The emerging role of MRI in the diagnosis and management of cardiomyopathies

Rochitte, Carlos Eduardo; Tassi, Eduardo Marinho; Shiozaki, Afonso Akio

doi:10.1007/s11886-006-0010-5

Cited by 38 publications

(23 citation statements)

References 69 publications

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“…3,7,10,[13][14][15][16] Contrastenhanced cardiovascular magnetic resonance (CMR) imaging with late gadolinium enhancement (LGE) is capable of noninvasive identification of myocardial fibrosis in coronary artery disease and cardiomyopathies, [17][18][19][20] including HCM. [21][22][23][24] Although recent investigations in HCM have demonstrated an association between LGE and ambulatory ventricular tachyarrhythmias, 14,[25][26][27] available data do not resolve the clinical utility of LGE in sudden death risk stratification.…”

Section: Editorial See P 455 Clinical Perspective On P 495mentioning

confidence: 99%

Prognostic Value of Quantitative Contrast-Enhanced Cardiovascular Magnetic Resonance for the Evaluation of Sudden Death Risk in Patients With Hypertrophic Cardiomyopathy

et al. 2014

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M ore than 50 years after its contemporary description, hypertrophic cardiomyopathy (HCM) remains the most common cause of sudden death in the young. [1][2][3][4][5][6] Although several clinical markers have proved to be useful guides for risk stratification, 3-5,7 current strategies do not identify all HCM patients at risk for sudden death. 3,5,8,9 Over the last Background-Hypertrophic cardiomyopathy (HCM) is the most common cause of sudden death in the young, although not all patients eligible for sudden death prevention with an implantable cardioverter-defibrillator are identified. Contrast-enhanced cardiovascular magnetic resonance with late gadolinium enhancement (LGE) has emerged as an in vivo marker of myocardial fibrosis, although its role in stratifying sudden death risk in subgroups of HCM patients remains incompletely understood. Methods and Results-We assessed the relation between LGE and cardiovascular outcomes in 1293 HCM patients referred for cardiovascular magnetic resonance and followed up for a median of 3.3 years. Sudden cardiac death (SCD) events (including appropriate defibrillator interventions) occurred in 37 patients (3%

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Section: Editorial See P 455 Clinical Perspective On P 495mentioning

confidence: 99%

Prognostic Value of Quantitative Contrast-Enhanced Cardiovascular Magnetic Resonance for the Evaluation of Sudden Death Risk in Patients With Hypertrophic Cardiomyopathy

et al. 2014

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“…Ischaemic scar tends to display a sub-endocardial or transmural distribution affecting a specific coronary territory. Histological evidence of myocardial fibrosis has also been described in non-ischaemic presentations [35–37]. While the precise mechanism behind this scar formation, which typically follows an epicardial or mid-will distribution, is unclear, interstitial and perivascular fibrosis ultimately results in myocardial necrosis [38].…”

Section: Tissue Characterizationmentioning

confidence: 99%

Optimal site selection and image fusion guidance technology to facilitate cardiac resynchronization therapy

Sieniewicz

Gould

Porter

et al. 2018

Expert Review of Medical Devices

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Introduction: Cardiac resynchronization therapy (CRT) has emerged as one of the few effective treatments for heart failure. However, up to 50% of patients derive no benefit. Suboptimal left ventricle (LV) lead position is a potential cause of poor outcomes while targeted lead deployment has been associated with enhanced response rates. Image-fusion guidance systems represent a novel approach to CRT delivery, allowing physicians to both accurately track and target a specific location during LV lead deployment.Areas covered: This review will provide a comprehensive evaluation of how to define the optimal pacing site. We will evaluate the evidence for delivering targeted LV stimulation at sites displaying favorable viability or advantageous mechanical or electrical properties. Finally, we will evaluate several emerging image-fusion guidance systems which aim to facilitate optimal site selection during CRT.Expert commentary: Targeted LV lead deployment is associated with reductions in morbidity and mortality. Assessment of tissue characterization and electrical latency are critical and can be achieved in a number of ways. Ultimately, the constraints of coronary sinus anatomy have forced the exploration of novel means of delivering CRT including endocardial pacing which hold promise for the future of CRT delivery.

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“…16 -28 However, the clinical significance of DE in HCM remains unresolved. 25,26,29 Therefore, we sought to investigate DE in a large HCM cohort by characterizing its prevalence, morphological profile, and relation to clinical and demographic features and prognosis.…”

mentioning

confidence: 99%

Clinical Profile and Significance of Delayed Enhancement in Hypertrophic Cardiomyopathy

Maron¹,

Appelbaum²,

Harrigan³

et al. 2008

Circ: Heart Failure

277

210

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Background-Contrast-enhanced cardiovascular magnetic resonance with delayed enhancement (DE) can provide in vivo assessment of myocardial fibrosis. However, the clinical significance of DE in hypertrophic cardiomyopathy (HCM) remains unresolved. Methods and Results-Cine and cardiovascular magnetic resonance with DE were performed in 202 HCM patients (mean age, 42Ϯ17 years; 71% male), DE was compared with clinical and demographic variables, and patients were followed up for 681Ϯ249 days for adverse disease events. DE was identified in 111 (55%) HCM patients, occupying 9%Ϯ11% of left ventricular myocardial volume, including Ͼ25% DE in 10% of patients. The presence of DE was related to occurrence of heart failure symptoms (Pϭ0.05) and left ventricular systolic dysfunction (Pϭ0.001). DE was present in all patients with ejection fraction Յ50% but also in 53% (102/192) of patients with preserved ejection fraction (PϽ0.001); %DE was both inversely related to (rϭϪ0.3; PϽ0.001) and an independent predictor of ejection fraction (rϭϪ0.4; PϽ0.001). DE (7%Ϯ7% of left ventricle) was present in 54 patients who were asymptomatic (and with normal ejection fraction). Over the follow-up period, the annualized adverse cardiovascular event rate in patients with DE exceeded that in patients without DE but did not achieve statistical significance (5.5% versus 3.3%; Pϭ0.5). Conclusions-In a large HCM cohort, DE was an independent predictor of systolic dysfunction but with only a modest relationship to heart failure symptoms. These data suggest an important role for myocardial fibrosis in the clinical course of HCM patients but are not sufficient at this time to consider DE as an independent risk factor for adverse prognosis.

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The emerging role of MRI in the diagnosis and management of cardiomyopathies

Cited by 38 publications

References 69 publications

Prognostic Value of Quantitative Contrast-Enhanced Cardiovascular Magnetic Resonance for the Evaluation of Sudden Death Risk in Patients With Hypertrophic Cardiomyopathy

Prognostic Value of Quantitative Contrast-Enhanced Cardiovascular Magnetic Resonance for the Evaluation of Sudden Death Risk in Patients With Hypertrophic Cardiomyopathy

Optimal site selection and image fusion guidance technology to facilitate cardiac resynchronization therapy

Clinical Profile and Significance of Delayed Enhancement in Hypertrophic Cardiomyopathy

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