Quantification of aortic stenosis diagnostic parameters: comparison of fast 3 direction and 1 direction phase contrast CMR and transthoracic echocardiography.

Background: Aortic stenosis (AS) is a common valvular disorder, and disease severity is currently assessed by transthoracic echocardiography (TTE). However, TTE results can be inconsistent in some patients, thus other diagnostic modalities such as cardiovascular magnetic resonance (CMR) are demanded. While traditional unidirectional phase-contrast CMR (1Dir PC-CMR) underestimates velocity if the imaging plane is misaligned to the flow direction, multi-directional acquisitions are expected to improve velocity measurement accuracy.

Factors Determining Left Main Coronary Artery Luminal Area.

Background: A certain minimal luminal cross-sectional area has been traditionally used in clinical practice as a cut-off value to determine severity of left main coronary artery (LMCA) stenosis. The severity of stenosis, however, depends on the baseline luminal area (ie, area prior to stenosis), which may vary among individuals. The present study was undertaken to define normal LMCA luminal area using current technology in vivo.

Diagnostic Performance of Treadmill Exercise Cardiac Magnetic Resonance: The Prospective, Multicenter Exercise CMR's Accuracy for Cardiovascular Stress Testing (EXACT) Trial.

Background: Stress cardiac magnetic resonance (CMR) has typically involved pharmacologic agents. Treadmill CMR has shown utility in single-center studies but has not undergone multicenter evaluation.

Methods And Results: Patients referred for treadmill stress nuclear imaging (SPECT) were prospectively enrolled across 4 centers.

Detection of Intraneural Median Nerve Microvascularity Using Contrast-Enhanced Sonography: A Pilot Study.

Objectives: Demonstrating vascularity within the human median nerve may be difficult using power Doppler sonography. To this end, a pilot study documenting contrast-enhanced vascularity of the median nerve was conducted.

Methods: Patients undergoing contrast-enhanced transthoracic echocardiography were recruited for this study (n = 24).

Comparison of the Safety of Adenosine and Regadenoson in Patients Undergoing Outpatient Cardiac Stress Testing.

Study Objective: To compare the adverse effect profiles of adenosine and regadenoson in patients undergoing outpatient cardiac stress testing.

Design: Single-center retrospective cohort study.

Setting: Two outpatient clinics, both of which are part of a single tertiary academic medical health system; one clinic exclusively used adenosine for cardiac stress testing, and the other clinic exclusively used regadenoson.

Collaborating with cardiac sonographers to develop work-related musculoskeletal disorder interventions.

For more than two decades, surveys of imaging technologists, including cardiac sonographers, diagnostic medical sonographers and vascular technologists, have consistently reported high prevalence of work-related musculoskeletal discomfort (WRMSD). Yet, intervention research involving sonographers is limited. In this study, we used a participatory approach to identifying needs and opportunities for developing interventions to reduce sonographers' exposures to WRMSD risk factors.

High-resolution harmonics ultrasound imaging for non-invasive characterization of wound healing in a pre-clinical swine model.

This work represents the first study employing non-invasive high-resolution harmonic ultrasound imaging to longitudinally characterize skin wound healing. Burn wounds (day 0-42), on the dorsum of a domestic Yorkshire white pig were studied non-invasively using tandem digital planimetry, laser speckle imaging and dual mode (B and Doppler) ultrasound imaging. Wound depth, as measured by B-mode imaging, progressively increased until day 21 and decreased thereafter.

A modified collagen gel dressing promotes angiogenesis in a preclinical swine model of chronic ischemic wounds.

We recently performed proteomic characterization of a modified collagen gel (MCG) dressing and reported promising effects of the gel in healing full-thickness excisional wounds. In this work, we test the translational relevance of our aforesaid findings by testing the dressing in a swine model of chronic ischemic wounds recently reported by our laboratory. Full-thickness excisional wounds were established in the center of bipedicle ischemic skin flaps on the backs of animals.

Comparison of treadmill exercise stress cardiac MRI to stress echocardiography in healthy volunteers for adequacy of left ventricular endocardial wall visualization: A pilot study.

Purpose: To compare exercise stress cardiac magnetic resonance (cardiac MR) to echocardiography in healthy volunteers with respect to adequacy of endocardial visualization and confidence of stress study interpretation.

Materials And Methods: Twenty-eight healthy volunteers (age 28 ± 11 years, 15 males) underwent exercise stress echo and cardiac MR one week apart assigned randomly to one test first. Stress cardiac MR was performed using an MRI-compatible treadmill; stress echo was performed as per routine protocol.

Two decades of Huntington disease testing: patient's demographics and reproductive choices.

Predictive testing for Huntington disease (HD) has been available in the United States (US) since 1987, and the Indiana University Predictive Testing Program has been providing this testing since 1990. To date there has been no published description of those who present for such testing in the US. Here we describe demographics of 141 individuals and reproductive decision making of a subset of 16 of those individuals who underwent predictive HD testing between 1990 and 2010 at one site in the US.

Isolated cardiac metastasis from plasmacytoid urothelial carcinoma of the bladder.

Unlabelled: A 57-year-old male with a history of hypertension presented with shortness of breath, intermittent substernal chest pain, subjective fevers, and a 30-pound weight loss. He was found to have a bladder mass four months prior to presentation, for which he underwent cystoscopy and surgical removal. Pathology demonstrated high-grade superficial plasmacytoid urothelial carcinoma extending into the submucosa but not the muscularis propria.

Relationship of cardiac magnetic resonance imaging and myocardial biopsy in the evaluation of nonischemic cardiomyopathy.

This study was performed to determine the relative role of cardiac magnetic resonance (CMR) imaging and endomyocardial biopsy (EMB) in the evaluation of cardiomyopathy. Sixty-six patients with a clinical diagnosis of nonischemic dilated cardiomyopathy or restrictive cardiomyopathy underwent both EMB and CMR imaging as part of their diagnostic evaluation. The authors retrospectively reviewed the results of these two methods to determine their diagnostic impact and congruency.

MR-compatible treadmill for exercise stress cardiac magnetic resonance imaging.

This article describes an MR-safe treadmill that enables cardiovascular exercise stress testing adjacent to the MRI system, facilitating cardiac MR imaging immediately following exercise stress. The treadmill was constructed of nonferromagnetic components utilizing a hydraulic power system. Computer control ensured precise execution of the standard Bruce treadmill protocol commonly used for cardiovascular exercise stress testing.

Noninvasive imaging of prosthetic cardiac devices.

The major advances in cardiovascular care can be linked to the combined growth of advanced imaging modalities and the variety of treatment options available for patients with complex structural, acquired and congenital, valvular, myocardial and aortic diseases. Paralleling this growth are the number and spectrum of complications - such as device failures and infections - that these patients will inevitably encounter. The keys to successful implementation of advanced cardiac therapy are the real-time images, 3D reconstructions, and the hemodynamic and tissue profiles that can be obtained to evaluate these patients and their devices.

Real-time cine and myocardial perfusion with treadmill exercise stress cardiovascular magnetic resonance in patients referred for stress SPECT.

Background: To date, stress cardiovascular magnetic resonance (CMR) has relied on pharmacologic agents, and therefore lacked the physiologic information available only with exercise stress.

Methods: 43 patients age 25 to 81 years underwent a treadmill stress test incorporating both Tc99m SPECT and CMR. After rest Tc99m SPECT imaging, patients underwent resting cine CMR.

Cardiac magnetic resonance with edema imaging identifies myocardium at risk and predicts worse outcome in patients with non-ST-segment elevation acute coronary syndrome.

Objectives: The aim of this study was to define the prevalence and significance of myocardial edema in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS).

Background: Most patients with NSTE-ACS undergo angiography, yet not all have obstructive coronary artery disease (CAD) requiring revascularization. Identifying patients with myocardium at risk could enhance the effectiveness of an early invasive strategy.

Lipomatous hypertrophy of the intraatrial septum resulting in right atrial inflow obstruction and atrial flutter.

Atrial arrhythmias can occasionally be associated with atrial structural abnormalities that may require sophisticated diagnostic imaging for management. Lipomatous hypertrophy of the intraatrial septum is generally considered a benign fatty infiltrative process usually limited to the atrial septum. We present a rare case of lipomatous hypertrophy of the intraatrial septum associated with atrial flutter and right atrial inflow obstruction in which atrial reconstruction alleviated not only the obstruction but also helped control a challenging arrhythmia.

A recurrent 16p12.1 microdeletion supports a two-hit model for severe developmental delay.

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls (P = 0.

Gender-related differences in coronary artery dimensions: a volumetric analysis.

Background: Women consistently have poorer revascularization outcomes and more coronary vascular complications compared to men. This has been attributed to smaller coronary arteries, though limited data exist to support this assumption.

Hypothesis: By using volumetric data obtained from multidetector cardiovascular computed tomography (CCT), we sought to determine to what extent gender influences coronary artery dimensions and test the hypothesis that women would have smaller coronary dimensions even after normalizing for body surface area and cardiac mass.

Myocardial ischemia in the absence of epicardial coronary artery disease in Friedreich's ataxia.

We present the first in vivo detection of microvascular abnormality in a patient with Friedreich's ataxia (FA) without epicardial coronary artery disease using cardiac magnetic resonance (CMR). The patient had exertional chest pain and dyspnea prompting referral for cardiac evaluation. These symptoms were reproduced during intravenous adenosine infusion, and simultaneous first-pass perfusion imaging showed a significant subendocardial defect; both symptoms and perfusion deficit were absent at rest.