Myocardial Vascular Function Assessed by Dynamic Oxygenation-sensitive Cardiac Magnetic Resonance Imaging Long-term Following Cardiac Transplantation

Iannino, Nadia; Fischer, Kady; Friedrich, Matthias G.; Hafyane, Tarik; Mongeon, François‐Pierre; White, Michel

doi:10.1097/tp.0000000000003419

Cited by 14 publications

(16 citation statements)

References 41 publications

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“…Multiple studies investigating myocardial oxygenation responses in healthy animal models as well as in various disease models (7,14,15,(17)(18)(19)(20)(21) have emerged over the last decade. As we use a cine variant, it measures a cardiac phase every 40 ms, thus strain can be analyzed from the same set of images.…”

Section: Advantages Of Non-invasive Imagingmentioning

confidence: 99%

Assessment of Myocardial Function During Blood Pressure Manipulations Using Feature Tracking Cardiovascular Magnetic Resonance

Fischer

Neuenschwander

Jung

et al. 2021

Front. Cardiovasc. Med.

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Background: Coronary autoregulation is a feedback system, which maintains near-constant myocardial blood flow over a range of mean arterial pressure (MAP). Yet in emergency or peri-operative situations, hypotensive or hypertensive episodes may quickly arise. It is not yet established how rapid blood pressure changes outside of the autoregulation zone (ARZ) impact left (LV) and right ventricular (RV) function. Using cardiovascular magnetic resonance (CMR) imaging, measurements of myocardial tissue oxygenation and ventricular systolic and diastolic function can comprehensively assess the heart throughout a range of changing blood pressures.Design and methods: In 10 anesthetized swine, MAP was varied in steps of 10–15 mmHg from 29 to 196 mmHg using phenylephrine and urapidil inside a 3-Tesla MRI scanner. At each MAP level, oxygenation-sensitive (OS) cine images along with arterial and coronary sinus blood gas samples were obtained and blood flow was measured from a surgically implanted flow probe on the left anterior descending coronary artery. Using CMR feature tracking-software, LV and RV circumferential systolic and diastolic strain parameters were measured from the myocardial oxygenation cines.Results: LV and RV peak strain are compromised both below the lower limit (LV: Δ1.2 ± 0.4%, RV: Δ4.4 ± 1.2%, p < 0.001) and above the upper limit (LV: Δ2.1 ± 0.4, RV: Δ5.4 ± 1.4, p < 0.001) of the ARZ in comparison to a baseline of 70 mmHg. LV strain demonstrates a non-linear relationship with invasive and non-invasive measures of oxygenation. Specifically for the LV at hypotensive levels below the ARZ, systolic dysfunction is related to myocardial deoxygenation (β = −0.216, p = 0.036) in OS-CMR and both systolic and diastolic dysfunction are linked to reduced coronary blood flow (peak strain: β = −0.028, p = 0.047, early diastolic strain rate: β = 0.026, p = 0.002). These relationships were not observed at hypertensive levels.Conclusion: In an animal model, biventricular function is compromised outside the coronary autoregulatory zone. Dysfunction at pressures below the lower limit is likely caused by insufficient blood flow and tissue deoxygenation. Conversely, hypertension-induced systolic and diastolic dysfunction points to high afterload as a cause. These findings from an experimental model are translatable to the clinical peri-operative environment in which myocardial deformation may have the potential to guide blood pressure management, in particular at varying individual autoregulation thresholds.

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Section: Advantages Of Non-invasive Imagingmentioning

confidence: 99%

Assessment of Myocardial Function During Blood Pressure Manipulations Using Feature Tracking Cardiovascular Magnetic Resonance

Fischer

Neuenschwander

Jung

et al. 2021

Front. Cardiovasc. Med.

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“…Microvascular reactivity has also been studied by oxygenation-sensitive CMR with a protocol of 1-min hyperventilation, followed by 30 s of apnea [91]. Significant differences were found between CAV and non-CAV HTx recipients, but intriguingly this difference was maintained between mild/absent and moderate-to-severe CAV.…”

Section: Cardiac Magnetic Resonancementioning

confidence: 99%

The role of non-invasive imaging modalities in cardiac allograft vasculopathy: an updated focus on current evidences

et al. 2021

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Cardiac allograft vasculopathy (CAV) is an obliterative and diffuse form of vasculopathy affecting almost 50% of patients after 10 years from heart transplant and represents the most common cause of long-term cardiovascular mortality among heart transplant recipients. The gold standard diagnostic technique is still invasive coronary angiography, which however holds potential for complications, especially contrast-related kidney injury and procedure-related vascular lesions. Non-invasive and contrast-sparing imaging techniques have been advocated and investigated over the past decades, in order to identify those that could replace coronary angiography or at least reach comparable accuracy in CAV detection. In addition, they could help the clinician in defining optimal timing for invasive testing. This review attempts to examine the currently available non-invasive imaging techniques that may be used in the follow-up of heart transplant patients, spanning from echocardiography to nuclear imaging, cardiac magnetic resonance and cardiac computed tomography angiography, weighting their advantages and disadvantages.

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“…As can be seen from the Figure 7, the image reconstructed by Bicubic [3] appears severely blurred, and the details of CMR cannot be observed. The image reconstructed by SRCNN [9], FSRCNN [10], and LapSRN [15] appears severely distorted, and the details of the information are not enough.…”

Section: Computational and Mathematical Methods In Medicinementioning

confidence: 97%

“…The CMR imaging can perform multiphase imaging in the time domain to form a dynamic image sequence of the cardiac cycle. Based on the imaging results, cardiac function evaluation indicators, such as ejection fraction, myocardial mass, and myocardial thickness, can be obtained, which is convenient for medical experts to analyze the systolic function of the heart and diagnose diseases [2][3][4]. However, the CMR images are very different from conventional images.…”

Section: Introductionmentioning

confidence: 99%

Cardiac Magnetic Resonance Images Superresolution via Multichannel Residual Attention Networks

Qiu

Cheng

Wang

2021

Computational and Mathematical Methods in Medicine

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The deep neural network has achieved good results in medical image superresolution. However, due to the medical equipment limitations and the complexity of the human body structure, it is difficult to reconstruct clear cardiac magnetic resonance (CMR) superresolution images. To reconstruct clearer CMR images, we propose a CMR image superresolution (SR) algorithm based on multichannel residual attention networks (MCRN), which uses the idea of residual learning to alleviate the difficulty of training and fully explore the feature information of the image and uses the back-projection learning mechanism to learn the interdependence between high-resolution images and low-resolution images. Furthermore, the MCRN model introduces an attention mechanism to dynamically allocate each feature map with different attention resources to discover more high-frequency information and learn the dependency between each channel of the feature map. Extensive benchmark evaluation shows that compared with state-of-the-art image SR methods, our MCRN algorithm not only improves the objective index significantly but also provides richer texture information for the reconstructed CMR images, and our MCRN algorithm is better than the Bicubic algorithm in evaluating the information entropy and average gradient of the reconstructed image quality.

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Myocardial Vascular Function Assessed by Dynamic Oxygenation-sensitive Cardiac Magnetic Resonance Imaging Long-term Following Cardiac Transplantation

Cited by 14 publications

References 41 publications

Assessment of Myocardial Function During Blood Pressure Manipulations Using Feature Tracking Cardiovascular Magnetic Resonance

Assessment of Myocardial Function During Blood Pressure Manipulations Using Feature Tracking Cardiovascular Magnetic Resonance

The role of non-invasive imaging modalities in cardiac allograft vasculopathy: an updated focus on current evidences

Cardiac Magnetic Resonance Images Superresolution via Multichannel Residual Attention Networks

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