scholarly journals Staphylococcus aureus Myocarditis with Associated Left Ventricular Apical Thrombus

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Michael McGee ◽  
Emily Shiel ◽  
Stephen Brienesse ◽  
Stuart Murch ◽  
Robert Pickles ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Systolic Function ◽  
Acute Myocarditis ◽  
Complete Recovery ◽  
Left Ventricular ◽  
Mural Thrombus ◽  
Intravenous Antibiotics ◽  
Discharge From Hospital

Staphylococcus aureus myocarditis is a rare diagnosis with a high mortality rate, usually seen in people who are immunocompromised. Here, we report a case of a 44-year-old man on methotrexate for rheumatoid arthritis who presented in septic shock and was diagnosed with staphylococcus aureus myocarditis. The myocarditis was associated with a left ventricular apical thrombus, with normal systolic function. The myocarditis and associated thrombus were characterised on transthoracic echocardiogram and subsequently on cardiac magnetic resonance imaging. Cardiac magnetic resonance (CMR) imaging showed oedema in the endomyocardium, consistent with acute myocarditis, associated with an apical mural thrombus. Repeat CMR 3 weeks following discharge from hospital showed marked improvement in endomyocardial oedema and complete resolution of the apical mural thrombus. He was treated with a 12-week course of antibiotics and anticoagulated with apixaban. The patient was successfully managed with intravenous antibiotics and anticoagulation with complete recovery.

scholarly journals EpCAM and microvascular obstruction in patients with STEMI: a cardiac magnetic resonance study

2021 ◽  
Vol 22 (Supplement_2) ◽  
Author(s):  
C Rios-Navarro ◽  
J Gavara ◽  
J Nunez ◽  
C Bonanad Lozano ◽  
E Revuelta-Lopez ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Microvascular Obstruction ◽  
Systolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
P Value ◽  
Ventricular Ejection Fraction ◽  
Systolic Volume

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): This study was funded by “Instituto de Salud Carlos III” and “Fondos Europeos de Desarrollo Regional FEDER” Bachground. Microvascular obstruction (MVO) is negatively associated with cardiac structure and worse prognosis after ST-segment elevation myocardial infarction (STEMI). Epithelial cell adhesion molecule (EpCAM), involved in endothelium adhesion, is an understudied area in the MVO setting. Purpose. We aimed to evaluate whether EpCAM is associated with the appearance of cardiac magnetic resonance (CMR)-derived MVO and long-term systolic function in reperfused STEMI. Methods. We prospectively included 106 patients with a first STEMI treated with primary percutaneous coronary intervention, quantifying serum levels of EpCAM 24 hours post-reperfusion. All patients underwent CMR imaging 1 week and 6 months post-STEMI. The independent correlation of EpCAM with MVO, systolic volume indices, and left ventricular ejection fraction (LVEF) was evaluated. Results. The mean age of the sample was 59 ± 13 years and 76% were male. Patients were dichotomized according to EpCAM median (4.48 pg/mL). At 1-week CMR, lower EpCAM was related to extensive MVO (p-value = 0.02) and greater infarct size (p-value = 0.02). At presentation, only EpCAM values were significantly associated with the presence of MVO in univariate (Odds Ratio [95% confidence interval] (OR [95% CI]): 0.58 [0.38-0.88], p-value = 0.01) and multivariate logistic regression models (OR [95% CI]: 0.54 [0.34-0.85], p-value = 0.007). Although MVO tends to resolve at chronic phases, decreased EpCAM was associated with worse systolic function: depressed LVEF (p-value = 0.009) and higher left ventricular end-systolic volume (p-value = 0.04). Conclusions. EpCAM is associated with occurrence of CMR-derived MVO at acute phases and long-term adverse ventricular remodeling post-STEMI. Future studies are needed to confirm EpCAM as biomarker, and eventually biotarget in STEMI pathophysiology.

scholarly journals Optimal timing of follow-up cardiac magnetic resonance in patients with acute myocarditis

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
M Ciabatti ◽  
L Ferri ◽  
A Camporeale ◽  
E Saletti ◽  
M Chioccioli ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Complete Resolution ◽  
Time Course ◽  
Acute Myocarditis ◽  
Left Ventricular ◽  
Optimal Timing ◽  
2D Echocardiography ◽  
Prognostic Stratification

Abstract Background Cardiac magnetic resonance (CMR) plays a central role in the diagnosis, follow-up and prognostic stratification of acute myocarditis. Several CMR features, including the extent of late gadolinium enhancement (LGE) at baseline, have been proposed as factors associated with a worse outcome. Recent studies evaluated temporal evolution of LGE and edema repeating CMR either at 6 months or at 12 months, demonstrating that persistence or worsening of LGE represents a negative prognostic marker. However, the time-course of edema resolution and LGE stabilization is currently unknown and therefore the optimal timing to repeat CMR for acute myocarditis prognostic stratification remains unclear. Purpose We aimed to assess the time course of edema and LGE evolution in order to identify the optimal timing to repeat CMR in patients with acute myocarditis. Methods We enrolled 36 patients with a diagnosis of acute myocarditis according to ESC position statement definition. All patients underwent CMR at clinical presentation (CMR-1), after 3–4 months (CMR-2) and after 12-months (CMR-3) follow-up. CMR evaluation included assessment of edema and LGE, and evaluation of structural and functional parameters including left (LVEF) and right ventricular ejection fraction (RVEF), left (LVGLS) and right ventricular global longitudinal strain (RVGLS) and indexed left ventricular mass (iLVM). After CMR-3 all patients were followed-up by yearly clinical evaluation, electrocardiogram (ECG) and 2D-echocardiography. Results The mean age was 28,8±10,3 years with 35 (97%) being male. All patients showed edema and LGE at CMR-1 with a LVEF of 58,5±12,2. At CMR-2 a significant reduction of edema (T2 positive segments 0,4±0,9 vs. 4,1±3,2 p<0.0001) and LGE extent (LGE ≥5SD 5,1±5,3 vs. 9,6±8,4 p<0.0001) was observed, with only 3 patients showing edema persistence. A significant improvement of LVEF (62,7±5,6 vs. 58,5±12,2 p<0.05), RVGLS (−24,4±5,4 vs. −21,6±7,4 p<0.05), associated with a significant reduction of iLVM (71,2±13,7 vs 78,1±15,2 g/mq) was also observed. At CMR-3 no further significant reduction of LGE extent was observed with no further improvement of LVEF, RVGLS and iLVM. In the 3 patients with persisting edema at CMR-2, a complete resolution was observed at CMR-3. After a mean follow-up of 60±23 months, no major cardiovascular events nor myocarditis recurrences were observed, with no patients showing left ventricular dysfunction nor progression to dilated cardiomyopathy at 2D-echocardiography. Conclusions In most patients with acute myocarditis a complete resolution of the inflammatory process with LGE stabilization and normalization of left ventricular function and mass can be observed after 3–4 months. Further CMR assessment should limited to patients with persisting oedema at 3–4 months CMR. Our findings suggest to redefine the follow-up schedule and imaging-based prognostic stratification strategies in patients with acute myocarditis. FUNDunding Acknowledgement Type of funding sources: None. Figure 1

Clinical Application of Information Medicine Cardiac Magnetic Resonance Quantitative Imaging in Central Nervous System Cardiology Cardiomyopathy

2021 ◽  
Vol 11 (2) ◽  
pp. 623-629
Author(s):  
Jianhong Shen ◽  
Zanfei Li ◽  
Xianliang Ren
Keyword(s):  
Central Nervous System ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Systolic Function ◽  
Quantitative Imaging ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Diffuse Fibrosis ◽  
Ventricular Systolic Function ◽  
The Relationship

Objective: To study the left ventricular systolic function in patients with central nervous system endocarditis myocarditis by using information-based cardiac magnetic resonance quantitative imaging technique. LGE and T1 mapping techniques were used to evaluate myocardial localized fibrosis and diffuse fibrosis, respectively. The situation is to explore the limitations and the relationship between diffuse cardiomyopathy and cardiac function. Methods: A total of 44 patients with dilated cardiomyopathy and 23 healthy volunteers were scanned with a magnetic resonance imager to determine the occurrence of focal myocardial and diffuse fibrosis, and to analyze the relationship between left ventricular systolic function and left ventricular systolic function. Relationship. Results: The TML values (1335.23 ± 60.91 ms) and LGE (–) subgroups (1309.05 ± 55.02 ms) in the DCMLGE(+) subgroup were significantly different from those in the control group (P < 0.001); however, DCMLGE ( There was no significant difference in the myocardial T1 values between the + and LGE (–) groups (P > 0.05). Conclusion: Cardiac magnetic resonance quantitative imaging technology can reflect the diffuse fibrosis of patients with cardiomyopathy, and can detect early myocardial fibrosis early. In addition, patients with cardiomyopathy have myocardial limitations and diffuse fibrosis, which affects the contractile function of the left ventricle of the heart.

scholarly journals Correlation between cardiac magnetic resonance feature tracking derived left ventricular strain and morphological characteristics of non-ischemic dilated cardiomyopathy at baseline and follow-up

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
E Pozo Osinalde ◽  
J Urmeneta Ulloa ◽  
J L Rodriguez Hernandez ◽  
L Perez De Isla ◽  
H Martinez Fernandez ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Feature Tracking ◽  
Systolic Function ◽  
Morphological Characteristics ◽  
Strain Analysis ◽  
Left Ventricular ◽  
Morphological Parameters ◽  
Non Ischemic Dilated Cardiomyopathy

Abstract Background Left ventricular (LV) strain from echocardiography is a known useful predictor of LVEF recovery in non-ischemic dilated cardiomyopathy (NIDCM). More recently, feature tracking (FT) has allowed LV myocardial deformation analysis using conventional cardiac magnetic resonance (CMR) cine sequences. Purpose Our aim is to establish the correlation between LV strain values from CMR-FT at diagnosis and morphological parameters at baseline and during follow-up. Methods Consecutive patients with NIDCM who underwent CMR were retrospectively collected. All the studies were performed in a 1.5 Tesla magnet following a standard acquisition protocol of conventional SSFP cine sequences in long and short axis. Global longitudinal, circumferential and radial strain (GLS, GCS and GRS, respectively) were obtained with a dedicated FT software. Correlation with CMR morphological parameters at baseline were evaluated. Likewise, in the cases with follow-up echocardiogram association between FT LV strain and evolution of morphofunctional variables was explored. Results CMR-FT strain analysis was performed in 98 patients (age 68±13 years, 72% males) with NIDCM. They showed severe LV dilatation (LVEDVi= 133.6±33.4 mL/m2) and systolic dysfunction (LVEF= 29.5±9.6%) at baseline. Myocardial fibrosis was detected in 38.8% of the patients with late gadolium enhancement (LGE) sequence. All the basal CMR morphological characteristics were significantly correlated with FT strain analysis (Table), even more markedly for GCS. However, there was no association of baseline morphofunctional parameters with LGE. An echocardiogram was performed in 85.7% of the patients during the follow-up (2.4 [1.8–3.4] years), with an LVEF &gt;50% in the 25.5% of the cases. These patients with preserved LVEF in the evolution showed better GCS (−9 vs −7.1%; p=0.019) at baseline, with no differences in the other FT LV strain parameters. Despite less fibrosis in LGE (16.1% vs 37.7%; p=0.037), none of the baseline morphofunctional CMR parameters (LVEF, LVEDVi...) were associated with systolic function restoration. In multivariate analysis, GCS was the only independent predictor (OR 1.16; p=0.045) of LVEF recovery among imaging variables. Conclusions All the FT derived LV strain values were correlated with the degree of basal morphofunctional involvement in NIDCM. Furthermore, GCS emerged as an independent imaging predictor of LV systolic function restoration in our series. FUNDunding Acknowledgement Type of funding sources: None. Table 1. Correlation between myocardial deformation values by feature tracking and morphofunctional variables in basal CMR.

Evaluation of Diastolic Dysfunction Using Cardiac Magnetic Resonance Imaging

2010 ◽  
Vol 6 (1) ◽  
pp. 21 ◽  
Author(s):  
Tarun Pandey ◽  
Kedar Jambhekar ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Diastolic Dysfunction ◽  
Systolic Function ◽  
Diastolic Heart Failure ◽  
Pulmonary Veins ◽  
Left Ventricular ◽  
Function Evaluation ◽  
Lv Function

Left ventricular (LV) diastolic dysfunction and diastolic heart failure (DHF) account for approximately 40–50% of all patients with congestive heart failure (CHF). Diastolic dysfunction can be evaluated directly by invasive cardiac catheterisation techniques or non-invasively by transthoracic echocardiography (TTE) or cardiac magnetic resonance (CMR) imaging. Due to its high spatial and temporal resolution, CMR is the accepted gold standard for evaluating ventricular systolic function. Using the cine-phase contrast technique, CMR can interrogate inflow through the mitral valve and pulmonary veins towards evaluation of diastolic dysfunction and has shown good correlation with TTE. Additionally, CMR can evaluate direct myocardial diastolic parameters that have no echo correlate, such as diastolic torsion rate. As CMR has the ability to characterise a range of diastolic impairments, it will likely become an important diagnostic test in the future, capable of comprehensive LV function evaluation. In this article, we focus on LV diastology, and review CMR methodology and parameters for the diagnosis of diastolic dysfunction.

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