| 1. |
- Borgquist, Rasmus, et al.
(författare)
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The diagnostic performance of imaging methods in ARVC using the 2010 Task Force criteria.
- 2014
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Ingår i: European heart journal cardiovascular Imaging. - : Oxford University Press (OUP). - 2047-2412 .- 2047-2404. ; 15:11, s. 1219-1225
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Tidskriftsartikel (refereegranskat)abstract
- This study evaluates the agreement between echocardiographic and cardiac magnetic resonance (CMR) imaging data, and the impact a discrepancy between the two may have on the clinical diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC).
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| 2. |
- Flachskampf, Frank A, et al.
(författare)
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Recommendations for transoesophageal echocardiography : EACVI update 2014
- 2014
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Ingår i: European Heart Journal Cardiovascular Imaging. - : Oxford University Press (OUP). - 2047-2404 .- 2047-2412. ; 15:4, s. 353-365
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Tidskriftsartikel (refereegranskat)abstract
- With this document, we update the recommendations for transoesophageal echocardiography (TOE) of the European Association of Cardiovascular Imaging. The document focusses on the areas of interventional TOE, in particular transcatheter aortic, mitral, and left atrial appendage interventions, as well as on the role of TOE in infective endocarditis, adult congenital heart disease, and aortic disease.
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| 3. |
- Rademakers, Frank, et al.
(författare)
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Determining optimal noninvasive parameters for the prediction of left ventricular remodeling in chronic ischemic patients
- 2013
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Ingår i: Scandinavian Cardiovascular Journal. - : Informa Healthcare. - 1401-7431 .- 1651-2006. ; 47:6, s. 329-334
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. DOPPLER-CIP aims to determine the optimal noninvasive parameters (myocardial function, perfusion, ventricular blood flow, cell integrity) and methodology (ergometry, echocardiography, scintigraphy, MRI) in a given ischemic substrate that best predicts the impact of an intervention (or the lack thereof) on adverse morphological ventricular remodeling and functional recovery. Moreover, the relative predictive value of each of these parameters, in respect to the cost of extracting this information in order to enable optimization of cost-effectiveness for improved health care, will be determined by this project. Design. DOPPLER-CIP is a multi-center registry study. All patients with ischemic heart disease included in this study undergo at least two noninvasive stress imaging examinations at baseline. The presence/or absence of left ventricular (LV) remodeling will be assessed after a follow-up of 2 years, during which all cardiac events will be registered. Results. 676 patients were included. Currently, baseline data analysis is almost finished and the follow-up is ongoing. Conclusions. After completion, DOPPLER-CIP will provide evidence-based guidelines toward the most effective use of cardiac imaging in the chronically ischemic heart disease patient. The study will generate information, knowledge, and insight into the new imaging methodologies and into the pathophysiology of chronic ischemic heart disease.
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| 4. |
- Rosendahl, Lene, 1963-
(författare)
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Infarct size and myocardial function : A methodological study
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The size of a myocardial infarction (MI) and the concurrent effect on left ventricular (LV) function are essential for decisions regarding patient care and treatment. Images produced with the late gadolinium enhancement (LGE) technique visualize the scar with high spatial resolution. The general aim of this thesis was to study methods to assess scar size in chronic MI, primarily with the use of LGE, and to relate area‐at‐risk and LV function to scar size.Myocardial perfusion single photon emission computed tomography (MPS) is a well established technique for the assessment of MI size. Our study showed that there is a fairly good agreement between MPS and LGE in the determination of scar size. Wall motion score index (WMSI) correlated moderately with both infarct size and infarct extent determined with LGE.Manual delineation of myocardium and scar is time consuming and subjective and there is a need for help in objective assessment. We showed that the semi‐automatic computer software, Segment, reduced the evaluation time ≥50% with maintained clinical accuracy.The segmented scar sequence ‐ inversion recovery fast gradient echo, IR_FGRE, is a well documented sequence for scar determination, however, the sequence requires regular heart rhythm and breath holding for good imaging. We showed that a single shot scar sequence ‐ steady state free precession, SS_SSFP ‐ acquired under free breathing in patients with ongoing atrial fibrillation, had significantly better image quality than IR_FGRE. The scar size and the error of determination were equal for both sequences and the examination time was shorter with SS_SSFP.In an acute MI it is essential to know the myocardial area‐at‐risk. WMSI is clinically the most common way of assessing LV function, but is highly subjective. Tissue Doppler imaging with strain measurements is considered objective and quantitative in assessing both global and regional LV function compared to WMSI. Our results showed that WMSI is superior to strain for the detection of scar with transmurality ≥50% in patients with acute MI. Also WMSI correlated better than strain on all levels (global, regional, segmental) with final scar size determined with LGE.LGE images visualize myocardial scar much more distinctly than any other modality. This new technique needs clinical validation but promises intense competition with existing modalities such as myocardial scintigraphy and echocardiography.However, in individual patient care all modalities should be used according to their own advantages and limitation.
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| 5. |
- Saberniak, Jorg, et al.
(författare)
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Vigorous physical activity impairs myocardial function in patients with arrhythmogenic right ventricular cardiomyopathy and in mutation positive family members
- 2014
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Ingår i: European Journal of Heart Failure. - : Wiley. - 1879-0844 .- 1388-9842. ; 16:12, s. 1337-1344
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Tidskriftsartikel (refereegranskat)abstract
- AimsExercise increases risk of ventricular arrhythmia in subjects with arrhythmogenic right ventricular cardiomyopathy (ARVC). We aimed to investigate the impact of exercise on myocardial function in ARVC subjects. Methods and ResultsWe included 110 subjects (age 4217years), 65 ARVC patients and 45 mutation-positive family members. Athletes were defined as subjects with 4h vigorous exercise/week [1440 metabolic equivalents (METsxminutes/week)] during a minimum of 6 years. Athlete definition was fulfilled in 37/110 (34%) subjects. We assessed right ventricular (RV) and left ventricular (LV) myocardial function by echocardiography, and by magnetic resonance imaging (MRI). The RV function by RV fractional area change (FAC), RV global longitudinal strain (GLS) by echocardiography, and RV ejection fraction (EF) by MRI was reduced in athletes compared with non-athletes (FAC 34 +/- 9% vs. 40 +/- 11%, RVGLS -18.3 +/- 6.1% vs. -22.0 +/- 4.8%, RVEF 32 +/- 8% vs. 43 +/- 10%, all P<0.01). LV function by LVEF and LVGLS was reduced in athletes compared with non-athletes (LVEF by echocardiography 50 +/- 10% vs. 57 +/- 5%, LVEF by MRI 46 +/- 6% vs. 53 +/- 8%, and LVGLS -16.7 +/- 4.2% vs. -19.4 +/- 2.9%, all P<0.01). The METsxminutes/week correlated with reduced RV and LV function by echocardiography and MRI (all P<0.01). The LVEF by MRI was also reduced in subgroups of athlete index patients (46 +/- 7% vs. 54 +/- 10%, P=0.02) and in athlete family members (47 +/- 3% vs. 52 +/- 6%, P<0.05). ConclusionAthletes showed reduced biventricular function compared with non-athletes in ARVC patients and in mutation-positive family members. The amount and intensity of exercise activity was associated with impaired LV and RV function. Exercise may aggravate and accelerate myocardial dysfunction in ARVC.
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| 6. |
- Zahid, Wasim, et al.
(författare)
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Mitral Annular Displacement by Doppler Tissue Imaging May Identify Coronary Occlusion and Predict Mortality in Patients with Non-ST-Elevation Myocardial Infarction
- 2013
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Ingår i: Journal of the American Society of Echocardiography. - : Elsevier BV. - 0894-7317 .- 1097-6795. ; 26:8, s. 875-884
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Tidskriftsartikel (refereegranskat)abstract
- Background: Mitral annular displacement (MAD) is a simple marker of left ventricular (LV) systolic function. The aim of this study was to test the hypothesis that MAD can distinguish patients with non-ST-segment elevation myocardial infarctions (NSTEMIs) from those with significant coronary artery disease without infarctions, identify coronary occlusion, and predict mortality in patients with NSTEMIs. MAD was compared with established indices of LV function. Methods: In this retrospective study, 167 patients with confirmed NSTEMIs were included at two Scandinavian centers. Forty patients with significant coronary artery disease but without myocardial infarctions were included as controls. Doppler tissue imaging was performed at the mitral level of the left ventricle in the three apical planes, and velocities were integrated over time to acquire MAD. LV ejection fraction, global longitudinal strain (GLS), and wall motion score index were assessed according to guidelines. Results: MAD and GLS could accurately distinguish patients with NSTEMIs from controls. During 48.6 +/- 12.1 months of follow-up, 22 of 167 died(13%). MAD, LV ejection fraction, and GLS were reduced and wall motion score index was increased among those who died compared with those who survived (P<.001, P<.001, P<.001, and P=.02, respectively). Multivariate Cox proportional-hazards analyses revealed that MAD was an independent predictor of death (hazard ratio, 1.36; 95% confidence interval, 1.07-1.73; P=.01). MAD and GLS were reduced and wall motion score index was increased in patients with coronary artery occlusion compared with those without occlusion (P=.006, P=.001, and P=.02), while LV ejection fraction did not differ (P=.20). Conclusions: MAD accurately identified patients with NSTEMIs, predicted mortality, and identified coronary occlusion in patients with NSTEMIs.
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