The international journal of cardiovascular imaging最新文献

Cardiac MRI (cMRI) is crucial for characterizing acute myocardial infarction (MI) complications. We present a case where acute ischemic edema demonstrated a magnitude (MAG) and phase-sensitive inversion recovery (PSIR) mismatch. This highlights that the MAG-PSIR mismatch can arise from the very long T1 times of acute edema, a key finding confirmed by T1 and T2 mapping [1].

Purpose: Left ventricular diastolic dysfunction (LVDD) is common in chronic kidney disease (CKD) and is suggested to be linked to worse renal prognosis. We investigated the associations between both the ratio of early mitral inflow velocity to early diastolic tissue velocity (E/e') and LVDD grades with the risk of end-stage kidney disease (ESKD).

Methods: This prospective cohort study included individuals with non-dialysis-dependent CKD from the nephrology outpatient clinics at Rigshospitalet and Herlev-Gentofte hospital, Copenhagen. All participants underwent a thorough, protocolized echocardiographic examination. The outcome was time to ESKD (defined as dialysis treatment or kidney transplantation).

Results: A total of 731 participants were included. Mean age was 57 ± 13 years and 39% were female. During a median follow-up of 3.8 years (IQR: 3.3;4.5), 102 individuals reached ESKD. In multivariable Cox regression models, both increasing continuous E/e' (HR = 1.09 [95%CI:1.03;1.15], P = 0.004, per 1 unit increase) and E/e' > 14 (HR = 3.44 [95%CI:1.44;8.26], P = 0.005) (reference E/e' < 8) were associated with ESKD, while E/e' 8-14 was not. Compared with no or indeterminate LVDD, LVDD grades 2 or 3 were associated with ESKD (HR = 2.92 [95% CI:1.44;5.94], P = 0.003), while LVDD grade 1 was not. E/e' > 14 and LVDD grade 2 or 3 demonstrated similar predictive accuracy with excellent specificity and negative predictive values, but poor positive predictive values and sensitivity.

Conclusion: Prominent LVDD assessed by E/e' and LVDD grades was independently associated with worse renal prognosis and had similar predictive accuracy in patients with non-dialysis dependent CKD.

Pulmonary arterial stiffness (PAS) is a noninvasive imaging biomarker associated with disease severity in pulmonary hypertension (PH). This study aimed to evaluate PAS using cardiac magnetic resonance (CMR) imaging and investigate its relationship with hemodynamic parameters from right heart catheterization (RHC) across PH subgroups. In this retrospective study, 44 patients with PH who underwent both RHC and CMR were classified into pre-capillary (precapPH), post-capillary (postcapPH), and combined pre- and post-capillary (combPH) PH groups based on guideline-defined criteria. PAS was assessed by CMR-derived pulse wave velocity (PWV) and relative area change (RAC) of the main pulmonary artery. RHC measurements included mPAP, PVR, and right ventricular pressures and mixed venous saturation. PWV was significantly higher in combPH (4.49 ± 1.32 m/s) compared to precapPH (3.40 ± 0.98 m/s, p = 0.04). RAC was significantly lower in combPH (0.18 ± 0.11) than in postcapPH (0.28 ± 0.09), p = 0.01) and precapPH (0.18 ± 0.07, p = 0.01). PWV correlated with mPAP (r = 0.34, p = 0.022), RAP (r = 0.39, p = 0.008), and RVEDVi (r = 0.34, p = 0.022), while RAC showed a negative correlation with PVR (r = - 0.36, p = 0.01). Distinct RV adaptation patterns were observed among subgroups, with combPH patients exhibiting the most impaired hemodynamics. CMR-derived PAS indices correlate with invasive hemodynamic markers and differ among PH subtypes. PWV and RAC may serve as useful noninvasive markers for assessing pulmonary vascular burden and differentiating disease severity in PH. Larger prospective studies are needed to validate their clinical utility.

Vieussens and Kugel arterial rings are rare anatomical variants of the coronary arteries, connecting the conical branch of the right coronary artery to the branches of the left coronary artery. We report a case of severe coronary artery disease of the distal left main trunk in a patient with Vieussens and Kugel arterial rings.