Publications
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Izgi C, Newsome S, Alpendurada F, et al., 2018, External Aortic Root Support to Prevent Aortic Dilatation in Patients With Marfan Syndrome, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 72, Pages: 1095-1105, ISSN: 0735-1097
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- Citations: 24
Yang G, Zhuang X, Khan H, et al., 2018, Fully automatic segmentation and objective assessment of atrial scars for longstanding persistent atrial fibrillation patients using late gadolinium-enhanced MRI, Medical Physics, Vol: 45, Pages: 1562-1576, ISSN: 0094-2405
PURPOSE: Atrial fibrillation (AF) is the most common heart rhythm disorder and causes considerable morbidity and mortality, resulting in a large public health burden that is increasing as the population ages. It is associated with atrial fibrosis, the amount and distribution of which can be used to stratify patients and to guide subsequent electrophysiology ablation treatment. Atrial fibrosis may be assessed non-invasively using late gadolinium-enhanced (LGE) magnetic resonance imaging (MRI) where scar tissue is visualised as a region of signal enhancement. However, manual segmentation of the heart chambers and of the atrial scar tissue is time-consuming and subject to inter-operator variability, particularly as image quality in AF is often poor. In this study, we propose a novel fully automatic pipeline to achieve accurate and objective segmentation of the heart (from MRI Roadmap data) and of scar tissue within the heart (from LGE MRI data) acquired in patients with AF. METHODS: Our fully automatic pipeline uniquely combines: (1) a multi-atlas based whole heart segmentation (MA-WHS) to determine the cardiac anatomy from an MRI Roadmap acquisition which is then mapped to LGE MRI, and (2) a super-pixel and supervised learning based approach to delineate the distribution and extent of atrial scarring in LGE MRI. We compared the accuracy of the automatic analysis to manual ground-truth segmentations in 37 patients with persistent long standing AF. RESULTS: Both our MA-WHS and atrial scarring segmentations showed accurate delineations of cardiac anatomy (mean Dice = 89%) and atrial scarring (mean Dice = 79%) respectively compared to the established ground truth from manual segmentation. In addition, compared to the ground truth, we obtained 88% segmentation accuracy, with 90% sensitivity and 79% specificity. Receiver operating characteristic analysis achieved an average area under the curve of 0.91. CONCLUSION: Compared with previously studied methods with manual interv
Izgi C, Mohiaddin R, Xu XY, et al., 2018, Aortic Leaflet Stress in Surgery for Genetically Determined Root Aneurysms: Biomechanical Insights, ANNALS OF THORACIC SURGERY, Vol: 105, Pages: 984-984, ISSN: 0003-4975
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Khan HR, Kralj-Hans I, Haldar S, et al., 2018, Catheter ablation versus thoracoscopic surgical ablation in long standing persistent atrial fibrillation (CASA-AF): study protocol for a randomised controlled trial, Trials, Vol: 19, ISSN: 1745-6215
BACKGROUND: Atrial fibrillation is the commonest arrhythmia which raises the risk of heart failure, thromboembolic stroke, morbidity and death. Pharmacological treatments of this condition are focused on heart rate control, rhythm control and reduction in risk of stroke. Selective ablation of cardiac tissues resulting in isolation of areas causing atrial fibrillation is another treatment strategy which can be delivered by two minimally invasive interventions: percutaneous catheter ablation and thoracoscopic surgical ablation. The main purpose of this trial is to compare the effectiveness and safety of these two interventions. METHODS/DESIGN: Catheter Ablation versus Thoracoscopic Surgical Ablation in Long Standing Persistent Atrial Fibrillation (CASA-AF) is a prospective, multi-centre, randomised controlled trial within three NHS tertiary cardiovascular centres specialising in treatment of atrial fibrillation. Eligible adults (n = 120) with symptomatic, long-standing, persistent atrial fibrillation will be randomly allocated to either catheter ablation or thoracoscopic ablation in a 1:1 ratio. Pre-determined lesion sets will be delivered in each treatment arm with confirmation of appropriate conduction block. All patients will have an implantable loop recorder (ILR) inserted subcutaneously immediately following ablation to enable continuous heart rhythm monitoring for at least 12 months. The devices will be programmed to detect episodes of atrial fibrillation and atrial tachycardia ≥ 30 s in duration. The patients will be followed for 12 months, completing appropriate clinical assessments and questionnaires every 3 months. The ILR data will be wirelessly transmitted daily and evaluated every month for the duration of the follow-up. The primary endpoint in the study is freedom from atrial fibrillation and atrial tachycardia at the end of the follow-up period. DISCUSSION: The CASA-AF Trial is a National Institute for Health
Heng EL, Semple T, Dimopoulos K, et al., 2018, A crown of thorns-right ventricular outflow tract obstruction caused by calcific pericardial ring, EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, Vol: 19, Pages: 83-83, ISSN: 2047-2404
Haldar SK, Jones DG, Bahrami T, et al., 2017, Catheter ablation vs electrophysiologically guided thoracoscopic surgical ablation in long-standing persistent atrial fibrillation: The CASA-AF Study, Heart Rhythm, Vol: 14, Pages: 1596-1603, ISSN: 1547-5271
BackgroundCatheter ablation (CA) outcomes for long-standing persistent atrial fibrillation (LSPAF) remain suboptimal. Thoracoscopic surgical ablation (SA) provides an alternative approach in this difficult to treat cohort.ObjectiveTo compare electrophysiological (EP) guided thoracoscopic SA with percutaneous CA as the first-line strategy in the treatment of LSPAF.MethodsFifty-one patients with de novo symptomatic LSPAF were recruited. Twenty-six patients underwent electrophysiologically guided thoracoscopic SA. Conduction block was tested for all lesions intraoperatively by an independent electrophysiologist. In the CA group, 25 consecutive patients underwent stepwise left atrial (LA) ablation. The primary end point was single-procedure freedom from atrial fibrillation (AF) and atrial tachycardia (AT) lasting >30 seconds without antiarrhythmic drugs at 12 months.ResultsSingle- and multiprocedure freedom from AF/AT was higher in the SA group than in the CA group: 19 of 26 patients (73%) vs 8 of 25 patients (32%) (P = .003) and 20 of 26 patients (77%) vs 15 of 25 patients (60%) (P = .19), respectively. Testing of the SA lesion set by an electrophysiologist increased the success rate in achieving acute conduction block by 19%. In the SA group, complications were experienced by 7 of 26 patients (27%) vs 2 of 25 patients (8%) in the CA group (P = .07).ConclusionIn LSPAF, meticulous electrophysiologically guided thoracoscopic SA as a first-line strategy may provide excellent single-procedure success rates as compared with those of CA, but there is an increased up-front risk of nonfatal complications.
Bruengger AAS, Wechalekar K, Khattar R, et al., 2017, Histologically proven myocardial carcinoid metastases: the value of multimodality imaging, Canadian Journal of Cardiology, Vol: 33, Pages: 1336.e9-1336.e12, ISSN: 1916-7075
We present a case of a patient with intramyocardial metastases from a carcinoid tumor. These findings were detected using cardiovascular magnetic resonance imaging, with functional metabolic activity analyzed using nuclear imaging and confirmed by histologic findings at surgical biopsy. This case highlights the value of cardiovascular magnetic resonance imaging and the importance of multimodality imaging.
Nyktari E, Vassiliou VS, Arzanauskaite M, et al., 2017, Challenging Occam's Razor: An Unusual Combination of Sarcoidosis and Amyloidosis. The Value of Cardiac Magnetic Resonance Imaging in Infiltrative Cardiomyopathies, CANADIAN JOURNAL OF CARDIOLOGY, Vol: 33, ISSN: 0828-282X
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Yang G, Zhuang X, Khan H, et al., 2017, Segmenting atrial fibrosis from late gadolinium-enhanced cardiac MRI by deep-learned features with stacked sparse auto-encoders, MIUA 2017, Publisher: Springer, Pages: 195-206, ISSN: 1865-0929
The late gadolinium-enhanced (LGE) MRI technique is a well-validated method for fibrosis detection in the myocardium. With this technique, the altered wash-in and wash-out contrast agent kinetics in fibrotic and healthy myocardium results in scar tissue being seen with high or enhanced signal relative to normal tissue which is ‘nulled’. Recently, great progress on LGE MRI has resulted in improved visualization of fibrosis in the left atrium (LA). This provides valuable information for treatment planning, image-based procedure guidance and clinical management in patients with atrial fibrillation (AF). Nevertheless, precise and objective atrial fibrosis segmentation (AFS) is required for accurate assessment of AF patients using LGE MRI. This is a very challenging task, not only because of the limited quality and resolution of the LGE MRI images acquired in AF but also due to the thinner wall and unpredictable morphology of the LA. Accurate and reliable segmentation of the anatomical structure of the LA myocardium is a prerequisite for accurate AFS. Most current studies rely on manual segmentation of the anatomical structures, which is very labor-intensive and subject to inter- and intra-observer variability. The subsequent AFS is normally based on unsupervised learning methods, e.g., using thresholding, histogram analysis, clustering and graph-cut based approaches, which have variable accuracy. In this study, we present a fully-automated multi-atlas propagation based whole heart segmentation method to derive the anatomical structure of the LA myocardium and pulmonary veins. This is followed by a supervised deep learning method for AFS. Twenty clinical LGE MRI scans from longstanding persistent AF patients were entered into this study retrospectively. We have demonstrated that our fully automatic method can achieve accurate and reliable AFS compared to manual delineated ground truth.
Yang G, Zhuang X, Khan H, et al., 2017, A fully automatic deep learning method for atrial scarring segmentation from late gadolinium-enhanced MRI images, 2017 IEEE 14th International Symposium on Biomedical Imaging, Publisher: IEEE, Pages: 844-848, ISSN: 1945-7928
Precise and objective segmentation of atrial scarring (SAS) is a prerequisite for quantitative assessment of atrial fibrillation using non-invasive late gadolinium-enhanced (LGE) MRI. This also requires accurate delineation of the left atrium (LA) and pulmonary veins (PVs) geometry. Most previous studies have relied on manual segmentation of LA wall and PVs, which is a tedious and error-prone procedure with limited reproducibility. There are many attempts on automatic SAS using simple thresholding, histogram analysis, clustering and graph-cut based approaches; however, in general, these methods are considered as unsupervised learning thus subject to limited segmentation accuracy. In this study, we present a fully-automated multi-atlas based whole heart segmentation method to derive the LA and PVs geometry objectively that is followed by a fully automatic deep learning method for SAS. Our deep learning method consists of a feature extraction step via super-pixel over-segmentation and a supervised classification step via stacked sparse auto-encoders. We demonstrate the efficacy of our method on 20 clinical LGE MRI scans acquired from a longstanding persistent atrial fibrillation cohort. Both quantitative and qualitative results show that our fully automatic method obtained accurate segmentation results compared to the manual segmentation based ground truths.
Liew AC, Raphael CE, Mohiaddin R, 2017, A 38-year-old man with progressive dyspnoea and ventricular tachycardia, HEART, Vol: 103, Pages: 833-+, ISSN: 1355-6037
Lota AS, Gatehouse PD, Mohiaddin RH, 2017, T2 mapping and T2*imaging in heart failure, Heart Failure Reviews, Vol: 22, Pages: 431-440, ISSN: 1382-4147
Cardiovascular magnetic resonance (CMR) is aversatile imaging modality that enables aetiological assessmentand provides additional information to that of standardechocardiography in a significant proportion of patients withheart failure. In addition to highly accurate and reproducibleassessment of ventricular volumes and replacement fibrosis,multiparametric mapping techniques have rapidly evolved tofurther expand the diagnostic and prognostic applications invarious conditions ranging from acute inflammatory and ischaemiccardiomyopathy, to cardiac involvement in systemicdiseases such as sarcoidosis and iron overload cardiomyopathy.In this review, we discuss the established role of T2*imaging and rapidly evolving clinical applications of myocardialT2 mapping as quantitative adjuncts to established qualitativeimaging techniques.
Lota A, Baksi J, Tsao A, et al., 2017, Cardiovascular magnetic resonance in survivors of sudden cardiac arrest: 14 year experience from a tertiary referral centre in the United Kingdom, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 69, Pages: 491-491, ISSN: 0735-1097
Patel HC, Hayward C, Keegan J, et al., 2017, Effects of renal denervation on vascular remodelling in patients with heart failure and preserved ejection fraction: A randomised control trial, JRSM Cardiovascular Disease, Vol: 6, ISSN: 2048-0040
Objective:To assess the effect of renal denervation (RDT) on micro- and macro-vascular function in patients with heartfailure with preserved ejection fraction (HFpEF).Design:A prospective, randomised, open-controlled trial with blinded end-point analysis.Setting:A single-centre London teaching hospital.Participants:Twenty-five patients with HFpEF who were recruited into the RDT-PEF trial.Main outcome measures:Macro-vascular: 24-h ambulatory pulse pressure, aorta distensibilty (from cardiac magneticresonance imaging (CMR), aorta pulse wave velocity (CMR), augmentation index (peripheral tonometry) and renal arteryblood flow indices (renal MR). Micro-vascular: endothelial function (peripheral tonometry) and urine microalbuminuria.Results:At baseline, 15 patients were normotensive, 9 were hypertensive and 1 was hypotensive. RDT did not lowerany of the blood pressure indices. Though there was evidence of abnormal vascular function at rest, RDT did not affectthese at 3 or 12 months follow-up.Conclusions:RDT did not improve markers of macro- and micro-vascular function.
Yang G, Zhuang X, Khan H, et al., 2017, Differentiation of Pre-ablation and Post-ablation Late Gadolinium-enhanced Cardiac MRI Scans of Longstanding Persistent Atrial Fibrillation Patients
Yang G, Zhuang X, Khan H, et al., 2017, Multi-atlas Propagation based Left Atrium Segmentation Coupled with Super-voxel based Pulmonary Veins Delineation in Late Gadolinium-enhanced Cardiac MRI
Pennell DJ, Baksi AJ, Prasad SK, et al., 2016, Review of Journal of Cardiovascular Magnetic Resonance 2015, Journal of Cardiovascular Magnetic Resonance, Vol: 18, Pages: 86-86, ISSN: 1097-6647
There were 116 articles published in the Journal of Cardiovascular Magnetic Resonance (JCMR) in 2015, which is a 14 % increase on the 102 articles published in 2014. The quality of the submissions continues to increase. The 2015 JCMR Impact Factor (which is published in June 2016) rose to 5.75 from 4.72 for 2014 (as published in June 2015), which is the highest impact factor ever recorded for JCMR. The 2015 impact factor means that the JCMR papers that were published in 2013 and 2014 were cited on average 5.75 times in 2015. The impact factor undergoes natural variation according to citation rates of papers in the 2 years following 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 with Open-Access publishing, the JCMR articles go on-line as they are accepted with no collating of the articles into sections or special thematic issues. For this reason, the Editors have felt that it is useful once per calendar year to summarize the papers for the readership into broad areas of interest or theme, so that areas of interest can be reviewed in a single article in relation to each other and other recent JCMR articles. The papers are presented in broad themes and set in context with related literature and previously published JCMR papers to guide continuity of thought in the journal. We hope that you find the open-access system increases wider reading and citation of your papers, and that you will continue to send your quality papers to JCMR for publication.
Page M, Quarto C, Mancuso E, et al., 2016, Metabolically Active Brown Fat Mimicking Pericardial Metastasis on PET/CT: The Discriminating Role of Cardiac Magnetic Resonance Imaging, CANADIAN JOURNAL OF CARDIOLOGY, Vol: 32, ISSN: 0828-282X
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Lindsay AC, Harron K, Jabbour RJ, et al., 2016, Prevalence and Prognostic Significance of Right Ventricular Systolic Dysfunction in Patients Undergoing Transcatheter Aortic Valve Implantation., Circulation: Cardiovascular Interventions, Vol: 9, ISSN: 1941-7640
BACKGROUND: Cardiovascular magnetic resonance (CMR) can provide important structural information in patients undergoing transcatheter aortic valve implantation. Although CMR is considered the standard of reference for measuring ventricular volumes and mass, the relationship between CMR findings of right ventricular (RV) function and outcomes after transcatheter aortic valve implantation has not previously been reported. METHODS AND RESULTS: A total of 190 patients underwent 1.5 Tesla CMR before transcatheter aortic valve implantation. Steady-state free precession sequences were used for aortic valve planimetry and to assess ventricular volumes and mass. Semiautomated image analysis was performed by 2 specialist reviewers blinded to patient treatment. Patient follow-up was obtained from the Office of National Statistics mortality database. The median age was 81.0 (interquartile range, 74.9-85.5) years; 50.0% were women. Impaired RV function (RV ejection fraction ≤50%) was present in 45 (23.7%) patients. Patients with RV dysfunction had poorer left ventricular ejection fractions (42% versus 69%), higher indexed left ventricular end-systolic volumes (96 versus 40 mL), and greater indexed left ventricular mass (101 versus 85 g/m(2); P<0.01 for all) than those with normal RV function. Median follow-up was 850 days; 21 of 45 (46.7%) patients with RV dysfunction died, compared with 43 of 145 (29.7%) patients with normal RV function (P=0.035). After adjustment for significant baseline variables, both RV ejection fraction ≤50% (hazard ratio, 2.12; P=0.017) and indexed aortic valve area (hazard ratio, 4.16; P=0.025) were independently associated with survival. CONCLUSIONS: RV function, measured on preprocedural CMR, is an independent predictor of mortality after transcatheter aortic valve implantation. CMR assessment of RV function may be important in the risk stratification of patients undergoing transcatheter aortic valve implantation.
Myerson SG, d'Arcy J, Christiansen JP, et al., 2016, Determination of Clinical Outcome in Mitral Regurgitation With Cardiovascular Magnetic Resonance Quantification, Circulation, Vol: 133, Pages: 2287-2296, ISSN: 0009-7322
Singh SD, Xu XY, Pepper JR, et al., 2016, Effects of aortic root motion on wall stress in the Marfan aorta before and after personalised aortic root support (PEARS) surgery, Journal of Biomechanics, Vol: 49, Pages: 2076-2084, ISSN: 1873-2380
Aortic root motion was previously identified as a risk factor for aortic dissection due to increased longitudinal stresses in the ascending aorta. The aim of this study was to investigate the effects of aortic root motion on wall stress and strain in the ascending aorta and evaluate changes before and after implantation of personalised external aortic root support (PEARS). Finite element (FE) models of the aortic root and thoracic aorta were developed using patient-specific geometries reconstructed from pre- and post-PEARS cardiovascular magnetic resonance (CMR) images in three Marfan patients. The wall and PEARS materials were assumed to be isotropic, incompressible and linearly elastic. A static load on the inner wall corresponding to the patients' pulse pressure was applied. Cardiovascular MR cine images were used to quantify aortic root motion, which was imposed at the aortic root boundary of the FE model, with zero-displacement constraints at the distal ends of the aortic branches and descending aorta. Measurements of the systolic downward motion of the aortic root revealed a significant reduction in the axial displacement in all three patients post-PEARS compared with its pre-PEARS counterparts. Higher longitudinal stresses were observed in the ascending aorta when compared with models without the root motion. Implantation of PEARS reduced the longitudinal stresses in the ascending aorta by up to 52%. In contrast, the circumferential stresses at the interface between the supported and unsupported aorta were increase by up to 82%. However, all peak stresses were less than half the known yield stress for the dilated thoracic aorta.
Mohiaddin R, Heng EE, 2016, Cardiovascular Magnetic Resonance in Marfan syndrome, Diagnosis and Management of Marfan Syndrome, Editors: Child, Publisher: Springer, ISBN: 9781447154426
This book has been written in response to the many excellent questions posed by our patients and their care teams, questions which deserve the best-informed and up to date answers provided by our experts in each of the many health areas ...
Yang G, Ye X, Slabaugh G, et al., 2016, Combined self-learning based single-image super-resolution and dual-tree complex wavelet transform denoising for medical images, Medical Imaging 2016: Image Processing, Publisher: Society of Photo Optical Instrumentation Engineers
In this paper, we propose a novel self-learning based single-image super-resolution (SR) method, which is coupled with dual-tree complex wavelet transform (DTCWT) based denoising to better recover high-resolution (HR) medical images. Unlike previous methods, this self-learning based SR approach enables us to reconstruct HR medical images from a single low-resolution (LR) image without extra training on HR image datasets in advance. The relationships between the given image and its scaled down versions are modeled using support vector regression with sparse coding and dictionary learning, without explicitly assuming reoccurrence or self-similarity across image scales. In addition, we perform DTCWT based denoising to initialize the HR images at each scale instead of simple bicubic interpolation. We evaluate our method on a variety of medical images. Both quantitative and qualitative results show that the proposed approach outperforms bicubic interpolation and state-of-the-art single-image SR methods while effectively removing noise.
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.
Yang G, Ye X, Slabaugh G, et al., 2016, Super-Resolved Enhancement of a Single Image and Its Application in Cardiac MRI, Pages: 179-190
Singh SD, Xu XY, Wood NB, et al., 2015, Aortic flow patterns before and after personalised external aortic root support implantation in Marfan patients., Journal of Biomechanics, Vol: 49, Pages: 100-111, ISSN: 1873-2380
Implantation of a personalised external aortic root support (PEARS) in the Marfan aorta is a new procedure that has emerged recently, but its haemodynamic implication has not been investigated. The objective of this study was to compare the flow characteristics and hemodynamic indices in the aorta before and after insertion of PEARS, using combined cardiovascular magnetic resonance imaging (CMR) and computational fluid dynamics (CFD). Pre- and post-PEARS MR images were acquired from 3 patients and used to build patient-specific models and upstream flow conditions, which were incorporated into the CFD simulations. The results revealed that while the qualitative patterns of the haemodynamics were similar before and after PEARS implantation, the post-PEARS aortas had slightly less disturbed flow at the sinuses, as a result of reduced diameters in the post-PEARS aortic roots. Quantitative differences were observed between the pre- and post-PEARS aortas, in that the mean values of helicity flow index (HFI) varied by -10%, 35% and 20% in post-PEARS aortas of Patients 1, 2 and 3, respectively, but all values were within the range reported for normal aortas. Comparisons with MR measured velocities in the descending aorta of Patient 2 demonstrated that the computational models were able to reproduce the important flow features observed in vivo.
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.
Izgi C, Nyktari E, Alpendurada F, et al., 2015, Effect of personalized external aortic root support on aortic root motion and distension in Marfan syndrome patients, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 197, Pages: 154-160, ISSN: 0167-5273
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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
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