Diagnostic and prognostic utility of cardiovascular magnetic resonance imaging in light-chain cardiac amyloidosis.

Although the presence of abnormal late gadolinium enhancement (LGE) in cardiac amyloidosis has been well established, its prognostic implication and utility to identify cardiac involvement in patients with systemic amyloidosis is unknown. The aim of this study was to assess the diagnostic and prognostic significance of cardiovascular magnetic resonance imaging in patients with amyloid light-chain amyloidosis but unknown cardiac involvement. Cardiovascular magnetic resonance imaging with LGE was performed in 28 patients with systemic amyloidosis.

Effect of the direct Renin inhibitor aliskiren, the Angiotensin receptor blocker losartan, or both on left ventricular mass in patients with hypertension and left ventricular hypertrophy.

Background: Left ventricular (LV) hypertrophy, a marker of cardiac end-organ damage, is associated with an increased risk of cardiovascular morbidity and mortality. Inhibitors of the renin-angiotensin-aldosterone system may reduce LV mass to a greater extent than other antihypertensive agents. We compared the effect of aliskiren, the first orally active direct renin inhibitor, the angiotensin-receptor blocker losartan, and their combination on the reduction of LV mass in hypertensive patients.

Abstracts of the 11th Annual Society for Cardiovascular Magnetic Resonance (SCMR) Scientific Sessions. Los Angeles, California, USA. February 1-3, 2008.

This paper features the most interesting presentations and discussions of the 2008 Annual Sessions of the Society for Cardiovascular Magnetic Resonance, which were held in Los Angeles from February 1 to 3, 2008. With more than 1100 attendees, this was the largest of the SCMR meetings ever. Among this year's highlights were scientific reports on CMR-based risk assessment, non-contrast tissue characterization, 3 T data, and interventional CMR.

Deciduous shrubs for ozone bioindication: Hibiscus syriacus as an example.

Ozone-like visible injury was detected on Hibiscus syriacus plants used as ornamental hedges. Weekly spray of the antiozonant ethylenediurea (EDU, 300ppm) confirmed that the injury was induced by ambient ozone. EDU induced a 75% reduction in visible injury.

Elevated night soil temperatures result in earlier incidence and increased extent of foliar ozone injury to common bean (Phaseolus vulgaris L.).

Elevated nighttime soil temperature (5 degrees C) increased bean seed germination and onset of foliar ozone injury.

Evaluating the left atrium by magnetic resonance imaging.

The emergence of catheter based ablation therapy for the prevention of recurrent atrial fibrillation has increased interest in the anatomy of the left atrium and pulmonary veins. In this article, we review the magnetic resonance imaging method of imaging the left atrium and the pulmonary veins, normal and variant anatomy, and the utility of imaging before and after atrial fibrillation ablation.

Use of the antiozonant ethylenediurea (EDU) in Italy: verification of the effects of ambient ozone on crop plants and trees and investigation of EDU's mode of action.

Twenty-four experiments where EDU was used to protect plants from ozone (O(3)) in Italy are reviewed. Doses of 150 and 450 ppm EDU at 2-3 week intervals were successfully applied to alleviate O(3)-caused visible injury and growth reductions in crop and forest species respectively. EDU was mainly applied as soil drench to crops and by stem injection or infusion into trees.

Inflow quantification in three-dimensional cardiovascular MR imaging.

Purpose: To investigate blood inflow enhancement (or lack thereof) in three-dimensional (3D) cardiovascular MR for both single phase whole-heart and cine biventricular functions.

Materials And Methods: A 3D imaging sequence is proposed in which radiofrequency excitation gradient is changed without modifying image acquisition or phase/slice encoding. This imaging sequence enables direct inflow measurement while retaining static voxel signal-to-noise ratio.

Prevalence, clinical significance, and natural history of left ventricular apical aneurysms in hypertrophic cardiomyopathy.

Background: Hypertrophic cardiomyopathy (HCM) is the most common genetic heart disease characterized by a diverse clinical and phenotypic spectrum. This study reports the prevalence, morphology, clinical course, and management of an underrecognized subgroup of HCM patients with left ventricular apical aneurysms.

Methods And Results: Of 1299 HCM patients, 28 (2%) were identified with left ventricular apical aneurysms, including a pair of identical twins.

2D free-breathing dual navigator-gated cardiac function validated against the 2D breath-hold acquisition.

Purpose: To develop and validate a free-breathing cardiac cine acquisition, with potential to simplify cardiac MR studies, provide registered slices, and increase spatial resolution.

Materials And Methods: A 2D free-breathing (FB) navigator-gated cine radial acquisition for cardiac function was developed that used two navigators (one placed prior to the QRS, and another 500 msec after the QRS complex, after systole) to provide complete motion-compensated assessment of systole, without loss of end-diastole. Eleven subjects were studied.

Assessment and significance of left ventricular mass by cardiovascular magnetic resonance in hypertrophic cardiomyopathy.

Objectives: Our aim was to assess the distribution and clinical significance of left ventricular (LV) mass in patients with hypertrophic cardiomyopathy (HCM).

Background: Hypertrophic cardiomyopathy is defined echocardiographically by unexplained left ventricular wall thickening. Left ventricular mass, quantifiable by modern cardiovascular magnetic resonance techniques, has not been systematically assessed in this disease.

Antithrombotic therapy in atrial fibrillation: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).

This chapter about antithrombotic therapy in atrial fibrillation (AF) is part of the American College of Chest Physicians Evidence-Based Guidelines Clinical Practice Guidelines (8th Edition). Grade 1 recommendations indicate that most patients would make the same choice and Grade 2 suggests that individual patient's values may lead to different choices (for a full understanding of the grading see Guyatt et al, CHEST 2008; 133[suppl]:123S-131S). Among the key recommendations in this chapter are the following (all vitamin K antagonist [VKA] recommendations have a target international normalized ratio [INR] of 2.

Left atrial function and scar after catheter ablation of atrial fibrillation.

Background: Catheter ablation of atrial fibrillation (AF) involves extensive radiofrequency ablation (RFA) of the left atrium (LA) around the pulmonary veins. The effect of this therapy on LA function is not fully characterized.

Objective: The purpose of this study was to determine whether catheter ablation of AF is associated with a change in LA function.

The promise of whole-heart coronary MRI.

The noninvasive detection of coronary artery disease has been a major goal of newer cardiac imaging technologies. Over the past decade, coronary MRI has undergone significant advances, resulting in excellent sensitivity for detecting coronary artery disease. Whole-heart coronary MRI, a technique that is somewhat analogous to coronary CT angiography, has emerged as a promising approach for the noninvasive evaluation of the coronary arteries.

Occurrence and frequency of arrhythmias in hypertrophic cardiomyopathy in relation to delayed enhancement on cardiovascular magnetic resonance.

Objectives: Our aim was to determine whether myocardial fibrosis, detected by cardiovascular magnetic resonance (CMR), represents an arrhythmogenic substrate in hypertrophic cardiomyopathy (HCM).

Background: Myocardial fibrosis is identified frequently in HCM; however, the clinical significance of this finding is uncertain.

Methods: We studied prevalence and frequency of tachyarrhythmias on 24-h ambulatory Holter electrocardiogram (ECG) with regard to delayed enhancement (DE) on contrast-enhanced CMR in 177 HCM patients (age 41 +/- 16 yrs; 95% asymptomatic or mildly symptomatic).

Protection of ash (Fraxinus excelsior) trees from ozone injury by ethylenediurea (EDU): roles of biochemical changes and decreased stomatal conductance in enhancement of growth.

Treatments with ethylenediurea (EDU) protect plants from ozone foliar injury, but the processes underlying this protection are poorly understood. Adult ash trees (Fraxinus excelsior), with or without foliar ozone symptoms in previous years, were treated with EDU at 450 ppm by gravitational trunk infusion in May-September 2005 (32.5 ppm h AOT40).

Comparison of a diurnal vs steady-state ozone exposure profile on growth and yield of oilseed rape (Brassica napus L.) in open-top chambers in the Yangtze Delta, China.

Most available exposure-response relationships for assessing crop loss due to elevated ozone (O(3)) have been established using data from chamber and open-top chamber experiments, using a simulated constant O(3) concentration exposure (square wave), which is not consistent with the diurnal variation of O(3) concentration that occurs in nature. We investigated the response of oilseed rape (Brassica napus L.) to O(3) as affected by two exposure regimes: one with a diurnal variation (CF100D) and another with a constant concentration (CF100).

Attrition in the RAND Health Insurance Experiment: a response to Nyman.

In a prior article in this journal, John Nyman argues that the effect on health care use and spending found in the RAND Health Insurance Experiment is an artifact of greater voluntary attrition in the cost-sharing plans relative to the free care plan. Specifically, he speculates that those in the cost-sharing plans, when faced with a hospitalization, withdrew. His argument is implausible because (1) families facing a hospitalization would be worse off financially by withdrawing; (2) a large number of observational studies find a similar effect of cost sharing on use; (3) those who left did not differ in their utilization prior to leaving; (4) if there had been no attrition and cost sharing did not reduce hospitalization rates, each adult in each family that withdrew would have had to have been hospitalized once each year for the duration of time they would otherwise have been in the experiment, an implausibly high rate; (5) there are benign explanations for the higher attrition in the cost-sharing plans.

Significance of papillary muscle abnormalities identified by cardiovascular magnetic resonance in hypertrophic cardiomyopathy.

Increased thickness of the left ventricular (LV) wall is the predominant feature of the hypertrophic cardiomyopathy (HC) phenotype. The structural characteristics of the LV papillary muscles (PMs) have received little attention. In this study, cardiovascular magnetic resonance (CMR) was used to characterize PM morphology in a large HC population.

Accuracy of electrocardiographic criteria for atrial enlargement: validation with cardiovascular magnetic resonance.

Background: Anatomic atrial enlargement is associated with significant morbidity and mortality. However, atrial enlargement may not correlate with clinical measures such as electrocardiographic (ECG) criteria. Past studies correlating ECG criteria with anatomic measures mainly used inferior M-mode or two-dimensional echocardiographic data.

Relation of left ventricular function, mass, and volume to NT-proBNP in type 1 diabetic patients.

Objectives: To measure left ventricular mass (LVM), left ventricular volumes, and left ventricular function (LVF) in a cohort of type 1 diabetic patients and to correlate measures of imaging to NH(2)-terminal pro-brain natriuretic peptide (NT-proBNP).

Research Design And Methods: In a cross-sectional study, all patients with type 1 diabetes underwent cardiovascular magnetic resonance imaging. We included 63 patients with diabetic nephropathy and 73 patients with normoalbuminuria.

Association of TIMI myocardial perfusion grade and ST-segment resolution with cardiovascular magnetic resonance measures of microvascular obstruction and infarct size following ST-segment elevation myocardial infarction.

Background: Impairment of coronary microvascular perfusion is common among patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). Cardiovascular magnetic resonance imaging (CMR) can identify microvascular obstruction (MO) following reperfusion of STEMI. We hypothesized that myocardial perfusion, as assessed by the Thrombolysis in Myocardial Infarction (TIMI) Myocardial Perfusion Grade (TMPG), would be associated with a CMR metric of MO in this population.