Epicardial Adipose Tissue Is Associated with Plaque Burden and Composition and Provides Incremental Value for the Prediction of Cardiac Outcome. A Clinical Cardiac Computed Tomography Angiography Study.

Objectives: We sought to investigate the association of epicardial adipose tissue (eCAT) volume with plaque burden, circulating biomarkers and cardiac outcomes in patients with intermediate risk for coronary artery disease (CAD).

Methods And Results: 177 consecutive outpatients at intermediate risk for CAD and completed biomarker analysis including high-sensitive Troponin T (hs-TnT) and hs-CRP underwent 256-slice cardiac computed tomography angiography (CCTA) between June 2008 and October 2011. Patients with lumen narrowing ≥50% exhibited significantly higher eCAT volume than patients without any CAD or lumen narrowing <50% (median (interquartile range, IQR): 108 (73-167) cm3 vs.

Reference values for left and right ventricular trabeculation and non-compacted myocardium.

Background: Since the differentiation between physiological and pathological trabeculation is challenging, we assessed its distribution in a reference population of selected healthy volunteers.

Methods: We studied 117 subjects (58 males) stratified into age tertiles and by gender. Cardiovascular magnetic resonance images were acquired using a standard SSFP-sequence.

Autologous transplantation of CD34(+) bone marrow derived mononuclear cells in management of non-reconstructable critical lower limb ischemia.

Patients with a decrease in limb perfusion with a potential threat to limb viability manifested by ischemic rest pain, ischemic ulcers, and/or gangrene are considered to have critical limb ischemia (CLI). Because of this generally poor outcome, there is a strong need for attempting any procedure to save the affected limb. The aim of this work is to evaluate the possibility to use stem cell therapy as a treatment option for patients with chronic critical lower limb ischemia with no distal run off.

Selective apheresis of C-reactive protein: a new therapeutic option in myocardial infarction?

Background: There is substantial evidence that C-reactive protein (CRP) mediates secondary damage of the myocardium after acute myocardial infarction (AMI). The aim of this animal trial in pigs was to specifically deplete CRP from porcine plasma after AMI and to study possible beneficial effects of the reduced CRP concentration on the infarcted area.

Methods: Ten pigs received balloon catheter-induced myocardial infarction.

Classification of diastolic function with phase-contrast cardiac magnetic resonance imaging: validation with echocardiography and age-related reference values.

Objectives: To investigate whether cardiac magnetic resonance phase-contrast imaging (PC-CMR) can determine left ventricular (LV) diastolic function in comparison to echocardiography (EC).

Background: Non-invasive evaluation of diastolic function is important for the diagnostic classification and risk stratification of patients with cardiomyopathies. With EC, diastolic function is classified based on the mitral blood flow, LV myocardial tissue Doppler velocities and pulmonary venous flow.

Giant Dilatation of the Right Coronary Aortic Bulb with Compression of the Right Ventricular Outflow Tract Mimicking a Ventricular Septal Defect: Diagnostic workup Using Echocardiography, Heart Catheterization, and Cardiac Computed Tomography.

Annuloaortic ectasia is a relatively rare diagnosis. Herein, we report an unusual case of an annuloaortic ectasia with asymmetric dilatation of the right coronary bulb mimicking a membranous ventricular septal defect (VSD) with Eisenmenger reaction by transthoracic echocardiography. Aortic angiography showed a dilated aortic root and moderate aortic regurgitation.

Conservatively treated incidental aneurysm of the distal left main coronary artery: detection by coronary angiography and noninvasive followup using coronary computed tomography angiography.

Coronary artery aneurysms are relatively rare and commonly associated with significant coronary artery disease (CAD), inflammatory diseases (Kawasaki syndrome, infection), or iatrogenic complications. Herein, we report an unusual case of an incidental coronary aneurysm of the left main artery in a patient without specific clinical symptoms of myocardial ischemia or systemic inflammation and without angiographically significant CAD. Angiographic images are provided, acquired during cardiac catheterization, as well as coronary computed tomography angiography (CCTA) images obtained at 1 year of followup.

Prediction of life-threatening arrhythmic events in patients with chronic myocardial infarction by contrast-enhanced CMR.

Objectives: We hypothesized that infarct transmurality assessed with late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) predicts arrhythmic events in patients with chronic myocardial infarction.

Background: Patients with decreased left ventricular function due to chronic myocardial infarction are at increased risk for life-threatening arrhythmias related to infarcted tissue. LGE-CMR accurately detects infarct morphology.

A new approach towards improved visualization of myocardial edema using T2-weighted imaging: a cardiovascular magnetic resonance (CMR) study.

Purpose: To compare T2-weighted cardiovascular magnetic resonance (CMR) imaging with AASPIR (asymmetric adiabatic spectral inversion recovery) and STIR (short T1 inversion recovery) for myocardial signal intensity, image quality, and fat suppression.

Materials And Methods: Forty consecutive patients (47 ± 16 years old) referred by cardiologists for CMR-based myocardial tissue characterization were scanned with both STIR and AASPIR T2-weighted imaging approaches. Signal intensity of left ventricular myocardium was normalized to a region of interest generating a signal-to-noise ratio (SNR).

Prognostic impact of T2-weighted CMR imaging for cardiac amyloidosis.

Objectives: Using cardiac magnetic resonance imaging (MRI) we tested the diagnostic value of various markers for amyloid infiltration.

Methods: We performed MRI at 1.5 T in 36 consecutive patients with cardiac amyloidosis and 48 healthy volunteers.

Specific removal of C-reactive protein by apheresis in a porcine cardiac infarction model.

Background: C-reactive protein (CRP) is a possible causative factor of the destructive processes observed during the weeks after myocardial infarction.

Methods: We developed a clinically relevant animal model including the removal of CRP from blood plasma utilizing a specific CRP adsorber and the visualization of the infarct scar in the living animal by cardiovascular magnetic resonance imaging as a tool to investigate the impact of CRP after acute myocardial infarction.

Results: We describe the facets of this model system and kinetics of clinical blood parameters like CRP and troponin.

An open-source software tool for the generation of relaxation time maps in magnetic resonance imaging.

Background: In magnetic resonance (MR) imaging, T1, T2 and T2* relaxation times represent characteristic tissue properties that can be quantified with the help of specific imaging strategies. While there are basic software tools for specific pulse sequences, until now there is no universal software program available to automate pixel-wise mapping of relaxation times from various types of images or MR systems. Such a software program would allow researchers to test and compare new imaging strategies and thus would significantly facilitate research in the area of quantitative tissue characterization.

Aortic dilatation in patients with prosthetic aortic valve: comparison of MRI and echocardiography.

Background And Aim Of The Study: Patients with prosthetic aortic valve have an increased risk for aortic dissection, which rises further with growing aortic diameters. Thus, accurate aortic monitoring is required. As transthoracic echocardiography (TTE), the current clinical standard, is frequently restricted to the proximal ascending aorta, the use of two-dimensional cardiovascular magnetic resonance (2D-CMR) in transverse orientation was investigated as a screening tool to assess ascending aortic dimensions.

The use of cardiovascular magnetic resonance in acute myocardial infarction.

Acute myocardial infarction (MI) results in reversible and irreversible injury to the myocardium, including stunning, edema, myocyte necrosis, and microvascular obstruction. Because of its unique tissue characterization capabilities, cardiovascular magnetic resonance provides a reliable means of visualizing and quantifying the extent of these injuries. Such characterization is readily achieved through a comprehensive examination including function, first-pass perfusion, T2 (edema), and late enhancement imaging sequences.

Takotsubo cardiomyopathy after nasal application of epinephrine--a magnetic resonance study.

Takotsubo cardiomyopathy (TTC), which is characterized by transient left ventricular impairment in absence of coronary artery disease, is usually associated with emotional or physical stress, supposing that catecholamines are involved in pathophysiology. The present article reports on two cases with characteristic features of TTC following nasal application of epinephrine during nasal surgery. Both subjects serially underwent cardiovascular magnetic resonance, which revealed myocardial vasodilatation, capillary leak and regional edema in the acute state and ruled out focal necrosis.

Feasibility of cardiovascular magnetic resonance to assess the orifice area of aortic bioprostheses.

Background: Prosthetic orifice area, usually calculated by transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE), provides important information regarding the hemodynamic performance of aortic bioprostheses. However, both TTE and TEE have limitations; therefore accurate and reproducible determination of the orifice area often remains a challenge. The present study aimed to investigate the feasibility of cardiovascular magnetic resonance (CMR) to assess the orifice areas of aortic bioprostheses.

Heritability of left ventricular and papillary muscle heart size: a twin study with cardiac magnetic resonance imaging.

Aims: Earlier studies in monozygotic (MZ) and dizygotic (DZ) twins showed genetic variance on echocardiographically determined heart size. However, cardiovascular magnetic resonance (CMR) is more precise and reproducible. We performed a twin study relying on CMR, focusing on left ventricular (LV) mass and papillary muscle, since there are no genetic reports on this structure.

Cardiovascular magnetic resonance in myocarditis: A JACC White Paper.

Cardiovascular magnetic resonance (CMR) has become the primary tool for noninvasive assessment of myocardial inflammation in patients with suspected myocarditis. The International Consensus Group on CMR Diagnosis of Myocarditis was founded in 2006 to achieve consensus among CMR experts and develop recommendations on the current state-of-the-art use of CMR for myocarditis. The recommendations include indications for CMR in patients with suspected myocarditis, CMR protocol standards, terminology for reporting CMR findings, and diagnostic CMR criteria for myocarditis (i.

Single lipoprotein apheresis session improves cardiac microvascular function in patients with elevated lipoprotein(a): detection by stress/rest perfusion magnetic resonance imaging.

The aim of this study was to explore the effects of a single lipoprotein apheresis session on myocardial stress/rest (S/R) perfusion in patients with elevated lipoprotein(a) (Lp(a)) and coronary artery disease using cardiac magnetic resonance imaging. Twenty patients with Lp(a) > 60 mg/dL and coronary artery disease were randomized into a control or a treatment group. Both groups underwent cardiac magnetic resonance imaging with assessment of left ventricular function, perfusion and viability, and the treatment group underwent lipoprotein apheresis immediately afterwards.

Acute oedema in the evaluation of microvascular reperfusion and myocardial salvage in reperfused myocardial infarction with cardiac magnetic resonance imaging.

Unlabelled: The accurate measurement of myocardial salvage is critical to the ongoing refinement of reperfusion strategies in acute myocardial infarction (AMI). Cardiac magnetic resonance imaging (CMR) can define the area at risk in AMI by the presence of myocardial oedema, identified by high signal intensity on T(2)-weighted imaging with a short inversion time inversion-recovery (STIR) sequence. In addition, myocardial necrosis can be identified with CMR delayed contrast enhanced imaging.