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22 pages, 3343 KiB

Open AccessReview

Assessment of Microvascular Disease in Heart and Brain by MRI: Application in Heart Failure with Preserved Ejection Fraction and Cerebral Small Vessel Disease

by Jonathan Bennett, Maud van Dinther, Paulien Voorter, Walter Backes, Josephine Barnes, Frederick Barkhof, Gabriella Captur, Alun D. Hughes, Carole Sudre and Thomas A. Treibel

Medicina 2023, 59(9), 1596; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina59091596 - 4 Sep 2023

Cited by 1 | Viewed by 1940

Abstract

The objective of this review is to investigate the commonalities of microvascular (small vessel) disease in heart failure with preserved ejection fraction (HFpEF) and cerebral small vessel disease (CSVD). Furthermore, the review aims to evaluate the current magnetic resonance imaging (MRI) diagnostic techniques [...] Read more.

The objective of this review is to investigate the commonalities of microvascular (small vessel) disease in heart failure with preserved ejection fraction (HFpEF) and cerebral small vessel disease (CSVD). Furthermore, the review aims to evaluate the current magnetic resonance imaging (MRI) diagnostic techniques for both conditions. By comparing the two conditions, this review seeks to identify potential opportunities to improve the understanding of both HFpEF and CSVD. Full article

(This article belongs to the Special Issue Cardiac Magnetic Resonance)

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11 pages, 1020 KiB

Open AccessReview

Evaluation of Ischemia with No Obstructive Coronary Arteries (INOCA) and Contemporary Applications of Cardiac Magnetic Resonance (CMR)

by Andrew Chang, Nicolas Kang, Joseph Chung, Aakash Rai Gupta and Purvi Parwani

Medicina 2023, 59(9), 1570; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina59091570 - 29 Aug 2023

Cited by 2 | Viewed by 2007

Abstract

Ischemia with no obstructive coronary arteries (INOCA) is a relatively newly discovered ischemic phenotype that affects patients similarly to obstructive coronary artery disease (CAD) but has a unique pathophysiology and epidemiology. Patients with INOCA present with ischemic signs and symptoms but no obstructive [...] Read more.

Ischemia with no obstructive coronary arteries (INOCA) is a relatively newly discovered ischemic phenotype that affects patients similarly to obstructive coronary artery disease (CAD) but has a unique pathophysiology and epidemiology. Patients with INOCA present with ischemic signs and symptoms but no obstructive CAD seen on coronary CTA or invasive coronary angiography, which can assess epicardial vessels. The mechanisms of INOCA can be grouped into three endotypes: coronary microvascular dysfunction, epicardial coronary vasospasm, or a combination of both. Accurate and comprehensive assessment of both epicardial and microvascular disease in suspected cases of INOCA is crucial for providing targeted therapy and improving outcomes in this underrepresented population. This review aims to clarify the complex pathophysiology of INOCA, present an overview of invasive and non-invasive diagnostic methods, and examine contemporary approaches for coronary perfusion assessment using cardiac magnetic resonance (CMR). We also explore how recent advancements in quantitative CMR can potentially revolutionize the evaluation of suspected INOCA by offering a rapid, accurate, and non-invasive diagnostic approach, thereby reducing the alarming number of cases that go undetected. Full article

(This article belongs to the Special Issue Cardiac Magnetic Resonance)

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17 pages, 2417 KiB

Open AccessReview

Cardiovascular Magnetic Resonance Imaging in Familial Dilated Cardiomyopathy

by Clement Lau, Uzma Gul, Boyang Liu, Gabriella Captur and Sandeep S. Hothi

Medicina 2023, 59(3), 439; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina59030439 - 23 Feb 2023

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Abstract

Dilated cardiomyopathy (DCM) is a common cause of non-ischaemic heart failure, conferring high morbidity and mortality, including sudden cardiac death due to systolic dysfunction or arrhythmic sudden death. Within the DCM cohort exists a group of patients with familial disease. In this article [...] Read more.

Dilated cardiomyopathy (DCM) is a common cause of non-ischaemic heart failure, conferring high morbidity and mortality, including sudden cardiac death due to systolic dysfunction or arrhythmic sudden death. Within the DCM cohort exists a group of patients with familial disease. In this article we review the pathophysiology and cardiac imaging findings of familial DCM, with specific attention to known disease subtypes. The role of advanced cardiac imaging cardiovascular magnetic resonance is still accumulating, and there remains much to be elucidated. We discuss its potential clinical roles as currently known, with respect to diagnostic utility and risk stratification. Advances in such risk stratification may help target pharmacological and device therapies to those at highest risk. Full article

(This article belongs to the Special Issue Cardiac Magnetic Resonance)

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21 pages, 1986 KiB

Open AccessReview

Phosphorus Magnetic Resonance Spectroscopy (³¹P MRS) and Cardiovascular Disease: The Importance of Energy

by Vasiliki Tsampasian, Donnie Cameron, Rashed Sobhan, George Bazoukis and Vassilios S. Vassiliou

Medicina 2023, 59(1), 174; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina59010174 - 15 Jan 2023

Cited by 3 | Viewed by 3161

Abstract

Background and Objectives: The heart is the organ with the highest metabolic demand in the body, and it relies on high ATP turnover and efficient energy substrate utilisation in order to function normally. The derangement of myocardial energetics may lead to abnormalities [...] Read more.

Background and Objectives: The heart is the organ with the highest metabolic demand in the body, and it relies on high ATP turnover and efficient energy substrate utilisation in order to function normally. The derangement of myocardial energetics may lead to abnormalities in cardiac metabolism, which herald the symptoms of heart failure (HF). In addition, phosphorus magnetic resonance spectroscopy (³¹P MRS) is the only available non-invasive method that allows clinicians and researchers to evaluate the myocardial metabolic state in vivo. This review summarises the importance of myocardial energetics and provides a systematic review of all the available research studies utilising ³¹P MRS to evaluate patients with a range of cardiac pathologies. Materials and Methods: We have performed a systematic review of all available studies that used ³¹P MRS for the investigation of myocardial energetics in cardiovascular disease. Results: A systematic search of the Medline database, the Cochrane library, and Web of Science yielded 1092 results, out of which 62 studies were included in the systematic review. The ³¹P MRS has been used in numerous studies and has demonstrated that impaired myocardial energetics is often the beginning of pathological processes in several cardiac pathologies. Conclusions: The ³¹P MRS has become a valuable tool in the understanding of myocardial metabolic changes and their impact on the diagnosis, risk stratification, and prognosis of patients with cardiovascular diseases. Full article

(This article belongs to the Special Issue Cardiac Magnetic Resonance)

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11 pages, 865 KiB

Open AccessReview

Contemporary Role of Cardiac Magnetic Resonance in the Management of Patients with Suspected or Known Coronary Artery Disease

by George Bazoukis, Stamatis S. Papadatos, Archontoula Michelongona, Konstantinos Lampropoulos, Dimitrios Farmakis and Vassilis Vassiliou

Medicina 2021, 57(7), 649; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57070649 - 24 Jun 2021

Cited by 2 | Viewed by 2786

Abstract

Cardiac magnetic resonance imaging (CMR) is a useful non-invasive radiation-free imaging modality for the management of patients with coronary artery disease (CAD). CMR cine imaging provides the “gold standard” assessment of ventricular function, late gadolinium enhancement (LGE) provides useful data for the diagnosis [...] Read more.

Cardiac magnetic resonance imaging (CMR) is a useful non-invasive radiation-free imaging modality for the management of patients with coronary artery disease (CAD). CMR cine imaging provides the “gold standard” assessment of ventricular function, late gadolinium enhancement (LGE) provides useful data for the diagnosis and extent of myocardial scar and viability, while stress imaging is an established technique for the detection of myocardial perfusion defects indicating ischemia. Beyond its role in the diagnosis of CAD, CMR allows accurate risk stratification of patients with established CAD. This review aims to summarize the data regarding the role of CMR in the contemporary management of patients with suspected or known coronary artery disease. Full article

(This article belongs to the Special Issue Cardiac Magnetic Resonance)

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10 pages, 8118 KiB

Open AccessCase Report

Marfan Syndrome beyond Aortic Root—Phenotyping Using Cardiovascular Magnetic Resonance Imaging and Clinical Implications

by Evangelia Nyktari, Maria Drakopoulou, Panagiotis Rozos, Sofia Loukopoulou, Thomas Vrachliotis, Soultana Kourtidou and Konstantinos Toutouzas

Medicina 2023, 59(5), 942; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina59050942 - 14 May 2023

Cited by 1 | Viewed by 2349

Abstract

Marfan syndrome (MFS) is an inherited autosomal-dominant connective tissue disorder with multiorgan involvement including musculoskeletal, respiratory, cardiovascular, ocular, and skin manifestations. Life expectancy in patients with MFS is primarily determined by the degree of cardiovascular involvement. Aortic disease is the major cardiovascular manifestation [...] Read more.

Marfan syndrome (MFS) is an inherited autosomal-dominant connective tissue disorder with multiorgan involvement including musculoskeletal, respiratory, cardiovascular, ocular, and skin manifestations. Life expectancy in patients with MFS is primarily determined by the degree of cardiovascular involvement. Aortic disease is the major cardiovascular manifestation of MFS. However, non-aortic cardiac diseases, such as impaired myocardial function and arrhythmia, have been increasingly acknowledged as additional causes of morbidity and mortality. We present two cases demonstrating the phenotypical variation in patients with MFS and how CMR (Cardiovascular Magnetic Resonance) could serve as a “one stop shop” to retrieveS all the necessary information regarding aortic/vascular pathology as well as any potential underlying arrhythmogenic substrate or cardiomyopathic process. Full article

(This article belongs to the Special Issue Cardiac Magnetic Resonance)

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12 pages, 1564 KiB

Open AccessCase Report

Magnetic Resonance Imaging in the Study of Cardiac Masses: A Case Series

by Jorge Joaquín Castro-Martín, Mauro Andrés Di Silvestre-Alonso, Manuel Rivero-García, Rebeca Muñoz-Rodríguez, María Manuela Izquierdo-Gómez, Flor Baeza-Garzón and Juan Lacalzada-Almeida

Medicina 2023, 59(4), 705; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina59040705 - 4 Apr 2023

Cited by 1 | Viewed by 1558

Abstract

Cardiac masses are currently studied using multimodality imaging. For diagnosis, different imaging techniques that can provide complementary information are used. Cardiac magnetic resonance imaging (MRI) has become a fundamental tool for this type of pathology owing to its ability to provide tissue characterization, [...] Read more.

Cardiac masses are currently studied using multimodality imaging. For diagnosis, different imaging techniques that can provide complementary information are used. Cardiac magnetic resonance imaging (MRI) has become a fundamental tool for this type of pathology owing to its ability to provide tissue characterization, spatial accuracy, and the anatomic relationships of the different structures. This study presents a series of four clinical cases with an initial diagnosis of a cardiac mass. All cases were evaluated at a single center, and patients were aged 57 to 72 years. An etiological study was conducted on all patients using different imaging techniques, including MRI. This study describes the diagnostic and therapeutic procedures of the four cases, which included two intracardiac metastases and two benign tumors. Cardiac MRI was decisive in the diagnostic process, determining the clinical decision-making in all four cases. Cardiac MRI has emerged as a pivotal technique in the diagnosis of cardiac masses. It can provide a highly accurate histological diagnosis without the need for invasive techniques. Full article

(This article belongs to the Special Issue Cardiac Magnetic Resonance)

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10 pages, 1388 KiB

Open AccessSystematic Review

The Role of Artificial Intelligence in Predicting Outcomes by Cardiovascular Magnetic Resonance: A Comprehensive Systematic Review

by Hosamadin Assadi, Samer Alabed, Ahmed Maiter, Mahan Salehi, Rui Li, David P. Ripley, Rob J. Van der Geest, Yumin Zhong, Liang Zhong, Andrew J. Swift and Pankaj Garg

Medicina 2022, 58(8), 1087; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58081087 - 12 Aug 2022

Cited by 4 | Viewed by 2723

Abstract

Background and Objectives: Interest in artificial intelligence (AI) for outcome prediction has grown substantially in recent years. However, the prognostic role of AI using advanced cardiac magnetic resonance imaging (CMR) remains unclear. This systematic review assesses the existing literature on AI in CMR [...] Read more.

Background and Objectives: Interest in artificial intelligence (AI) for outcome prediction has grown substantially in recent years. However, the prognostic role of AI using advanced cardiac magnetic resonance imaging (CMR) remains unclear. This systematic review assesses the existing literature on AI in CMR to predict outcomes in patients with cardiovascular disease. Materials and Methods: Medline and Embase were searched for studies published up to November 2021. Any study assessing outcome prediction using AI in CMR in patients with cardiovascular disease was eligible for inclusion. All studies were assessed for compliance with the Checklist for Artificial Intelligence in Medical Imaging (CLAIM). Results: A total of 5 studies were included, with a total of 3679 patients, with 225 deaths and 265 major adverse cardiovascular events. Three methods demonstrated high prognostic accuracy: (1) three-dimensional motion assessment model in pulmonary hypertension (hazard ratio (HR) 2.74, 95%CI 1.73–4.34, p < 0.001), (2) automated perfusion quantification in patients with coronary artery disease (HR 2.14, 95%CI 1.58–2.90, p < 0.001), and (3) automated volumetric, functional, and area assessment in patients with myocardial infarction (HR 0.94, 95%CI 0.92–0.96, p < 0.001). Conclusion: There is emerging evidence of the prognostic role of AI in predicting outcomes for three-dimensional motion assessment in pulmonary hypertension, ischaemia assessment by automated perfusion quantification, and automated functional assessment in myocardial infarction. Full article

(This article belongs to the Special Issue Cardiac Magnetic Resonance)

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6 pages, 1336 KiB

Open AccessCase Report

The Case of a 44-Year-Old Survivor of Unrepaired Tetralogy of Fallot, Right Aortic Arch and Abdominal Aortopulmonary Collateral Vessels

by Roxana Ciltea, Alina Ioana Nicula, Mircea Bajdechi, Alexandru Scafa-Udriste, Roxana Rimbas, Gheorghe Iana and Dragos Vinereanu

Medicina 2022, 58(8), 1011; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58081011 - 28 Jul 2022

Cited by 1 | Viewed by 2021

Abstract

The most common congenital cyanotic heart disease is described in the literature as the Tetralogy of Fallot. This abnormality is characterized by the presence of ventricular septal defect (VSD), obstruction of the right ventricular (RV) outflow tract, right ventricular hypertrophy, and overriding aorta. [...] Read more.

The most common congenital cyanotic heart disease is described in the literature as the Tetralogy of Fallot. This abnormality is characterized by the presence of ventricular septal defect (VSD), obstruction of the right ventricular (RV) outflow tract, right ventricular hypertrophy, and overriding aorta. In patients with pulmonary atresia with ventricular septal defect (PA/VSD), major aortopulmonary collateral arteries (MAPCA) are common; however, although some of them do not have PA/VSD, they do have other particular anatomical variants. The case we are presenting in this article is a rare mild symptomatic adult noncorrected TOF, with preserved RV function, right aortic arch, and MAPCAs (“classic” thoracic MAPCAs but also abdominal MAPCAs). The anatomy of a complex congenital defect is well illustrated by cardiac magnetic resonance (CMR) and computer tomography angiography (CTA), and these imaging techniques are mostly used to understand the relative clinical “silence” TOF. Imaging scans thus play a key role in the evaluation of these patients, being very important to know the indications and limitations of each method, but also to learn to combine them with each other depending on the clinical picture of the patient’s presentation. Additionally, the close collaboration between clinicians and imagers is essential for a correct, complete and detailed preoperative evaluation, being subsequently essential for cardiovascular surgeons, the whole team thus deciding the best therapeutic management. Full article

(This article belongs to the Special Issue Cardiac Magnetic Resonance)

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