RESUMEN
Using hybridized [18F]-fluorodeoxyglucose positron emission tomography with cardiac magnetic resonance, we identify active myocardial inflammation and demonstrate its relationship with late gadolinium enhancement, in Fabry disease. We demonstrate that late gadolinium enhancement represents, at least in part, active myocardial inflammation and identify an early inflammatory phenotype that may represent a therapeutic window before irreversible tissue injury and adaptation occur. (Level of Difficulty: Intermediate.).
RESUMEN
BACKGROUND: Simple reproducible methods of measuring arterial stiffness, a powerful index of prognosis, are becoming available. AIM: To compare the pulse wave transit time (TT) and pulse wave velocity (PWV) between MRI and an arm cuff-based oscillometric method, the Arteriograph. MATERIALS AND METHODS: MRI phase-contrast data were acquired at the aortic arch and just above the aortic bifurcation in 49 men (age 53±6 years). Supine left-arm Arteriograph measurements were made after MRI using the surface sternal notch to symphysis pubis pathway length. RESULTS: MRI TT and PWV covered 86% of aortic root-bifurcation length omitting a mean 4.7 cm of proximal ascending aorta. Arteriograph TT (71±9 ms) was 6.6 ms [95% confidence interval (CI) 3.9-9.4] or 10% higher than MRI (64±10 ms). Arteriograph PWV (7.9±1.3 m/s) was 1.33 m/s (95% CI 0.95-1.70) higher than MRI (6.6±1.2 m/s), primarily because the surface aortic length was 70 mm (95% CI 59-81) longer than MRI. Arteriograph-MRI PWV difference decreased to 0.31 m/s (95% CI 0.01-0.61) when Arteriograph PWV was calculated using the MRI aortic path length and to 0.25 m/s (95% CI -0.05 to 0.55) after correcting for the aortic segments omitted in the MRI method. After similar TT corrections for MRI, the Arteriograph-MRI difference in TT reduced to 3.2 ms (95% CI 0.2-6). CONCLUSION: TT estimations by Arteriograph and MRI are close. More accurate length estimation from MRI-derived models improves Arteriograph PWV measurement.