scholarly journals Reversible Myocardial Injury and Intraventricular Thrombus Associated with Aluminium Phosphide Poisoning

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Abdelkader Jalil El Hangouche ◽  
Hala Fennich ◽  
Oumaima Alaika ◽  
Taoufiq Dakka ◽  
Zaineb Raissouni ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Transthoracic Echocardiography ◽  
Left Ventricular Systolic Dysfunction ◽  
Myocardial Dysfunction ◽  
Systolic Dysfunction ◽  
Cardiac Injury ◽  
Symptomatic Treatment ◽  
Left Ventricular ◽  
Aluminium Phosphide

Aluminium phosphide (ALP) is widely used as a fumigant pesticide. In case of ALP poisoning, it is responsible for myocardial dysfunction, related to toxic myocarditis, and hemodynamic disorders. We report a case of a 28-year-old female who had intentionally ingested ALP and was admitted with cardiogenic shock. The transthoracic echocardiography (TTE) at the time of admission showed severe global myocardial hypokinesia with the presence of a giant left ventricular thrombus. Cardiovascular magnetic resonance (CMR) revealed extensive toxic myocarditis with a left ventricular systolic dysfunction. All cardiac lesions were reversible after symptomatic treatment, within 6 months. We aim, by reporting this case, to evidence the complete reversibility of cardiac injury due to aluminium phosphide poisoning documented by transthoracic echocardiography and cardiovascular magnetic resonance.

scholarly journals Myocardial involvement in children with post-COVID multisystem inflammatory syndrome: a cardiovascular magnetic resonance based multicenter international study—the CARDOVID registry

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Florence A. Aeschlimann ◽  
Nilanjana Misra ◽  
Tarique Hussein ◽  
Elena Panaioli ◽  
Jonathan H. Soslow ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Left Ventricular Systolic Dysfunction ◽  
Acute Myocarditis ◽  
Systolic Dysfunction ◽  
Disease Onset ◽  
Myocardial Damage ◽  
Left Ventricular ◽  
World Health ◽  
Inflammatory Syndrome

Abstract Background Recent evidence shows an association between coronavirus disease 2019 (COVID-19) infection and a severe inflammatory syndrome in children. Cardiovascular magnetic resonance (CMR) data about myocardial injury in children are limited to small cohorts. The aim of this multicenter, international registry is to describe clinical and cardiac characteristics of multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 using CMR so as to better understand the real extent of myocardial damage in this vulnerable cohort. Methods and results Hundred-eleven patients meeting the World Health Organization criteria for MIS-C associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), having clinical cardiac involvement and having received CMR imaging scan were included from 17 centers. Median age at disease onset was 10.0 years (IQR 7.0–13.8). The majority of children had COVID-19 serology positive (98%) with 27% of children still having both, positive serology and polymerase chain reaction (PCR). CMR was performed at a median of 28 days (19–47) after onset of symptoms. Twenty out of 111 (18%) patients had CMR criteria for acute myocarditis (as defined by the Lake Louise Criteria) with 18/20 showing subepicardial late gadolinium enhancement (LGE). CMR myocarditis was significantly associated with New York Heart Association class IV (p = 0.005, OR 6.56 (95%-CI 1.87–23.00)) and the need for mechanical support (p = 0.039, OR 4.98 (95%-CI 1.18–21.02)). At discharge, 11/111 (10%) patients still had left ventricular systolic dysfunction. Conclusion No CMR evidence of myocardial damage was found in most of our MIS-C cohort. Nevertheless, acute myocarditis is a possible manifestation of MIS-C associated with SARS-CoV-2 with CMR evidence of myocardial necrosis in 18% of our cohort. CMR may be an important diagnostic tool to identify a subset of patients at risk for cardiac sequelae and more prone to myocardial damage. Clinical trial registration: The study has been registered on ClinicalTrials.gov, Identifier NCT04455347, registered on 01/07/2020, retrospectively registered.

Abstract 13928: Subclinical Myocardial Dysfunction With Coronavirus Disease 2019

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jordan B Strom ◽  
Lila M Martin ◽  
Sarah E Fostello ◽  
James D Chang ◽  
Connie W Tsao ◽  
...  
Keyword(s):  
Left Ventricular Systolic Dysfunction ◽  
Myocardial Dysfunction ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Cardiac Injury ◽  
Multivariable Analysis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Multicenter Studies ◽  
Ventricular Ejection Fraction

Background: Coronavirus disease 2019 (COVID-19) is associated with cardiac injury and overt myocardial dysfunction. However, whether COVID-19 is associated with subclinical myocardial dysfunction is unknown. Methods: We evaluated patients hospitalized for COVID-19 referred for transthoracic echocardiography (TTE), between March 17 and May 22, 2020, with a left ventricular ejection fraction (LVEF) ≥ 50%. Controls in a 1:1 ratio were selected from patients receiving TTE during the same month. Global longitudinal strain (GLS) was used to assess the association of COVID-19 and subclinical myocardial disease. Results: Among 99 patients (49 cases, 50 controls), average GLS was significantly reduced in cases vs. controls (mean ± SD, -14.8 ± 4.0% vs. -21.1 ± 4.0%, p < 0.0001). A total of 82.8% of cases vs. 7.1% of controls had an average GLS below normal (> 18%; p < 0.0001), which persisted despite multivariable adjustment ( Table ). Among COVID-19 patients with a prior TTE, absolute average GLS decreased 3.2% (p = 0.008) despite no change in LVEF (p = 0.41). Average GLS was reduced in non-survivors compared with survivors (p = 0.04), though only septal wall thickness (p = 0.03) was associated with in-hospital mortality on multivariable analysis. Conclusions: Among hospitalized patients receiving TTE, COVID-19 is independently associated with subclinical left ventricular systolic dysfunction in the vast majority of patients, and subclinical LV dysfunction is associated with survival. The clinical implications of these findings should be evaluated in future longitudinal multicenter studies.

scholarly journals Moderated Posters session: cardiovascular magnetic resonanceP967Simplified segmental calculation of extracellular volume with T1 mapping for evaluation of diffuse interstitial fibrosisP968Diffuse myocardial fibrosis quantification by magnetic resonance imaging in patients with aortic valve diseasesP969Occult anthracycline cardiac injury in adolescents and young adults cancer survivors with normal left ventricular ejection fractionP970Reference values for regional and global myocardial T2 mapping with cardiovascular magnetic resonance at 1.5T vs 3TP971The accuracy of a real-time MR method in the assessment of right ventricular volume and functionP972Can blunted heart rate response to adenosine vasodilator stress have prognostic implications on myocardial perfusion imaging by cardiovascular magnetic resonance?P973Association of vitamin d with left atrial fibrosis in patients with lone AF undergoing cryoablationP974Left ventricular remodelling after mitral valve reconstruction: a 1-year prospective cMRI studyP975Abnormal regional myocardial motion in patients with left ventricular pressure overload detected by MR tissue phase mapping at rest and during stressP976Potential utility of splenic switch-off to improve the diagnostic performance of vasodilator stress cardiac magnetic resonance. Preliminary study.

2015 ◽  
Vol 16 (suppl 2) ◽  
pp. S150-S152 ◽  
Author(s):  
P Bazal ◽  
O-A Nastase ◽  
MS Vieira ◽  
A M Maceira Gonzalez ◽  
J Kowal ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
T2 Mapping ◽  
Extracellular Volume ◽  
Cardiac Injury ◽  
Left Ventricular Pressure ◽  
Left Ventricular ◽  
Vasodilator Stress ◽  
Left Ventricular Ejection ◽  
Tissue Phase Mapping

scholarly journals Myocardial fibrosis in asymptomatic and symptomatic chronic severe primary mitral regurgitation and relationship to tissue characterisation and left ventricular function on cardiovascular magnetic resonance

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Boyang Liu ◽  
Desley A. H. Neil ◽  
Monisha Premchand ◽  
Moninder Bhabra ◽  
Ramesh Patel ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Mitral Regurgitation ◽  
Exercise Capacity ◽  
Myocardial Fibrosis ◽  
Myocardial Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
Tissue Characterisation

Abstract Background Myocardial fibrosis occurs in end-stage heart failure secondary to mitral regurgitation (MR), but it is not known whether this is present before onset of symptoms or myocardial dysfunction. This study aimed to characterise myocardial fibrosis in chronic severe primary MR on histology, compare this to tissue characterisation on cardiovascular magnetic resonance (CMR) imaging, and investigate associations with symptoms, left ventricular (LV) function, and exercise capacity. Methods Patients with class I or IIa indications for surgery underwent CMR and cardiopulmonary exercise testing. LV biopsies were taken at surgery and the extent of fibrosis was quantified on histology using collagen volume fraction (CVFmean) compared to autopsy controls without cardiac pathology. Results 120 consecutive patients (64 ± 13 years; 71% male) were recruited; 105 patients underwent MV repair while 15 chose conservative management. LV biopsies were obtained in 86 patients (234 biopsy samples in total). MR patients had more fibrosis compared to 8 autopsy controls (median: 14.6% [interquartile range 7.4–20.3] vs. 3.3% [2.6–6.1], P < 0.001); this difference persisted in the asymptomatic patients (CVFmean 13.6% [6.3–18.8], P < 0.001), but severity of fibrosis was not significantly higher in NYHA II-III symptomatic MR (CVFmean 15.7% [9.9–23.1] (P = 0.083). Fibrosis was patchy across biopsy sites (intraclass correlation 0.23, 95% CI 0.08–0.39, P = 0.001). No significant relationships were identified between CVFmean and CMR tissue characterisation [native T1, extracellular volume (ECV) or late gadolinium enhancement] or measures of LV function [LV ejection fraction (LVEF), global longitudinal strain (GLS)]. Although the range of ECV was small (27.3 ± 3.2%), ECV correlated with multiple measures of LV function (LVEF: Rho = − 0.22, P = 0.029, GLS: Rho = 0.29, P = 0.003), as well as NTproBNP (Rho = 0.54, P < 0.001) and exercise capacity (%PredVO2max: R = − 0.22, P = 0.030). Conclusions Patients with chronic primary MR have increased fibrosis before the onset of symptoms. Due to the patchy nature of fibrosis, CMR derived ECV may be a better marker of global myocardial status. Clinical trial registration Mitral FINDER study; Clinical Trials NCT02355418, Registered 4 February 2015, https://clinicaltrials.gov/ct2/show/NCT02355418

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