The Intraventricular Hemodynamic Forces Estimated Using Routine CMR Cine Images

Lapinskas, Tomas; Pedrizzetti, Gianni; Stoiber, Lukas; Düngen, Hans‐Dirk; Edelmann, Frank; Pieske, Burkert; Kelle, Sebastian

doi:10.1016/j.jcmg.2018.08.012

Cited by 23 publications

(31 citation statements)

References 4 publications

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“…In particular, circumferential strain might indicate irreversible damage in AR and could be addressed in future trial design (41,42). Intraventricular hemodynamic forces integrate strain and LV volumes and do also provide comprehensive information on LV dysfunction (22,25). The clinical implications of IVPG over time remains to be defined, since their prognostic implications remain unknown.…”

Section: Discussionmentioning

confidence: 99%

“…Our group previously described LV hemodynamic forces as a non-invasive technique that might Abbreviations: AR, Aortic regurgitation; AS, Aortic stenosis; AVD, Aortic valve disease; AVR, Aortic valve replacement; AVS, Acquired voxel size; CMR, Cardiac magnetic resonance imaging; ECV, extracellular volume; EDV, End-diastolic volume; EDVI, End-diastolic volume index; EF, Ejection fraction; ESV, Endsystolic volume; ESVI, End-systolic volume index; FU, Follow-up; HemForces, Hemodynamic forces; IVPG, Intraventricular pressure gradients; LGE, Late Gadolinium Enhancement; LV, Left ventricle; LVEF, Left ventricular ejection fraction; LVMI, Mass index; MyoGCS, Global myocardial circumferential strain; MyoGLS, Global myocardial longitudinal strain; RVS, Reconstructed voxel size; SI, Sphericity index; TAVR, Transcatheter aortic valve replacement; TE, Echo time; TR, Time to repetition; 4Ch, Four chamber. detect myocardial dysfunction at an early stage, when traditional parameters such as volume and ejection fraction are still unchanged (25). The aim of our study was to monitor the LVremodeling after AVR in patients with severe AS or AR over 10 years.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of 10-Year Left-Ventricular-Remodeling by CMR in Patients Following Aortic Valve Replacement

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Stoiber

Nasser

et al. 2021

Front. Cardiovasc. Med.

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Aims: Aortic valve replacement (AVR) may result in reverse cardiac remodeling. We aimed to assess long-term changes in the myocardium following AVR by Cardiac Magnetic Resonance Imaging (CMR).Methods: We prospectively observed the long-term left ventricular (LV) function and structure of 27 patients with AVR [n = 19 with aortic stenosis (AS); n = 8 with aortic regurgitation (AR)] by CMR. Patients underwent CMR before, as well as 1, 5, and 10 years after AVR. We evaluated clinical parameters, LV volumes, mass, geometry, ejection fraction (EF), global myocardial longitudinal strain (MyoGLS), global myocardial circular strain (MyoGCS), hemodynamic forces (HemForces), and Late Gadolinium Enhancement (LGE).Results: The median of LVMI, EDVI, and ESVI decreased in both groups. Patients with AR had higher initial values of EDVI and ESVI and showed a more prominent initial reduction. In AS, MyoGLS improved already after 1 year and remained constant afterward, whereas, in AR no improvement of MyoGLS was found. MyoGCS remained unchanged in the AS group but deteriorated in the AR group over 10 years. Ejection fraction (EF) was higher in AS patients compared to AR 10 years post-AVR. Late gadolinium enhancement (LGE) could be found more frequently in AS patients.Conclusion: CMR was well suited to investigate myocardial changes over a 10-year follow up period in patients with aortic valve disease. Regarding the long-term functional changes following AVR, patients with AR seemed to benefit less from AVR compared to AS patients. Fibrosis was more common in AS, but this did not reflect functional evolution in these patients. Close monitoring seems indispensable to avoid irreversible structural damage of the heart and to perform AVR at an appropriate stage.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessment of 10-Year Left-Ventricular-Remodeling by CMR in Patients Following Aortic Valve Replacement

Rank

Stoiber

Nasser

et al. 2021

Front. Cardiovasc. Med.

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“…New technologies to assess intraventricular pressure gradients or LV kinetic energy by 4D flow cardiac MRI are under development. Evaluation of LV kinetic energy or haemodynamic forces will potentially allow better characterization of patient populations at various stages of HF 190 by providing quantitative measures, and might be of interest for diagnosis and therapy control in patients with myocardial inflammation.…”

Section: Imagingmentioning

confidence: 99%

Myocarditis and inflammatory cardiomyopathy: current evidence and future directions

et al. 2020

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Inflammatory cardiomyopathy is defined as myocarditis in association with cardiac dysfunction and ventricular remodelling 1,2. Despite extensive research and improved diagnosis and understanding of the pathogenesis of inflammatory cardiomyopathy, this disorder is still associated with a poor prognosis when complicated by left ventricular (LV) dysfunction, heart failure (HF) or arrhythmia 3. Furthermore, fulminant myocarditis, a rare, sudden and severe cardiac inflammation, is one of the main causes of cardiogenic shock in young adults 4,5. Prompt diagnosis and specific treatment strategies are needed to reduce mortality and the need for heart transplantation in these patients 4,5. Many questions remain unanswered regarding the pathogenesis of inflammatory cardiomyopathy and the role of the viral infection, the immune system, the host genetic background and the environment in disease progression and prognosis. These gaps in knowledge highlight the need for advanced experimental systems that can better model the human immune system and the need to improve the characterization and classification of the patients, for example, with the use of phenomapping and phenomics, which involve detailed evaluation of immune status, viral presence and/or other biomarkers. In this Review, we discuss the available evidence and identify the gaps in our understanding of the pathogenesis, diagnosis, treatment and prognosis of myocarditis and inflammatory cardiomyopathy, appraise the available animal and cell models of these conditions and propose future directions for the field. We discuss the role

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“…The aortic diameter was measured at peak systole in the 3-chamber projection from the inner edge of the valve. This formulation was included in a prototype version of the previously mentioned software for STE; an analogous prototype was previously used with feature tracking in cine magnetic resonance imaging (MRI) [19].…”

Section: Hemodynamic Forcesmentioning

confidence: 99%

“…HDFs were proposed as an indicator of the correct sequence of IVPGs generation and thus of LV pumping function [15]. Recent studies have demonstrated that parameters based on HDF compared to LV EF and strain may provide additional information about structural and functional LV adaptations, representing promising markers for the identification of silent sub-clinical myocardial dysfunction [16][17][18][19][20]. Interestingly, innovative mathematical developments demonstrated that the HDFs in the LV can be computed exactly through a proper post-processing of results of standard STE [21,22].…”

Section: Introductionmentioning

confidence: 99%

Reference Ranges of Left Ventricular Hemodynamic Forces in Healthy Adults: A Speckle-Tracking Echocardiographic Study

Ferrara

Capuano

Cocchia³

et al. 2021

JCM

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Background: The normal limits of left ventricular (LV) hemodynamic forces (HDFs) are not exactly known. The aim of this study was to explore the full spectrum of HDF parameters in healthy subjects and determine their physiologic correlates. Methods: 269 healthy subjects were enrolled (mean age: 43 ± 14 years; 123 (45.7%) men). All participants underwent an echo-Doppler examination. Tri-plane tissue tracking from apical views was used to measure 2D global endocardial longitudinal strain (GLS), circumferential strain (GCS), and LV HDFs. HDFs were normalized with LV volume and divided by specific weight. Results: LV systolic longitudinal HDFs (%) were higher in men (20.8 ± 6.5 vs. 18.9 ± 5.6, p = 0.009; 22.0 ± 6.7 vs. 19.8 ± 5.6, p = 0.004, respectively). There was a significant correlation between GCS (increased) (r = −0.240, p < 0.001) and LV longitudinal HDFs (reduced) (r = −0.155, p = 0.01) with age. In a multivariable analysis age, BSA, pulse pressure, heart rate and GCS were the only independent variables associated with LV HDFs (β coefficient = −0.232, p < 0.001; 0.149, p = 0.003; 0.186, p < 0.001; 0.396, p < 0.001; −0.328, p < 0.001; respectively). Conclusion: We report on the physiologic range of LV HDFs. Knowledge of reference values of HDFs may prompt their implementation into clinical routine and allow a more comprehensive assessment of the LV function.

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The Intraventricular Hemodynamic Forces Estimated Using Routine CMR Cine Images

Cited by 23 publications

References 4 publications

Assessment of 10-Year Left-Ventricular-Remodeling by CMR in Patients Following Aortic Valve Replacement

Assessment of 10-Year Left-Ventricular-Remodeling by CMR in Patients Following Aortic Valve Replacement

Myocarditis and inflammatory cardiomyopathy: current evidence and future directions

Reference Ranges of Left Ventricular Hemodynamic Forces in Healthy Adults: A Speckle-Tracking Echocardiographic Study

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