Improving the diagnosis of LV non-compaction with cardiac magnetic resonance imaging

Dosage of Dabigatran as a Risk Factor for Bleeding in Atrial Fibrillation

“…The inverse probability of treatment weighting method could lead to extreme results compared with other PS methods, such as PS matching in studies, for example, with different distributions of the PS. 4 The question remains open on how PS were distributed in the 2 treatment groups in the study of Hernandez et al 1 and how many events and which effects would have been seen within the PS percentiles. Without this additional information, it is difficult to evaluate the results, especially when only a limited number of events was observed in the smaller cohort.…”

“…Although the authors lacked access to detailed laboratory results, such as creatinine clearance, obtaining a list of patients with International Classification of Diseases, Ninth Revision (ICD-9), coding for chronic kidney disease could have sufficed. In addition, as an increasing number of antiplatelets augments bleeding risk, 4 it is worth noting the average number of antiplatelets used per patient.…”

“…2 Patients with decreased creatinine clearance, those with concomitant administration of P-glycoprotein inhibitors, and probably elderly patients with low body weight or those older than 75 years require dose-adjusted dabigatran. 3,4 The ORBIT-AF trial 5 showed that 56% of patients with severe kidney disease did not receive appropriately adjusted doses of dabigatran. It is thus uncertain whether many of the patients with bleeding episodes were receiving improper dosing regimens.…”

Role of Imaging Techniques for Diagnosis, Prognosis and Management of Heart Failure Patients: Cardiac Magnetic Resonance

“…CMR is also helpful in the diagnosis of Chagas disease 54 , LV non-compaction 55, 56 and infiltrative disorders like Anderson-Fabry disease. 57 Maceira et al 58 found significant cardiac changes in a cohort of 94 asymptomatic individuals who were active cocaine abusers when compared to a group of healthy volunteers.…”

Letter regarding Choudhary et al. “Improving the diagnosis of LV non-compaction with cardiac magnetic resonance imaging”

“…

The excellent paper by Dr. Choudhary et al highlights the issues surrounding developing a cardiovascular magnetic resonance based semiautomated technique for quantification of non-compacted (NC) and compacted (C) masses and ascertaining their relationships to global and regional left ventricular function [1]. In their study, late gadolinium enhancement cardiovascular magnetic resonance (LGE-CMR) was performed 10 min after injection of 0.2 mmol/kg of contrast agent at 1.5 T. Their results demonstrate that the NC:C ratio derived from relative signal intensities of myocardium and blood pool improves the ability to detect clinically relevant NC.

A previous international, multicenter, double-blinded, randomized trial shows that LGE-CMR at 1.5 T using contrast doses of ≥0.2 mmol/kg is effective [2].

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