Impaired Myocardial Perfusion from Persistent Mammary Side Branches: A Role for Functional Imaging and Embolization

The diagnosis and management of ischemic symptoms in patients after coronary artery bypass surgery can be challenging. It has been hypothesized that persistent branches of the internal mammary artery can divert flow from the left anterior descending artery and cause symptoms. We present a case in which successful coil embolization of a side branch improved flow and clinical symptoms. Side branch embolization might be a useful treatment option and should be considered in the management of symptomatic patients with a patent mammary graft

1110 Improved real-time cine with the use of a 32-channel cardiac array and Karhunen-Loeve Transform filter

This is the author accepted manuscript. The final version is available from SAGE Publications via the DOI in this record.Leader-member exchange (LMX) theory proposes that leaders develop different quality relationships with those they manage and this is predictive of work performance. While LMX quality has been viewed as univalent (ranging from low to high quality), this paper proposes that it can also be bivalent in nature (i.e., coexisting positive and negative thoughts towards the relationship), which we refer to as LMX ambivalence. A survey measure of LMX ambivalence is developed, and through three validation and two main studies, it is shown to have construct, discriminant, and incremental predictive validity beyond that of LMX quality. Hypotheses concerning LMX ambivalence and task performance are tested in two main studies and show that (1) LMX ambivalence is negatively related to performance regardless of LMX quality, (2) high levels of perceived support from the organization (Study 1) or coworkers (Study 2) nullify the negative association between LMX ambivalence and performance, and (3) high LMX ambivalence leads to more negative affect and in turn lower task performance, but only when coworker support is low (Study 2). These results show the importance of viewing LMX quality not only in terms of its absolute level (low vs. high quality) but also as a bivalent construct where both positive and negative cognitions can coexist. They also demonstrate the value of social support in buffering the negative effects of LMX ambivalence. Furthermore, our findings extend a central tenet of LMX theory by implying that LMX quality varies not only within groups (i.e., LMX differentiation) but also within leader-follower dyads

Rapid phase-modulated water excitation steady-state free precession for fat suppressed cine cardiovascular MR

<p>Abstract</p> <p>Background</p> <p>The purpose of this article is to describe a steady-state free precession (SSFP) sequence for fat-suppressed cine cardiovascular magnetic resonance (CMR). A rapid phase-modulated binomial water-excitation (WE) pulse is utilized to minimize repetition time and acquisition time.</p> <p>Methods</p> <p>Three different water-excitation pulses were combined with cine-SSFP for evaluation. The frequency response of each sequence was simulated and examined in phantom imaging studies. The ratio of fat to water signal amplitude was measured in phantoms to evaluate the fat-suppression capabilities of each method. Six volunteers underwent CMR of the heart at 1.5T to compare retrospectively-gated cine-SSFP with and without water-excitation. The ratio of fat to myocardium signal amplitude was measured for conventional cine-SSFP and phase-modulated WE-SSFP. The proposed WE-SSFP method was tested in one patient referred for CMR to characterize a cardiac mass.</p> <p>Results and discussion</p> <p>The measured frequency response in a phantom corresponded to the numerical Bloch equation simulation demonstrating the widened stop-band around the fat resonant frequency for all water-excitation pulses tested. <it>In vivo </it>measurements demonstrated that a rapid, phase-modulated water-excitation pulse significantly reduced the signal amplitude ratio of fat to myocardium from 6.92 ± 2.9 to 0.8 ± 0.13 (mean ± SD) without inducing any perceptible artifacts in SSFP cine CMR.</p> <p>Conclusion</p> <p>fat-suppression can be achieved in SSFP cine CMR while maintaining steady-state equilibrium using rapid, phase modulated, binomial water-excitation pulses.</p

Preoperative Assessment of Anomalous Right Coronary Artery Arising from the Main Pulmonary Artery

Anomalous origin of the right coronary artery from the pulmonary artery is a rare condition. Two cases are presented in this paper. One case was treated by ligation and coronary artery bypass. The other was treated by direct reimplantation of the anomalous coronary artery into the aorta

Truncus arteriosus with aortic arch interruption: cardiovascular magnetic resonance findings in the unrepaired adult

Truncus arteriosus (TA) is a rare congenital condition defined as a single arterial vessel arising from the heart that gives origin to the systemic, pulmonary and coronary circulations. We discuss the unique case of a 28 year-old female patient with unrepaired TA and interruption of the aortic arch who underwent cardiovascular magnetic resonance (CMR)

Cardiac function and myocardial perfusion immediately following maximal treadmill exercise inside the MRI room

Treadmill exercise stress testing is an essential tool in the prevention, detection, and treatment of a broad spectrum of cardiovascular disease. After maximal exercise, cardiac images at peak stress are typically acquired using nuclear scintigraphy or echocardiography, both of which have inherent limitations. Although CMR offers superior image quality, the lack of MRI-compatible exercise and monitoring equipment has prevented the realization of treadmill exercise CMR