Challenging Occam’s razor: An unusual combination of sarcoidosis and amyloidosis. The value of CMR in infiltrative cardiomyopathies

We describe the case of a 66-year old woman with the extremely rare combination of sarcoidosis-amyloidosis (light-chain) and the important role of cardiovascular magnetic resonance imaging to differentiate between these two infiltrative diseases. Myocardial characterization with T1 mapping can improve disease detection especially in overlap cases and possibly obviate the need for cardiac biopsy

Outcome in Dilated Cardiomyopathy Related to the Extent, Location, and Pattern of Late Gadolinium Enhancement.

OBJECTIVES: This study sought to investigate the association between the extent, location, and pattern of late gadolinium enhancement (LGE) and outcome in a large dilated cardiomyopathy (DCM) cohort. BACKGROUND: The relationship between LGE and prognosis in DCM is incompletely understood. METHODS: The authors examined the association between LGE and all-cause mortality and a sudden cardiac death (SCD) composite based on the extent, location, and pattern of LGE in DCM. RESULTS: Of 874 patients (588 men, median age 52 years) followed for a median of 4.9 years, 300 (34.3%) had nonischemic LGE. Estimated adjusted hazard ratios for patients with an LGE extent of 0 to 2.55%, 2.55% to 5.10%, and >5.10%, respectively, were 1.59 (95% confidence interval [CI]: 0.99 to 2.55), 1.56 (95% CI: 0.96 to 2.54), and 2.31 (95% CI: 1.50 to 3.55) for all-cause mortality, and 2.79 (95% CI: 1.42 to 5.49), 3.86 (95% CI: 2.09 to 7.13), and 4.87 (95% CI: 2.78 to 8.53) for the SCD endpoint. There was a marked nonlinear relationship between LGE extent and outcome such that even small amounts of LGE predicted a substantial increase in risk. The presence of septal LGE was associated with increased mortality, but SCD was most associated with the combined presence of septal and free-wall LGE. Predictive models using LGE presence and location were superior to models based on LGE extent or pattern. CONCLUSIONS: In DCM, the presence of septal LGE is associated with a large increase in the risk of death and SCD events, even when the extent is small. SCD risk is greatest with concomitant septal and free-wall LGE. The incremental value of LGE extent beyond small amounts and LGE pattern is limited

Sex‐ and age‐based differences in the natural history and outcome of dilated cardiomyopathy

Aim: To evaluate the relationship between sex, age and outcome in dilated cardiomyopathy (DCM). Methods and results: We used proportional hazard modelling to examine the association between sex, age and all‐cause mortality in consecutive patients with DCM. Overall, 881 patients (290 women, median age 52 years) were followed for a median of 4.9 years. Women were more likely to present with heart failure (64.0% vs. 54.5%; P = 0.007) and had more severe symptoms (P 60 years of age was driven by non‐sudden death. Conclusion: Women with DCM have better survival compared to men, which may partly be due to less severe left ventricular dysfunction and a smaller scar burden. There is increased mortality driven by non‐sudden death in patients >60 years of age that is less marked in women. Outcomes with contemporary treatment were favourable, with a low incidence of sudden death

CARDIAC SARCOIDOSIS IN AN ADULT PERSON WITH CYSTIC FIBROSIS: A CASE REPORT

Cardiac sarcoidosis and cystic fibrosis (CF) are both rare conditions and their co-existence has not previously been noted in adults. For the first time we report a case of isolated cardiac sarcoidosis in a woman with CF, and discuss the possible combined aetiological factors. As the life expectancy of people with CF continues to increase, clinicians should be aware of the emergence of concomitant inflammatory conditions typically diagnosed in adulthood, and the diagnostic challenges this may present

Gender discrepancy in research activities during radiology residency

Vernuccio, Federica/0000-0003-0350-1794; Arzanauskaite, Monika/0000-0002-4004-4150; Shelmerdine, Susan/0000-0001-6642-9967WOS: 000503697500001PubMed: 31865450Objective To investigate the presence of gender disparity in academic involvement during radiology residency and to identify and characterize any gender differences in perceived barriers for conducting research. Methods An international call for participation in an online survey was promoted via social media and through multiple international and national radiological societies. A 35-question survey invited radiology trainees worldwide to answer questions regarding exposure and barriers to academic radiology during their training. Gender differences in response proportions were analyzed using either Fisher's exact or chi-squared tests. Results Eight hundred fifty-eight participants (438 men, 420 women) from Europe (432), Asia (241), North and South America (144), Africa (37), and Oceania (4) completed the survey. Fewer women radiology residents were involved in research during residency (44.3%, 186/420 vs 59.4%, 260/438; p <= 0.0001) and had fewer published original articles (27.9%, 117/420 vs. 40.2%, 176/438; p = 0.001). Women were more likely to declare gender as a barrier to research (24.3%, 102/420 vs. 6.8%, 30/438; p < 0.0001) and lacked mentorship/support from faculty (65%, 273/420 vs. 55.7%, 244/438; p = 0.0055). Men were more likely to declare a lack of time (60.3%, 264/438 vs. 50.7%, 213/420; p = 0.0049) and lack of personal interest (21%, 92/438 vs. 13.6%, 57/420, p = 0.0041) in conducting research. Conclusion Fewer women were involved in academic activities during radiology residency, resulting in fewer original published studies compared to their men counterparts. This is indicative of an inherent gender imbalance. Lack of mentorship reported by women radiologists was a main barrier to research