Angiolymphoid Hyperplasia With Eosinophilia‐Acquired Port‐Wine‐Stain–Like Lesions: Attempt At Treatment With The Argon Laser

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/110832/1/hed00011.pd

A consensus statement by the Society for Cardiovascular Magnetic Resonance (SCMR) endorsed by the European Association for Cardiovascular Imaging (EACVI)

Parametric mapping techniques provide a non-invasive tool for quantifying tissue alterations in myocardial disease in those eligible for cardiovascular magnetic resonance (CMR). Parametric mapping with CMR now permits the routine spatial visualization and quantification of changes in myocardial composition based on changes in T1, T2, and T2*(star) relaxation times and extracellular volume (ECV). These changes include specific disease pathways related to mainly intracellular disturbances of the cardiomyocyte (e.g., iron overload, or glycosphingolipid accumulation in Anderson-Fabry disease); extracellular disturbances in the myocardial interstitium (e.g., myocardial fibrosis or cardiac amyloidosis from accumulation of collagen or amyloid proteins, respectively); or both (myocardial edema with increased intracellular and/or extracellular water). Parametric mapping promises improvements in patient care through advances in quantitative diagnostics, inter- and intra-patient comparability, and relatedly improvements in treatment. There is a multitude of technical approaches and potential applications. This document provides a summary of the existing evidence for the clinical value of parametric mapping in the heart as of mid 2017, and gives recommendations for practical use in different clinical scenarios for scientists, clinicians, and CMR manufacturers

T1 and ECV Mapping in Myocardial Disease

T1 mapping using cardiovascular magnetic resonance (CMR) introduces novel techniques for myocardial tissue characterization to detect and quantify disease processes occurring at the microscopic level. Even though T1 mapping has limited spatial resolution, cellular and molecular changes occurring within each voxel can affect the aggregate T1 signal rendering them quantifiable. The estimated T1-based parameters quantified on a “map” demonstrate the spatial localization of these changes whereby each pixel expresses the quantitative value of that parameter. This quantification permits detection of diffuse disease even if it is not directly visible. Rather than relying on nonspecific functional measures, T1 mapping focuses on intrinsic changes of myocardial composition that advances understanding about specific disease pathways. These changes in myocardial tissue composition inform diagnosis and prognosis. T1 mapping encompasses two key parameters: native (i.e., precontrast) T1 and extracellular volume fraction (ECV) derived from additional postcontrast T1 and blood T1 measurements. These advances introduce new tools to detect focal and diffuse myocardial derangements occurring in cardiac disease that can be otherwise difficult to detect. T1 and ECV mapping foster precision medicine and personalized care, promising to improve patient outcomes through targeted therapy. Capitalizing on the opportunities introduced by T1 mapping and ECV requires further investigation

Extracellular volume fraction is associated with B-type natriuretic peptide in hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy is a common cardiovascular genetic disease characterized by sarcomeric gene mutations which lead to findings of cardiac hypertrophy, myocyte disarray, and fibrosis. While late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) detects focal, macroscopic regions of replacement fibrosis non-invasively, novel T1 CMR measurement techniques including extracellular volume fraction (ECV) diffuse interstitial fibrosis throughout the myocardium. Plasma B-type natriuretic peptide levels are often elevated in situations of increased wall tension and volume overload. Given that such states may be associated with myocardial fibrosis, and because BNP levels provide independent prognostic insight in HCM, we sought to determine the association between BNP and ECV measurement by CMR

Feasibility of the REDCap platform for Single Center and Collaborative Multicenter CMR Research

REDCap (Research Enterprise Data CAPture) software may provide a feasible platform for CMR Centers to: a) capture clinical throughput securely for research purposes, and 2) collaborate using a common platform for either distributed or centralized data storage. REDCap may facilitate CMR Centers' participation in the research enterprise, especially those with limited resources. REDCap may catalyze multicenter studies with "distributed data collection" where CMR sites can clone shared data dictionaries across sites for subsequent compilation into a singular master data file

The global cardiovascular magnetic resonance registry (GCMR) of the society for cardiovascular magnetic resonance (SCMR): its goals, rationale, data infrastructure, and current developments

BACKGROUND: With multifaceted imaging capabilities, cardiovascular magnetic resonance (CMR) is playing a progressively increasing role in the management of various cardiac conditions. A global registry that harmonizes data from international centers, with participation policies that aim to be open and inclusive of all CMR programs, can support future evidence-based growth in CMR. METHODS: The Global CMR Registry (GCMR) was established in 2013 under the auspices of the Society for Cardiovascular Magnetic Resonance (SCMR). The GCMR team has developed a web-based data infrastructure, data use policy and participation agreement, data-harmonizing methods, and site-training tools based on results from an international survey of CMR programs. RESULTS: At present, 17 CMR programs have established a legal agreement to participate in GCMR, amongst them 10 have contributed CMR data, totaling 62,456 studies. There is currently a predominance of CMR centers with more than 10 years of experience (65%), and the majority are located in the United States (63%). The most common clinical indications for CMR have included assessment of cardiomyopathy (21%), myocardial viability (16%), stress CMR perfusion for chest pain syndromes (16%), and evaluation of etiology of arrhythmias or planning of electrophysiological studies (15%) with assessment of cardiomyopathy representing the most rapidly growing indication in the past decade. Most CMR studies involved the use of gadolinium-based contrast media (95%). CONCLUSION: We present the goals, mission and vision, infrastructure, preliminary results, and challenges of the GCMR. TRIAL REGISTRATION: Identification number on ClinicalTrials.gov: NCT02806193. Registered 17 June 2016