Sex differences in myocardial remodeling and extracellular volume in aortic regurgitation.

Whether sex differences exist in the cardiac remodeling related to aortic regurgitation (AR) is unclear. Cardiac magnetic resonance (CMR) is the current non-invasive reference standard for cardiac remodeling assessment and can evaluate tissue characteristics. This prospective cohort included patients with AR undergoing CMR between 2011 and 2020.

Differences in Myocardial Remodeling and Tissue Characteristics in Chronic Isolated Aortic and Mitral Regurgitation.

Background: The left ventricular hemodynamic load differs between aortic regurgitation (AR) and primary mitral regurgitation (MR). We used cardiac magnetic resonance to compare left ventricular remodeling patterns, systemic forward stroke volume, and tissue characteristics between patients with isolated AR and isolated MR.

Methods: We assessed remodeling parameters across the spectrum of regurgitant volume.

Micronodular Thymoma with Lymphoid Stroma: A Mediastinal Mass Masquerading as a Pericardial Mass.

A 61-year-old man presented to the emergency room with lower extremity edema. Physical exam was only remarkable for a diastolic murmur in the right carotid area and left lower extremity edema. Venous Doppler revealed a deep venous thrombosis in the left lower extremity.

Regional Replacement and Diffuse Interstitial Fibrosis in Aortic Regurgitation: Prognostic Implications From Cardiac Magnetic Resonance.

Objectives: This study used cardiac magnetic resonance (CMR) to assess left ventricular (LV) remodeling in chronic aortic regurgitation (AR) to identify both forms of myocardial fibrosis and examine its association with clinical outcomes.

Background: Chronic AR leads to LV remodeling, which is associated with 2 forms of myocardial fibrosis: regional replacement fibrosis that is directly imaged by late gadolinium enhancement (LGE) CMR; and diffuse interstitial fibrosis, which can be inferred by T1 mapping techniques.

Methods: Patients with chronic AR who were undergoing contrast CMR with T1 mapping for valve assessment from 2011 to 2018 were enrolled.

Baseline global longitudinal strain predictive of anthracycline-induced cardiotoxicity.

Background: Cancer therapy-related cardiac dysfunction (CTRD) is a major source of morbidity and mortality in long-term cancer survivors. Decreased GLS predicts decreased left ventricular ejection fraction (LVEF) in patients receiving anthracyclines, but knowledge regarding the clinical utility of baseline GLS in patients at low-risk of (CTRD) is limited.

Objectives: The purpose of this study was to investigate whether baseline echocardiographic assessment of global longitudinal strain (GLS) before treatment with anthracyclines is predictive of (CTRD) in a broad cohort of patients with normal baseline LVEF.

Myocardial Scar and Mortality in Chronic Aortic Regurgitation.

Background Chronic aortic regurgitation (AR) can be associated with myocardial scarring. It is unknown if scarring in AR is linked to poor outcomes and whether aortic valve replacement impacts this association. We investigated the relationship of myocardial scarring to mortality in chronic AR using cardiac magnetic resonance.

Impact of Social Media and Virtual Learning on Cardiology During the COVID-19 Pandemic Era and Beyond.

Over the past decade, advances in digital trends and technology have greatly impacted the medical field with rapid delivery of and access to information. The field of cardiovascular medicine in particular has seen major technological advances and is well versed in the use of digital platforms and social media. In these unprecedented times of the COVID-19 pandemic, social media and other digital platforms are essential tools for communication, education, and delivery of information.

Examining the impact of inducible ischemia on myocardial fibrosis and exercise capacity in hypertrophic cardiomyopathy.

Myocardial ischemia in hypertrophic cardiomyopathy (HCM) is associated with poor outcomes. Vasodilator stress cardiac magnetic resonance (CMR) can detect and quantitate inducible ischemia in HCM patients. We hypothesized that myocardial ischemia assessed by CMR is associated with myocardial fibrosis and reduced exercise capacity in HCM.

Cardiac Computed Tomography for Structural Heart Disease Assessment and Therapeutic Planning: Focus on Prosthetic Valve Dysfunction.

Of the 100,000-plus valve surgeries performed each year in the United States, up to 6% of those develop complications from prosthetic valve dysfunction. Prosthetic valve dysfunction (PVD) can be life threatening and often challenging to diagnose. In this review, we discuss the prevalence and incidence of PVD, explore its different etiologies, and assess the role of multimodality imaging with an emphasis on cardiac multidetector computed tomography (MDCT) for evaluating patients with PVD.

Cardiac Computed Tomography for Comprehensive Coronary Assessment: Beyond Diagnosis of Anatomic Stenosis.

Cardiac computed tomography angiography (CCTA) has evolved into a versatile imaging modality that can depict atherosclerosis burden, determine functional significance of a stenotic lesion, and guide the management and treatment of stable coronary artery disease.1 With newer-generation scanners, diagnostic CCTA can be obtained in the majority of patients with a very acceptable radiation dose. We discuss the ability of CCTA to provide comprehensive assessment of a patient with suspected CAD, including functional techniques of stress-rest myocardial perfusion assessment using a vasodilator and a purely post-processing approach that assesses fractional flow reserve derived by CCTA.

Comparison of Echocardiographic Assessment of Tricuspid Regurgitation Against Cardiovascular Magnetic Resonance.

Objectives: The aim of this study was to compare echocardiographic methods of determining tricuspid regurgitation (TR) severity against TR regurgitant volume (TR) by cardiovascular magnetic resonance (CMR).

Background: TR is usually assessed using echocardiography, but it is not known how this compares with quantitative measurements of TR severity by CMR.

Methods: Echocardiographic and CMR methods were compared in 337 patients.

Disparity in spatial distribution of pericardial calcifications in constrictive pericarditis.

Background: Pericardial calcification is seen among patients with constrictive pericarditis (CP). However, the pattern of pericardial calcium distribution and the association with clinical outcomes and imaging data are not well described.

Methods: This was a retrospective study from 2007 to 2013 to evaluate the pattern of pericardial calcium distribution by CT in CP using a semiquantitative calcium scoring system to calculate total pericardial calcium burden and distribution.

Prospective assessment of combined handgrip strength and Mini-Cog identifies hospitalized heart failure patients at increased post-hospitalization risk.

Aims: The utility of combined assessment of both frailty and cognitive impairment in hospitalized heart failure (HF) patients for incremental post-discharge risk stratification, using handgrip strength and Mini-Cog as feasible representative parameters, was investigated.

Methods And Results: A prospective, single-centre cohort study of older adults (age ≥65) hospitalized for HF being discharged to home was performed. Pre-discharge, grip strength was assessed using a dynamometer (Jamar hydrolic hand dynamometer, Lafayette Instruments, Lafayette, IN, USA) and was defined as weak if the maximal value was below the gender-derived and body mass index-derived cut-offs according to Fried criteria.

Medication self-management skills and cognitive impairment in older adults hospitalized for heart failure: A cross-sectional study.

Background: Cognitive impairment is highly prevalent among older adults (aged ≥65 years) hospitalized for heart failure and has been associated with poor outcomes. Poor medication self-management skills have been associated with poor outcomes in this population as well. The presence and extent of an association between cognitive impairment and poor medication self-management skills in this population has not been clearly defined.

Prognostic implication of relative regional strain ratio in cardiac amyloidosis.

Objective: Cardiac amyloidosis (CA) is a rapidly progressive disease that portends poor prognosis. Our objective was to evaluate the prognostic impact of relative regional strain ratio (RRSR, a measure of the relative apical sparing of longitudinal strain (LS)) in CA.

Methods: This is a retrospective study evaluating 97 patients with CA from 2004 to 2013.

Usefulness of cardiac magnetic resonance-guided management in patients with recurrent pericarditis.

Recurrent pericarditis (RP) affects 10% to 50% of patients with acute pericarditis. The use of steroids has been associated with increased recurrence rate of pericarditis, along with known major side effects. Cardiac magnetic resonance imaging (CMR) is more frequently used to assess pericardial inflammation and less commonly to guide therapy.

Serial hemodynamic measurements in post-cardiac arrest cardiogenic shock treated with therapeutic hypothermia.

Aims: Mortality from cardiogenic shock complicating acute myocardial infarction (MI) remains high despite contemporary treatment. Therapeutic Hypothermia (TH) offers cardiovascular and systemic effects that may prove beneficial in this population, however, current data are limited. This study sought to evaluate the effect of therapeutic hypothermia on serial hemodynamics obtained in subjects with post-cardiac arrest cardiogenic shock.