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Cardiovascular magnetic resonance imaging, or CMRI, is a non-invasive diagnostic test that employs a magnetic field and radiofrequency waves to create precise images of the heart and arteries. It provides comprehensive information about cardiac anatomy, function, perfusion, and tissue characterization without ionizing radiation.IndicationsCMRI diagnoses various heart conditions, including tissue damage from heart attacks, ischemic heart disease, myocarditis, aortic issues (tears, aneurysms,...
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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking
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Pseudo-infarction pattern in diffuse systemic sclerosis. Evaluation using cardiovascular magnetic resonance.

Sophie Mavrogeni1, Georgia Karabela2, Loukia Koutsogeorgopoulou3

  • 1Onassis Cardiac Surgery Center, Athens, Greece.

International Journal of Cardiology
|April 21, 2016
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Summary

Cardiovascular magnetic resonance (CMR) revealed myocardial fibrosis in diffuse systemic sclerosis (dSSc) patients with Q waves. This fibrosis stems from the systemic disease, not coronary artery disease (CAD).

Keywords:
Cardiovascular magnetic resonanceECGMyocardial fibrosisScleroderma

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Area of Science:

  • Cardiology
  • Radiology
  • Rheumatology

Background:

  • Diffuse systemic sclerosis (dSSc) is a condition marked by vascular damage and fibrosis.
  • Cardiac involvement in dSSc, though often asymptomatic, is a significant cause of mortality, accounting for 36% of deaths.
  • The underlying pathophysiology of Q waves in dSSc patients and their relation to cardiac involvement remains unclear.

Purpose of the Study:

  • To investigate the utility of cardiovascular magnetic resonance (CMR) in elucidating the cause of Q waves in dSSc patients.
  • To differentiate between systemic disease-related fibrosis and coronary artery disease (CAD) as the cause of Q waves.

Main Methods:

  • 105 dSSc patients with atypical symptoms and normal routine assessments underwent ECG and 1.5 T CMR.
  • Biventricular function was assessed using steady-state free-precession (SSFP) sequences.
  • Myocardial fibrosis was identified and quantified using late gadolinium enhancement (LGE) imaging after gadolinium-DTPA injection, expressed as a percentage of left ventricular (LV) mass.

Main Results:

  • Q waves were observed in 25/105 (anterior), 8/105 (inferior), and 5/105 (anterior and inferior) dSSc patients.
  • Patchy intramyocardial LGE was detected in 24/25 patients with anterior Q waves, involving 8±2% of LV mass, primarily in the intraventricular septum and lateral wall.
  • Only one patient had transmural LGE indicative of LAD occlusion; inferior Q waves correlated with inferior wall LGE (5±2% LV mass), and combined Q waves with anterior and inferolateral LGE (9±2% LV mass).

Conclusions:

  • CMR imaging effectively identified myocardial fibrosis in dSSc patients presenting with Q waves.
  • The observed pattern of myocardial fibrosis is attributable to the systemic nature of dSSc, rather than obstructive coronary artery disease (CAD).
  • CMR provides crucial insights into the cardiac manifestations of dSSc, aiding in differential diagnosis and patient management.