Progression of Myocardial Fibrosis in Nonischemic DCM and Association With Mortality and Heart Failure Outcomes

Mandawat, Aditya; Chattranukulchai, Pairoj; Mandawat, Anant; Blood, Anne J.; Ambati, Sindhoor; Hayes, Brenda; Rehwald, Wolfgang G; Kim, Han W.; Heitner, John F.; Shah, Dipan J.; Klem, Igor

doi:10.1016/j.jcmg.2020.11.006

Cited by 40 publications

(30 citation statements)

References 34 publications

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“…LGE enables to differentiate viable from non-viable myocardium, ischemic from non-ischemic cardiomyopathies, and plays a pivotal role in diagnosing different non-ischemic cardiomyopathies (104)(105)(106)(107)(108). Moreover, LGE presence and extent have been reported to hold prognostic value in different cardiomyopathies (109)(110)(111)(112). In 111 patients with HFpEF, LGE extent was an independent predictor of cardiovascular death or decompensated HF admission, even after adjustment for age, diabetes mellitus, functional class, LVEF, and history of HF hospitalizations (113).…”

Section: Tissue Characterizationmentioning

confidence: 99%

Advances in Multimodality Cardiovascular Imaging in the Diagnosis of Heart Failure With Preserved Ejection Fraction

Torto

Guaricci²,

Pomarico³

et al. 2022

Front. Cardiovasc. Med.

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Heart failure with preserved ejection fraction (HFpEF) is a syndrome defined by the presence of heart failure symptoms and increased levels of circulating natriuretic peptide (NP) in patients with preserved left ventricular ejection fraction and various degrees of diastolic dysfunction (DD). HFpEF is a complex condition that encompasses a wide range of different etiologies. Cardiovascular imaging plays a pivotal role in diagnosing HFpEF, in identifying specific underlying etiologies, in prognostic stratification, and in therapeutic individualization. Echocardiography is the first line imaging modality with its wide availability; it has high spatial and temporal resolution and can reliably assess systolic and diastolic function. Cardiovascular magnetic resonance (CMR) is the gold standard for cardiac morphology and function assessment, and has superior contrast resolution to look in depth into tissue changes and help to identify specific HFpEF etiologies. Differently, the most important role of nuclear imaging [i.e., planar scintigraphy and/or single photon emission CT (SPECT)] consists in the screening and diagnosis of cardiac transthyretin amyloidosis (ATTR) in patients with HFpEF. Cardiac CT can accurately evaluate coronary artery disease both from an anatomical and functional point of view, but tissue characterization methods have also been developed. The aim of this review is to critically summarize the current uses and future perspectives of echocardiography, nuclear imaging, CT, and CMR in patients with HFpEF.

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Section: Tissue Characterizationmentioning

confidence: 99%

Advances in Multimodality Cardiovascular Imaging in the Diagnosis of Heart Failure With Preserved Ejection Fraction

Torto

Guaricci²,

Pomarico³

et al. 2022

Front. Cardiovasc. Med.

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“…A minimal change in LVEF may accompany progressive fibrosis. It can help with identifying a high-risk cohort and individuals with DCM ( 40 ). This suggests that visualization of FAP expression by FAPI PET/CT imaging could help determine the degree of myocardial damage following DM in progressive CAD and other chronic myocardial diseases.…”

Section: Discussionmentioning

confidence: 99%

A clinical study on relationship between visualization of cardiac fibroblast activation protein activity by Al18F-NOTA-FAPI-04 positron emission tomography and cardiovascular disease

Lyu

Han

Zhao

et al. 2022

Front. Cardiovasc. Med.

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ObjectiveFAP plays a vital role in myocardial injury and fibrosis. Although initially used to study imaging of primary and metastatic tumors, the use of FAPI tracers has recently been studied in cardiac remodeling after myocardial infarction. The study aimed to investigate the application of FAPI PET/CT imaging in human myocardial fibrosis and its relationship with clinical factors.Materials and methodsRetrospective analysis of FAPI PET/CT scans of twenty-one oncological patients from 05/2021 to 03/2022 with visual uptake of FAPI in the myocardium were applying the American Heart Association 17-segment model of the left ventricle. The patients’ general data, echocardiography, and laboratory examination results were collected, and the correlation between PET imaging data and the above data was analyzed. Linear regression models, Kendall’s TaU-B test, the Spearman test, and the Mann–Whitney U test were used for the statistical analysis.Results21 patients (60.1 ± 9.4 years; 17 men) were evaluated with an overall mean LVEF of 59.3 ± 5.4%. The calcific plaque burden of LAD, LCX, and RCA are 14 (66.7%), 12 (57.1%), and 9 (42.9%). High left ventricular SUVmax correlated with BMI (P < 0.05) and blood glucose level (P < 0.05), and TBR correlated with age (P < 0.05). A strong correlation was demonstrated between SUVmean and CTnImax (r = 0.711, P < 0.01). Negative correlation of SUVmean and LVEF (r = −0.61, P < 0.01), SUVmax and LVEF (r = −0.65, P < 0.01) were found. ROC curve for predicting calcified plaques by myocardial FAPI uptake (SUVmean) in LAD, LCX, and RCA territory showed AUCs were 0.786, 0.759, and 0.769.ConclusionFAPI PET/CT scans might be used as a new potential method to evaluate cardiac fibrosis to help patients’ management further. FAPI PET imaging can reflect the process of myocardial fibrosis. High FAPI uptakes correlate with cardiovascular risk factors and the distribution of coronary plaques.

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“…Circulating Ca 2+ protein imbalance leads to the development of IDCM, the incidence of which depends on the species [ 13 , 14 ]. The main molecular mechanisms in the pathogenesis of DCM are increased circulating and tissue levels of norepinephrine, aldosterone, endothelin, vasopressin and cytokines, which lead to structural changes in cardiomyocytes and the extracellular matrix, ultimately leading to myocardial cell necrosis and fibrosis [ 15 ]. These microscopic changes lead to adverse structural remodeling, which is prone to malignant events such as SCD, VT and VF due to disturbances in the conduction system of the remodeled cardiac structure [ 16 ], so early diagnosis and intervention is very essential to save lives.…”

Section: Discussionmentioning

confidence: 99%

Double Gain: The Radio Frequency Catheter Ablation of Ventricular Aneurysm Related Recurrent Ventricular Tachycardia on a Tremendous Cardiac Outpouching

Jiang

Huang

et al. 2022

Diagnostics

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Dilated cardiomyopathy (DCM) is a classic type of non-ischemic cardiomyopathy. Of these, idiopathic cardiomyopathy (IDCM) is a rare type of non-genetic dilated cardiomyopathy. More specifically, the patient had suspected IDCM combined with sustained polymorphic ventricular tachycardia (PMVT) of left ventricular basal segmental origin, cardiac systolic dysfunction and an ejection fraction (EF) of 29%. He had an abnormally large ventricular aneurysm (VA) in the posterior wall of the left ventricle with left ventricular end diastolic dimension (LVDd) of 90 mm. We performed an endocardial radiofrequency catheter ablation (RFCA) of the patient’s recurrent ventricular tachycardia (VT) on the basis of an implantable cardioverter (ICD). Although minimally invasive RFCA also carries a high risk, it is currently a two-pronged option to improve the patient’s quality of life and to prevent the recurrence of VT. Postoperatively, the patient was routinely given optimal anti-arrhythmic and heart failure (HF) treatments to improve cardiac function as well as being followed up for 9 months. The patient’s EF ascended to 36% without any recurrence of VT. In summary, RFCA of suspected IDCM combined with VA and VT of basal area origin would be an effective treatment.

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Progression of Myocardial Fibrosis in Nonischemic DCM and Association With Mortality and Heart Failure Outcomes

Cited by 40 publications

References 34 publications

Advances in Multimodality Cardiovascular Imaging in the Diagnosis of Heart Failure With Preserved Ejection Fraction

Advances in Multimodality Cardiovascular Imaging in the Diagnosis of Heart Failure With Preserved Ejection Fraction

A clinical study on relationship between visualization of cardiac fibroblast activation protein activity by Al18F-NOTA-FAPI-04 positron emission tomography and cardiovascular disease

Double Gain: The Radio Frequency Catheter Ablation of Ventricular Aneurysm Related Recurrent Ventricular Tachycardia on a Tremendous Cardiac Outpouching

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