BACKGROUND: Duchenne muscular dystrophy (DMD) patients are monitored periodically for cardiac involvement, including cardiac MRI with gadolinium-based contrast agents (GBCA). Texture analysis (TA) offers an alternative approach to assess late gadolinium enhancement (LGE) without relying on GBCA administration, impacting DMD patients' care. The study aimed to evaluate the prognostic value of selected TA features in the LGE assessment of DMD patients. RESULTS: We developed a pipeline to extract TA features of native T1 parametric mapping and evaluated their prognostic value in assessing LGE in DMD patients. For this evaluation, five independent TA features were selected using Boruta to identify relevant features based on their importance, least absolute shrinkage and selection operator (LASSO) to reduce the number of features, and hierarchical clustering to target multicollinearity and identify independent features. Afterward, logistic regression was used to determine the features with better discrimination ability. The independent feature inverse difference moment normalized (IDMN), which measures the pixel values homogeneity in the myocardium, achieved the highest accuracy in classifying LGE (0.857 (0.572-0.982)) and also was significantly associated with changes in the likelihood of LGE in a subgroup of patients with three yearly examinations (estimate: 23.35 (8.7), p-value = 0.008). Data are presented as mean (SD) or median (IQR) for normally and non-normally distributed continuous variables and numbers (percentages) for categorical ones. Variables were compared with the Welch t-test, Wilcoxon rank-sum, and Chi-square tests. A P-value < 0.05 was considered statistically significant. CONCLUSION: IDMN leverages the information native T1 parametric mapping provides, as it can detect changes in the pixel values of LGE images of DMD patients that may reflect myocardial alterations, serving as a supporting tool to reduce GBCA use in their cardiac MRI examinations.
- MeSH
- dítě MeSH
- Duchennova muskulární dystrofie * diagnostické zobrazování patologie MeSH
- gadolinium MeSH
- kontrastní látky MeSH
- lidé MeSH
- magnetická rezonanční tomografie * metody MeSH
- mladiství MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Acquiring pulmonary circulation parameters as a potential marker of cardiopulmonary function is not new. Methods to obtain these parameters have been developed over time, with the latest being first-pass perfusion sequences in cardiovascular magnetic resonance (CMR). Even though more data on these parameters has been recently published, different nomenclature and acquisition methods are used across studies; some works even reported conflicting data. The most commonly used circulation parameters obtained using CMR include pulmonary transit time (PTT) and pulmonary transit beats (PTB). PTT is the time needed for a contrast agent (typically gadolinium-based) to circulate from the right ventricle (RV) to the left ventricle (LV). PTB is the number of cardiac cycles the process takes. Some authors also include corrected heart rate (HR) versions along with standard PTT. Besides other methods, CMR offers an option to assess stress circulation parameters, but data are minimal. This review aims to summarize the up-to-date findings and provide an overview of the latest progress on this promising, dynamically evolving topic.
COVID-19 manifestation is associated with a strong immune system activation leading to inflammation and subsequently affecting the cardiovascular system. The objective of the study was to reveal possible interconnection between prolongated inflammation and the development or exacerbation of long-term cardiovascular complications after COVID-19. We investigated correlations between humoral and cellular immune system markers together with markers of cardiovascular inflammation/dysfunction during COVID-19 onset and subsequent recovery. We analyzed 22 hospitalized patients with severe COVID-19 within three timepoints (acute, 1 and 6 months after COVID-19) in order to track the impact of COVID-19 on the long-term decline of the cardiovascular system fitness and eventual development of CVDs. Among the cytokines dysregulated during COVID-19 changes, we showed significant correlations of IL-18 as a key driver of several pathophysiological changes with markers of cardiovascular inflammation/dysfunction. Our findings established novel immune-related markers, which can be used for the stratification of patients at high risk of CVDs for further therapy.
- Publikační typ
- časopisecké články MeSH
INTRODUCTION: One of the most common complications of coronavirus disease 2019 (COVID-19) is myocardial injury, and although its cause is unclear, it can alter the heart's contractility. This study aimed to characterize the ventricular and atrial strain in patients who recovered from COVID-19 using cardiovascular magnetic resonance feature-tracking (CMR-FT). METHODS: In this single-center study, we assessed left ventricle (LV) and right ventricular (RV) global circumferential strain (GCS), global longitudinal strain (GLS), global radial strain (GRS), left atrial (LA) and right atrial (RA) longitudinal strain (LS) parameters by CMR-FT. The student's t-test and Wilcoxon rank-sum test were used to compare the variables. RESULTS: We compared seventy-two patients who recovered from COVID-19 (49 ± 16 years) to fifty-four controls (49 ± 12 years, p = 0.752). The patients received a CMR examination 48 (34 to 165) days after the COVID-19 diagnosis. 28% had LGE. Both groups had normal LV systolic function. Strain parameters were significantly lower in the COVID-19 survivors than in controls. DISCUSSION: Patients who recovered from COVID-19 exhibited significantly lower strain in the left ventricle (through LVGCS, LVGLS, LVGRS), right ventricle (through RVGLS and RVGRS), left atrium (through LALS), and right atrium (through RALS) than controls.
- Publikační typ
- časopisecké články MeSH
Kardiomyopatie jsou definovány jako onemocnění srdečního svalu, která vedou k poruše jeho struktury a funkce a nejsou způsobena jinou příčinou (ischemickou chorobou srdeční, hypertenzí, chlopenní či vrozenou srdeční vadou). Podle fenotypového vyjádření je rozdělujeme na dilatační, hypertrofické, restriktivní, arytmogenní a zvláštní skupinu představují tzv. neklasifikované kardiomyopatie, mezi něž je řazena nonkompaktní kardiomyopatie a takotsubo kardiomyopatie. Pod stejným fenotypovým vyjádřením se mohou skrývat etiologicky odlišné formy onemocnění a současně se fenotypové vyjádření může u řady kardiomyopatií v průběhu vývoje onemocnění měnit. U každého typu kardiomyopatie dále rozlišujeme formu familiární (geneticky podmíněnou) a získanou. Klinicky se onemocnění manifestuje především symptomy srdečního selhání, ať s redukovanou, mírně sníženou či zachovanou ejekční frakcí, příznaky plynoucími z řady arytmií, přítomny mohou být projevy extrakardiální, v některých případech však nemusí být po relativně dlouhou dobu symptomy vyjádřeny. Pokud není onemocnění včas rozpoznáno a léčeno, může vést k významné morbiditě a mortalitě, a to zejména u mladých osob, jež kardiomyopatie často postihují. Díky rozvoji řady diagnostických a terapeutických metod došlo v posledních letech k významnému posunu v diagnostice i léčbě řady kardiomyopatií, a tím i zlepšení prognózy nemocných.
Cardiomyopathies are defined as myocardial disorders in which the heart muscle is structurally and functionaly abnormal in the absence of a disease sufficient to cause this abnormality such as coronary artery disease, hypertension, valvular or congenital heart disease. According to the phenotype expresion cardiomyopathies are divided into dilated, hypertrophic, restrictive, arrhytmogenic and unclassified cardiomyopathies (noncompaction and tako-tsubo cardiomyopathy). The same phenotypic expression may include etiologically different forms of the disease, and at the same time phenotypic expression may change in many cardiomyopathies in the course of illness. For each type of cardiomyopathy, we further distinguish the familial (genetic) form and the acquired form. The clinical manifestation of the disease includes symptoms of heart failure, with reduced, mildly reduced or preserved ejection fraction, symptoms resulting from a number of arrhythmias and extracardiac symptoms, but in some cases symptoms may not be presented for a relatively long time. The disease can lead to significant morbidity and mortality if not detected and treated early, especially in young people who are frequently affected. Significant developments in diagnostic and treatment methods have led to an improvement in the prognosis of patients with cardiomyopathies in recent years.
- MeSH
- amyloidóza diagnostické zobrazování terapie MeSH
- dilatační kardiomyopatie diagnostické zobrazování genetika terapie MeSH
- genetické testování MeSH
- hypertrofická kardiomyopatie diagnostické zobrazování genetika terapie MeSH
- kardiomyopatie * diagnóza MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
INTRODUCTION: Major clinically relevant inflammatory events such as septic shock and severe COVID-19 trigger dynamic changes in the host immune system, presenting promising candidates for new biomarkers to improve precision diagnostics and patient stratification. Hepcidin, a master regulator of iron metabolism, has been intensively studied in many pathologies associated with immune system activation, however these data have never been compared to other clinical settings. Thus, we aimed to reveal the dynamics of iron regulation in various clinical settings and to determine the suitability of hepcidin and/or ferritin levels as biomarkers of inflammatory disease severity. COHORTS: To investigate the overall predictive ability of hepcidin and ferritin, we enrolled the patients suffering with three different diagnoses - in detail 40 patients with COVID-19, 29 patients in septic shock and eight orthopedic patients who were compared to nine healthy donors and all cohorts to each other. RESULTS: We showed that increased hepcidin levels reflect overall immune cell activation driven by intrinsic stimuli, without requiring direct involvement of infection vectors. Contrary to hepcidin, ferritin levels were more strongly boosted by pathogen-induced inflammation - in septic shock more than four-fold and in COVID-19 six-fold in comparison to sterile inflammation. We also defined the predictive capacity of hepcidin-to-ferritin ratio with AUC=0.79 and P = 0.03. DISCUSSION: Our findings confirm that hepcidin is a potent marker of septic shock and other acute inflammation-associated pathologies and demonstrate the utility of the hepcidin-to-ferritin ratio as a predictor of mortality in septic shock, but not in COVID-19.
- MeSH
- biologické markery MeSH
- COVID-19 * MeSH
- ferritiny MeSH
- hepcidiny metabolismus MeSH
- lidé MeSH
- septický šok * MeSH
- zánět MeSH
- železo metabolismus MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Vrozené anomálie koronárních arterií jsou zřídka se vyskytující odchylky v anatomii a představují relativně vzácné nálezy při koronarografickém vyšetření. Důsledky přítomnosti koronární anomálie mohou být benigní, klinicky jsou většinou němé a bývají diagnostikovány náhodně. V některých případech však mohou mít závažné následky a prvními klinickými projevy mohou být arytmie, rozvoj srdečního selhání či akutní infarkt myokardu (1-3). V našem sdělení předkládáme kazuistiku 48letého pacienta s akutním infarktem myokardu spodní stěny při atypickém odstupu pravé koronární arterie (ACD) z levého koronárního sinu s interarteriálním průběhem, s přítomností fibrilace komor v úvodu.
Congenital coronary artery anomalies are rare abnormalities in the anatomy and represent relatively rare findings on coronary angiography. The consequences of the presence of a coronary anomaly can be benign and often diagnosed incidentally. However, in some cases, they can have serious consequences, with the initial clinical manifestations being arrhythmias, the development of heart failure, or acute myocardial infarction (1-3). We present a case report of a 48-year-old patient with acute myocardial infarction of the inferior wall with an anomalous origin of the right coronary artery from the left coronary sinus with an interarterial course and the presence of ventricular fibrillation at the onset.
- Klíčová slova
- atypický odstup pravé koronární arterie,
- MeSH
- infarkt myokardu spodní stěny * diagnóza etiologie patologie terapie MeSH
- koronární cévy patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
BACKGROUND: Cadmium-Zinc-Telluride (CZT) technology allows use of low activities of radiopharmaceuticals. The aim was to verify the values of left ventricular volume parameters, obtained via ultra-low-dose thallium Single Photon Emission Computed Tomography (SPECT) using a CZT camera. METHODS AND RESULTS: Forty-five patients referred for an assessment of myocardial perfusion or viability imaging were examined using CZT-SPECT and 1.5 T magnetic resonance (MRI) scanner. The ultra-low-dose protocol with 0.5 Mbq 201-Tl per kg of body weight was used. The values of end-systolic (ESV) and end-diastolic volumes (EDV), left ventricular ejection fraction (EF) and myocardial mass (MM) were assessed using both techniques. A very good correlation was found between the EF, ESV, and EDV values assessed with CZT-SPECT and cardiac magnetic resonance MRI; the Pearson coefficients were 0.86, 0.95, and 0.91, respectively. A moderate correlation was found for myocardial mass, r = 0.57. Compared to MRI, SPECT systematically overestimated ESV and MM, while it underestimates the EF, with P ≤ .001 in all cases. There was no difference in EDV estimation. CONCLUSIONS: Left ventricular volumes and ejection fraction assessed via ultra-low-dose CZT-SPECT showed very good correlation with the values obtained by MRI. A moderate correlation was found for myocardial mass.
- MeSH
- funkce levé komory srdeční * MeSH
- jednofotonová emisní výpočetní tomografie * metody MeSH
- kadmium MeSH
- lidé MeSH
- magnetická rezonanční tomografie metody MeSH
- radioizotopy thallia MeSH
- telur MeSH
- tepový objem MeSH
- zinek MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
