Adverse left ventricular remodeling (ALVR) and subsequent heart failure after myocardial infarction (MI) remain a major cause of patient morbidity and mortality worldwide. Overt inflammation has been identified as the common pathway underlying myocardial fibrosis and development of ALVR post-MI. With its ability to simultaneously provide information about cardiac structure, function, perfusion, and tissue characteristics, cardiac magnetic resonance (CMR) is well poised to inform prognosis and guide early surveillance and therapeutics in high-risk cohorts. Further, established and evolving CMR-derived biomarkers may serve as clinical endpoints in prospective trials evaluating the efficacy of novel anti-inflammatory and antifibrotic therapies. This review provides an overview of post-MI ALVR and illustrates how CMR may help clinical adoption of novel therapies via mechanistic or prognostic imaging markers.
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http://dx.doi.org/10.1016/j.jcmg.2024.03.012 | DOI Listing |
Int J Cardiol Heart Vasc
February 2025
Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Germany.
Background And Aims: Cardiotoxicity from immune checkpoint inhibitor (ICI) therapy is a challenge in clinical practice, and the assessment of ICI-related myocarditis (ICI-M) is often complicated by a variable phenotype. Cardiac magnetic resonance imaging (CMR) is used frequently, but evidence is poor. Here, we aim to assess the role of CMR in the assessment of suspected ICI-M in a real-world clinical setting.
View Article and Find Full Text PDFFront Cardiovasc Med
January 2025
Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Aims: This retrospective cohort study aimed to investigate the efficacy of dual-chamber left Bundle branch pacing (LBBP) as an alternative therapy for heart failure patients with complete left bundle branch block (CLBBB) and indications for defibrillator with cardiac resynchronization therapy (CRT-D).
Methods: 34 patients met inclusion criteria were enrolled in the study. These criteria included a left ventricular ejection fraction (LVEF) of lower than 35%, a New York Heart Association functional class of II-IV, CLBBB meeting Strauss's criteria, intraventricular dyssynchrony, and confirmed correction of CLBBB during LBBP.
Nature
January 2025
German Centre for Cardiovascular Research (DZHK), Partner Site Lower Saxony, Göttingen, Germany.
Cardiomyocytes can be implanted to remuscularize the failing heart. Challenges include sufficient cardiomyocyte retention for a sustainable therapeutic impact without intolerable side effects, such as arrhythmia and tumour growth. We investigated the hypothesis that epicardial engineered heart muscle (EHM) allografts from induced pluripotent stem cell-derived cardiomyocytes and stromal cells structurally and functionally remuscularize the chronically failing heart without limiting side effects in rhesus macaques.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
ARHC/Stroke Service, Naas General Hospital, Naas, Kildare, Ireland.
A woman in her early 60s presented with multiple transient neurological symptoms over the course of 20 months, including transient loss of power to her right lower limb. Initial workup with CT brain scan, carotid dopplers and ECG revealed no abnormality; however, MRI of the brain suggested recent ischaemic events in separate cortical territories. Subsequent transoesophageal echocardiogram revealed a large mobile mass histologically confirmed to be an atrial myxoma.
View Article and Find Full Text PDFBMJ Open
January 2025
Department of Cardiovascular Sciences, University of Leicester and the National Institute for Health Research Leicester Biomedical Research Centre, Glenfield Hospital, Leicester LE3 9QP, UK
Introduction: Heart failure with preserved ejection fraction (HFpEF) is characterised by severe exercise intolerance, particularly in those living with obesity. Low-energy meal-replacement plans (MRPs) have shown significant weight loss and potential cardiac remodelling benefits. This pragmatic randomised trial aims to evaluate the efficacy of MRP-directed weight loss on exercise intolerance, symptoms, quality of life and cardiovascular remodelling in a multiethnic cohort with obesity and HFpEF.
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