“Myocardial transit-time” (MyoTT): a novel and easy-to-perform CMR parameter to assess microvascular disease

AbstractBackgroundMyocardial microvascular disease may occur during the disease course of different cardiac as well as systemic disorders. With the present study, we introduce a novel and easy-to-perform cardiovascular magnetic resonance (CMR) parameter named “myocardial transit-time” (MyoTT).MethodsN = 20 patients with known hypertrophic cardiomyopathy (HCM) andN = 20 control patients without relevant cardiac disease underwent dedicated CMR studies on a 1.5-T MR scanner. The CMR protocol comprised cine and late-gadolinium-enhancement (LGE) imaging as well as first-pass perfusion acquisitions at rest for MyoTT measurement. MyoTT was defined as the blood circulation time from the orifice of the coronary arteries to the pooling in the coronary sinus (CS), and accordingly measured as the temporal difference between the appearances of CMR contrast agent in the aortic root and the CS reflecting the transit-time of gadolinium in the myocardial microvascu lature.ResultsPatients with HCM had a significantly prolonged MyoTT compared to controls (11.0 (9.1 –14.5) s vs. 6.5 (4.8–8.4) s,p 
Source: Clinical Research in Cardiology - Category: Cardiology Source Type: research

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This study evaluated the diagnostic value of the novel cardiovascular magnetic resonance (CMR) parameter “myocardial transit-time” (MyoTT) in distinguishing cardiac amyloidosis from other hypertrophic cardiomyopathies.MethodsN  = 20 patients with biopsy-proven cardiac amyloidosis (CA),N  = 20 patients with known hypertrophic cardiomyopathy (HCM), andN  = 20 control patients without relevant cardiac disease underwent dedicated CMR studies on a 1.5-T MR scanner. The CMR protocol comprised cine and late-gadolinium-enhancement (LGE) imaging as well as first-pass perfusion a...
Source: Clinical Research in Cardiology - Category: Cardiology Source Type: research
AbstractPurpose of ReviewMagnetic resonance imaging (MRI) has enabled non-invasive myocardial tissue characterization in a wide range of cardiovascular diseases by quantifying several tissue specific parameters such as T1, T2, and T2* relaxation times. Simultaneous assessment of these parameters has recently gained interest to potentially improve diagnostic accuracy and enable further understanding of the underlying disease. However, these quantitative maps are usually acquired sequentially and are not necessarily co-registered, making multi-parametric analysis challenging. Magnetic resonance fingerprinting (MRF) has been ...
Source: Current Cardiology Reports - Category: Cardiology Source Type: research
ConclusionThe SD algorithm in cases of HCM may not be able to correctly assess wall thickness and LV volume. Our study suggests that the OSEM is more suitable in cases of HCM than the SD algorithm.
Source: Journal of Nuclear Cardiology - Category: Nuclear Medicine Source Type: research
AbstractPurpose of ReviewIn hypertrophic cardiomyopathy (HCM), the presence of vessel abnormalities with microvascular dysfunction is a well-known feature. The aim of this review is to present the evidences that support this notion and to describe the physiopathologic and clinical consequences of microvascular dysfunction.Recent FindingsAfter having demonstrated the presence and significance of microvascular dysfunction in HCM, the myocardial blood flow (MBF) measurement by positron emission tomography (PET) is ready to develop into a clinical tool for disease evaluation, in particular for patient prognostication. Alternat...
Source: Current Cardiovascular Imaging Reports - Category: Radiology Source Type: research
ConclusionPET-LVCD reflects greater degree of myopathy and microvascular dysfunction in HCM. Differences in the cardiac effects of exercise and vasodilators and timing of stress-image acquisition could underlie discordance in ischemic EKG changes and LVCD by ECHO and PET, in HCM.
Source: Journal of Nuclear Cardiology - Category: Nuclear Medicine Source Type: research
Hypertrophic cardiomyopathy (HC) patients are at increased risk for sudden cardiac death (SCD). Abnormalities in myocardial blood flow (MBF) detected by positron emission tomography (PET) are common in HC, but a PET marker that identifies patients at risk for SCD is lacking. We hypothesized that disparities in regional myocardial perfusion detected by PET would identify HC patients at risk for ventricular arrhythmias. In order to test this hypothesis, we quantified global and regional MBF by 13NH3-PET at rest/stress, and developed a heterogeneity index to assess MBF heterogeneity, in 133 symptomatic HC patients.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Patients with hypertrophic cardiomyopathy (HC) are at increased risk of sudden cardiac death. Abnormalities in myocardial blood flow (MBF) detected by positron emission tomography (PET) are common in HC, but a PET marker that identifies patients at risk of sudden cardiac death is lacking. We hypothesized that disparities in regional myocardial perfusion detected by PET would identify patients with HC at risk of ventricular arrhythmias. To test this hypothesis, we quantified global and regional MBFs by 13NH3-PET at rest and at stress, and developed a heterogeneity index to assess MBF heterogeneity in 133 symptomatic patients with HC.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
ConclusionsAnatomic characteristics specific to HCM hearts contribute to lower correlations between MBF/MFR values obtained by PMod and QPET, compared with non-HCM patients. These differences indicate that PMod and QPET cannot be used interchangeably for MBF/MFR analyses in HCM patients.
Source: Journal of Nuclear Cardiology - Category: Nuclear Medicine Source Type: research
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Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Source Type: blogs
AbstractPurposeApical wall thickening with an “ace-of-spades” configuration is a unique sign of apical hypertrophic cardiomyopathy (AHCM). We investigated spade-shaped FDG uptake around the left ventricular apex (SSUA) incidentally found in routine oncological FDG PET.MethodsCases showing SSUA were selected based on retrospective review. The pattern or intensity of SSUA was compared with the results of electrocardiogram (ECG), echocardiography, and stress myocardial perfusion SPECT. The diagnosis of ACHM was based on the presence of giant negative T wave in ECG, thickness of spade-shaped hypertrophy in the apex...
Source: Annals of Nuclear Medicine - Category: Nuclear Medicine Source Type: research
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