PURPOSE: Dual velocity encoding PC-MRI can produce spurious artifacts when using high ratios of velocity encoding values (VENCs), limiting its ability to generate high-quality images across a wide range of encoding velocities. This study aims to propose and compare dual-VENC correction methods for such artifacts. THEORY AND METHODS: Two denoising approaches based on spatiotemporal regularization are proposed and compared with a state-of-the-art method based on sign correction. Accuracy is assessed using simulated data from an aorta and brain aneurysm, as well as 8 two-dimensional (2D) PC-MRI ascending aorta datasets. Two temporal resolutions (30,60) ms and noise levels (9,12) dB are considered, with noise added to the complex magnetization. The error is evaluated with respect to the noise-free measurement in the synthetic case and to the unwrapped image without additional noise in the volunteer datasets. RESULTS: In all studied cases, the proposed methods are more accurate than the Sign Correction technique. Using simulated 2D+T data from the aorta (60 ms, 9 dB), the Dual-VENC (DV) error 0.82±0.07$$ 0.82\pm 0.07 $$ is reduced to: 0.66±0.04$$ 0.66\pm 0.04 $$ (Sign Correction); 0.34±0.04$$ 0.34\pm 0.04 $$ and 0.32±0.04$$ 0.32\pm 0.04 $$ (proposed techniques). The methods are found to be significantly different (p-value <0.05$$ <0.05 $$ ). Importantly, brain aneurysm data revealed that the Sign Correction method is not suitable, as it increases error when the flow is not unidirectional. All three methods improve the accuracy of in vivo data. CONCLUSION: The newly proposed methods outperform the Sign Correction method in improving dual-VENC PC-MRI images. Among them, the approach based on temporal differences has shown the highest accuracy.

• MeSH
• Algorithms * MeSH
• Aorta * diagnostic imaging   MeSH
• Artifacts * MeSH
• Phantoms, Imaging MeSH
• Image Interpretation, Computer-Assisted methods   MeSH
• Intracranial Aneurysm diagnostic imaging   MeSH
• Humans MeSH
• Magnetic Resonance Imaging * methods   MeSH
• Brain diagnostic imaging   MeSH
• Computer Simulation MeSH
• Image Processing, Computer-Assisted * methods   MeSH
• Signal-To-Noise Ratio * MeSH
• Reproducibility of Results MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH

Cantrellova pentalogie je vzácný syndrom spojený s embryologickou vadou střední linie zahrnující řadu malformací: anomálie dolní části hrudní kosti, přední části bránice, srdce a přední části břišní stěny. Lze jej klasifikovat jako úplný, pravděpodobný nebo částečný, ale nejdůležitější je popsat a pochopit příslušné anomálie. Popisujeme případ pozdní diagnózy Cantrellovy pentalogie v 35. týdnu a 5 dnech těhotenství u ženy z vnitrozemí státu Pará v brazilské Amazonii. Fetální echokardiografie potvrdila diagnózu Cantrellovy pentalogie s Fallotovou tetralogií a ultrazvukové vyšetření ukázalo oboustranný talipes. Císařský řez byl proveden ve 36. týdnu z důvodu preeklampsie superponované na chronickou arteriální hypertenzi se známkami závažného průběhu. Novorozenec mužského pohlaví se narodil s hmotností 2 320 g. Postnatální echokardiografie potvrdila diagnózu Cantrellovy pentalogie a karyotyp byl normální (46, XY). Novorozenec byl propuštěn ve 47 dnech věku s dobrým hmotnostním přírůstkem, umělým kojením a ambulantním sledováním kardiologem a kardiochirurgem.

Cantrell’s pentalogy is a rare syndrome associated with a midline embryological defect involving a series of malformations: anomalies of the lower sternum, anterior diaphragm, heart, and anterior abdominal wall. It can be classified as complete, probable or partial, but the most important thing is to describe and understand the anomalies involved. We describe a case of a late diagnosis of Cantrell’s pentalogy at 35 weeks and 5 days of pregnancy in a woman from the interior of Pará state, an Amazon Brazilian region. Fetal echocardiography confirmed the diagnosis of Cantrell’s pentalogy with tetralogy of Fallot and ultrasound examination showing a bilateral clubfoot. Cesarean section was performed at 36 weeks because of pre-eclampsia superimposed on chronic arterial hypertension with signs of severity. The male newborn was delivered weighting 2,320 grams. Postnatal echocardiography confirmed the diagnosis of Cantrell’s pentalogy and karyotype was normal (46, XY). Infant was discharged at 47 days of age with good weight gain, artificial breastfeeding, and outpatient follow-up by the cardiology and cardiac surgery specialists.

• MeSH
• Pentalogy of Cantrell * diagnosis   therapy   MeSH
• Cesarean Section MeSH
• Echocardiography methods   MeSH
• Tetralogy of Fallot diagnostic imaging   MeSH
• Humans MeSH
• Abnormalities, Multiple diagnostic imaging   MeSH
• Infant, Newborn MeSH
• Clubfoot diagnostic imaging   MeSH
• Pre-Eclampsia MeSH
• Prenatal Diagnosis methods   MeSH
• Ultrasonography, Prenatal methods   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Infant, Newborn MeSH
• Publication type
• Case Reports MeSH

Anderson-Fabry disease (AFD) is a rare genetic disease with X-linked transmission characterized by a defect in the enzyme alpha-galactosidase A, which impairs glycosphingolipid metabolism and leads to an excessive storage of globotriaosylceramide (Gb3) within lysosomes. AFD involves renal, cardiac, vascular, and nervous systems and is mainly observed in male patients with onset in childhood, although cardiac manifestation is often shown in adults. AFD cardiomyopathy is caused by the accumulation of Gb3 within myocytes first showed by left ventricular hypertrophy and diastolic dysfunction, leading to restrictive cardiomyopathy and systolic heart failure with biventricular involvement. The diagnosis of AFD cardiomyopathy may be insidious in the first stages and requires accurate differential diagnosis with other cardiomyopathies with hypertrophic phenotype. However, it is fundamental to promptly initiate specific therapies that have shown promising results, particularly for early treatment. A careful integration between clinical evaluation, genetic tests, and cardiac imaging is required to diagnose AFD with cardiac involvement. Basic and advanced echocardiography, cardiac magnetic resonance, and nuclear imaging may offer pivotal information for early diagnosis (Graphical Abstract), and the management of these patients is often limited to centres with high expertise in the field. This clinical consensus statement, developed by experts from the European Society of Cardiology (ESC) Working Group on Myocardial and Pericardial Diseases and the European Association of Cardiovascular Imaging of the ESC, aims to provide practical advice for all clinicians regarding the use of multimodality imaging to simplify the diagnostic evaluation, prognostic stratification, and management of cardiac involvement in AFD.

• MeSH
• Early Diagnosis MeSH
• Diagnosis, Differential MeSH
• Child MeSH
• Adult MeSH
• Echocardiography methods   standards   MeSH
• Fabry Disease * diagnostic imaging   therapy   MeSH
• Consensus MeSH
• Humans MeSH
• Multimodal Imaging * methods   standards   MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Consensus Development Conference MeSH

Structural, architectural, contractile, or electrophysiological alterations may occur in the left atrium (LA). The concept of LA cardiopathy is supported by accumulating scientific evidence demonstrating that LA remodelling has become a cornerstone diagnostic and prognostic marker. The structure and the function of the LA and left atrial appendage (LAA), which is an integral part of the LA, are key elements for a better understanding of multiple clinical conditions, most notably atrial fibrillation, cardioembolism, heart failure, and mitral valve diseases. Rational use of various imaging modalities is key to obtain the relevant clinical information. Accordingly, this clinical consensus document from the European Association of Cardiovascular Imaging, in collaboration with the European Heart Rhythm Association, provides comprehensive, up-to-date, and evidence-based guidance to cardiologists and cardiac imagers for the best practice of imaging LA and LAA for the diagnosis, management, and prognostication of the patients.

• MeSH
• Echocardiography methods   MeSH
• Atrial Fibrillation diagnostic imaging   MeSH
• Cardiac Imaging Techniques MeSH
• Cardiology MeSH
• Consensus * MeSH
• Humans MeSH
• Multimodal Imaging * methods   MeSH
• Prognosis MeSH
• Atrial Appendage * diagnostic imaging   MeSH
• Societies, Medical * MeSH
• Heart Atria * diagnostic imaging   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Practice Guideline MeSH
• Geographicals
• Europe MeSH

BACKGROUND: Left ventricular thrombus (LVT) formation is one of the well-known and serious complications of acute myocardial infarction (AMI) due to the risk of systemic arterial embolization (SE). To diagnose LVT, echocardiography (TTE) is used. Late gadolinium-enhanced cardiovascular magnetic resonance (DE-CMR) is the gold standard for diagnosing LVT. OBJECTIVES: The aim of this observational study was to determine the role of transthoracic echocardiography and cardiac markers in predicting the occurrence of LVT compared with a reference cardiac imaging (DE-CMR) and to determine the risk of systemic embolization to the CNS using brain MRA. METHODS: Seventy patients after MI managed by percutaneous coronary intervention (localization: 92.9% anterior wall, 7% other; median age 58.7 years) were initially examined by transthoracic echocardiography (TTE, n=69) with a focus on LVT detection. Patients were then referred for DE-CMR (n=55). Laboratory determination of cardiac markers (Troponin T and NTproBNP) was carried out in all. Brain MRA was performed 1 year apart (n=51). RESULTS: The prevalence of LVT detected by echocardiography: (n=11/69, i.e. 15.9%); by DE-CMR: (n=9/55, i.e. 16.7%). Statistically significant parameters to predict the occurrence of LVT after AMI (cut off value): (a) detected by echocardiography: anamnestic data - delay (≥ 5 hours), echocardiographic parameters - left atrial volume index (LAVI≥ 32 mL/m2), LV EF Simpson biplane and estimated (≤ 42%), tissue Doppler determination of septal A wave velocity (≤ 7.5cm/s); (b) detected by DE-CMR: anamnestic data - delay (≥ 13 hours), DE-CMR parameters - left ventricular end-diastolic diameter (≥ 54mm). The value of cardiac markers (Troponin T and NTproBNP in ng/L) in LVT detected by echocardiography did not reach statistical significance. In LVT detected by DE-CMR, NTproBNP was statistically significantly increased at 1 month after AMI onset (no optimal cut-off value could be determined). There was no statistically significant association between the LVT detection (both modalities) and the occurrence of clinically manifest and silent cardioembolic events. CONCLUSION: Our study confirmed a relatively high prevalence of LVT in the high-risk group of patients with anterior wall STEMI. Due to the low prevalence of thromboembolic complications, no significant association between the LVT detection and the occurrence of a cardioembolic event was demonstrated.

• MeSH
• Biomarkers blood   MeSH
• Echocardiography MeSH
• Myocardial Infarction * complications   MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Natriuretic Peptide, Brain blood   MeSH
• Peptide Fragments blood   MeSH
• Prevalence MeSH
• Prospective Studies MeSH
• Aged MeSH
• Heart Ventricles diagnostic imaging   MeSH
• Thrombosis * etiology   diagnostic imaging   epidemiology   MeSH
• Troponin T blood   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH

Echokardiografie se řadí mezi nejdůležitější a nejčastěji používané zobrazovací metody v diagnostice plicní embolie (PE). Na rozdíl od angiografie či scintigrafie plic sice neposkytuje přímou informaci o anatomických poměrech v plicním řečišti a místě jeho obstrukce, ale o hemodynamických dopadech na pravé srdce. Je důležitým článkem v časné rizikové stratifikaci nemocných, a to zejména u těžších forem PE a v některých případech může rozhodovat i o způsobu zahájení léčby nebo o nutnosti zvýšeného dohledu na jednotce intenzivní péče. Mimo jiné umožnuje získat důležité diferenciálně diagnostické informace o dalších potencionálních příčinách symptomů napodobujících PE. Je taktéž základním skríningovým nástrojem v diagnostice chronické tromboembolické plicní hypertenze u nemocných po prodělané epizodě PE i přes účinnou antikoagulační léčbu. V tomto článku se budeme zabývat postavením echokardiografie v managmentu nemocných s PE a rozebereme jednotlivé echokardiografické parametry, které nás přivádí k diagnóze, způsob jejich akvizice a limitace v hodnocení.

Echocardiography is considered as important and frequent imaging method in the diagnostics of pulmonary embolism (PE). In fact, when compared to angiography or nuclear scanning, it does not detect a direct site of the occlusion of the pulmonary arteries but visualizes hemodynamical consequences of the obstruction on the right heart. Echocardiography has a key role in the management of patients with severe forms of PE and in some cases, its crucial for the decision making when reperfusion therapy is considered or when increased monitoring of the patients at intensive care unit is required. Also, it allows to detect other potential causes of the symptoms that could mimic PE. Furthermore, it is a main screening method in the detection of chronic thromboembolic pulmonary hypertension, in persons with persisting symptoms of dyspnoea and fatigue after the episode of PE, despite the anticoagulative treatment. In this article we will discuss the role of echocardiography in the management of patients with PE, we will analyse single parameters, that clarify the diagnosis, and we will also mention the limitations of the method.

• MeSH
• Echocardiography methods   MeSH
• Humans MeSH
• Pulmonary Embolism * diagnosis   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

BACKGROUND: Patients with advanced chronic liver disease (ACLD) are at high risk of developing hepatocellular carcinoma (HCC). Therefore, biannual surveillance is recommended. This large-scale multicenter study aimed to stratify the risk of HCC development in ACLD. METHODS: From 3016 patients with ACLD screened in 17 European and Chinese centers, 2340 patients with liver stiffness measurement (LSM) determined using different techniques (two-dimensional shear-wave elastography [2D-SWE], transient elastography, and point shear-wave elastography) and with different disease severities were included. Cox regression was used to explore risk factors for HCC. We used these data to create an algorithm, named PLEASE, but referred to in this manuscript as "the algorithm"; the algorithm was validated in internal and two external cohorts across elastography techniques. RESULTS: HCC developed in 127 (5.4%) patients during follow-up. LSM by 2D-SWE (hazard ratio: 2.28) was found to be associated with developing HCC, alongside age, sex, etiology, and platelet count (C-index: 0.8428). We thus established the algorithm with applicable cutoffs, assigning a maximum of six points: platelet count less than 150×109/l, LSM greater than or equal to 15 kPa, age greater than or equal to 50 years, male sex, controlled/uncontrolled viral hepatitis, or presence of steatotic liver diseases. Within 2 years, with a median follow-up of 13.7 months, patients in the high-risk group (≥4 points) had an HCC incidence of 15.6% (95% confidence interval [CI], 12.1% to 18.7%) compared with the low-risk group, at 1.7% (95% CI, 0.9% to 2.5%). CONCLUSIONS: Our algorithm stratified patients into two groups: those at higher risk of developing HCC and those at lower risk. Our data provide equipoise to test the prospective utility of the algorithm with respect to clinical decisions about screening patients with ACLD for incident HCC. (Funded by the German Research Foundation and others; ClinicalTrials.gov number, NCT03389152.).

• MeSH
• Algorithms MeSH
• Chronic Disease MeSH
• Adult MeSH
• Elasticity Imaging Techniques * MeSH
• Carcinoma, Hepatocellular * epidemiology   diagnostic imaging   diagnosis   MeSH
• Middle Aged MeSH
• Humans MeSH
• Liver Neoplasms * epidemiology   diagnostic imaging   diagnosis   MeSH
• Liver Diseases epidemiology   diagnostic imaging   diagnosis   MeSH
• Risk Factors MeSH
• Aged MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH

Hypertrofická kardiomyopatie je onemocnění, se kterým se v kardiologické praxi setkáváme relativně často. U většiny pacientů je spojená s přítomností klidové nebo zátěžové obstrukce ve výtokovém traktu levé komory, která je klíčová v rozvoji příznaků srdečního selhání. Cílem terapie je odstranění nebo alespoň zmírnění subaortální obstrukce, ať už invazivně, nebo pomocí léků. Dosud dostupná farmakoterapie β-blokátory a blokátory kalciových kanálů (typu verapamilu či diltiazemu) je terapií nespecifickou a v řadě případů limitovanou horším snášením léčby, výskytem nežádoucích účinků nebo kontraindikacemi. Objev léčiv ze skupiny inhibitorů srdečního myozinu představuje novou možnost specifické farmakoterapie, která je schopna redukovat hyperkontraktilitu, subaortální obstrukci a zlepšit kvalitu života pacientů.

Hypertrophic cardiomyopathy is a relatively common disease in cardiology practice. In most patients, it is associated with the presence of a resting or exercise obstruction in the left ventricular outflow tract, which is crucial for the development of heart failure symptoms. The goal of treatment is to eliminate or at least relieve the subaortic obstruction, either invasively or with medical therapy. The current pharmacological treatment with β-blockers and calcium channel blockers (such as verapamil or diltiazem) is non-specific and often limited by poor tolerability, adverse effects, or contraindications. The discovery of drugs from the cardiac myosin inhibitor group represents a new option for specific pharmacotherapy capable of reducing hypercontractility and subaortic obstruction and improving patients’ quality of life.

• Keywords
• mavakamten,
• MeSH
• Benzylamines pharmacology   therapeutic use   MeSH
• Diagnostic Imaging methods   MeSH
• Echocardiography, Doppler methods   MeSH
• Dyspnea etiology   MeSH
• Cardiomyopathy, Hypertrophic * diagnostic imaging   drug therapy   complications   MeSH
• Aged MeSH
• Uracil analogs & derivatives   pharmacology   therapeutic use   MeSH
• Check Tag
• Aged MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

PURPOSE: The aim of this study is to design a method of myocardial T1 quantification in small laboratory animals and to investigate the effects of spatiotemporal regularization and the needed acquisition duration. METHODS: We propose a compressed-sensing approach to T1 quantification based on self-gated inversion-recovery radial two/three-dimensional (2D/3D) golden-angle stack-of-stars acquisition with image reconstruction performed using total-variation spatiotemporal regularization. The method was tested on a phantom and on a healthy rat, as well as on rats in a small myocardium-remodeling study. RESULTS: The results showed a good match of the T1 estimates with the results obtained using the ground-truth method on a phantom and with the literature values for rats myocardium. The proposed 2D and 3D methods showed significant differences between normal and remodeling myocardium groups for acquisition lengths down to approximately 5 and 15 min, respectively. CONCLUSIONS: A new 2D and 3D method for quantification of myocardial T1 in rats was proposed. We have shown the capability of both techniques to distinguish between normal and remodeling myocardial tissue. We have shown the effects of image-reconstruction regularization weights and acquisition length on the T1 estimates.

• MeSH
• Phantoms, Imaging MeSH
• Rats MeSH
• Magnetic Resonance Imaging methods   MeSH
• Myocardium * MeSH
• Image Processing, Computer-Assisted methods   MeSH
• Reproducibility of Results MeSH
• Imaging, Three-Dimensional * methods   MeSH
• Animals MeSH
• Check Tag
• Rats MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Pod fenotypem hypertrofické kardiomyopatie (HCM) se skrývá skupina onemocnění různé etiologie. Nejčastěji má HCM obraz typické sarkomerické formy s hyperkontraktilitou hypertrofické levé komory, poruchou diastolické funkce a variabilním výskytem obstrukce výtokového traktu levé komory. Méně často se jedná o fenokopie HCM podmíněné infiltrativními nebo střádavými onemocněními myokardu, jako jsou srdeční amyloidózy nebo některé vrozené metabolické poruchy (Fabryho nemoc, glykogenózy atd.). Cílem práce je popis diagnostických kritérií HCM a doporučených postupů pro detekci obstrukce v dutině levé komory. Rozebíráme diagnostiku fenokopií HCM onemocnění, ke které přispívá identifikace varovných klinických známek (tzv. red-flags). Dalšími metodami pro identifikaci fenokopií HCM je provedení standardizovaného laboratorního screeningu, komplexní magnetické rezonance srdce a molekulárně-genetického vyšetření při záchytu onemocnění. Cílem diagnostického postupu je tedy potvrzení diagnózy HCM, identifikace etiologie a přítomnosti či absence obstrukční patofyziologie daného případu HCM, jejichž znalost umožní individualizovanou léčbu onemocnění. Diskutována jsou také doporučení pro screening HCM v rodinách.

• MeSH
• Amyloidosis diagnostic imaging   genetics   pathology   MeSH
• Echocardiography methods   MeSH
• Genetic Testing methods   MeSH
• Cardiomyopathy, Hypertrophic * diagnostic imaging   genetics   classification   pathology   MeSH
• Cardiac Imaging Techniques MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Prognosis MeSH
• Radionuclide Imaging MeSH
• Check Tag
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH