Relation of B-type natriuretic peptide to left ventricular wall stress as assessed by cardiac magnetic resonance imaging in patients with dilated cardiomyopathy

2007 ◽  
Vol 85 (8) ◽  
pp. 790-799 ◽  
Author(s):  
P. Alter ◽  
H. Rupp ◽  
M.B. Rominger ◽  
A. Vollrath ◽  
F. Czerny ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Wall Stress ◽  
Left Ventricular ◽  
Ventricular Wall ◽  
Resonance Imaging ◽  
Sphere Model ◽  
Lv Mass ◽  
Systolic Wall Stress

Ventricular loading conditions are crucial determinants of cardiac function and prognosis in heart failure. B-type natriuretic peptide (BNP) is mainly stored in the ventricular myocardium and is released in response to an increased ventricular filling pressure. We examined, therefore, the hypothesis that BNP serum concentrations are related to ventricular wall stress. Cardiac magnetic resonance imaging (MRI) was used to assess left ventricular (LV) mass and cardiac function of 29 patients with dilated cardiomyopathy and 5 controls. Left ventricular wall stress was calculated by using a thick-walled sphere model, and BNP was assessed by immunoassay. LV mass (r = 0.73, p < 0.001) and both LV end-diastolic (r = 0.54, p = 0.001) and end-systolic wall stress (r = 0.66, p < 0.001) were positively correlated with end-diastolic volume. LV end-systolic wall stress was negatively related to LV ejection fraction (EF), whereas end-diastolic wall stress was not related to LVEF. BNP concentration correlated positively with LV end-diastolic wall stress (r = 0.50, p = 0.002). Analysis of variance revealed LV end-diastolic wall stress as the only independent hemodynamic parameter influencing BNP (p < 0.001). The present approach using a thick-walled sphere model permits determination of mechanical wall stress in a clinical routine setting using standard cardiac MRI protocols. A correlation of BNP concentration with calculated LV stress was observed in vivo. Measurement of BNP seems to be sufficient to assess cardiac loading conditions. Other relations of BNP with various hemodynamic parameters (e.g., EF) appear to be secondary. Since an increased wall stress is associated with cardiac dilatation, early diagnosis and treatment could potentially prevent worsening of the outcome.

Transient left ventricular wall thickening in a 14-year-old girl with influenza A myocarditis

2014 ◽  
Vol 25 (1) ◽  
pp. 187-190 ◽  
Author(s):  
Carol A. Wittlieb-Weber ◽  
Matthew A. Harris ◽  
Joseph W. Rossano
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Cardiac Magnetic Resonance Imaging ◽  
Influenza A ◽  
Left Ventricular ◽  
Left Ventricular Wall ◽  
Wall Thickening ◽  
Ventricular Wall ◽  
Resonance Imaging

AbstractWe describe a case of influenza A myocarditis and transient left ventricular wall thickening in a 14-year-old girl presenting with acute heart failure. Admission echocardiogram revealed significant left ventricular hypertrophy with depressed left ventricular systolic function. The aetiology of the ventricular thickening was demonstrated to be myocardial oedema using cardiac magnetic resonance imaging. The natural course of this unusual clinical presentation of acute myocarditis and the importance of cardiac magnetic resonance imaging in this challenging clinical setting are discussed.

P4360Personalised shape models of the left ventricle from 3D echocardiography: an initial comparison to cardiac magnetic resonance imaging

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Zhao ◽  
K Gilbert ◽  
C R McDougal ◽  
V Y Wang ◽  
H Houle ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Cardiac Magnetic Resonance Imaging ◽  
Left Ventricular ◽  
Patient Specific ◽  
Resonance Imaging ◽  
Shape Models ◽  
Lv Mass ◽  
3D Echo

Abstract Background The heart constantly adapts to maintain cardiac output. In the longer term, this process (remodeling) can manifest as changes in ventricular volume, sphericity, and/or wall thickness, amongst several other morphological indices. Previous studies have shown the significance of remodeling in evaluations of survival, and as a determinant of the clinical course of heart failure. Yet surprisingly, diagnostic measures, typically of left ventricular (LV) mass and ejection fraction, neglect much of the shape information that is available through imaging. A recent UK Biobank study revealed that morphometric atlases show more compelling associations with cardiovascular risk factors, than do LV mass and volumes. While it has been possible to construct shape models from cardiac magnetic resonance imaging (MRI), such a framework is still under development for echocardiography (echo). Purpose Despite MRI being long regarded as the gold standard, it is greatly limited by high costs, long scan times and incompatibility with ferromagnetic cardiac devices. In contrast, echo has presented as a convenient alternative, whilst also offering good temporal resolution. The advancements of 3D echo now provide adequate spatial resolution and thus elicit the possibility of conducting more complex analyses on this modality. With the ability to extract LV geometry directly from 3D echo acquisitions, we sought to create dynamic, 3D patient-specific models–and subsequently compare these results to those derived from MRI. Methods As part of an ongoing study, 8 volunteers with no known cardiovascular problems (nor family history thereof), were recruited for non-invasive imaging. Cine MRI and 3D echo of the LV were acquired within a 2 hour session. A Siemens Avanto Fit 1.5 T MRI scanner and Siemens ACUSON SC2000 Ultrasound System with a 4Z1c Transducer were used. 3D models of the LV were generated independently from echo (EchobuildR 2.7 prototype software, Siemens Ultrasound) and MRI acquisitions (Cardiac Image Modeller v8.1), and registered to fiducial landmarks (apex, base plane, right ventricular inserts) and myocardial contours. Results Euclidian distances between 1682 corresponding points sampled from the surface of echo/MRI models were calculated, and used as a discrepancy measure (Figure). Across the 8 cases, we found an average root mean square deviation (RMSD) of 5.71 mm at end-systole and 6.03 mm at end-diastole. The maximum RMSD for a single model was 9.47 mm (case 8, ES). Conclusion We demonstrate that it is possible to create shape models from 3D echo examinations for comparison with MRI. As more cases are collected, we will devise methods to objectively quantify the mismatch that may arise between models derived from the two modalities. The establishment of such a framework would not only provide previously unavailable measures of shape and function, but in turn leverage the significantly wider clinical reach of echocardiography.

Regional assessment of wall curvature and wall stress in left ventricle with magnetic resonance imaging

1999 ◽  
Vol 277 (3) ◽  
pp. H901-H910 ◽  
Author(s):  
Philippe Balzer ◽  
Alain Furber ◽  
Stéphane Delépine ◽  
Frédéric Rouleau ◽  
Franck Lethimonnier ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Left Ventricle ◽  
Wall Stress ◽  
Left Ventricular ◽  
Cine Mri ◽  
Short Axis ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Systolic Wall Stress

Left ventricular functional abnormalities are associated with regional increases of wall stress and modifications of wall curvature. This study describes the integration of the short-axis and long-axis wall curvatures for determining peak systolic wall stress. Quantification was realized with cine magnetic resonance imaging (MRI) from the location of the endocardial and epicardial borders of the left ventricle on pairs of consecutive short-axis sections. Fifteen normal volunteers were subjected to cine MRI, and different methods of calculating peak systolic wall stress were compared. A short-axis analysis showed a 55 ± 13% increase of the circumferential mean of the peak systolic wall stress between apical and basal sections. Regarding the curvature, no significant increase of wall stress was observed except on the septal wall (31 ± 18%). Short-axis studies proved to be insufficient for determining the regional variations of left ventricular wall stress and for providing normal reference values for the location of abnormal regions in patients.

Sign in / Sign up

Export Citation Format

Share Document