Quantitative characterization of myocardial infarction by cardiovascular magnetic resonance predicts future cardiovascular events in patients with ischemic cardiomyopathy

<p>Abstract</p> <p>Background</p> <p>Cardiovascular magnetic resonance (CMR) can provide quantitative data of the myocardial tissue utilizing high spatial and temporal resolution along with exquisite tissue contrast. Previous studies have correlated myocardial scar tissue with the occurrence of ventricular arrhythmia. This study was conducted to evaluate whether characterization of myocardial infarction by CMR can predict cardiovascular events in patients with ischemic cardiomyopathy (ICM).</p> <p>Results</p> <p>We consecutively studied 86 patients with ICM (LVEF < 50%, mean LVEF: 26 ± 12%) with CMR before revascularization or medication therapy ± implantable cardiac defibrillator, determined the amount of myocardial scar, and followed for development of cardiovascular events. Thirty-three patients (38%) had cardiovascular events (mean follow-up: 20 ± 16 months). Patients who developed cardiovascular events had larger scar volume and scar percentage of the myocardium than those who did not develop cardiovascular events (16.8 ± 12.4 cm3 vs. 11.7 ± 12.6 cm3, p = 0.023 and 10.2 ± 6.9% vs. 7.2 ± 6.7%, p = 0.037, respectively). There were no significant differences in LVEDV, LVESV and LVEF between the patients with and without cardiovascular events (231 ± 76 ml vs. 230 ± 88 ml; 180 ± 73 ml vs. 175 ± 90 ml; and 25 ± 10% vs. 27 ± 13%, respectively).</p> <p>Conclusion</p> <p>Quantification of the scar volume and scar percentage by CMR is superior to LVEDV, LVESV, and LVEF in prognosticating the future likelihood of the development of cardiovascular events in patients with ICM.</p

Nasal continuous positive airway pressure improves myocardial perfusion reserve and endothelial-dependent vasodilation in patients with obstructive sleep apnea

<p>Abstract</p> <p>Background</p> <p>Obstructive sleep apnea (OSA) has been associated with cardiovascular disease (CVD), but whether OSA is an independent risk factor for CVD is controversial. The purpose of this study is to determine if patients with OSA have subclinical cardiovascular disease that is detectable by multi-modality cardiovascular imaging and whether these abnormalities improve after nasal continuous positive airway pressure (nCPAP).</p> <p>Results</p> <p>Of the 35 consecutive subjects with newly diagnosed moderate to severe OSA recruited from the Stanford Sleep Disorders Clinic, 20 patients were randomized to active vs. sham nCPAP. Active nCPAP was titrated to pressures that would prevent sleep disordered breathing based on inpatient polysomnography. OSA patients had baseline vascular function abnormalities including decreased myocardial perfusion reserve (MPR), brachial flow mediated dilation (FMD) and nitroglycerin-induced coronary vasodilation. Patients randomized to active nCPAP had improvement of MPR (1.5 ± 0.5 vs. 3.0 ± 1.3, p = 0.02) and brachial FMD (2.5% ± 5.7% vs. 9.0% ± 6.5%, p = 0.03) after treatment, but those randomized to sham nCPAP showed no significant improvement. There were no significant changes seen in chamber sizes, systolic and diastolic function, valvular function and coronary vasodilation to nitroglycerin.</p> <p>Conclusions</p> <p>Patients with moderate to severe OSA had decreased MPR and brachial FMD that improved after 3 months of nCPAP. These findings suggest that relief of apnea in OSA may improve microvascular disease and endothelial dysfunction, which may prevent the development of overt cardiovascular disease. Further study in a larger patient population may be warranted.</p

Quantitative characterization of myocardial infarction by cardiovascular magnetic resonance predicts future cardiovascular events in patients with ischemic cardiomyopathy-1

<p><b>Copyright information:</b></p><p>Taken from "Quantitative characterization of myocardial infarction by cardiovascular magnetic resonance predicts future cardiovascular events in patients with ischemic cardiomyopathy"</p><p>http://www.jcmr-online.com/content/10/1/17</p><p>Journal of Cardiovascular Magnetic Resonance 2008;10(1):17-17.</p><p>Published online 9 Apr 2008</p><p>PMCID:PMC2322993.</p><p></p

Quantitative characterization of myocardial infarction by cardiovascular magnetic resonance predicts future cardiovascular events in patients with ischemic cardiomyopathy-0

<p><b>Copyright information:</b></p><p>Taken from "Quantitative characterization of myocardial infarction by cardiovascular magnetic resonance predicts future cardiovascular events in patients with ischemic cardiomyopathy"</p><p>http://www.jcmr-online.com/content/10/1/17</p><p>Journal of Cardiovascular Magnetic Resonance 2008;10(1):17-17.</p><p>Published online 9 Apr 2008</p><p>PMCID:PMC2322993.</p><p></p

Quantitative characterization of myocardial infarction by cardiovascular magnetic resonance predicts future cardiovascular events in patients with ischemic cardiomyopathy-2

<p><b>Copyright information:</b></p><p>Taken from "Quantitative characterization of myocardial infarction by cardiovascular magnetic resonance predicts future cardiovascular events in patients with ischemic cardiomyopathy"</p><p>http://www.jcmr-online.com/content/10/1/17</p><p>Journal of Cardiovascular Magnetic Resonance 2008;10(1):17-17.</p><p>Published online 9 Apr 2008</p><p>PMCID:PMC2322993.</p><p></p