P319Is the measurement of QRS duration valid and reproducible in patients with left bundle branch block?

Los niveles en sangre de PGC-1α predice miocardio salvado y remodelado ventricular tras infarto agudo de miocardio con elevación del segmento ST

et al.

Prognostic value of pulmonary vascular resistance estimated by cardiac magnetic resonance in patients with chronic heart failure.

Pulmonary arterial hypertension is known to be related to worse prognosis in patients with heart failure (HF). Quantification of pulmonary vascular resistance (PVR) still requires invasive right heart catheterization. Recent studies have shown an accurate method for non-invasive estimation of PVR by cardiac magnetic resonance (CMR). Our aim was to evaluate the prognostic value of PVR calculated by CMR in patients with congestive HF.We calculated PVR by CMR in 132 patients [age 65.6 ± 13.1 years, left ventricular ejection fraction (LVEF) 35.1 ± 16.4%, ischaemic aetiology 40%] recently admitted for decompensated HF and derived to our cardiac imaging unit for diagnosis. Patients with cardiac e…

Mean velocity of the pulmonary artery estimated by cardiac magnetic resonance as an early prognostic predictor in heart failure.

Background and objective: To identify early, non-invasive prognostic indicators in heart failure (HF), with and without associated pulmonary hypertension, by means of cardiac magnetic resonance, and oxidative stress and anti-inflammatory biomarkers such as Trolox (TM) (antioxidant status) and IL-10 (anti-inflammatory cytokine). Patients and methods: We prospectively included 70 patients admitted for new-onset HF. During index admission, mean velocity of the pulmonary artery (mvPA) was measured, and blood Trolox (TM) and IL-10 determined. The study sample was divided in two groups according to the optimal cut-off value for event prediction calculated by the ROC curve (mvPA = 8 cm/s), conside…

Metaplasia grasa. Dos infartos crónicos en el mismo paciente detectados por cardiorresonancia

Late gadolinium enhancement-cardiovascular magnetic resonance identifies coronary artery disease as the aetiology of left ventricular dysfunction in acute new-onset congestive heart failure

Aims We evaluated the ability of late gadolinium enhancement (LGE) using cardiovascular magnetic resonance (CMR) to identify acute new-onset heart failure (HF) with left ventricular systolic dysfunction (LVSD), whether or not in relation to underlying coronary artery disease (CAD), in patients with no clinical evidence of associated ischaemic cardiomyopathy. Methods and results Hundred consecutive patients admitted with acute new-onset decompensated HF and EF ,40%, with no clinical or electrocardiographic data suggestive of CAD. The patients were classified according to the presence or absence of significant CAD (stenosis � 70% in at least one major vessel). Twenty-one patients (21%) had si…

Pronóstico al año en pacientes con insuficiencia cardiaca en España. Registro ESC-EORP-HFA Heart Failure Long-Term

Resumen Introduccion y objetivos La insuficiencia cardiaca (IC) es un problema creciente de salud y una carga importante para la sociedad. Pese a ello, con frecuencia se minusvalora globalmente la gravedad del pronostico. Este estudio estima el pronostico al ano en pacientes con IC aguda y cronica en Espana y resto de Europa. Metodos Un total de 2.829 pacientes con IC (589 IC aguda y 2.240 IC cronica) seleccionados en 27 centros hospitalarios en Espana, atendidos por cardiologos y que participan en el registro ESC-EORP-HFA Heart Failure Long-Term, con 211 centros y 12.440 pacientes en total, se siguieron un ano para monitorizar la mortalidad y el ingreso hospitalario. Resultados La mortalid…

Valoración no invasiva de injertos aortocoronarios y coronarias nativas con tomografía computarizada de 64 detectores: comparación con la coronariografía invasiva

Introduccion y objetivos Aunque la tomografia computarizada (TC) multidetector muestra una elevada exactitud diagnostica en la valoracion no invasiva de las arterias coronarias e injertos, son escasos los trabajos que valoren su fiabilidad en el estudio conjunto de vasos nativos, injertos y vasos distales a las anastomosis. El objetivo de este estudio es valorar la exactitud diagnostica de la TC de 64 detectores en la valoracion de injertos coronarios y arterias coronarias nativas. Metodos Se estudia con TC de 64 detectores a 36 pacientes revascularizados quirurgicamente e indicacion clinica de evaluacion angiografica de sus injertos. Se analizo la exactitud diagnostica de la TC para la det…

Isolated RV diverticulum: diagnosis by cardiac magnetic resonance and 3D TEE

A 16-year-old male was referred to our hospital because of exertional chest pain. There was no personal or family history of any cardiovascular disease. Findings on physical examination and vital signs were normal. An ECG showed a right bundle superoanterior zonal block pattern with low potentials in frontal plane and intraventricular conduction delay (QRS Complex 120 msg) with pseudo-epsilon wave in V1 …

[Diagnostic performance of surface electrocardiogram in early detection of chagasic cardiomyopathy].

Contrast-enhanced cardiac magnetic resonance imaging (CMR) allows early detection of myocardial involvement by Trypanosoma cruzi infection. The aim of our study was to assess the diagnostic performance of the surface electrocardiogram (ECG) in the early detection of Chagas' cardiomyopathy (CCM) compared with CMR.We included 43 asymptomatic patients (30 women, 42 ± 9.8 years), diagnosed of Chagas disease. The sample was divided into 2 groups according to the presence (n=17) or absence (n=26) of electrocardiographic abnormalities. All patients underwent CMR and late gadolinium enhancement (LGE) was used as a marker of early myocardial involvement.Six (14%) patients had a LGE significantly hig…

Coronary artery dissection. Follow-up by MDCT.

and a feature consistent with a thrombus, probably located in the false lumen (Figure, D). Based on these findings, a new coronary angiography with possible surgical revascularization was planned, but 12 hours after the MDCT examination, the patient experienced an episode of chest pain with ST-segment elevation from V1 to V5, complicated by electromechanical dissociation, and culminating in death. A post-mortem study was not performed. This case illustrates the usefulness of MDCT for follow-up of coronary stents located in proximal segments, and for identifying specific complications: extension of a dissection and even visualization of a coronary thrombus.

Gerbode-type left ventricular outflow tract to right atrial fistula complicating prosthetic aortic valve replacement identified by cardiac computed tomographic angiography

Abstract Acquired left ventricular-right atrial communication ( Gerbode-type defect) is a rare complication of infective endocarditis. Although transesophageal echocardiography remains the technique of choice for the evaluation of complications of endocarditis this case highlights the usefulness of cardiac computed tomography in this scenario, particularly in cases where assessment of coronary anatomy is required before surgery.

Microvascular Obstruction After Radiofrequency Ablation of Ventricular Tachycardia Comprehensive Evaluation by Magnetic Resonance Imaging and Computed Tomography

Disección coronaria. Seguimiento con TCMD

(fig. 1B y C), detectandose ademas progresion de la diseccion hasta segmento medio de circunfleja con imagen compatible con trombo, probablemente en su falsa luz (fig. 1D). Ante estos hallazgos, se planeo nueva coronariografia con vistas a una posible revascularizacion quirurgica, pero 12 h despues del examen con TCMD el paciente experimento episodio de dolor toracico con elevacion del ST de V1 a V5, complicado con disociacion electromecanica y muerte. No se realizo necropsia. El caso demuestra la utilidad de la TCMD en el seguimiento de los stents coronarios localizados en segmentos proximales, asi como en la identificacion de complicaciones concretas: extension de la diseccion e incluso v…

La concentración sanguínea de PGC-1a predice miocardio salvado y remodelado ventricular tras infarto agudo de miocardio con elevación del segmento ST

et al.

Diagnóstico etilógico de la disfunción ventricular izquierda con tomografia computerizada: comparación con coronariografía y cardiorresonancia

[EN] Introduction and objectives To evaluate the capability of multidetector computed tomography to diagnose the coronary etiology of left ventricular dysfunction compared with using invasive coronary angiography and magnetic resonance. Methods Forty consecutive patients with left ventricular dysfunction of uncertain etiology underwent invasive coronary angiography and contrast magnetic resonance. All patients were evaluated with multidetector computed tomography including coronary calcium presence and score, noninvasive coronary angiography, and myocardial tissue assessment. Results The sensitivity and specificity of the presence of coronary calcium to identify left ventricular dysfunction…

Non-Invasive Assessment of Coronary Artery Bypass Grafts and Native Coronary Arteries Using 64-Slice Computed Tomography: Comparison With Invasive Coronary Angiography

Introduction and objectives Although the diagnostic accuracy of CT in the non-invasive assessment of coronary arteries and grafts is known to be high, only a few studies have investigated the technique's reliability for the combined assessment of native coronary arteries, grafts, and vessels lying distal to anastomoses. The aim of this study was to evaluate the diagnostic accuracy of 64-slice CT for assessing coronary grafts and native coronary arteries. Methods In the study, 64-slice CT was used to evaluate 36 patients who had undergone coronary artery bypass graft surgery and had a clinical indication for angiographic graft assessment. The diagnostic accuracy of CT for identifying signifi…

Isolated non-compaction of the myocardium as a cause of coronary and cerebral embolic events in the same patient.

A 44-year-old woman with a history of smoking and previous cerebral thrombo-embolism presented to the emergency department with prolonged chest pain and ECG changes showing an acute anterior myocardial infarction. She was referred to the cath-lab for primary angioplasty. Coronary angiography showed a thrombotic occlusion at the origin of first diagonal …

Lipomatous Metaplasia. Two Chronic Infarcts in the Same Patient Detected by Cardiac Magnetic Resonance

Incidental finding of migrated pacing lead fragment into pulmonary artery detected with CT

This case shows a rare complication of a migrated atrial lead into the pulmonary artery incidentally detected during a comprehensive evaluation of coronary CT angiography.

Velocidad media de la arteria pulmonar estimada por resonancia magnética cardiaca como predictor pronóstico precoz en insuficiencia cardiaca

Resumen Introduccion y objetivo La hipertension pulmonar asocia peor pronostico en insuficiencia cardiaca (IC). En este estudio buscamos identificar predictores pronosticos no invasivos en IC con y sin hipertension pulmonar asociada, mediante resonancia magnetica cardiaca y determinacion de marcadores de estres oxidativo y antiinflamatorios. Pacientes y metodos Inclusion prospectiva de 70 pacientes ingresados por IC de comienzo, en los que se determino la velocidad media de arteria pulmonar (vmAP) y la concentracion sanguinea de TroloxTM (estatus antioxidante) e IL-10 (citocina antiinflamatoria). La muestra se dividio en dos grupos de acuerdo con el valor optimo de vmAP para la prediccion d…

Clinical Benefit of Cardiac Resynchronization Therapy With a Defibrillator in Patients With an Ejection Fraction > 35% Estimated by Cardiac Magnetic Resonance

A B S T R A C T Introduction and objectives: Cardiac resynchronization therapy with a defibrillator prolongs survival and improves quality of life in advanced heart failure. Traditionally, patients with ejection fraction > 35 estimated by echocardiography have been excluded. We assessed the prognostic impact of this therapy in a group of patients with severely depressed systolic function as assessed by echocardiography but with an ejection fraction > 35% as assessed by cardiac magnetic resonance. Methods: We analyzed consecutive patients admitted for decompensated heart failure between 2004 and 2011. The patients were in functional class II-IV, with a QRS to 120 ms, ejection fraction 35% es…

Prognostic Value of Pulmonary Vascular Resistance by Magnetic Resonance in Systolic Heart Failure

Abstract Background: Pulmonary hypertension is associated with poor prognosis in heart failure. However, non-invasive diagnosis is still challenging in clinical practice. Objective: We sought to assess the prognostic utility of non-invasive estimation of pulmonary vascular resistances (PVR) by cardiovascular magnetic resonance to predict adverse cardiovascular outcomes in heart failure with reduced ejection fraction (HFrEF). Methods: Prospective registry of patients with left ventricular ejection fraction (LVEF) < 40% and recently admitted for decompensated heart failure during three years. PVRwere calculated based on right ventricular ejection fraction and average velocity of the pulmonary…