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1.
Nat Commun ; 11(1): 5355, 2020 10 23.
Artigo em Inglês | MEDLINE | ID: mdl-33097705

RESUMO

Water and lipids are key participants in many biological processes, but there are few non-invasive methods that provide quantification of these components in vivo, and none that can isolate and quantify lipids in the blood. Here we develop a new imaging modality termed shortwave infrared meso-patterned imaging (SWIR-MPI) to provide label-free, non-contact, spatial mapping of water and lipid concentrations in tissue. The method utilizes patterned hyperspectral illumination to target chromophore absorption bands in the 900-1,300 nm wavelength range. We use SWIR-MPI to monitor clinically important physiological processes including edema, inflammation, and tumor lipid heterogeneity in preclinical models. We also show that SWIR-MPI can spatially map blood-lipids in humans, representing an example of non-invasive and contact-free measurements of in vivo blood lipids. Together, these results highlight the potential of SWIR-MPI to enable new capabilities in fundamental studies and clinical monitoring of major conditions including obesity, cancer, and cardiovascular disease.


Assuntos
Raios Infravermelhos , Lipídeos/sangue , Imagem Óptica/métodos , Ondas de Rádio , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Água/análise , Tecido Adiposo Marrom/diagnóstico por imagem , Tecido Adiposo Marrom/patologia , Adulto , Animais , Biomarcadores/sangue , Doenças Cardiovasculares/diagnóstico por imagem , Edema/diagnóstico por imagem , Edema/patologia , Feminino , Xenoenxertos , Humanos , Inflamação/diagnóstico por imagem , Inflamação/patologia , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Neoplasias/diagnóstico por imagem , Neoplasias/patologia , Obesidade/diagnóstico por imagem , Imagem Óptica/instrumentação , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Espectroscopia de Luz Próxima ao Infravermelho/instrumentação
2.
Medicine (Baltimore) ; 99(35): e21891, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871919

RESUMO

To analyze the relationship between aortic measures and biometric parameters in a large cohort of consecutive patients undergoing computed tomography coronary angiography.1170 patients (717 men/453 women) performing computed tomography coronary angiography for coronary evaluation were retrospectively evaluated. Aortic diameters and areas were measured at reproducible anatomic landmarks, perpendicular to the axis of vessel, at the level of the aortic root (AoR), the sinotubular junction (STJ), and the tubular ascending aorta (TAo). Biometric parameters and cardiovascular risk factors were recorded.The average values of AoR, STJ, and TAo were 35.63 ±â€Š5.00 mm, 30.56 ±â€Š4.82 mm, 35.07 ±â€Š5.84 mm. Hypertension was significantly associated with aortic dimensions.Aortic measures were significantly different between men and women (37.56 ±â€Š4.77 mm vs 32.58 ±â€Š3.68 mm for AoR, 31.88 ±â€Š4.84 mm vs 28.47 ±â€Š3.98 mm for STJ and 35.93 ±â€Š5.86 mm vs 33.70 ±â€Š5.54 mm for TAo) (P < .001) and linearly increased with age. Low Spearman correlation coefficients were found and the correlation of TAo diameters with age displayed the highest values (ρ = 0.372 for male and ρ = 0.373 for female, P < .001). Multiple linear regression analysis models were compared by R. The best model used body surface area (BSA) and age as independent variables and TAo diameter as dependent variable (R = 0.29 for AoR; R = 0.21 for STJ, and R = 0.20 for TAo).In conclusion, in our population low correlation between aortic dimensions and biometric parameters highlights the difficulty of identifying normal ranges, as well as issues related to normalization using conventional biometric parameters.


Assuntos
Aorta/anatomia & histologia , Aorta/diagnóstico por imagem , Biometria , Doenças Cardiovasculares/diagnóstico por imagem , Doenças Cardiovasculares/patologia , Angiografia Coronária , Tomografia Computadorizada por Raios X , Fatores Etários , Idoso , Superfície Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais
3.
Radiol Med ; 125(11): 1013-1023, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32964326

RESUMO

The purpose of this article is to provide an overview on the role of CT scan and MRI according to selected guidelines by the European Society of Cardiology (ESC) and the American College of Cardiology/American Heart Association (ACC/AHA). ESC and ACC/AHA guidelines were systematically reviewed for recommendations to CT and MRI use in specific cardiovascular (CV) clinical categories. All recommendations were collected in a dataset, including the class of recommendation, the level of evidence (LOE), the specific imaging technique, the clinical purpose of the recommendation and the recommending Society. Among the 43 included guidelines (ESC: n = 18, ACC/AHA: n = 25), 26 (60.4%) contained recommendations for CT scan or MRI (146 recommendations: 62 for CT and 84 for MRI). Class of recommendation IIa (32.9%) was the most represented, followed by I (28.1%), IIb (24%) and III (11.9%). MRI recommendations more frequently being of higher class (I: 36.9%, IIa: 29.8%, IIb: 21.4%, III: 11.9%) as compared to CT (I: 16.1%, IIa: 37.1%, IIb: 27.4%, III: 19.4%). Most of recommendation (55.5%) were based on expert opinion (LOE C). The use of cardiac CT and cardiac MR in the risk assessment, diagnosis, therapeutic and procedural planning is in continuous development, driven by an increasing need to evolve toward an imaging-guided precision medicine, combined with cost-effectiveness and healthcare sustainability. These developments must be accompanied by an increased availability of high-performance scanners in healthcare facilities and should emphasize the need of increasing the number of radiologists fully trained in cardiac imaging.


Assuntos
Cardiologia/normas , Doenças Cardiovasculares/diagnóstico por imagem , Angiografia por Tomografia Computadorizada , Imagem por Ressonância Magnética , Guias de Prática Clínica como Assunto , Medicina de Precisão/métodos , Doenças Cardiovasculares/prevenção & controle , Angiografia por Tomografia Computadorizada/métodos , Angiografia Coronária/métodos , Vasos Coronários/diagnóstico por imagem , Europa (Continente) , Coração/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética/métodos , Prevenção Primária , Sociedades Médicas , Estados Unidos
4.
J Cardiovasc Magn Reson ; 22(1): 61, 2020 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-32878639

RESUMO

The aim of this document is to provide specific recommendations on the use of cardiovascular magnetic resonance (CMR) protocols in the era of the COVID-19 pandemic. In patients without COVID-19, standard CMR protocols should be used based on clinical indication as usual. Protocols used in patients who have known / suspected active COVID-19 or post COVID-19 should be performed based on the specific clinical question with an emphasis on cardiac function and myocardial tissue characterization. Short and dedicated protocols are recommended.


Assuntos
Doenças Cardiovasculares/diagnóstico por imagem , Infecções por Coronavirus/prevenção & controle , Controle de Infecções/organização & administração , Imagem Cinética por Ressonância Magnética/normas , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Índice de Gravidade de Doença , Sociedades Médicas , Estados Unidos
5.
Medicine (Baltimore) ; 99(30): e20923, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791673

RESUMO

Overweight and obesity in childhood are associated with early cardiovascular dysfunction and promote heightened risk of cardiovascular morbidity and mortality in adulthood. Waist circumference (WC) correlates with visceral obesity, which is why obese children with elevated WC need to be carefully monitored to prevent long-term cardio-metabolic complications. The purpose of our study was to establish if WC could be a predictor of cardiovascular complications in children.The authors conducted a retrospective study that included 160 overweight and obese children and adolescents, aged 6 to 18 years. Patients were evaluated completely anthropometrically, biologically, and imagistic. The anthropometric data tracked were height, weight, WC, and body mass index. Echocardiography evaluated the following parameters: the interventricular septum, left ventricular mass, the relative thickness of the ventricular wall, the pathological epicardial fat.Our results confirm that the presence of visceral obesity was significantly associated (χ = 11.72, P = .0006) with pathological epicardial fat. In children, visceral obesity is not a risk factor for vascular or cardiac impairment, but in adolescents, the results showed that visceral obesity is an important predictive factor for the occurrence of vascular (AUC = 0.669, P = .021) and cardiac (AUC = 0.697, P = .037) impairment. Concentric left ventricular (LV) hypertrophy is significantly influenced by the presence of visceral obesity (AUC = 0.664, P = .013 children; AUC = 0.716, P = .026 adolescents).WC above the 90th percentile is a predictive factor for increased LVM index and concentric hypertrophy in both children and adolescents.


Assuntos
Doenças Cardiovasculares/etiologia , Obesidade Abdominal/complicações , Obesidade Pediátrica/complicações , Circunferência da Cintura , Adolescente , Doenças Cardiovasculares/diagnóstico por imagem , Criança , Ecocardiografia , Feminino , Humanos , Masculino , Estudos Retrospectivos
6.
Medicine (Baltimore) ; 99(31): e21460, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756167

RESUMO

Volume status is a key parameter for cardiovascular-related mortality in dialysis patients. Although N-terminal pro-B-type natriuretic peptide (NT-proBNP), myeloperoxidase, copeptin, and pro-adrenomedullin have been reported as volume markers, the relationship between body fluid status and volume markers in dialysis patients is uncertain. Therefore, we investigated the utility of volume status biomarkers based on body composition monitor (BCM) analyses.We enrolled pre-dialysis, hemodialysis (HD), and peritoneal dialysis (PD) patients and age- and gender-matched healthy Korean individuals (N = 80). BCM and transthoracic echocardiography were performed and NT-proBNP, myeloperoxidase, copeptin, and pro-adrenomedullin concentrations were measured. Relative hydration status (ΔHS, %) was defined in terms of the hydration status-to-extracellular water ratio with a cutoff of 15%, and hyperhydrated status was defined as ΔHS > 15%.Although there were no significant differences in total body water, extracellular water, or intracellular water among groups, mean amount of volume overload and hyperhydrated status were significantly higher in HD and PD patients compared with control and pre-dialysis patients. Mean amount of volume overload and hyperhydrated status were also significantly associated with higher NT-proBNP and pro-adrenomedullin levels in HD and PD patients, although not with myeloperoxidase or copeptin levels. Furthermore, they were significantly associated with cardiac markers (left ventricular mass index, ejection fraction, and left atrial diameter) in HD and PD patients compared with those in the control and pre-dialysis groups.On the basis of increased plasma NT-proBNP and pro-adrenomedullin concentrations, we might be able to make predictions regarding the volume overload status of dialysis patients, and thereby reduce cardiovascular-related mortality through appropriate early volume control.


Assuntos
Biomarcadores/sangue , Líquidos Corporais/metabolismo , Doenças Cardiovasculares/mortalidade , Disfunção Ventricular Esquerda/fisiopatologia , Adrenomedulina/sangue , Adulto , Composição Corporal/fisiologia , Doenças Cardiovasculares/diagnóstico por imagem , Estudos de Casos e Controles , Diálise/métodos , Diálise/tendências , Ecocardiografia/métodos , Feminino , Glicopeptídeos/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Diálise Peritoneal/estatística & dados numéricos , Peroxidase/sangue , Precursores de Proteínas/sangue , Diálise Renal/estatística & dados numéricos , República da Coreia/epidemiologia , Volume Sistólico , Resultado do Tratamento , Disfunção Ventricular Esquerda/diagnóstico por imagem
7.
J Cardiovasc Magn Reson ; 22(1): 58, 2020 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-32772930

RESUMO

During the peak phase of the COVID-19 pandemic, alterations of standard operating procedures were necessary for health systems to protect patients and healthcare workers and ensure access to vital hospital resources. As the peak phase passes, re-activation plans are required to safely manage increasing clinical volumes. In the context of cardiovascular magnetic resonance (CMR), re-activation objectives include continued performance of urgent CMR studies and resumption of CMR in patients with semi-urgent and elective indications in an environment that is safe for both patients and health care workers.


Assuntos
Betacoronavirus , Doenças Cardiovasculares/diagnóstico por imagem , Infecções por Coronavirus/prevenção & controle , Imagem por Ressonância Magnética/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Sistema Cardiovascular/diagnóstico por imagem , Humanos , Valor Preditivo dos Testes , Sociedades Médicas
8.
Arq Bras Cardiol ; 115(1): 111-126, 2020 07.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32813825

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic is a huge challenge to the health system because of the exponential increase in the number of individuals affected. The rational use of resources and correct and judicious indication for imaging exams and interventional procedures are necessary, prioritizing patient, healthcare personnel, and environmental safety. This review was aimed at guiding health professionals in safely and effectively performing imaging exams and interventional procedures.


Assuntos
Betacoronavirus , Doenças Cardiovasculares/cirurgia , Procedimentos Cirúrgicos Cardiovasculares/estatística & dados numéricos , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Guias de Prática Clínica como Assunto , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/diagnóstico por imagem , Doenças Transmissíveis Emergentes/epidemiologia , Infecções por Coronavirus/epidemiologia , Ecocardiografia , Humanos , Pandemias , Pneumonia Viral/epidemiologia
9.
Indian Heart J ; 72(3): 145-150, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32768012

RESUMO

An echocardiographic investigation is one of the key modalities of diagnosis in cardiology. There has been a rising presence of cardiological comorbidities in patients positive for COVID-19. Hence, it is becoming extremely essential to look into the correct safety precautions, healthcare professionals must take while conducting an echo investigation. The decision matrix formulated for conducting an echocardiographic evaluation is based on presence or absence of cardiological comorbidity vis-à-vis positive, suspected or negative for COVID-19. The safety measures have been constructed keeping in mind the current safety precautions by WHO, CDC and MoHFW, India.


Assuntos
Doenças Cardiovasculares/diagnóstico por imagem , Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar/prevenção & controle , Ecocardiografia/métodos , Pandemias/prevenção & controle , Segurança do Paciente , Pneumonia Viral/prevenção & controle , Cardiologia , Doenças Cardiovasculares/epidemiologia , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Índia , Controle de Infecções/métodos , Masculino , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto , Síndrome Respiratória Aguda Grave/epidemiologia , Síndrome Respiratória Aguda Grave/prevenção & controle , Sociedades Médicas
11.
PLoS One ; 15(8): e0236667, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32756570

RESUMO

BACKGROUND: Obstructive sleep apnea (OSA) is associated with cardiovascular co-morbidities and mortality. Arterial stiffness is an independent predictor of cardiovascular risk and mortality, and is influenced by the presence of OSA and related comorbidities. There is a paucity of data regarding long-term evolution of arterial stiffness in CPAP-treated OSA patients. We aimed to prospectively study long term PWV variations and determinants of PWV deterioration. METHODS: In a prospective obese OSA cohort, at time of diagnosis and after several years of follow-up we collected arterial stiffness measured by carotid-femoral pulse wave velocity (PWV), clinical and metabolic parameters, and CPAP adherence. Univariate and multivariate analyses were performed in order to determine contributing factors. RESULTS: Seventy two OSA patients (men: 52.8%, median age: 55.8 years and median BMI of 38.5 kg/m2) with a prevalence of hypertension: 58.3%, type 2 diabetes: 20.8%, hypercholesterolemia: 33.3%, current or past smoking: 59.7%, were evaluated after a median follow-up of 7.4 [5.8; 8.3] years. Over the period of follow-up, the median increase in PWV was 1.34 [0.10; 2.37] m/s. In multivariate analysis, the increase in PWV was associated with older age (10 extra years was associated with a 5.24 [1.35; 9.12] % increase in PWV) and hypertension (a significant increase in PWV of 8.24 [1.02; 15.57] %). No impact of CPAP adherence on PWV evolution was found. CONCLUSION: PWV progression in CPAP-treated OSA patients is mainly related to pre-existing cardio-metabolic comorbidities and not influenced by CPAP adherence. In this high cardiovascular risk population, it is crucial to associated weight management and exercise with CPAP treatment.


Assuntos
Doenças Cardiovasculares/fisiopatologia , Pressão Positiva Contínua nas Vias Aéreas/efeitos adversos , Obesidade/fisiopatologia , Apneia Obstrutiva do Sono/terapia , Rigidez Vascular/fisiologia , Monitorização Ambulatorial da Pressão Arterial , Doenças Cardiovasculares/diagnóstico por imagem , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Estudos de Coortes , Pressão Positiva Contínua nas Vias Aéreas/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/diagnóstico por imagem , Obesidade/epidemiologia , Polissonografia , Fatores de Risco , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/diagnóstico por imagem , Apneia Obstrutiva do Sono/fisiopatologia
13.
Methodist Debakey Cardiovasc J ; 16(2): 146-154, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32670475

RESUMO

Since early 2020, the world has been facing a pandemic caused by the novel coronavirus SARS-CoV-2. Although this positive single-stranded RNA virus primarily causes pulmonary infection and failure, it has been associated with multiple cardiovascular diseases including troponin elevation, myocarditis, and cardiac arrhythmias. Cardiac patients are susceptible to developing more severe infection from SARS-COV-2, making management complicated. In this review we discuss the cardiac manifestations of COVID-19 infections as well as considerations for the management of primary cardiac pathologies during this pandemic.


Assuntos
Doenças Cardiovasculares/epidemiologia , Causas de Morte , Infecções por Coronavirus/epidemiologia , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Adulto , Fatores Etários , Idoso , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/epidemiologia , Doenças Cardiovasculares/diagnóstico por imagem , China/epidemiologia , Comorbidade , Infecções por Coronavirus/prevenção & controle , Feminino , Saúde Global , Humanos , Imagem Cinética por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/epidemiologia , Miocardite/diagnóstico , Miocardite/epidemiologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Prevalência , Medição de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Análise de Sobrevida , Tomografia Computadorizada por Raios X/métodos , Troponina T/sangue , Populações Vulneráveis/estatística & dados numéricos
14.
Pediatr Clin North Am ; 67(4): 635-639, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32650860

RESUMO

Telehealth is a promising new tool in medicine that has changed the landscape of medical care. The benefits of telehealth technology are immense, including improved access to care and potential savings in monetary and opportunity costs. Current challenges of incorporating telehealth services into regular clinical care include licensure and regulatory barriers, difficulty obtaining insurance reimbursements, and high costs of setting up successful telehealth infrastructures. These challenges threaten telehealth's future scalability and expansion to reach all patients in need.


Assuntos
Doenças Cardiovasculares/diagnóstico por imagem , Exercício Físico , Transplante de Coração , Estado Nutricional , Telemedicina/métodos , Adolescente , Doenças Cardiovasculares/cirurgia , Doenças Cardiovasculares/terapia , Criança , Dietoterapia , Ecocardiografia/métodos , Humanos , Reembolso de Seguro de Saúde , Pais , Telemedicina/economia , Telemedicina/legislação & jurisprudência , Função Ventricular Esquerda , Comunicação por Videoconferência
16.
JACC Cardiovasc Imaging ; 13(7): 1615-1626, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32646721
17.
Methodist Debakey Cardiovasc J ; 16(2): 138-145, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32670474

RESUMO

The number of cardiovascular imaging studies is growing exponentially, and so is the need to improve clinical workflow efficiency and avoid missed diagnoses. With the availability and use of large datasets, artificial intelligence (AI) has the potential to improve patient care at every stage of the imaging chain. Current literature indicates that in the short-term, AI has the capacity to reduce human error and save time in the clinical workflow through automated segmentation of cardiac structures. In the future, AI may expand the informational value of diagnostic images based on images alone or a combination of images and clinical variables, thus facilitating disease detection, prognosis, and decision making. This review describes the role of AI, specifically machine learning, in multimodality imaging, including echocardiography, nuclear imaging, computed tomography, and cardiac magnetic resonance, and highlights current uses of AI as well as potential challenges to its widespread implementation.


Assuntos
Técnicas de Imagem Cardíaca , Doenças Cardiovasculares/diagnóstico por imagem , Diagnóstico por Computador , Interpretação de Imagem Assistida por Computador , Aprendizado de Máquina , Humanos , Imagem Multimodal , Valor Preditivo dos Testes
18.
J Cardiovasc Magn Reson ; 22(1): 53, 2020 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-32684167

RESUMO

BACKGROUND: Conventional 2D inversion recovery (IR) and phase sensitive inversion recovery (PSIR) late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) have been widely incorporated into routine CMR for the assessment of myocardial viability. However, reliable suppression of fat signal, and increased isotropic spatial resolution and volumetric coverage within a clinically feasible scan time remain a challenge. In order to address these challenges, this work proposes a highly efficient respiratory motion-corrected 3D whole-heart water/fat LGE imaging framework. METHODS: An accelerated IR-prepared 3D dual-echo acquisition and motion-corrected reconstruction framework for whole-heart water/fat LGE imaging was developed. The acquisition sequence includes 2D image navigators (iNAV), which are used to track the respiratory motion of the heart and enable 100% scan efficiency. Non-rigid motion information estimated from the 2D iNAVs and from the data itself is integrated into a high-dimensional patch-based undersampled reconstruction technique (HD-PROST), to produce high-resolution water/fat 3D LGE images. A cohort of 20 patients with known or suspected cardiovascular disease was scanned with the proposed 3D water/fat LGE approach. 3D water LGE images were compared to conventional breath-held 2D LGE images (2-chamber, 4-chamber and stack of short-axis views) in terms of image quality (1: full diagnostic to 4: non-diagnostic) and presence of LGE findings. RESULTS: Image quality was considered diagnostic in 18/20 datasets for both 2D and 3D LGE magnitude images, with comparable image quality scores (2D: 2.05 ± 0.72, 3D: 1.88 ± 0.90, p-value = 0.62) and overall agreement in LGE findings. Acquisition time for isotropic high-resolution (1.3mm3) water/fat LGE images was 8.0 ± 1.4 min (3-fold acceleration, 60-88 slices covering the whole heart), while 2D LGE images were acquired in 5.6 ± 2.2 min (12-18 slices, including pauses between breath-holds) albeit with a lower spatial resolution (1.40-1.75 mm in-plane × 8 mm slice thickness). CONCLUSION: A novel framework for motion-corrected whole-heart 3D water/fat LGE imaging has been introduced. The method was validated in patients with known or suspected cardiovascular disease, showing good agreement with conventional breath-held 2D LGE imaging, but offering higher spatial resolution, improved volumetric coverage and good image quality from a free-breathing acquisition with 100% scan efficiency and predictable scan time.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Adiposidade , Água Corporal/química , Doenças Cardiovasculares/diagnóstico por imagem , Meios de Contraste/administração & dosagem , Coração/diagnóstico por imagem , Imageamento Tridimensional , Imagem por Ressonância Magnética , Compostos Organometálicos/administração & dosagem , Tecido Adiposo/fisiopatologia , Adulto , Idoso , Suspensão da Respiração , Técnicas de Imagem de Sincronização Cardíaca , Doenças Cardiovasculares/fisiopatologia , Eletrocardiografia , Feminino , Coração/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes
19.
Int J Cardiovasc Imaging ; 36(11): 2265-2278, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32686028

RESUMO

To assess left ventricular myocardial native T1/T2 values and systolic strain and their associations with B-type natriuretic peptide (BNP) and dialysis vintage in hemodialysis (HD) patients with a preserved left ventricular ejection fraction (LVEF). Forty-three HD patients with end-stage renal disease (ESRD) but a preserved LVEF (≥ 50%) and 28 healthy volunteers were enrolled. BNP was measured at the time of cardiac magnetic resonance (CMR) measurements. Global native T1 and T2 values were significantly higher in the HD patients (native T1: 1056 ± 32 ms vs. 1006 ± 25 ms, p < 0.001; T2: 50 ± 3 ms vs. 46 ± 2 ms, p < 0.001) than in the controls. The mean peak global circumferential strain (GCS) and global longitudinal strain (GLS) were both significantly reduced in the HD patients compared with the controls (GCS: - 13 ± 3 vs. - 16 ± 3, p < 0.001; GLS: - 12 ± 4 vs. - 15 ± 3, p = 0.001). In the HD patients, the global native T1 value showed a positive correlation with the global T2 value (r = 0.311, p = 0.042) and significant correlations with GCS (r = 0.564, p < 0.001) and GLS (r = 0.359, p = 0.018). Significant positive correlations were found between lg BNP levels and T2 values (r = 0.569, p < 0.0001) and the left atrial volume index (LAVI) (r = 0.536, p = 0.012). GLS showed significant positive correlations with the LVMI (r = 0.354, p = 0.020) and dialysis vintage (p = 0.026; r = - 0.339) in the HD patients. HD patients with a preserved LVEF have increased native T1/T2 values and decreased strain compared to controls. T2 values and the LVAI were positively associated with BNP in HD patients.


Assuntos
Doenças Cardiovasculares/diagnóstico por imagem , Falência Renal Crônica/terapia , Imagem Cinética por Ressonância Magnética , Peptídeo Natriurético Encefálico/sangue , Diálise Renal , Volume Sistólico , Função Ventricular Esquerda , Idoso , Biomarcadores/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/fisiopatologia , Estudos de Casos e Controles , Duração da Terapia , Feminino , Humanos , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/fisiopatologia , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Valor Preditivo dos Testes , Estudos Prospectivos , Reprodutibilidade dos Testes
20.
Expert Rev Med Devices ; 17(6): 565-577, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32510252

RESUMO

INTRODUCTION: Artificial intelligence (AI) describes the use of computational techniques to mimic human intelligence. In healthcare, this typically involves large medical datasets being used to predict a diagnosis, identify new disease genotypes or phenotypes, or guide treatment strategies. Noninvasive imaging remains a cornerstone for the diagnosis, risk stratification, and management of patients with cardiovascular disease. AI can facilitate every stage of the imaging process, from acquisition and reconstruction, to segmentation, measurement, interpretation, and subsequent clinical pathways. AREAS COVERED: In this paper, we review state-of-the-art AI techniques and their current applications in cardiac imaging, and discuss the future role of AI as a precision medicine tool. EXPERT OPINION: Cardiovascular medicine is primed for scalable AI applications which can interpret vast amounts of clinical and imaging data in greater depth than ever before. AI-augmented medical systems have the potential to improve workflow and provide reproducible and objective quantitative results which can inform clinical decisions. In the foreseeable future, AI may work in the background of cardiac image analysis software and routine clinical reporting, automatically collecting data and enabling real-time diagnosis and risk stratification.


Assuntos
Inteligência Artificial , Doenças Cardiovasculares/diagnóstico por imagem , Diagnóstico por Imagem , Humanos , Aprendizado de Máquina , Medicina de Precisão , Software
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