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Cardiac MRI revascularisation

Paloma Gastelurrutia, Carolina Gálvez-Montón, Maria Luisa Cámara, Juan Bustamante-Munguira, Pablo García-Pavia, Pablo Avanzas, J Alberto San Román, Domingo Pascual-Figal, Eduardo de Teresa, Maria G Crespo-Leiro, Nicolás Manito, Julio Núñez, Francisco Fernández-Avilés, Ángel Caballero, Albert Teis, Josep Lupón, Ramón Brugada, Carlos Martín, Jacobo Silva, Ana Revilla-Orodea, Sergio J Cánovas, Jose M Melero, Jose J Cuenca-Castillo, Angel Gonzalez-Pinto, Antoni Bayes-Genis
INTRODUCTION: Cardiac adipose tissue is a source of progenitor cells with regenerative capacity. Studies in rodents demonstrated that the intramyocardial delivery of cells derived from this tissue improves cardiac function after myocardial infarction (MI). We developed a new reparative approach for damaged myocardium that integrates the regenerative properties of cardiac adipose tissue with tissue engineering. In the adipose graft transposition procedure (AGTP), we dissect a vascularised flap of autologous pericardial adipose tissue and position it over the myocardial scarred area...
August 4, 2017: BMJ Open
Fiona Campbell, Praveen Thokala, Lesley C Uttley, Anthea Sutton, Alex J Sutton, Abdallah Al-Mohammad, Steven M Thomas
BACKGROUND: Cardiac magnetic resonance imaging (CMR) is increasingly used to assess patients for myocardial viability prior to revascularisation. This is important to ensure that only those likely to benefit are subjected to the risk of revascularisation. OBJECTIVES: To assess current evidence on the accuracy and cost-effectiveness of CMR to test patients prior to revascularisation in ischaemic cardiomyopathy; to develop an economic model to assess cost-effectiveness for different imaging strategies; and to identify areas for further primary research...
September 2014: Health Technology Assessment: HTA
David P Ripley, Ansuman Saha, Albert Teis, Akhlaque Uddin, Petra Bijsterveld, Ananth Kidambi, Adam K McDiarmid, Mohan Sivananthan, Sven Plein, Dudley J Pennell, John P Greenwood
BACKGROUND: Aberrant coronary arteries represent a diverse group of congenital disorders. Post-mortem studies reveal a high risk of exercise-related sudden cardiac death in those with an anomalous coronary artery originating from the opposite sinus of Valsalva (ACAOS) with an inter-arterial course. There is little documentation of lifetime history and long-term follow-up of patients with coronary artery anomalies. METHODS: Patients with anomalous coronary arteries undergoing cardiovascular magnetic resonance over a 15-year period were identified and classified by anatomy and course...
May 20, 2014: Journal of Cardiovascular Magnetic Resonance
Felice Achilli, Cristina Malafronte, Stefano Maggiolini, Laura Lenatti, Lidia Squadroni, Giuseppe Gibelli, Maurizio C Capogrossi, Viola Dadone, Francesco Gentile, Beatrice Bassetti, Filiberto Di Gennaro, Paola Camisasca, Ivan Calchera, Laura Valagussa, Gualtiero I Colombo, Giulio Pompilio
OBJECTIVE: To assess whether granulocyte colony-stimulating factor (G-CSF) treatment induces a sustained benefit on adverse remodelling in patients with large anterior ST-elevation myocardial infarction (STEMI) and left ventricular (LV) dysfunction after successful reperfusion. METHODS: The STEM-AMI Trial was a prospective, placebo-controlled, multicentre study. Sixty consecutive patients with a first anterior STEMI, who underwent primary percutaneous coronary intervention 2-12 h after symptom onset, with LV ejection fraction (LVEF) ≤45% measured by echocardiography within 12 h after successful revascularisation (TIMI flow score ≥2), were randomised 1:1 to G-CSF (5 µg/Kg body weight b...
April 2014: Heart: Official Journal of the British Cardiac Society
Karsten Keller, Johannes Beule, Jörn Oliver Balzer, Meike Coldewey, Thomas Munzel, Wolfgang Dippold, Philipp Wild
We report about a 56-year-old man with dyspnoea and leg pain diagnosed with Leriche syndrome and chronic heart failure caused by dilated cardiomyopathy (DCM) with acute cardiac decompensation. Optimising of chronic heart failure therapy with diuretic and antihypertensive drugs leaded to recompensation. A defibrillator was implanted, and afterwards surgical therapy of Leriche syndrome was planned.Leriche syndrome is an uncommon variant of atherosclerotic occlusive disease characterised by total occlusion in abdominal aorta and/or both iliac arteries...
March 2014: Wiener Klinische Wochenschrift
Ananth Kidambi, Adam N Mather, Akhlaque Uddin, Manish Motwani, David P Ripley, Bernhard A Herzog, Adam McDiarmid, Julian Gunn, Sven Plein, John P Greenwood
OBJECTIVE: ST-elevation acute myocardial infarction (STEMI) is frequently associated with reciprocal ST depression in contralateral ECG leads. The relevance of these changes is debated. This study examined whether reciprocal ECG changes in STEMI reflect larger myocardial area at risk (AAR) and/or infarct size. DESIGN: Patients were stratified by presence of reciprocal change on the presenting ECG, defined as ≥ 1 mm ST depression in ≥ 2 inferior leads for anterior STEMI, or ≥ 2 anterior leads for inferior STEMI...
November 2013: Heart: Official Journal of the British Cardiac Society
Janusz Konstanty-Kalandyk, Jacek Piątek, Tomasz Miszalski-Jamka, Paweł Rudziński, Zbigniew Walter, Krzysztof Bartuś, Małgorzata Urbańczyk-Zawadzka, Jerzy Sadowski
BACKGROUND: There are a growing number of patients with end-stage coronary artery disease (CAD) and refractory angina. Angiogenesis may be induced by intramyocardial injection of autologous bone marrow stem cells, intensified by inflammation around channels performed by laser. AIM: To assess the effect of a combined treatment consisting of transmyocardial laser revascularisation (TLMR) and intramyocardial injection of bone-marrow derived stem cells (bone marrow laser revascularisation, BMLR) in patients with refractory angina one year after the procedure...
2013: Kardiologia Polska
Henning Kelbæk, Thomas Engstrøm, Kiril A Ahtarovski, Jacob Lønborg, Niels Vejlstrup, Frants Pedersen, Lene Holmvang, Steffen Helqvist, Kari Saunamäki, Erik Jørgensen, Peter Clemmensen, Lene Kløvgaard, Hans-Henrik Tilsted, Bent Raungaard, Jan Ravkilde, Jens Aaroe, Svend Eggert, Lars Køber
AIMS: Disturbance in the flow of an infarct-related artery due to embolisation of thrombus and plaque material occurs frequently during primary percutaneous coronary intervention (PCI) and is associated with impaired prognosis. The aim of the present study was to minimise the risk of embolisation during PCI in patients with ST-segment elevation myocardial infarction (STEMI). METHODS AND RESULTS: Of 124 consecutive patients with STEMI, thrombectomy and/or balloon dilatation was performed in 110 (89%)...
February 22, 2013: EuroIntervention
Declan P O'Regan, Ben Ariff, A John Baksi, Fabiana Gordon, Giuliana Durighel, Stuart A Cook
OBJECTIVES: Our aim was to evaluate the relationship between the degree of salvage following acute ST elevation myocardial infarction (STEMI) and subsequent reversible contractile dysfunction using cardiac magnetic resonance (CMR) imaging. METHODS: Thirty-four patients underwent CMR examination 1-7 days after primary percutaneous coronary intervention (PPCI) for acute STEMI with follow-up at 1 year. The ischaemic area-at-risk (AAR) was assessed with T2-weighted imaging and myocardial necrosis with late gadolinium enhancement...
May 2013: European Radiology
Salvatore Geraci, Alessio La Manna, Corrado Tamburino
BACKGROUND: A 53-year-old man symptomatic for unstable angina, underwent PCI for a severe stenosis of the first obtuse marginal and a CTO of the left circumflex arteries. INVESTIGATIONS: Physical examination, myocardial necrosis markers, ECG, transthoracic echocardiography, exercise ECG test, bilateral coronary angiography, cardiac magnetic resonance. DIAGNOSIS: During PCI, antegrade contrast injection displaced a large clot from the guiding catheter into the left coronary artery causing massive thrombosis...
November 22, 2012: EuroIntervention
Christian-H Heeger, Kai Jaquet, Holger Thiele, Yanuar Zulkarnaen, Alessandro Cuneo, Dirk Haller, Dietmar Kivelitz, Tobias Schmidt, Korff Krause, Andreas Metzner, Carsten Schneider, Karl-Heinz Kuck, Martin W Bergmann
AIMS: Patients with symptomatic heart failure following acute ST-elevation myocardial infarction (STEMI) received transendocardial application of bone marrow-derived mononuclear cells (BMC) to improve left ventricular (LV) function and clinical outcome. METHODS AND RESULTS: Patients (n=12) with LV ejection fraction (EF) <45% and NYHA Class ≥II received NOGA-guided transendocardial injection of BMC into the infarction border zone 17.5±0.8 days following successful interventional revascularisation after STEMI...
October 2012: EuroIntervention
Shazia T Hussain, Matthias Paul, Sven Plein, Gerry P McCann, Ajay M Shah, Michael S Marber, Amedeo Chiribiri, Geraint Morton, Simon Redwood, Philip MacCarthy, Andreas Schuster, Masaki Ishida, Mark A Westwood, Divaka Perera, Eike Nagel
BACKGROUND: In patients with stable coronary artery disease (CAD), decisions regarding revascularisation are primarily driven by the severity and extent of coronary luminal stenoses as determined by invasive coronary angiography. More recently, revascularisation decisions based on invasive fractional flow reserve (FFR) have shown improved event free survival. Cardiovascular magnetic resonance (CMR) perfusion imaging has been shown to be non-inferior to nuclear perfusion imaging in a multi-centre setting and superior in a single centre trial...
September 19, 2012: Journal of Cardiovascular Magnetic Resonance
Angela G Bertaso, James D Richardson, Dennis T L Wong, Michael S Cunnington, Adam J Nelson, Hussam Tayeb, Kerry Williams, Derek P Chew, Matthew I Worthley, Karen S L Teo, Stephen G Worthley
BACKGROUND: The high diagnostic accuracy of adenosine stress cardiac magnetic resonance (AS-CMR) for detecting coronary artery stenoses, with high sensitivity and specificity, is well documented. Prognostic data, particularly in non-low risk study populations and for greater than 12 months of follow up, is however lacking or variable in its findings. We present prognostic data, in an intermediate cardiovascular risk cohort undergoing adenosine stress perfusion CMR, over approximately 2 years of follow up...
September 1, 2013: International Journal of Cardiology
Dennis T L Wong, James D Richardson, Rishi Puri, Adam J Nelson, Angela G Bertaso, Karen S L Teo, Matthew I Worthley, Stephen G Worthley
BACKGROUND: Advances in the management of myocardial infarction have resulted in substantial reductions in morbidity and mortality. METHODS: However, after acute treatment a number of diagnostic and prognostic questions often remain to be answered, whereby cardiac imaging plays an essential role. RESULTS: For example, some patients will sustain early mechanical complications after infarction, while others may develop significant ventricular dysfunction...
August 2012: European Radiology
Andreas Schuster, Marcus R Makowski, Christian H P Jansen, Meinrad Gawaz, Rene M Botnar, Eike Nagel, Boris Bigalke
Coronary artery disease remains a major hazard within the western world despite early revascularisation and advanced medical therapy strategies. One of its major substrates is platelet activation and thrombus formation, triggering acute events such as myocardial infarction and ischemic strokes. There are a variety of non-invasive imaging strategies being translated from bench to bedside into clinical practice that tackle specific aspects of the pathophysiology of thrombus formation. Some of those techniques are able to visualize native contrast differences between thrombus and surrounding tissue, others focus on the use of specific contrast agents targeting thrombotic components such as fibrin or activated platelets...
September 2012: Current Vascular Pharmacology
David M Clifford, Sheila A Fisher, Susan J Brunskill, Carolyn Doree, Anthony Mathur, Suzanne Watt, Enca Martin-Rendon
BACKGROUND: Stem cell therapy offers a promising approach to the regeneration of damaged vascular and cardiac tissue after acute myocardial infarction (AMI). This has resulted in multiple randomised controlled trials (RCTs) worldwide. OBJECTIVES: To critically evaluate evidence from RCTs on the effectiveness of adult bone marrow-derived stem cells (BMSC) to treat acute myocardial infarction (AMI). SEARCH METHODS: This Cochrane review is an update of a previous one (published in 2008)...
2012: Cochrane Database of Systematic Reviews
W Chan, A H Ellims, S J Duffy, D M Kaye, A J Taylor
Cardiac magnetic resonance imaging (CMR) has matured into a robust, accurate and highly reproducible imaging modality for the assessment of cardiac function and ischaemic heart disease. The unique physical properties of CMR permit depiction of pathology-specific tissue contrast based on differences in tissue composition, such as myocardial oedema, necrosis and fibrosis. This can be imaged at high spatial resolution allowing characterisation of the acuity of an ischaemic event, the presence and extent of myocardial ischaemia, necrosis and viability...
January 2012: Internal Medicine Journal
S W Kirschbaum, P J de Feyter, R-J M van Geuns
Cardiac magnetic resonance imaging (CMR) is a new robust versatile non-invasive imaging technique that can detect global and regional myocardial dysfunction, presence of myocardial ischaemia and myocardial scar tissue in one imaging session without radiation, with superb spatial and temporal resolution, inherited three-dimensional data collection and with relatively safe contrast material. The reproducibility of CMR is high which makes it possible to use this technique for serial assessment to evaluate the effect of revascularisation therapy in patients with ischaemic heart disease...
May 2011: Netherlands Heart Journal
William J van Gaal, Jayanth R Arnold, Luca Testa, Theo Karamitsos, Chris C S Lim, Francis A Ponnuthurai, Steffen Petersen, Jane M Francis, Joseph Selvanayagam, Rana Sayeed, Nicholas West, Steve Westaby, Stefan Neubauer, Adrian P Banning
AIMS: To compare the frequency and extent of Troponin I and late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) defined injury following PCI compared with CABG in patients with multivessel and/or left main coronary artery disease (CAD), and interpret these finding in light of the new ESC/ACCF/AHA/WHF Task Force definitions for necrosis and infarction. METHODS AND RESULTS: Prospective, registered, single centre randomised controlled trial. Eighty patients with 3 vessel CAD (≥ 50% stenoses), or 2 vessel CAD including a type C lesion in the LAD, and/or left main disease were enrolled...
January 2011: EuroIntervention
Declan P O'Regan, Ben Ariff, Clare Neuwirth, Yvonne Tan, Giuliana Durighel, Stuart A Cook
BACKGROUND: In patients with acute myocardial infarction, restoration of coronary flow by primary coronary intervention (PCI) can lead to profound ischaemia-reperfusion injury with detrimental effects on myocardial salvage. Non-invasive assessment of interstitial myocardial haemorrhage by T2* cardiac MRI (T2*-CMR) provides a novel and specific biomarker of severe reperfusion injury which may be of prognostic value. OBJECTIVE: To characterise the determinants of acute ischaemia-reperfusion injury following ST elevation myocardial infarction (STEMI) using CMR...
December 2010: Heart: Official Journal of the British Cardiac Society
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