Purpose:To prospectively assess the use of cardiac MRI with delayed contrast enhancement (DCE) for identifying patients with active myocarditis among those presenting with acute coronary syndrome (ACS) but no coronary stenosis. Materials and Methods:A total of 27 consecutive patients (age ϭ 45 Ϯ 17 years; 14 male) presenting with ACS (chest pain, positive troponin-I) and no coronary stenosis, underwent cardiac MRI 9 Ϯ 7 days after pain onset and 8 Ϯ 5 months later (N ϭ 19). Steady-state free-precession pulse (SSFP) sequence was applied for the assessment of myocardial function and both inversion-recovery (IR) and SSFP sequences were used for analyzing the topography and extent of DCE areas. Rest sestamibi-gated-single photon emission CT (SPECT) was also systematically performed.Results: Subepicardial DCE pattern typical of acute myocarditis was documented in 12 patients (44%). Ischemic DCE pattern (transmural or subendocardial focal DCE) was documented in 12 of the 15 remaining patients (44%). Patients with subepicardial DCE had: higher C-reactive protein (CRP) levels (38 Ϯ 32 vs. 14 Ϯ 24 mg/mL; P ϭ 0.04), lower Framingham cardiovascular risk (3 Ϯ 3% vs. 9 Ϯ 5%; P Ͻ 0.001), lower incidence of perfusion SPECT defects (17% vs. 73%; P ϭ 0.01), higher left ventricular (LV) enddiastolic volume (77 Ϯ 16 vs. 64 Ϯ 10 mL/m 2 ; P ϭ 0.02), and higher regression of DCE areas at follow-up (-65 Ϯ 17% vs. -18 Ϯ 23%; P ϭ 0.002).Conclusion: DCE pattern of active myocarditis can be seen in patients presenting with ACS but no coronary stenosis.

When planned with a low-dose stress-first protocol on a CZT camera, MPI provides high diagnostic performances and a dramatic reduction in patient radiation doses. This reduction is even greater in low-risk subgroups with high rates of normal stress images, thus allowing the mean radiation dose to be balanced against cardiac risk in targeted populations.

Concentric remodeling is frequently documented by MRI in the middle-aged men with abdominal obesity and in association with a decrease in TAC no longer counter-balanced by a decrease in TPVR, suggesting a remodeling from proximal to peripheral vasculature.

Sinus-rhythm EAM helps identify the limits of post-infarct scars. However, the accuracy of EAM for precise scar delineation is limited. This limit might be circumvented using anatomical information provided by 3D MRI data.

Aortic inflammation, assessed by hybrid FDG-PET/CT imaging, is associated with an enhanced aortic stiffness, in addition to the concurrent impact of calcifications.

Patients with chronic CAD exhibit much higher exercise releases of ANP and BNP when they are treated with beta-blockers. This enhanced secretion of potent vasodilating and natriuretic agents constitutes an original therapeutic mechanism for further protecting diseased hearts against stress.

Myocardial activities acquired during exercise CZT SPECT are strongly influenced by body weight and tracer type, and are dramatically higher than those obtained using an Anger camera, allowing very low-dose protocols to be planned, especially for (99m)Tc-sestamibi and in non-obese subjects.

LV function, assessed on a CZT camera with low injected activities and limited recording times, correlates well with the reference assessment from cardiac MRI.