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1. Magnetic resonance assessment of left ventricular volumes and mass using a single-breath-hold 3D k-t BLAST cine b-SSFP in comparison with multiple-breath-hold 2D cine b-SSFP

Author

Niels van Pelt, Robert-Jan van Geuns, Alexia Rossi, Koen Nieman, Erica Maffei, Jan Bogaert, Chiara Martini, Filippo Cademartiri, Giancarlo Messalli, Nico R. Mollet, Annachiara Aldrovandi, Annick C. Weustink, Massimo Imbriaco, Maffei, E, Messalli, G, Martini, C, Rossi, A, van Pelt, N, van Geuns, Rj, Weustink, Ac, Mollet, Nr, Nieman, K, Aldrovandi, A, Imbriaco, Massimo, Bogaert, J, and Cademartiri, F.

Subjects
Ejection fraction, Science & Technology, medicine.diagnostic_test, business.industry, Radiology, Nuclear Medicine & Medical Imaging, Magnetic resonance imaging, Single breath, Left ventricle, 3D b-SSFP, Volumetric quantification, k-t BLAST, medicine, Original Article, Radiology, Nuclear Medicine and imaging, business, Nuclear medicine, Life Sciences & Biomedicine, Cardiac MRI, 2D b-SSFP, Gradient echo
Abstract

OBJECTIVE: To assess the feasibility of single-breath-hold three-dimensional cine b-SSFP (balanced steady-state free precession gradient echo) sequence (3D-cine), accelerated with k-t BLAST (broad-use linear acquisition speed-up technique), compared with multiple-breath-hold 2D cine b-SSFP (2D-cine) sequence for assessment of left ventricular (LV) function. METHODS: Imaging was performed using 1.5-T MRI (Achieva, Philips, The Netherlands) in 46 patients with different cardiac diseases. Global functional parameters, LV mass, imaging time and reporting time were evaluated and compared in each patient. RESULTS: Functional parameters and mass were significantly different in the two sequences [3D end-diastolic volume (EDV) = 129 ± 44 ml vs 2D EDV = 134 ± 49 ml; 3D end-systolic volume (ESV) = 77 ± 44 ml vs 2D ESV = 73 ± 50 ml; 3D ejection fraction (EF) = 43 ± 15% vs 2D EF = 48 ± 15%; p

Published
2010
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2. Prognostic value of CT coronary angiography in diabetic and non-diabetic subjects with suspected CAD: importance of presenting symptoms.

Author

Maffei E, Seitun S, Martini C, Guaricci AI, Tarantini G, van Pelt N, Weustink AC, Mollet NR, Berti E, Grilli R, Messalli G, Aldrovandi A, and Cademartiri F

Abstract

Aim: To assess the prognostic relevance of 64-slice computed tomography coronary angiography (CT-CA) and symptoms in diabetics and non-diabetics referred for cardiac evaluation., Methods: We followed 210 patients with diabetes type 2 (DM) and 203 non-diabetic patients referred for CT-CA for ruling out coronary artery disease (CAD). Patients were without known history of CAD and were divided into four categories on the basis of symptoms at presentation (none, atypical angina, typical angina and dyspnoea). Clinical end points were major cardiac events (MACE): cardiac-related death, non-fatal myocardial infarction, unstable angina and cardiac revascularizations. Cox proportional hazard models, with and without adjustment for risk factors and multiplicative interaction term (obstructive CAD × DM), were developed to predict outcome., Results: DM patients with dyspnoea or who were asymptomatic showed a higher prevalence of obstructive CAD than non-diabetics (p ≤ 0.01). At mean follow-up of 20.4 months, DM patients had worse cardiac event-free survival in comparison with non-DM patients (90% vs. 81%, p = 0.02). In multivariate analysis, CT-CA evidence of obstructive CAD (in DM patients: HR: 6.4; 95% CI: 2.3-17.5; p < 0.001; in non-DM patients: HR: 7.4; 95% CI: 2.1-26.7; p = 0.002) and the presence of typical angina (in DM patients: HR: 2.9; 95% CI: 1.3-6.3; p = 0.007; in non-DM patients: HR: 2.7; 95% CI: 1.1-7.1; p = 0.03) were independent predictors of MACE in both groups. Furthermore, other independent outcome predictors included dyspnoea (HR: 3.8; 95% CI: 1.7-8.5; p = 0.001), the number of segments with any CAD (HR: 1.1; 95% CI: 1.001-1.2; p = 0.04) in DM patients and coronary calcium score >100 in non-DM patients (HR: 5.6; 95% CI: 1.4-21.5; p = 0.01). In Cox regression analysis of the overall population, interaction term obstructive CAD × DM resulted in non-significance., Conclusions: Among DM patients, dyspnoea carried a high event risk with a MACE rate four times higher. CT-CA findings were strongly predictive of outcome and proved valuable for further risk stratification.

Published
2011
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