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Introducción: En estudios de medicina nuclear se ha observado que la disminución de la fracción de expulsión del ventrículo izquierdo (FEVI) se asocia con enfermedad coronaria trivascular; en resonancia magnética cardiaca (RMC) no se ha estudiado el papel que desempeña la disminución de la FEVI., Objetivo: Evaluar la asociación entre la disminución de la FEVI y la isquemia cardiaca en pacientes con estudios de RMC con adenosina., Método: Estudio transversal comparativo. Los criterios de inclusión fueron pacientes evaluados con RMC con adenosina entre enero de 2009 y junio de 2015. Se comparó el cambio en la FEVI en pacientes con estudio positivo versus pacientes con estudio negativo para isquemia por este método., Resultados: Se incluyeron 59 pacientes: 41 del sexo masculino (70 %), edad de 59.7 ± 10.9 años; 38 % de los estudios fueron positivos para isquemia. La delta de la FEVI (FEVI postestrés - FEVI reposo) fue de -0.16 ± 5.9 versus 5.3 ± 4.7 (p<0.001) en pacientes con y sin isquemia, respectivamente., Conclusión: Los pacientes con estudios positivos para isquemia tuvieron menor delta FEVI que los que tuvieron estudios negativos para isquemia., Background: The decrease in left ventricular ejection fraction (LVEF) has been observed to be associated with three-vessel coronary disease in nuclear medicine studies; however, the role played by LVEF decrease has not been studied with cardiovascular magnetic resonance (CMR)., Objective: To assess the association between LVEF decrease and cardiac ischemia in patients with CMR studies with adenosine., Method: Cross-sectional, comparative study. Inclusion criteria were: patients assessed with CMR with adenosine between January 2009 and June 2015. LVEF change was compared between patients testing positive for ischemia versus those who tested negative., Results: Fifty nine patients were included: 41 were males (70%), mean age was 59.7 ± 10.9 years; 38% of the studies tested positive for ischemia. Delta LVEF (post-stress LVEF – resting LVEF) was –0.16 ± 5.9 versus 5.3 ± 4.7 (p < 0.001) in patients with and without ischemia, respectively., Conclusion: Patients who tested positive for ischemia had lower delta LVEF than those with negative studies for ischemia., (Copyright: © 2018 SecretarÍa de Salud.)

Background: ECG is widely used in the evaluation of patients with acute myocarditis. Magnetic resonance imaging (MRI) has emerged as the most important imaging tool in the diagnosis of myocarditis. The objective of this study is to determine the agreement between ECG and MRI findings in patients with acute myocarditis., Methods: This is a retrospective cohort that includes 32 consecutive patients with acute myocarditis. ST elevation (STE) in mm was registered in every ECG lead. In every myocardial segment the presence of late enhancement (LE) was registered., Results: STE was found in 75% of the patients, with the inferolateral region being the most frequently affected (46.9%). LE was found in most of the patients (87.5%); the inferolateral wall was also the most frequently affected (50%). There was a moderate agreement between the inferolateral localization of STE and LE in patients with acute myocarditis, k = 0.43, p = 0.01. There was no agreement for the other localizations., Conclusion: There was a moderate agreement between the localization of STE and LE only in the inferolateral localization. LE localization based on the STE localization cannot be inferred, neither vice versa in another localization different from the inferolateral., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Objective: To evaluate the agreement between de ECG leads with ST elevation and the myocardial segments that present myocardial edema in the MRI study, in patients with acute myocardial infarction., Methods: There were included 91 patients with a first ST elevation myocardial infarction (STEMI) with reperfusion therapy during the first 12 hours of onset symptoms, in whom a Cardiovascular Magnetic Resonance (CMR) was done (mean 3 day after the ischemic event). Among the ECG leads (thoracic circle), there were identified those with ST higher elevation. In the CMR there were evaluated the myocardial segments with edema (T2-weighted sequence with hyperintensity)., Results: The ECG leads with the best sensibility in the detection of injury, corresponding to cellular edema, were: basal anterior and anteroseptal: V2; basal inferoseptal LIII and aVF; basal inferior and inferolateral: LIII; basal anterolateral V7-V9; mid anterior and anteroseptal:V2 and V3; mid inferoseptal, inferior and inferolateral: LIII and aVF; mid anterolateral V2 and V8; apical anterior and septal: V2-V4; apical inferior and lateral: LII, LIII and aVF; apex: V2-V4., Conclusions: The surface ECG leads with higher ST elevation corresponded to the myocardial segments with more important edema (defined as someone with hyperintensity in the T2- weighted MRI sequence).

Objective: To evaluate the utility of the cardiovascular magnetic resonance imaging (cMRI) for quantify the aortic area in adult patients with pure aortic stenosis (AS)., Method: Comparative cross-sectional study, blinded, in patients with AS, without another valvular pathology associated. A transthoracic echocardiogram (TTE) and cMRI were performed, in all of them. Results were analyzed by Student t test and ji-square, considering significant values p < 0.05. Bayesian analysis and ROC curve, for the determination of the disease severity., Results: No were significant differences with respect to quantification of the speed of transvalvular flow between both methods (TTE 4.593 +/- 0.9114 m/s vs. cMRI 4.233 +/- 0.6894 m/s, p = 0.080), nor the ejection fraction (TTE 54.27 +/-16.451 vs. cMRI 48.40 +/-17.332, p = 0.760). The cMRI seems to underestimate the maximum and medium gradients compared with the TTE, in 12.53 mm Hg and 10.07 mm Hg respectively. The sensitivity for the diagnosis of severe aortic stenosis is 90% with specificity 80%., Conclusions: The cMRI is a useful diagnostic method for the evaluation of patients with pure aortic valve stenosis, as good as TTE. cMRI can to be a diagnostic alternative in cases with limitations to TTE.

Objective: To analyze the usefulness of magnetic resonance for the morphological diagnosis in complex congenital cardiopathies and compare it with the transthoracic echocardiogram., Method: We included 45 patients with clinical suspicion of severe congenital cardiopathy. A magnetic resonance and a transthoracic echocardiogram were performed and the anatomy and size of the cardiac cavities were compared. Descriptive statistics were used and Bland-Altman test was used to analyze concordance between both methods., Results: There were no significant differences in the measures obtained with either method, except for the left ventricle ejection fraction (66.56 +/- 9.47 with ECO vs 52.32 +/- 13.85 with MR, p = 0.0001) and for diameter of the left branch of the pulmonary artery (9.77 +/- 6.80 with ECO vs 12.83 +/- 8.46 with MR, p = 0.05). The sensitivity, specificity, and predictive values of MR were high to analyze the AV and VA connection, but not for the atrial sinus and the venous drainages (pulmonary and systemic). Concordance of ejection fraction measures, McGoon index, and size of VD revealed few extreme values., Conclusions: MR and ECO are similar for the morphological diagnosis of severe congenital cardiopathies, but MR can be better than ECO for the visualization of extracardiac structures.

Heart masses, including tumors (primary and secondary) and pseudotumor (cysts and thrombus), are rare entities, but of increasing interest in cardiac imaging areas. The clinical manifestations are related to the intracardiac effect of mass, embolization, and systemic symptoms in the case of tumors; however, some of them are detected incidentally. Nowadays, imaging techniques and the advancement of their tools perform the morphological, functional, and tissue characterization of the masses, and additionally know the anatomical relationships, which are crucial factors for the treatment and surgical planning. [ABSTRACT FROM AUTHOR]

Background: the cardiotoxic effects of antineoplastic treatments have been described for several years. The development of non-invasive cardiovascular imaging, and especially cardiac magnetic resonance, have permitted a better understanding of the physiopathology, and earlier diagnosis of these complications. The objective of this study was to evaluate intramyocardial delayed enhancement in Mexican population which received antineoplastic treatment (cisplatin + vinorelbine ± nimotuzumab) for cervico-uterine cancer. This is the first study to evaluate cardiotoxicity diagnosed by cardiac magnetic resonance in patients who take these drugs. Material and methods: a prolective and prospective observational study in 46 patients with diagnosis of stage 4 cervical carcinoma, between 25 and 70 years of age, treated with first-line chemotherapy, without radiological evidence of metastasis, without prior cardiovascular comorbidity. Subjects underwent cardiac magnetic resonance before receiving chemotherapy and 6 months after. Results: the patients' average age was 49 ± 9.6 years. In the initial study, 34.8% of patients had delayed enhancement with insignificant increase (to 41.3%) in the studio at the end of the follow-up period. No significant changes were observed in hemodynamic parameters of the left ventricle following chemotherapy. Ventricular remodeling was observed in 17.4% and drop in left ventricular ejection fraction (of at least 10 percentage points) in 8.6%. Conclusion: cancer patients present intramyocardial delayed enhancement from before antineoplastic treatment. Following administration of chemotherapy signs of ventricular remodeling can be observed in short-term follow-up. [ABSTRACT FROM AUTHOR]

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Objective: To evaluate the utility of the cardiovascular magnetic resonance imaging (cMRI) for quantify the aortic area in adult patients with pure aortic stenosis (AS). Method: Comparative cross-sectional study, blinded, in patients with AS, without another valvular pathology associated. A transthoracic echocardiogram (TTE) and cMRI were performed, in all of them. Results were analyzed by Student t test and ji-square, considering significant values p < 0.05. Bayesian analysis and ROC curve, for the determination of the disease severity. Results: No were significant differences with respect to quantification of the speed of transvalvular flow between both methods (TTE 4.593 ± 0.9114 m/s vs cMRI 4.233 ± 0.6894 m/s, p = 0.080), nor the ejection fraction (TTE 54.27 ± 16.451 vs cMRI 48.40 ± 17.332, p = 0.760). The cMRI seems to underestimate the maximum and medium gradients compared with the TTE, in 12.53 mm Hg and 10.07 mm Hg respectively. The sensitivity for the diagnosis of severe aortic stenosis is 90% with specificity 80%. Conclusions: The cMRI is a useful diagnostic method for the evaluation of patients with pure aortic valve stenosis, as good as TTE. cMRI can to be a diagnostic alternative in cases with limitations to TTE. [ABSTRACT FROM AUTHOR]