Reference values for healthy human myocardium using a T1 mapping methodology: results from the International T1 Multicenter cardiovascular magnetic resonance study

BACKGROUND:T1 mapping is a robust and highly reproducible application to quantify myocardial relaxation of longitudinal magnetisation. Available T1 mapping methods are presently site and vendor specific, with variable accuracy and precision of T1 values between the systems and sequences. We assessed the transferability of a T1 mapping method and determined the reference values of healthy human myocardium in a multicenter setting.METHODS:Healthy subjects (n = 102; mean age 41 years (range 17-83), male, n = 53 (52%)), with no previous medical history, and normotensive low risk subjects (n=113) referred for clinical cardiovascular magnetic resonance (CMR) were examined. Further inclusion criteria for all were absence of regular medication and subsequently normal findings of routine CMR. All subjects underwent T1 mapping using a uniform imaging set-up (modified Look- Locker inversion recovery, MOLLI, using scheme 3(3)3(3)5)) on 1.5 Tesla (T) and 3 T Philips scanners. Native T1-maps were acquired in a single midventricular short axis slice and repeated 20 minutes following gadobutrol. Reference values were obtained for native T1 and gadolinium-based partition coefficients, lambda and extracellular volume fraction (ECV) in a core lab using standardized postprocessing.RESULTS:In healthy controls, mean native T1 values were 950 +/- 21 msec at 1.5 T and 1052 +/- 23 at 3 T. lambda and ECV values were 0.44 +/- 0.06 and 0.25 +/- 0.04 at 1.5 T, and 0.44 +/- 0.07 and 0.26 +/- 0.04 at 3 T, respectively. There were no significant differences between healthy controls and low risk subjects in routine CMR parameters and T1 values. The entire cohort showed no correlation between age, gender and native T1. Cross-center comparisons of mean values showed no significant difference for any of the T1 indices at any field strength. There were considerable regional differences in segmental T1 values. lambda and ECV were found to be dose dependent. There was excellent inter- and intraobserver reproducibility for measurement of native septal T1.CONCLUSION:We show transferability for a unifying T1 mapping methodology in a multicenter setting. We provide reference ranges for T1 values in healthy human myocardium, which can be applied across participating sites

Arrhythmia and death following percutaneous revascularization in ischemic left ventricular dysfunction: Prespecified analyses from the REVIVED-BCIS2 trial

BACKGROUND: Ventricular arrhythmia is an important cause of mortality in patients with ischemic left ventricular dysfunction. Revascularization with coronary artery bypass graft or percutaneous coronary intervention is often recommended for these patients before implantation of a cardiac defibrillator because it is assumed that this may reduce the incidence of fatal and potentially fatal ventricular arrhythmias, although this premise has not been evaluated in a randomized trial to date. METHODS: Patients with severe left ventricular dysfunction, extensive coronary disease, and viable myocardium were randomly assigned to receive either percutaneous coronary intervention (PCI) plus optimal medical and device therapy (OMT) or OMT alone. The composite primary outcome was all-cause death or aborted sudden death (defined as an appropriate implantable cardioverter defibrillator therapy or a resuscitated cardiac arrest) at a minimum of 24 months, analyzed as time to first event on an intention-to-treat basis. Secondary outcomes included cardiovascular death or aborted sudden death, appropriate implantable cardioverter defibrillator (ICD) therapy or sustained ventricular arrhythmia, and number of appropriate ICD therapies. RESULTS: Between August 28, 2013, and March 19, 2020, 700 patients were enrolled across 40 centers in the United Kingdom. A total of 347 patients were assigned to the PCI+OMT group and 353 to the OMT alone group. The mean age of participants was 69 years; 88% were male; 56% had hypertension; 41% had diabetes; and 53% had a clinical history of myocardial infarction. The median left ventricular ejection fraction was 28%; 53.1% had an implantable defibrillator inserted before randomization or during follow-up. All-cause death or aborted sudden death occurred in 144 patients (41.6%) in the PCI group and 142 patients (40.2%) in the OMT group (hazard ratio, 1.03 [95% CI, 0.82–1.30]; P =0.80). There was no between-group difference in the occurrence of any of the secondary outcomes. CONCLUSIONS: PCI was not associated with a reduction in all-cause mortality or aborted sudden death. In patients with ischemic cardiomyopathy, PCI is not beneficial solely for the purpose of reducing potentially fatal ventricular arrhythmias. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01920048

At Home in the Revolution :What Women Said and Did in 1916

https://digitalcommons.montclair.edu/all_books/1112/thumbnail.jp

Poets & the Peacock Dinner : The Literary History of a Meal

https://digitalcommons.montclair.edu/all_books/1164/thumbnail.jp

A Box for Wilfrid Blunt

This essay analyzes the testimonial occasion organized by Lady Gregory, Yeats, and Pound to honor the poet and anti-imperialist Wilfrid Scawen Blunt (1840-1922). On 18 January 1914, Blunt welcomed six younger poets to his house in Sussex, where they dined on a peacock culled from his flock. At the ritual center of the meal was the presentation to Blunt of a marble box containing his guests\u27 poems; on the top of the box, designed by Gaudier-Brzeska, was a reclining nude woman. The dinner had a double purpose: to construct a poetic genealogy that would give meaning to a distinctly masculine literary tradition and to make that genealogy visible. Accounts of the event were planted in four journals, and the famous photograph, with the tall, impressively bearded Blunt surrounded by his scions, appears in all the poets\u27 biographies. With its potent combination of homosocial intimacy and artistic glamour, the peacock dinner claimed an important place in its participants\u27 memories and resonated in their writing for many years

Augusta Gregory, Bernard Shaw, and the Shewing-Up of Dublin Castle

In 1909 the lord lieutenant of Ireland attempted to prevent the Abbey Theatre from producing Bernard Shaw\u27s Shewing-Up of Blanco Posnet because the English lord chamberlain had denied the play a license. Shaw and the Abbey directors Lady Gregory and W. B. Yeats seized the opportunity to contest the extension of English censorship to Ireland. With their genius for hype, they produced the spectacle of their resistance, winning nationalist support for the Abbey. The triumphant first performance was a multivalent occasion, the season\u27s most stylish and seditious event. Gregory filled the theater with Dublin Castle society, members of the very state apparatus that had tried to stop the production; but in meetings with Castle officials and in Abbey press releases, she adopted the idiom of the Irish rebel tradition. Like those other Irish happenings the speech from the dock and the graveside oration, this event was staged not only for its immediate audience but for the Irish people of the future