factors in cardiovascular health of thalassaemia patients. Promising new imaging technology and therapies could ameliorate the long-term prognosis.
Lam WC, Pennell DJ, 2016, Imaging of the heart: historical perspective and recent advances, POSTGRADUATE MEDICAL JOURNAL, Vol: 92, Pages: 99-104, ISSN: 0032-5473
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Vassiliou V, Wassilew K, Malley T, et al., 2016, Incremental benefit in correlation with histology of native T1 mapping, partition coefficient and extracellular volume fraction in patients with aortic stenosis, Journal of Cardiovascular Magnetic Resonance, Vol: 18, ISSN: 1097-6647
Vassiliou V, Wassilew K, Asimakopoulos G, et al., 2016, Histological validation of a new CMR T1-mapping-based protocol to improve accuracy for fibrosis assessment in patients with aortic stenosis, Journal of Cardiovascular Magnetic Resonance, Vol: 18, Pages: 1-3, ISSN: 1097-6647
Scott AD, Ferreira P, Nielles-Vallespin S, et al., 2016, Can we predict the diffusion “sweet-spot” based on a standard cine?, Journal of Cardiovascular Magnetic Resonance, Vol: 18, Pages: 1-3, ISSN: 1097-6647
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Scott AD, Nielles-Vallespin S, Ferreira P, et al., 2016, In-vivo cardiac DTI: An initial comparison of M012 compensated spin-echo and STEAM, Journal of Cardiovascular Magnetic Resonance, Vol: 18, Pages: 1-3, ISSN: 1097-6647
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Wage R, Gatehouse P, Jasmin NH, et al., 2016, Myocardial T1 and ECV mapping: How we optimise technical aspects of acquisition, Journal of Cardiovascular Magnetic Resonance, Vol: 18, Pages: 1-2, ISSN: 1097-6647
Jin N, Fernandes JL, Firmin D, et al., 2016, Free-breathing myocardial T2* Mapping using GRE-EPI and MOCO for myocardial and hepatic iron overload assessment: A multi-centre study, Journal of Cardiovascular Magnetic Resonance, Vol: 18, Pages: 1-2, ISSN: 1097-6647
Vassiliou V, Anita S, Malley T, et al., 2016, Systolic T1 mapping for estimation of myocardial diffuse fibrosis, Journal of Cardiovascular Magnetic Resonance, Vol: 18, Pages: 1-2, ISSN: 1097-6647
Mathew GL, Vassiliou V, Heng EL, et al., 2016, Streamlining trigger delay estimation for T1 mapping, Journal of Cardiovascular Magnetic Resonance, Vol: 18, Pages: 1-2, ISSN: 1097-6647
Scott AD, Nielles-Vallespin S, Ferreira PF, et al., 2016, The effects of noise in cardiac diffusion tensor imaging and the benefits of averaging complex data, NMR in Biomedicine, Vol: 29, Pages: 588-599
McGill LA, Ferreira PF, Scott AD, et al., 2016, Relationship between cardiac diffusion tensor imaging parameters and anthropometrics in healthy volunteers, Journal of Cardiovascular Magnetic Resonance, Vol: 18, Pages: 2-2
Jin N, da Silveira JS, Jolly M-P, et al., 2015, Free-breathing myocardial T2* mapping using GRE-EPI and automatic non-rigid motion correction, Journal of Cardiovascular Magnetic Resonance, Vol: 17, ISSN: 1532-429X
Pennell DJ, Porter JB, Piga A, et al., 2015, Association of Liver Iron Concentration Levels with Myocardial T2*Responses in Transfusion-Dependent Thalassemia Major Patients Treated with Deferasirox and Deferoxamine-Extension of Cordelia Study, 57th Annual Meeting of the American-Society-of-Hematology, Publisher: AMER SOC HEMATOLOGY, ISSN: 0006-4971
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Jensen AS, Broberg CS, Rydman R, et al., 2015, Impaired Right, Left, or Biventricular Function and Resting Oxygen Saturation Are Associated With Mortality in Eisenmenger Syndrome: A Clinical and Cardiovascular Magnetic Resonance Study., Circulation: Cardiovascular Imaging, Vol: 8, ISSN: 1941-9651
BACKGROUND: Patients with Eisenmenger syndrome (ES) have better survival, despite similar pulmonary vascular pathology, compared with other patients with pulmonary arterial hypertension. Cardiovascular magnetic resonance (CMR) is useful for risk stratification in idiopathic pulmonary arterial hypertension, whereas it has not been evaluated in ES. We studied CMR together with other noninvasive measurements in ES to evaluate its potential role as a noninvasive risk stratification test. METHODS AND RESULTS: Between 2003 and 2005, 48 patients with ES, all with a post-tricuspid shunt, were enrolled in a prospective, longitudinal, single-center study. All patients underwent a standardized baseline assessment with CMR, blood test, echocardiography, and 6-minute walk test and were followed up for mortality until the end of December 2013. Twelve patients (25%) died during follow-up, mostly from heart failure (50%). Impaired ventricular function (right or left ventricular ejection fraction) was associated with increased risk of mortality (lowest quartile: right ventricular ejection fraction, <40%; hazard ratio, 4.4 [95% confidence interval, 1.4-13.5]; P=0.01 and left ventricular ejection fraction, <50%; hazard ratio, 6.6 [95% confidence interval, 2.1-20.8]; P=0.001). Biventricular impairment (lowest quartile left ventricular ejection fraction, <50% and right ventricular ejection fraction, <40%) conveyed an even higher risk of mortality (hazard ratio, 8.0 [95% confidence interval, 2.5-25.1]; P=0.0004). No other CMR or noninvasive measurement besides resting oxygen saturation (hazard ratio, 0.90 [0.83-0.97]/%; P=0.007) was associated with mortality. CONCLUSIONS: Impaired right, left, or biventricular systolic function derived from baseline CMR and resting oxygen saturation are associated with mortality in adult patients with ES. CMR is a useful noninvasive tool, which may be incorporated in the risk stratification assessment of ES during lifelong follow-up.
Alam MH, Auger D, Smith GC, et al., 2015, T1 at 1.5T and 3T compared with conventional T2*at 1.5T for cardiac siderosis, Journal of Cardiovascular Magnetic Resonance, Vol: 17, ISSN: 1532-429X
Background: Myocardial black blood (BB) T2* relaxometry at 1.5T provides robust, reproducible and calibratednon-invasive assessment of cardiac iron burden. In vitro data has shown that like T2*, novel native ModifiedLook-Locker Inversion recovery (MOLLI) T1 shortens with increasing tissue iron. The relative merits of T1 andT2* are largely unexplored. We compared the established 1.5T BB T2* technique against native T1 values at1.5T and 3T in iron overload patients and in normal volunteers.Methods: A total of 73 subjects (42 male) were recruited, comprising 20 healthy volunteers (controls) and 53 patients(thalassemia major 22, sickle cell disease 9, hereditary hemochromatosis 9, other iron overload conditions 13). Singlemid-ventricular short axis slices were acquired for BB T2* at 1.5T and MOLLI T1 quantification at 1.5T and 3T.Results: In healthy volunteers, median T1 was 1014 ms (full range 939–1059 ms) at 1.5T and modestly increased to1165ms (full range 1056–1224 ms) at 3T. All patients with significant cardiac iron overload (1.5T T2* values <20 ms) hadT1 values <939 ms at 1.5T, and <1056 ms at 3T. Associations between T2* and T1 were found to be moderatewith y =377 · x0.282 at 1.5T (R2 = 0.717), and y =406 · x0.294 at 3T (R2 = 0.715). Measures of reproducibility of T1appeared superior to T2*.Conclusions: T1 mapping at 1.5T and at 3T can identify individuals with significant iron loading as defined bythe current gold standard T2* at 1.5T. However, there is significant scatter between results which may reflectmeasurement error, but it is also possible that T1 interacts with T2*, or is differentially sensitive to aspects of ironchemistry or other biology. Hurdles to clinical implementation of T1 include the lack of calibration against humanmyocardial iron concentration, no demonstrated relation to cardiac outcomes, and variation in absolute T1 valuesbetween scanners, which makes inter-centre comparisons difficult. The relative merit
Raphael CE, Vassiliou V, Alpendurada F, et al., 2015, Clinical value of cardiovascular magnetic resonance in patients with MR-conditional pacemakers., European Heart Journal- Cardiovascular Imaging, Vol: 17, Pages: 1178-1185, ISSN: 2047-2404
AIMS: Magnetic resonance (MR) conditional pacemakers are increasingly implanted into patients who may need cardiovascular MR (CMR) subsequent to device implantation. We assessed the added value of CMR for diagnosis and management in this population. METHODS AND RESULTS: CMR and pacing data from consecutive patients with MR conditional pacemakers were retrospectively reviewed. Images were acquired at 1.5 T (Siemens Magnetom Avanto). The indication for CMR and any resulting change in management was recorded. The quality of CMR was rated by an observer blinded to clinical details, and data on pacemaker and lead parameters were collected pre- and post-CMR. Seventy-two CMR scans on 69 patients performed between 2011 and 2015 were assessed. All scans were completed successfully with no significant change in lead thresholds or pacing parameters. Steady-state free precession (SSFP) cine imaging resulted in a greater frequency of non-diagnostic imaging (22 vs. 1%, P < 0.01) compared with gradient echo sequences (GRE). Right-sided pacemakers were associated with less artefact than left-sided pacemakers. Late gadolinium enhancement imaging was performed in 59 scans with only 2% of segments rated of non-diagnostic quality. The CMR data resulted in a new diagnosis in 27 (38%) of examinations; clinical management was changed in a further 18 (25%). CONCLUSIONS: CMR in patients with MR conditional pacemakers provided diagnostic or management-changing information in the majority (63%) of our cohort. The use of gradient echo cine sequences can reduce rates of non-diagnostic imaging. Right-sided device implantation may be considered in patients likely to require CMR examination.
Pennell DJ, Baksi AJ, Prasad SK, et al., 2015, Review of Journal of Cardiovascular Magnetic Resonance 2014, Journal of Cardiovascular Magnetic Resonance, Vol: 17, ISSN: 1532-429X
There were 102 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2014, which is a6 % decrease on the 109 articles published in 2013. The quality of the submissions continues to increase. The 2013JCMR Impact Factor (which is published in June 2014) fell to 4.72 from 5.11 for 2012 (as published in June 2013).The 2013 impact factor means that the JCMR papers that were published in 2011 and 2012 were cited on average4.72 times in 2013. The impact factor undergoes natural variation according to citation rates of papers in the 2 yearsfollowing publication, and is significantly influenced by highly cited papers such as official reports. However,the progress of the journal’s impact over the last 5 years has been impressive. Our acceptance rate is <25 %and has been falling because the number of articles being submitted has been increasing. In accordance withOpen-Access publishing, the JCMR articles go on-line as they are accepted with no collating of the articlesinto sections or special thematic issues. For this reason, the Editors have felt that it is useful once per calendar year tosummarize the papers for the readership into broad areas of interest or theme, so that areas of interest canbe reviewed in a single article in relation to each other and other recent JCMR articles. The papers are presented inbroad themes and set in context with related literature and previously published JCMR papers to guide continuity ofthought in the journal. We hope that you find the open-access system increases wider reading and citation of yourpapers, and that you will continue to send your quality papers to JCMR for publication.
Giannakidis A, Nyktari E, Keegan J, et al., 2015, Rapid automatic segmentation of abnormal tissue in late gadolinium enhancement cardiovascular magnetic resonance images for improved management of long-standing persistent atrial fibrillation., Biomedical Engineering Online, Vol: 14, ISSN: 1475-925X
BACKGROUND: Atrial fibrillation (AF) is the most common heart rhythm disorder. In order for late Gd enhancement cardiovascular magnetic resonance (LGE CMR) to ameliorate the AF management, the ready availability of the accurate enhancement segmentation is required. However, the computer-aided segmentation of enhancement in LGE CMR of AF is still an open question. Additionally, the number of centres that have reported successful application of LGE CMR to guide clinical AF strategies remains low, while the debate on LGE CMR's diagnostic ability for AF still holds. The aim of this study is to propose a method that reliably distinguishes enhanced (abnormal) from non-enhanced (healthy) tissue within the left atrial wall of (pre-ablation and 3 months post-ablation) LGE CMR data-sets from long-standing persistent AF patients studied at our centre. METHODS: Enhancement segmentation was achieved by employing thresholds benchmarked against the statistics of the whole left atrial blood-pool (LABP). The test-set cross-validation mechanism was applied to determine the input feature representation and algorithm that best predict enhancement threshold levels. RESULTS: Global normalized intensity threshold levels T PRE = 1 1/4 and T POST = 1 5/8 were found to segment enhancement in data-sets acquired pre-ablation and at 3 months post-ablation, respectively. The segmentation results were corroborated by using visual inspection of LGE CMR brightness levels and one endocardial bipolar voltage map. The measured extent of pre-ablation fibrosis fell within the normal range for the specific arrhythmia phenotype. 3D volume renderings of segmented post-ablation enhancement emulated the expected ablation lesion patterns. By comparing our technique with other related approaches that proposed different threshold levels (although they also relied on reference regions from within the LABP) for segmenting enhancement in LGE CMR data-sets of AF patients, we illustra
Giannakidis A, Nyktari E, Keegan J, et al., 2015, Rapid automatic segmentation of abnormal tissue in late gadolinium enhancement cardiovascular magnetic resonance images for improved management of long‑standing persistent atrial fibrillation, Biomedical Engineering Online, Vol: 14, ISSN: 1475-925X
Baksi AJ, Pennell DJ, 2015, Cardiomyopathy, Advanced Cardiac Imaging, Pages: 399-438, ISBN: 9781782422822
Heng EL, Gatzoulis MA, Smith GC, et al., 2015, Early cardiac remodelling post-pulmonary valve replacement in patients with repaired tetralogy of Fallot, Congress of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 357-358, ISSN: 0195-668X
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