Clinical Practice Variations in the Management of Ischemia With No Obstructive Coronary Artery Disease.

Background Ischemia with no obstructive coronary artery disease is a condition associated with major adverse cardiovascular outcomes. To date, there are no specific American Heart Association or American College of Cardiology guidelines. The objective of this survey is to better understand the clinical practice and knowledge gaps that exist nationally.

Normal sex and age-specific parameters in a multi-ethnic population: a cardiovascular magnetic resonance study of the Canadian Alliance for Healthy Hearts and Minds cohort.

Background: Despite the growing utility of cardiovascular magnetic resonance (CMR) for cardiac morphology and function, sex and age-specific normal reference values derived from large, multi-ethnic data sets are lacking. Furthermore, most available studies use a simplified tracing methodology. Using a large cohort of participants without history of cardiovascular disease (CVD) or risk factors from the Canadian Alliance for Healthy Heart and Minds, we sought to establish a robust set of reference values for ventricular and atrial parameters using an anatomically correct contouring method, and to determine the influence of age and sex on ventricular parameters.

The impact of reporting magnetic resonance imaging incidental findings in the Canadian alliance for healthy hearts and minds cohort.

Background: In the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.

Clinical Practice Variations in the Management of Stress-Induced Cardiomyopathy: A Canadian Perspective.

Despite increased recognition of stress-induced cardiomyopathy (SIC), there are no randomized controlled trials or established guidelines to direct therapeutic strategies and little is known about the local experience in Canada. The objective of this study was to better understand the clinical practice variations in the management of SIC across Canada. By using an online platform, a series of questions were distributed to practicing cardiologists between October and November 2018.

Cardiovascular risk is associated with a transmural gradient of myocardial oxygenation during adenosine infusion.

Aims: In patients with coronary artery disease (CAD), a transmural gradient of myocardial perfusion has been repeatedly observed, with the subendocardial layer showing more pronounced perfusion deficits. Oxygenation-sensitive cardiovascular magnetic resonance (OS-CMR) allows for monitoring transmural changes of myocardial oxygenation in vivo. We hypothesized that OS-CMR could help identify a transmural oxygenation gradient as a disease marker in patients at risk for CAD.

Relationship of vasodilator-induced changes in myocardial oxygenation with the severity of coronary artery stenosis: a study using oxygenation-sensitive cardiovascular magnetic resonance.

Aims: To explore the impact of the functional severity of coronary artery stenosis on changes in myocardial oxygenation during pharmacological vasodilation, using oxygenation-sensitive cardiovascular magnetic resonance (OS-CMR) imaging and invasive fractional flow reserve (FFR). An FFR is considered a standard of reference for assessing haemodynamic relevance of coronary artery stenosis; yet, the relationship of FFR to changes in myocardial oxygenation during vasodilator stress and thus to an objective marker for ischaemia on the tissue level is not well understood.

Methods And Results: We prospectively recruited 64 patients with suspected/known coronary artery disease undergoing invasive angiography.

Indications, safety and image quality of cardiovascular magnetic resonance: experience in >5,000 North American patients.

Background: CMR offers accurate assessment of structure and function with high resolution. Although the use of CMR has been well established in Europe, information is lacking for the extent of this emerging modality in North America.

Objectives: This study aimed to summarize indications, safety, image quality, extent of contrast use and extent of stress tests performed in a high-volume CMR centre.