Six-Year Prognostic Value of Microvascular Obstruction After Reperfused ST-Elevation Myocardial Infarction as Assessed by Contrast-Enhanced Cardiovascular Magnetic Resonance.

Although recent studies showed the prognostic value of cardiac magnetic resonance (CMR) parameters especially microvascular obstruction (MO) after reperfused ST-elevation myocardial infarction (STEMI), a study assessing their prognostic significance for long-term follow-up is missing so far. The objective of this study was to determine the prognostic impact of MO on long-term prognosis after reperfused first STEMI in a setting allocating CMR-assessed parameters to hard clinical events only. In 249 patients, CMR was performed after reperfused STEMI, and hereby, left ventricular ejection fraction (LVEF), infarct size (IS), and the amount of MO were quantified.

Prognostic value of routine cardiac magnetic resonance assessment of left ventricular ejection fraction and myocardial damage: an international, multicenter study.

Background: Cardiac magnetic resonance (CMR) is considered the reference standard for assessment of left ventricular ejection fraction (LVEF) and myocardial damage. However, few studies have evaluated the relationship between CMR findings and patient outcome, and of these, most are small and none multicenter. We performed an international, multicenter study to assess the prognostic importance of routine CMR in patients with known or suspected heart disease.

Head-to-head comparison of contrast-enhanced cardiovascular magnetic resonance and ²⁰¹Thallium single photon emission computed tomography for prediction of reversible left ventricular dysfunction in chronic ischaemic heart disease.

Delayed contrast-enhanced cardiovascular magnetic resonance (DE-CMR) allows assessment of reversibility of myocardial dysfunction. Comparative data to other modalities is scarce. Purpose of this study was to compare DE-CMR and (201)Thallium single photon emission computed tomography (SPECT) for prediction of reversible left ventricular (LV) dysfunction in patients with chronic ischaemic heart disease.

Analysis of coronary calcifications versus Framingham and PROCAM risk assessment in patients with a first myocardial infarction.

Unlabelled: We compared the extent of coronary calcifications as quantified by electron beam tomography (EBT) to the predicted 10-year cardiovascular event risk based on Framingham and PROCAM algorithms in patients with a first myocardial infarction (MI).

Methods: In 156 patients (56.7 +/- 22 years), EBT was performed <4 weeks after MI.

Non-interventional cardiac diagnostics: computed tomography, magnetic resonance and real-time three-dimensional echocardiography. Techniques and clinical applications.

New cardiovascular imaging modalities, including computed tomography (CT), magnetic resonance (MR) imaging and real-time three-dimensional echocardiography, have great potential for providing important and additional information concerning cardiac function and pathology. With significant and extremely fast technical improvements, non-invasive cardiac imaging has become a focal point in the diagnosis of cardiac disease. Thereby CT has been shown to allow the visualization of coronary arteries concerning calcifications, significant stenoses and coronary plaques, whereas MR imaging demonstrated its ability to evaluate cardiac morphology and function as well as perfusion imaging and viability assessment.

Relationship of contractile function to transmural extent of infarction in patients with chronic coronary artery disease.

Objectives: We sought to determine the relationship of contractile function to the transmural extent of infarction (TEI) in patients with chronic coronary artery disease.

Background: In the setting of reperfused, chronic myocardial infarction (MI), the relationship of contractile function to the TEI has not been established.

Methods: We studied function by cine magnetic resonance imaging (MRI) and the TEI by contrast-enhanced MRI in 31 patients with single-vessel disease 162 +/- 62 days after reperfused first MI.

Coronary calcifications in young patients with first, unheralded myocardial infarction: a risk factor matched analysis by electron beam tomography.

Objective: To compare the presence and extent of coronary calcifications in young patients with first, unheralded acute myocardial infarction with matched controls without a history of coronary artery disease.

Methods: In 102 patients under 60 years of age (19-59 years, mean 41 years; 88% male), electron beam tomography was done 1-14 days after acute myocardial infarction, before any coronary intervention. Coronary calcifications were quantified using the Agatston score.

Incidence and characteristics of segmental postsystolic longitudinal shortening in normal, acutely ischemic, and scarred myocardium.

Objective: Myocardial longitudinal shortening after aortic valve closure (postsystolic shortening [PSS]) is considered a marker of pathology with diagnostic potential. However, PSS can also occur in healthy subjects. We, therefore, investigated the occurrence and characteristics of PSS in control subjects and patients, and how to distinguish normality from disease.

Diagnostic value of maximum intensity projections versus source images for assessment of contrast-enhanced three-dimensional breath-hold magnetic resonance coronary angiography.

Rationale And Objectives: We compared maximum intensity projections (MIP) versus original source images (SI) in respect to detection of coronary artery stenoses by means of magnetic resonance (MR) coronary angiography.

Methods: MR coronary angiography was performed on 61 patients. MIP and SI were independently evaluated as to presence of significant stenoses in the proximal and midcoronary segments and compared with x-ray angiography.

Contrast-enhanced MRI and routine single photon emission computed tomography (SPECT) perfusion imaging for detection of subendocardial myocardial infarcts: an imaging study.

Background: Myocardial infarcts are routinely detected by nuclear imaging techniques such as single photon emission computed tomography (SPECT) myocardial perfusion imaging. A newly developed technique for infarct detection based on contrast-enhanced cardiovascular magnetic resonance (CMR) has higher spatial resolution than SPECT. We postulated that this technique would detect infarcts missed by SPECT.

Comparison of contrast-enhanced breath-hold and free-breathing respiratory-gated imaging in three-dimensional magnetic resonance coronary angiography.

Suppression of respiratory motion is one of the major challenges of magnetic resonance (MR) coronary angiography. Two approaches to compensate for respiratory motion have often been proposed: breath-hold (BH) and free-breathing respiratory-gated (FBRG) imaging. So far, however, these approaches have never been directly compared.

Influence of lipid-lowering therapy on the progression of coronary artery calcification: a prospective evaluation.

Background: Coronary calcification measured by fast computed tomography techniques is a surrogate marker of coronary atherosclerotic plaque burden. In a cohort study, we prospectively investigated whether lipid-lowering therapy with a cholesterol synthesis enzyme inhibitor reduces the progression of coronary calcification.

Methods And Results: In 66 patients with coronary calcifications in electron beam tomography (EBT), LDL cholesterol >130 mg/dL, and no lipid-lowering treatment, the EBT scan was repeated after a mean interval of 14 months and treatment with cerivastatin was initiated (0.

Matrix metalloproteinase-9 (gelatinase B) is elevated during mobilization of peripheral blood progenitor cells by G-CSF.

Background: Matrix metalloproteinase-9 (MMP-9 or gelatinase B) has recently been implicated in the IL-8-induced mobilization of HPCs in rhesus monkeys and mice. It is not known whether administration of G-CSF causes expression of MMP-9 during HPC mobilization.

Study Design And Methods: Blood samples from 15 allogeneic progenitor cell donors were collected before and during G-CSF-induced HPC mobilization.

A direct comparison of noninvasive coronary angiography by electron beam tomography and navigator-echo-based magnetic resonance imaging for the detection of restenosis following coronary angioplasty.

Rationale And Objectives: To compare electron beam tomography (EBT) with MR imaging (MRI) for detection of restenosis after coronary angioplasty (PTCA).

Methods: One hundred eighteen patients after PTCA were investigated. By EBT, 50 axial images were acquired (3-mm slice thickness, 120-160 mL radiographic contrast agent).

Noninvasive coronary angiography by magnetic resonance imaging, electron-beam computed tomography, and multislice computed tomography.

In recent years, several techniques for noninvasive imaging of the coronary artery lumen (noninvasive coronary angiography) have been developed. These techniques include magnetic resonance imaging, electron-beam computed tomography, and, most recently, multislice computed tomography. Each of these techniques has specific advantages and disadvantages.

Interleukin-6 is a major effector molecule of short-term G-CSF treatment inducing bone metabolism and an acute-phase response.

Objective: The biological steps leading to hematopoietic progenitor cell (HPC) mobilization from the bone marrow to the peripheral blood compartment during G-CSF treatment are still poorly defined. In this study, we investigated G-CSF-mediated secretion of cytokines as potential mediators.

Materials And Methods: Plasma and urine samples from G-CSF-mobilized donors for HPC transplantation were collected before and during mobilization therapy.

Variability of repeated coronary artery calcium measurements by electron beam tomography.

In 120 patients, the mean interscan variability of coronary calcium quantification by electron beam tomography was 19.9% (median 7.8%) for the traditional calcium score, and 16.

Contrast enhanced electron beam computed tomography to analyse the coronary arteries in patients after acute myocardial infarction.

Objective: To evaluate the accuracy of contrast enhanced electron beam computed tomography (EBCT) after acute myocardial infarction in determining patency of the infarct related artery and detecting high grade stenoses and occlusions in the coronary vessels.

Design: Case study using blinded comparison with invasive coronary angiography.

Patients: 36 patients (mean age 53 years) 4-70 days after acute myocardial infarction.

Imaging of the coronary arteries using magnetic resonance angiography.

Magnetic resonance imaging of the coronary arteries is difficult due to the tortuous course of these vessels, their small diameter, and their rapid movement caused by respiration and cardiac contraction. Initial investigations could demonstrate the feasibility of non-invasive magnetic resonance coronary angiography using 2-dimensional turbo-FLASH gradient-echo sequences in repeated breathholds of approximately 16 heart beats duration. Further developments, especially the design of navigator-echo-based respiratory gated 3-dimensional imaging sequences, permitted the acquisition of contiguous volume data sets of the heart which eliminated many limitations of 2-dimensional repeated breathhold sequences.

Noninvasive detection of coronary artery stenosis using contrast-enhanced three-dimensional breath-hold magnetic resonance coronary angiography.

Objectives: The purpose of this study was to evaluate a contrast-enhanced three-dimensional (3D) breath-hold magnetic resonance (MR) technique for detection of coronary artery stenoses.

Background: The accuracy of previously published MR coronary angiography protocols varies widely. Recently, coronary artery imaging using T1-shortening contrast agent has become possible, but so far there are no data concerning its clinical application.

Poststenotic coronary blood flow following percutaneous transluminal coronary angioplasty.

Poststenotic intracoronary flow velocity measurements both prior to and following percutaneous transluminal coronary angioplasty (PTCA) by use of a Doppler-tipped guidewire allow estimation of haemodynamic improvement due to interventional procedures. Since poststenotic coronary artery vasoconstriction routinely occurs after PTCA, haemodynamic improvement may be overestimated when measured by flow velocity alone. In 38 patients scheduled for elective PTCA in single vessel disease (left anterior descending = 19; left circumflex = 9; right coronary artery = 10) change of poststenotic coronary blood flow (CBF) was calculated by the combined use of intracoronary flow velocity measurement (average peak velocity: APV) and quantitative coronary angiography (cross sectional area: CSA) both prior to and following PTCA.