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6. Functional and prognostic implications of cardiac magnetic resonance feature tracking-derived remote myocardial strain analyses in patients following acute myocardial infarction

Author

Lange, Torben, Stiermaier, Thomas, Backhaus, Sören J., Boom, Patricia C., Kowallick, Johannes T., de Waha-Thiele, Suzanne, Lotz, Joachim, Kutty, Shelby, Bigalke, Boris, Gutberlet, Matthias, Feistritzer, Hans-Josef, Desch, Steffen, Hasenfuß, Gerd, Thiele, Holger, Eitel, Ingo, and Schuster, Andreas

Published
2021
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25. Heart Failure and Cardiorenal Syndrome: A Narrative Review on Pathophysiology, Diagnostic and Therapeutic Regimens—From a Cardiologist's View.

Author

Mitsas, Angelos C., Elzawawi, Mohamed, Mavrogeni, Sophie, Boekels, Michael, Khan, Asim, Eldawy, Mahmoud, Stamatakis, Ioannis, Kouris, Dimitrios, Daboul, Baraa, Gunkel, Oliver, Bigalke, Boris, van Gisteren, Ludger, Almaghrabi, Saif, and Noutsias, Michel

Subjects
HEART failure, CARDIO-renal syndrome, CARDIAC magnetic resonance imaging, BUNDLE-branch block, ACUTE kidney failure, CHRONIC kidney failure
Abstract

In cardiorenal syndrome (CRS), heart failure and renal failure are pathophysiologically closely intertwined by the reciprocal relationship between cardiac and renal injury. Type 1 CRS is most common and associated with acute heart failure. A preexistent chronic kidney disease (CKD) is common and contributes to acute kidney injury (AKI) in CRS type 1 patients (acute cardiorenal syndrome). The remaining CRS types are found in patients with chronic heart failure (type 2), acute and chronic kidney diseases (types 3 and 4), and systemic diseases that affect both the heart and the kidney (type 5). Establishing the diagnosis of CRS requires various tools based on the type of CRS, including non-invasive imaging modalities such as TTE, CT, and MRI, adjuvant volume measurement techniques, invasive hemodynamic monitoring, and biomarkers. Albuminuria and Cystatin C (CysC) are biomarkers of glomerular filtration and integrity in CRS and have a prognostic impact. Comprehensive "all-in-one" magnetic resonance imaging (MRI) approaches, including cardiac magnetic resonance imaging (CMR) combined with functional MRI of the kidneys and with brain MRI are proposed for CRS. Hospitalizations due to CRS and mortality are high. Timely diagnosis and initiation of effective adequate therapy, as well as multidisciplinary care, are pertinent for the improvement of quality of life and survival. In addition to the standard pharmacological heart failure medication, including SGLT2 inhibitors (SGLT2i), renal aspects must be strongly considered in the context of CRS, including control of the volume overload (diuretics) with special caution on diuretic resistance. Devices involved in the improvement of myocardial function (e.g., cardiac resynchronization treatment in left bundle branch block, mechanical circulatory support in advanced heart failure) have also shown beneficial effects on renal function. [ABSTRACT FROM AUTHOR]

Published
2022
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29. Simultaneous [18F]fluoride and gadobutrol enhanced coronary positron emission tomography/magnetic resonance imaging for in vivo plaque characterization.

Author

Wurster, Thomas H, Landmesser, Ulf, Abdelwahed, Youssef S, Skurk, Carsten, Morguet, Andreas, Leistner, David M, Fröhlich, Georg, Haghikia, Arash, Engel, Leif Christopher, Schuster, Andreas, Noutsias, Michel, Schulze, Daniel, Hamm, Bernd, Furth, Christian, Brenner, Winfried, Botnar, Rene M, Bigalke, Boris, and Makowski, Marcus R

Subjects
IN vivo studies, MAGNETIC resonance imaging, ATHEROSCLEROSIS, CORONARY angiography, RADIOPHARMACEUTICALS, POSITRON emission tomography, CORONARY artery disease, OPTICAL coherence tomography, DESCRIPTIVE statistics, DEOXY sugars
Abstract

Aims 18F-sodium fluoride ([18F]fluoride) and gadobutrol are promising probes for positron emission tomography (PET) and magnetic resonance imaging (MRI) characterizing coronary artery disease (CAD) activity. Unlike [18F]fluoride-PET/computed tomography (CT), the potential of PET/MR using [18F]fluoride and gadobutrol simultaneously, has so far not been evaluated. This study assessed feasibility and diagnostic potential of [18F]fluoride and gadobutrol enhanced dual-probe PET/MR in patients with CAD. Methods and results Twenty-one patients (age, 66.7 ± 6.7 years) with CAD scheduled for invasive coronary angiography (XCA) underwent simultaneous [18F]fluoride (mean activity/effective dose: 157.2 ± 29.7 MBq/3.77 ± 0.72 mSv) and gadobutrol enhanced PET/MR on an integrated PET/MRI (3 T) scanner. Optical coherence tomography (OCT) was used as reference. Target-to-background ratio (TBR, [18F]fluoride-PET) and contrast-to-noise ratio (CNR) values (MRI, gadobutrol) were calculated for each coronary segment. Previously suggested PET/CT-TBR thresholds for adverse coronary events were evaluated. High-risk plaques, i.e. calcified and non-calcified thin-cap fibroatheromas (TCFAs) were predominantly located in segments with a TBR >1.28 (P = 0.012). Plaques containing a lipid core on OCT, were more frequently detected in segments with a TBR >1.25 (P < 0.001). TBR values significantly correlated with maximum calcification thickness (P = 0.009), while fibrous cap thickness was significantly less in segments with a TBR >1.28 (P = 0.044). Above a TBR threshold of >1.28, CNR values significantly correlated with the presence of calcified TCFAs (P = 0.032). Conclusion Simultaneous [18F]fluoride and gadobutrol dual-probe PET/MRI is feasible in clinical practice and may facilitate the identification of high-risk patients. The combination of coronary MR-derived CNR values post gadobutrol and [18F]fluoride based TBR values may improve identification of high-risk plaque features. [ABSTRACT FROM AUTHOR]

Published
2022
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30. Left-atrial long-axis shortening allows effective quantification of atrial function and optimized risk prediction following acute myocardial infarction.

Author

Backhaus, Sören J., Rösel, Simon F., Stiermaier, Thomas, Schmidt-Rimpler, Jonas, Evertz, Ruben, Schulz, Alexander, Lange, Torben, Kowallick, Johannes T., Kutty, Shelby, Bigalke, Boris, Gutberlet, Matthias, Hasenfuß, Gerd, Thiele, Holger, Eitel, Ingo, and Schuster, Andreas

Subjects
MYOCARDIAL infarction, HEALTH outcome assessment, DIAGNOSTIC imaging, PROGNOSIS, CLINICAL trials
Abstract

Aims Deformation imaging enables optimized risk prediction following acute myocardial infarction (AMI). However, costly and time-consuming post processing has hindered widespread clinical implementation. Since manual left-ventricular long-axis strain (LV LAS) has been successfully proposed as a simple alternative for LV deformation imaging, we aimed at the validation of left-atrial (LA) LAS. Methods and results The AIDA STEMI and TATORT-NSTEMI trials recruited 795 patients with ST-elevation myocardial infarction and 440 with non-ST-elevation myocardial infarction. LA LAS was assessed as the systolic distance change between the middle of a line connecting the origins of the mitral leaflets and either a perpendicular line towards the posterior atrial wall (LAS90) or a line connecting to the O LA posterior portion of the greatest distance irrespective of a predefined angle (LAS). Primary endpoint was major adverse cardiac event (MACE) occurrence within 12 months. There were no significant differences between LA LAS and LAS90, both with excellent reproducibility. LA LAS correlated significantly with LA reservoir function (Es, r = 0.60, P < 0.001). Impaired LA LAS resulted in higher MACE occurrence [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.82-0.88, P < 0.001]. LA LAS (HR 0.90, 95% CI 0.83-0.97, P = 0.005) and LV global longitudinal strain (GLS, P = 0.025) were the only independent predictors o for MACE in multivariate analyses. C-statistics demonstrated incremental value of LA LAS in addition to GLS (P = 0.016) and non- e inferiority compared with FT Es (area under the receiver operating characteristic curve 0.74 vs. 0.69, P = 0.256). Conclusion Left-atrial LAS provides fast and software-independent approximations of quantitative LA function with similar value for risk prediction compared with dedicated deformation imaging. Clinical trial registration ClinicalTrials.gov: NCT00712101 and NCT01612312 [ABSTRACT FROM AUTHOR]

Published
2022
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35. Fully Automated Cardiac Assessment for Diagnostic and Prognostic Stratification Following Myocardial Infarction

Author

Schuster, Andreas, Lange, Torben, Backhaus, Sören J., Strohmeyer, Carolin, Boom, Patricia C., Matz, Jonas, Kowallick, Johannes T., Lotz, Joachim, Steinmetz, Michael, Kutty, Shelby, Bigalke, Boris, Gutberlet, Matthias, de Waha‐Thiele, Suzanne, Desch, Steffen, Hasenfuß, Gerd, Thiele, Holger, Stiermaier, Thomas, and Eitel, Ingo

Subjects
Male, cardiac magnetic resonance imaging, Magnetic Resonance Imaging (MRI), Myocardial Infarction, risk stratification, automated postprocessing, Risk Assessment, Imaging, Automation, Artificial Intelligence, Risk Factors, Image Interpretation, Computer-Assisted, Humans, deep learning software, artificial intelligence, Original Research, Aged, Myocardium, Heart, Stroke Volume, Middle Aged, Prognosis, Magnetic Resonance Imaging, Feasibility Studies, Female, Software
Abstract

Background Cardiovascular magnetic resonance imaging is considered the reference methodology for cardiac morphology and function but requires manual postprocessing. Whether novel artificial intelligence–based automated analyses deliver similar information for risk stratification is unknown. Therefore, this study aimed to investigate feasibility and prognostic implications of artificial intelligence–based, commercially available software analyses. Methods and Results Cardiovascular magnetic resonance data (n=1017 patients) from 2 myocardial infarction multicenter trials were included. Analyses of biventricular parameters including ejection fraction (EF) were manually and automatically assessed using conventional and artificial intelligence–based software. Obtained parameters entered regression analyses for prediction of major adverse cardiac events, defined as death, reinfarction, or congestive heart failure, within 1 year after the acute event. Both manual and uncorrected automated volumetric assessments showed similar impact on outcome in univariate analyses (left ventricular EF, manual: hazard ratio [HR], 0.93 [95% CI 0.91–0.95]; P

Published
2020

40. Hantavirus infection: a neglected diagnosis in thrombocytopenia and fever?

Author

Denecke, Barbara, Bigalke, Boris, Haap, Michael, Overkamp, Dietrich, Lehnert, Hendrik, and Haas, Christian S.

Subjects
Hantavirus infections -- Risk factors, Hantavirus infections -- Diagnosis, Hantavirus infections -- Care and treatment, Thrombocytopenia -- Complications and side effects, Thrombocytopenia -- Diagnosis, Thrombocytopenia -- Care and treatment
Abstract

Thrombocytopenia, fever, and acute renal failure are characteristic features of nephropathia epidemica, the predominant hantavirus infection in Europe. However, clinical presentation and blood cell counts may point to other disorders, [...]

Published
2010
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44. Quantitative assessment of magnetic resonance derived perfusion measurements using advanced techniques: comparison with microspheres in an explanted pig heart system

Author

Schuster Andreas, Zarinabad Niloufar, Ishida Masaki, Sinclair Matthew, van den Wijngaard Jeroen P, Morton Geraint, Hautvast Gilion, Bigalke Boris, van Horssen Pepijn, Smith Nic, Spaan Jos A, Siebes Maria, Chiribiri Amedeo, and Nagel Eike

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Published
2013
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