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Background Regional contractile dysfunction is a frequent finding in hypertrophic cardiomyopathy (HCM). We aimed to investigate the contribution of different tissue characteristics in HCM to regional contractile dysfunction. Methods We prospectively recruited 50 patients with HCM who underwent cardiovascular magnetic resonance (CMR) studies at 3.0 T including cine imaging, T1 mapping and late gadolinium enhancement (LGE) imaging. For each segment of the American Heart Association model segment thickness, native T1, extracellular volume (ECV), presence of LGE and regional strain (by feature tracking and tissue tagging) were assessed. The relationship of segmental function, hypertrophy and tissue characteristics were determined using a mixed effects model, with random intercept for each patient. Results Individually segment thickness, native T1, ECV and the presence of LGE all had significant associations with regional strain. The first multivariable model (segment thickness, LGE and ECV) demonstrated that all strain parameters were associated with segment thickness (P

Background Aortic stiffness is increasingly used as an independent predictor of adverse cardiovascular outcomes. We sought to compare the impact of transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) upon aortic vascular function using cardiovascular magnetic resonance (CMR) measurements of aortic distensibility and pulse wave velocity (PWV). Methods and results A 1.5 T CMR scan was performed pre-operatively and at 6 m post-intervention in 72 patients (32 TAVI, 40 SAVR; age 76 ± 8 years) with high-risk symptomatic severe aortic stenosis. Distensibility of the ascending and descending thoracic aorta and aortic pulse wave velocity were determined at both time points. TAVI and SAVR patients were comparable for gender, blood pressure and left ventricular ejection fraction. The TAVI group were older (81 ± 6.3 vs. 72.8 ± 7.0 years, p

Background Left atrial (LA) size is a marker of poor prognosis in a variety of cardiovascular conditions. Severe aortic stenosis results in elevated LV afterload with compensatory hypertrophy and increased filling pressures. This is associated with progressive left atrial enlargement and dysfunction. Intervention for aortic stenosis results in LV reverse remodelling, however the effect of TAVI or SAVR upon LA function remains poorly understood and the two treatments have not been directly compared. We sought to accurately determine LA size and function using CMR in patients with severe symptomatic aortic stenosis and identify changes following TAVI compared to SAVR.

Background Mitral annular plane systolic excursion (MAPSE) is known to have prognostic importance in the risk stratification of patients with acute myocardial infarction (MI). In post-MI patients with MAPSE

Background The effect of transcatheter aortic valve implantation (TAVR) on left ventricular remodelling early following valve implantation has not previously been evaluated using cardiac magnetic resonance (CMR). Early left ventricular mass (LVM) regression (assessed using echocardiography) has been linked to a 50% reduction in rehospitalisation in the first year following TAVR. We sought to establish using CMR, the reference standard non-invasive imaging technique for LVM quantification, whether LVM regression occurs early post-TAVR.

Background Longitudinal motion of the mitral valve, known as the mitral annular plane of systolic excursion (MAPSE), correlates well with LV systolic function. Similarly, tricuspid annular plane systolic excursion (TAPSE) correlates well with RV systolic function. Echocardiographically, the absolute value of TAPSE was greater than MAPSE, by 54.5% in a recent study of normal subjects and the MAPSE/TAPSE ratio is 0.66±0.14 (1). However, the interventricular systolic relationship has not been accurately defined in the presence of regional wall motion abnormalities. We hypothesised that the interventricular systolic relationship, measured by the ratio of averagedMAPSE and TAPSE, changes in the presence of acute myocardial infarction with regional wall motion abnormality.

Background Global longitudinal strain and mitral annular plane systolic excursion (MAPSE) have been validated as an echocardiographic measure of longitudinal function in patients with aortic stenosis (AS). Cardiac magnetic resonance imaging (CMR) offers a simple and easy measure of MAPSE and been validated in various patient groups. Longitudinal function in aortic stenosis is usually reduced before a reduction in ejection fraction is seen. We sought to investigate the impact of TAVI upon longitudinal function and global ejection fraction in patients treated for symptomatic severe AS.

Methods Twenty patients underwent CMR at 3T (Achieva TX system, Philips Healthcare, Best, The Netherlands) within 3 days following reperfused ST-elevation MI. Black blood, cine, T2w, T2-mapping, T2*-mapping and LGE imaging (0.1mmol/kg gadolinium DTPA) were performed in identical short axis locations using the ‘3 of 5’ approach. Data were evaluated offline using commercial software (cvi42 v4.1.5, Circle Cardiovascular Imaging Inc., Calgary, Canada). On the LGE images showing the largest infarct volume, infarct size was determined by using a semi-automated histogram-based thresholding method. This slice was evaluated for visual presence of IMH by the three methods. Signal intensity (SI) and respective standard deviation of SI (SD) were measured for the infarcted myocardium, remote myocardium and any IMH (if present). SNR was computed for each using the formula=0.655((SI)/(SD)). CNR was determined comparing contrast-to-noise of infarcted myocardium to IMH (SNRi-SNRIMH). Results Of the twenty patients, 55% (n=11) had IMH on T2wimaging. The mean (±standard deviation) SNR and CNR values are listed in Table 1. The visual assessment of T2w imaging correlated strongly to T2-maps (r=0.69; p=0.001) and to the T2*-maps (r=0.60; p=0.005). The SNR for IMH and infarct zone were significantly different for only T2w imaging (Figure 1). Quantitative CNR for T2w imaging correlated strongly to visual assessment of all three imaging modalities (T2wr=0.650; p=0.002, T2-mapr=0.454; p=0.04, T2*-mapr=0.603;p=0.005). The CNR for T2-maps and T2*-maps did not show similar correlation to the visual assessment.