Erratum to "Epigallocathechin-3 gallate inhibits cardiac hypertrophy through blocking reactive oxidative species-dependent and -independent signal pathways" [Free Radical Biol. Med. 40 (2006) 1756-1775].

[Clinical features and long-term outcome comparison of patients with midventricular obstructive hypertrophic cardiomyopathy and apical hypertrophic cardiomyopathy].

OBJECTIVE:To compare the clinical features and long-term outcome of patients with midventricular obstructive hypertrophic cardiomyopathy (MVOHCM) and patients with apical hypertrophic cardiomyopathy (AHCM) in China.METHODS:This retrospective study analyzed clinical data of 66 patients with MVOHCM and 263 patients with AHCM from a consecutive single-center cohort consisting of 2 413 patients with HCM. The clinical features, cardiovascular mortality and morbidity were compared between the two groups.RESULTS:Compared with the AHCM, patients in the MVOHCM group was younger and more likely to be symptomatic over a mean follow-up of 7 years. The proportion of MVOHCM and AHCM were 2.7% (66/2 413) and 10.9% (263/2 413) (P < 0.001), respectively, in this cohort. Cardiovascular mortality of the two groups were 13.6% (9/66) and 0.8% (2/263) (P < 0.001), and cardiovascular morbidity of the two groups were 53.0% (35/66) and 14.4% (38/263) (P < 0.001).CONCLUSION:MVOHCM is rarer, but the clinical manifestations and long-term outcomes are worse compared with AHCM in this patient cohort.

Comparison of the prevalence, clinical features, and long-term outcomes of midventricular hypertrophy vs apical phenotype in patients with hypertrophic cardiomyopathy.

BACKGROUND:Previous studies on the association between the distribution of left ventricle hypertrophy and the clinical features of hypertrophic cardiomyopathy (HCM) have yielded unclear results. The aim of this study was to investigate the differences in the prevalence, clinical features, management strategies, and long-term outcomes between patients with midventricular hypertrophic obstructive cardiomyopathy (MVHOCM) and patients with apical HCM (ApHCM).METHODS:A retrospective study of 60 patients with MVHOCM and 263 patients with ApHCM identified in a consecutive single-centre cohort consisting of 2068 patients with HCM was performed. The prevalence, clinical features, and natural history of the patients in these 2 groups were compared.RESULTS:Compared with ApHCM patients, patients with MVHOCM tended to be much younger and more symptomatic during their initial evaluation. Over a mean follow-up of 7 years, the probability of cardiovascular mortality and that of morbidity was significantly greater in MVHOCM patients compared with ApHCM patients (log-rank, P < 0.001).CONCLUSIONS:Our results suggest that, compared with ApHCM, MVHOCM represents an uncommon presentation of the clinical spectrum of HCM that is characterized by progressive clinical deterioration leading to increased cardiovascular mortality and morbidity. Our results also underscore the importance of the timely recognition of MVHOCM for the prediction of prognosis and the early consideration of appropriate management strategies.

Transplantation with autologous mesenchymal stem cells after acute myocardial infarction evaluated by magnetic resonance imaging: an experimental study.

PURPOSE:The purpose of this study was to track and investigate the effects of autologous bone marrow-derived mesenchymal stem cells (MSCs) transplantation after acute myocardial infarction in swine assessed by magnetic resonance imaging (MRI).MATERIALS AND METHODS:Twenty-four Chinese mini-pigs (27±3 kg) were divided into 4 groups, including control groups (groups 1 and 3) and MSCs transplantation groups (group 2, super paramagnetic iron oxide labeled and group 4, 4',6-diamidino-2-phenylindole labeled). Super paramagnetic iron oxide-labeled and 4',6-diamidino-2-phenylindole-labeled MSCs (3.0×10⁶ cells/mL) with a volume of 10 mL were injected into the left anterior descending artery by a catheter at 1 week after acute myocardial infarction, respectively. Cell distribution, cardiac functions, and scar tissue were quantitatively assessed by MRI.RESULTS:The reduction of the T2* value in the myocardium, spleen, and liver in group 2 was significantly greater than that in group 1. MRI showed that function and scar size at baseline and 3 days after cell infusion were not significantly different between groups 1 and 2. Six weeks later left ventricular ejection fraction (P<0.0001), end-systolic volume (P<0.05), the number of dyskinetic segments (P<0.0001), left ventricular weight index (P<0.0001), and the infarcted size (P<0.0001) in group 4 were all improved comparing with those in group 3.CONCLUSIONS:The majority of MSCs entrapped by the extracardial organs were mainly in the spleen. Catheter-based delivery of autologous bone marrow-derived MSCs into infarcted myocardium is feasible and effective.

Myocardial viability in chronic ischemic heart disease: comparison of delayed-enhancement magnetic resonance imaging with 99mTc-sestamibi and 18F-fluorodeoxyglucose single-photon emission computed tomography.

OBJECTIVES:We sought to compare delayed-enhancement MRI (DE-MRI) with 99mTc-sestamibi and 18F-fluorodeoxyglucose (18F-FDG) single-photon emission computed tomography (SPECT) for the assessment of myocardial viability.METHODS:Thirty-four patients with prior myocardial infarction underwent DE-MRI and 99mTc-sestamibi/18F-FDG SPECT. The area of delayed enhancement by DE-MRI was defined as scar tissue. The region with concordantly reduced perfusion and glucose metabolism was defined as nonviable myocardium. In a 17-segment model, the segmental extent of hyperenhancement was compared with segmental 99mTc-sestamibi and 18F-FDG uptake defect. All segments were divided into five different severities by segmental extent of hyperenhancement in DE-MRI and were classified into different viability situations by segmental 99mTc-sestamibi and 18F-FDG uptake in SPECT.RESULTS:A total of 578 segments were studied. Sensitivity and specificity of DE-MRI in identifying segments with flow/metabolism match were 61.32 and 95.35%, respectively. Semiquantitatively assessed relative MRI scar tissue correlated well with 99mTc-sestamibi and 18F-FDG SPECT (r = 0.63, P = 0.0284). However, of the 431 segments defined as normal by DE-MRI, 82 segments (19%) were scored as nonviable by 18F-FDG SPECT. During these segments, 48 showed less than 50% reduced 18F-FDG uptake, 25 showed 50-75% reduced 18F-FDG uptake, and nine showed no 18F-FDG uptake.CONCLUSION:MRI hyperenhancement as a marker of myocardial scar closely agrees with 99mTc-sestamibi and 18F-FDG SPECT. Nuclear technology and DE-MRI show their own predominance and limitation in assessment of myocardial viability and detecting irreversibly injured tissue.

[Analysis of complications during and post interventional therapy of congenital heart disease].

OBJECTIVE:To analyze the incidence and cause of complications during and after interventional therapy for congenital heart disease (CHD).METHODS:From April 1986 to April 2009, 388 out of 6029 patients with CHD developed complications during and post interventional therapy, another 5 patients died post procedure, clinical data from these 393 patients were retrospectively analyzed. The patients with severe functional insufficiency requiring intervention or surgery during and after interventional therapy were classified as severe complications.RESULTS:The overall complication rate was 6.44% [7.69% post atrial septal defect occlusion, 4.20% post patent ductus arteriosus (PDA) occlusion, 1.31% post percutaneous balloon pulmonary valvuloplasty, 14.94% post ventricular septal defect occlusion, 3.13% post percutaneous closure of aortopulmonary collaterals, 30.95% post catheter embolotherapy of pulmonary arteriovenous malformations, 12.50% post transcatheter closure of coronary artery fistulae, 20.00% post transcatheter closure of ruptured sinus of Valsava aneurysm, 66.67% post percutaneous balloon aortic valvuloplasty]. The severe complication rate was 0.65%(39/6029). The procedure-related mortality rate was 0.08% (5/6029), 0.26% (2/761) post percutaneous balloon pulmonary valvuloplasty, 0.05% (1/2070) post PDA occlusion, 9.10% (1/11) post balloon atrial septostomy, 33.33% (1/3) post percutaneous balloon aortic valvuloplasty. Emergency Cardiovascular surgery rate was 0.22% (13/6029). Selective surgery was required in 0.13% (8/6029) of patients post procedure. Two patients (0.03%) received permanent pacemaker implantation.CONCLUSIONS:The severe complications and mortality rate of interventional therapy for CHD are relative low. Post procedure follow-up is needed fro monitoring possible procedure-related complications.

[Autologous bone marrow mononuclear cells and peripheral endothelial progenitor cells differentiation in myocardial ischemia reperfusion injury region in swine].

OBJECTIVE:To investigate the differentiation status of autologous bone marrow mononuclear cells (BM-MNC) and peripheral endothelial progenitor cells (EPC) transplanted into myocardial ischemia reperfusion injury region in swine.METHODS:BM-MNC marked with PKH26 (n = 9), EPC marked with CM-DiI (n = 7), phosphate buffer saline (control, n = 7) were transplanted into myocardial ischemia reperfusion injury region of swine by intracoronary artery injection. Specimens were harvested 4 weeks after injection for histological analysis (HE, immunochemical stain for vWF, alpha-sarcomeric-actin and fibronectin antibody). Cell differentiation was observed under transmission electronmicroscope.RESULTS:The number of small blood vessels was similar between BM-MNC group and EPC group (13.39 +/- 6.96/HP vs.12.39 +/- 4.72/HP, P < 0.05), but was significantly higher than that of control group (P < 0.05). Responsive intensity of immunochemical stain for fibronectin antibody was significantly lower in BM-MNC and EPC groups than that in control group. Responsive intensity of immunochemical stain for alpha-sarcomeric-actin antibody was similar among the three groups. Cluster cells were observed in one swine from BM-MNC group which might relate to the proliferation of stem cells in situ. Immature endothelial cells and myocytes were also detected by transmission electronmicroscope in BM-MNC and EPC group.CONCLUSION:BM-MNC and EPC transplanted into myocardial ischemia reperfusion injury region in swine stimulated the formation of blood vessels and inhibited fibrogenesis.

[Diagnostic value of magnetic resonance imaging for arrhythmogenic right ventricular cardiomyopathy].

OBJECTIVE:To evaluate the diagnostic value of magnetic resonance imaging (MRI) for arrhythmogenic right ventricular cardiomyopathy (ARVC).METHODS:MRI was performed in 27 (male 21, mean age: 37.4 y, ranging from 15 - 67 y) clinically diagnosed ARVC patients according to the 1994 ARVC diagnosis criteria of WHO from Oct. 2004 to Jun. 2006. Heart chamber size, fat infiltration, local or global ventricular function, myocardium perfusion of contrast first pass and late enhancement were examined.RESULTS:Fat infiltration was found in 24 (88.89%), trabecular disarray in 17 (62.96%), significant dilated right ventricle outlet (RVOT) in 18 (66.67%), dilated RV apex in 14 (51.85%), dilated RV free wall and posterior wall in 18 (66.67%) and right atrium enlargement in 11 (40.74%) patients. Local RV dysfunction was found in 18.52% (5/27), global RV dysfunction in 70.37% (19/27) of patients with mean RV ejection fraction (EF) of 35%. Left ventricle was affected in 40.74% (11/27) of patients. Perfusion defects were found in only 10.52% (2/19) of patients. Positive late enhancement of myocardium were found in 36.84% (7/19) of patients and affecting mainly the wall of RVOT and the free wall associated with lateral wall enhancement of LV. Five patients received heart transplantation and histology on transplanted hearts confirmed the MRI findings.CONCLUSION:"One-stop-shop" MRI scanning can be used for the diagnosis of ARVC. While for some ARVC cases with dominant abnormality in LV, it is difficult for MRI to differentiate ARVC from dilated cardiomyopathy or coronary heart disease. We found fibrosis of lateral wall of LV can be a characteristic sign of ARVC.

[Identification of viable myocardium delayed enhancement magnetic resonance imaging and 99Tcm-sestamibi or 18F-fluorodeoxyglucose single photon emission computed tomography].

OBJECTIVE:The aim of this study was to investigate the feasibility and accuracy of delayed enhancement magnetic resonance imaging (DE-MRI) for the assessment of myocardial viability in patients with myocardial infarction in comparison with (99)Tc(m)-sestamibi (MIBI) single photon emission computed tomography (SPECT) and (18)F-fluorodeoxyglucose (FDG) SPECT. Scar was defined as regionally increased MRI signal intensity 15 minutes after injection of 0.2 mmol/kg gadolinium-diethylenetriamine pentaacetic acid or reduced perfusion and glucose metabolism defined by SPECT.METHODS:A total of 34 patients with myocardial infarction (29 males, 58.0 +/- 9.8 years) were imaged with MRI and SPECT.RESULTS:A total of 578 segments were analyzed. DE-MRI and SPECT identified 431 and 336 viable segments respectively and SPECT also identified 30 ischemic segments. Necrotic segments identified by DE-MRI and SPECT were 147 and 212 respectively. Sensitivity and specificity of DE-MRI in identifying segments with matched flow/metabolism defects (scar tissues) was 61.3% and 95.4%, respectively. Quantitatively assessed relative MRI infarct area correlated well with SPECT infarct size. The value of Kappa was 0.51.CONCLUSION:DE-MRI provides a good tool for differentiating viable myocardium from scar tissues and the detection accuracy is comparable between DE-MRI and SPECT.

[Clinical characterizations of patients with isolated left ventricular noncompaction diagnosed by magnetic resonance imaging].

OBJECTIVE:To observe the clinical and magnetic resonance imaging (MRI) characterizations in patients with isolated left ventricular noncompaction (LVNC).METHODS:All patients were examined by MRI. The LV was divided into 9 segments for localizing non compacted segments. A new value, C/VS, was introduced to assess the degree of non compacted segments.RESULTS:A total of 31 patients was diagnosed as LVNC (23 males; 39.9 +/- 15.7 years). Palpitations presented in 74% of patients, abnormal EKG found in 93.5% of patients, 33.3% segments were affected and most commonly in the mid-ventricular and apical segments, 84% of patients had > or = 2 affected segments. Right ventricle was affected in 2 patients. Left ventricular thrombi were detected in 3 patients. LVEF was 37.2% +/- 16.5% (14% - 70%), N/C was 3.6 +/- 1.4 (2.2 - 9.2) and C/VS was 0.43 +/- 0.11 (0.27 - 0.69).CONCLUSIONS:Cardiac MRI allows accurate LVNC assessment.

Erratum to "Epigallocathechin-3 gallate inhibits cardiac hypertrophy through blocking reactive oxidative species-dependent and -independent signal pathways" [Free Radical Biol. Med. 40 (2006) 1756-1775].

[Clinical features and long-term outcome comparison of patients with midventricular obstructive hypertrophic cardiomyopathy and apical hypertrophic cardiomyopathy].

OBJECTIVE:To compare the clinical features and long-term outcome of patients with midventricular obstructive hypertrophic cardiomyopathy (MVOHCM) and patients with apical hypertrophic cardiomyopathy (AHCM) in China.METHODS:This retrospective study analyzed clinical data of 66 patients with MVOHCM and 263 patients with AHCM from a consecutive single-center cohort consisting of 2 413 patients with HCM. The clinical features, cardiovascular mortality and morbidity were compared between the two groups.RESULTS:Compared with the AHCM, patients in the MVOHCM group was younger and more likely to be symptomatic over a mean follow-up of 7 years. The proportion of MVOHCM and AHCM were 2.7% (66/2 413) and 10.9% (263/2 413) (P < 0.001), respectively, in this cohort. Cardiovascular mortality of the two groups were 13.6% (9/66) and 0.8% (2/263) (P < 0.001), and cardiovascular morbidity of the two groups were 53.0% (35/66) and 14.4% (38/263) (P < 0.001).CONCLUSION:MVOHCM is rarer, but the clinical manifestations and long-term outcomes are worse compared with AHCM in this patient cohort.

Comparison of the prevalence, clinical features, and long-term outcomes of midventricular hypertrophy vs apical phenotype in patients with hypertrophic cardiomyopathy.

BACKGROUND:Previous studies on the association between the distribution of left ventricle hypertrophy and the clinical features of hypertrophic cardiomyopathy (HCM) have yielded unclear results. The aim of this study was to investigate the differences in the prevalence, clinical features, management strategies, and long-term outcomes between patients with midventricular hypertrophic obstructive cardiomyopathy (MVHOCM) and patients with apical HCM (ApHCM).METHODS:A retrospective study of 60 patients with MVHOCM and 263 patients with ApHCM identified in a consecutive single-centre cohort consisting of 2068 patients with HCM was performed. The prevalence, clinical features, and natural history of the patients in these 2 groups were compared.RESULTS:Compared with ApHCM patients, patients with MVHOCM tended to be much younger and more symptomatic during their initial evaluation. Over a mean follow-up of 7 years, the probability of cardiovascular mortality and that of morbidity was significantly greater in MVHOCM patients compared with ApHCM patients (log-rank, P < 0.001).CONCLUSIONS:Our results suggest that, compared with ApHCM, MVHOCM represents an uncommon presentation of the clinical spectrum of HCM that is characterized by progressive clinical deterioration leading to increased cardiovascular mortality and morbidity. Our results also underscore the importance of the timely recognition of MVHOCM for the prediction of prognosis and the early consideration of appropriate management strategies.

Transplantation with autologous mesenchymal stem cells after acute myocardial infarction evaluated by magnetic resonance imaging: an experimental study.

PURPOSE:The purpose of this study was to track and investigate the effects of autologous bone marrow-derived mesenchymal stem cells (MSCs) transplantation after acute myocardial infarction in swine assessed by magnetic resonance imaging (MRI).MATERIALS AND METHODS:Twenty-four Chinese mini-pigs (27±3 kg) were divided into 4 groups, including control groups (groups 1 and 3) and MSCs transplantation groups (group 2, super paramagnetic iron oxide labeled and group 4, 4',6-diamidino-2-phenylindole labeled). Super paramagnetic iron oxide-labeled and 4',6-diamidino-2-phenylindole-labeled MSCs (3.0×10⁶ cells/mL) with a volume of 10 mL were injected into the left anterior descending artery by a catheter at 1 week after acute myocardial infarction, respectively. Cell distribution, cardiac functions, and scar tissue were quantitatively assessed by MRI.RESULTS:The reduction of the T2* value in the myocardium, spleen, and liver in group 2 was significantly greater than that in group 1. MRI showed that function and scar size at baseline and 3 days after cell infusion were not significantly different between groups 1 and 2. Six weeks later left ventricular ejection fraction (P<0.0001), end-systolic volume (P<0.05), the number of dyskinetic segments (P<0.0001), left ventricular weight index (P<0.0001), and the infarcted size (P<0.0001) in group 4 were all improved comparing with those in group 3.CONCLUSIONS:The majority of MSCs entrapped by the extracardial organs were mainly in the spleen. Catheter-based delivery of autologous bone marrow-derived MSCs into infarcted myocardium is feasible and effective.

Myocardial viability in chronic ischemic heart disease: comparison of delayed-enhancement magnetic resonance imaging with 99mTc-sestamibi and 18F-fluorodeoxyglucose single-photon emission computed tomography.

OBJECTIVES:We sought to compare delayed-enhancement MRI (DE-MRI) with 99mTc-sestamibi and 18F-fluorodeoxyglucose (18F-FDG) single-photon emission computed tomography (SPECT) for the assessment of myocardial viability.METHODS:Thirty-four patients with prior myocardial infarction underwent DE-MRI and 99mTc-sestamibi/18F-FDG SPECT. The area of delayed enhancement by DE-MRI was defined as scar tissue. The region with concordantly reduced perfusion and glucose metabolism was defined as nonviable myocardium. In a 17-segment model, the segmental extent of hyperenhancement was compared with segmental 99mTc-sestamibi and 18F-FDG uptake defect. All segments were divided into five different severities by segmental extent of hyperenhancement in DE-MRI and were classified into different viability situations by segmental 99mTc-sestamibi and 18F-FDG uptake in SPECT.RESULTS:A total of 578 segments were studied. Sensitivity and specificity of DE-MRI in identifying segments with flow/metabolism match were 61.32 and 95.35%, respectively. Semiquantitatively assessed relative MRI scar tissue correlated well with 99mTc-sestamibi and 18F-FDG SPECT (r = 0.63, P = 0.0284). However, of the 431 segments defined as normal by DE-MRI, 82 segments (19%) were scored as nonviable by 18F-FDG SPECT. During these segments, 48 showed less than 50% reduced 18F-FDG uptake, 25 showed 50-75% reduced 18F-FDG uptake, and nine showed no 18F-FDG uptake.CONCLUSION:MRI hyperenhancement as a marker of myocardial scar closely agrees with 99mTc-sestamibi and 18F-FDG SPECT. Nuclear technology and DE-MRI show their own predominance and limitation in assessment of myocardial viability and detecting irreversibly injured tissue.

[Analysis of complications during and post interventional therapy of congenital heart disease].

OBJECTIVE:To analyze the incidence and cause of complications during and after interventional therapy for congenital heart disease (CHD).METHODS:From April 1986 to April 2009, 388 out of 6029 patients with CHD developed complications during and post interventional therapy, another 5 patients died post procedure, clinical data from these 393 patients were retrospectively analyzed. The patients with severe functional insufficiency requiring intervention or surgery during and after interventional therapy were classified as severe complications.RESULTS:The overall complication rate was 6.44% [7.69% post atrial septal defect occlusion, 4.20% post patent ductus arteriosus (PDA) occlusion, 1.31% post percutaneous balloon pulmonary valvuloplasty, 14.94% post ventricular septal defect occlusion, 3.13% post percutaneous closure of aortopulmonary collaterals, 30.95% post catheter embolotherapy of pulmonary arteriovenous malformations, 12.50% post transcatheter closure of coronary artery fistulae, 20.00% post transcatheter closure of ruptured sinus of Valsava aneurysm, 66.67% post percutaneous balloon aortic valvuloplasty]. The severe complication rate was 0.65%(39/6029). The procedure-related mortality rate was 0.08% (5/6029), 0.26% (2/761) post percutaneous balloon pulmonary valvuloplasty, 0.05% (1/2070) post PDA occlusion, 9.10% (1/11) post balloon atrial septostomy, 33.33% (1/3) post percutaneous balloon aortic valvuloplasty. Emergency Cardiovascular surgery rate was 0.22% (13/6029). Selective surgery was required in 0.13% (8/6029) of patients post procedure. Two patients (0.03%) received permanent pacemaker implantation.CONCLUSIONS:The severe complications and mortality rate of interventional therapy for CHD are relative low. Post procedure follow-up is needed fro monitoring possible procedure-related complications.

[Autologous bone marrow mononuclear cells and peripheral endothelial progenitor cells differentiation in myocardial ischemia reperfusion injury region in swine].

OBJECTIVE:To investigate the differentiation status of autologous bone marrow mononuclear cells (BM-MNC) and peripheral endothelial progenitor cells (EPC) transplanted into myocardial ischemia reperfusion injury region in swine.METHODS:BM-MNC marked with PKH26 (n = 9), EPC marked with CM-DiI (n = 7), phosphate buffer saline (control, n = 7) were transplanted into myocardial ischemia reperfusion injury region of swine by intracoronary artery injection. Specimens were harvested 4 weeks after injection for histological analysis (HE, immunochemical stain for vWF, alpha-sarcomeric-actin and fibronectin antibody). Cell differentiation was observed under transmission electronmicroscope.RESULTS:The number of small blood vessels was similar between BM-MNC group and EPC group (13.39 +/- 6.96/HP vs.12.39 +/- 4.72/HP, P < 0.05), but was significantly higher than that of control group (P < 0.05). Responsive intensity of immunochemical stain for fibronectin antibody was significantly lower in BM-MNC and EPC groups than that in control group. Responsive intensity of immunochemical stain for alpha-sarcomeric-actin antibody was similar among the three groups. Cluster cells were observed in one swine from BM-MNC group which might relate to the proliferation of stem cells in situ. Immature endothelial cells and myocytes were also detected by transmission electronmicroscope in BM-MNC and EPC group.CONCLUSION:BM-MNC and EPC transplanted into myocardial ischemia reperfusion injury region in swine stimulated the formation of blood vessels and inhibited fibrogenesis.

[Diagnostic value of magnetic resonance imaging for arrhythmogenic right ventricular cardiomyopathy].

OBJECTIVE:To evaluate the diagnostic value of magnetic resonance imaging (MRI) for arrhythmogenic right ventricular cardiomyopathy (ARVC).METHODS:MRI was performed in 27 (male 21, mean age: 37.4 y, ranging from 15 - 67 y) clinically diagnosed ARVC patients according to the 1994 ARVC diagnosis criteria of WHO from Oct. 2004 to Jun. 2006. Heart chamber size, fat infiltration, local or global ventricular function, myocardium perfusion of contrast first pass and late enhancement were examined.RESULTS:Fat infiltration was found in 24 (88.89%), trabecular disarray in 17 (62.96%), significant dilated right ventricle outlet (RVOT) in 18 (66.67%), dilated RV apex in 14 (51.85%), dilated RV free wall and posterior wall in 18 (66.67%) and right atrium enlargement in 11 (40.74%) patients. Local RV dysfunction was found in 18.52% (5/27), global RV dysfunction in 70.37% (19/27) of patients with mean RV ejection fraction (EF) of 35%. Left ventricle was affected in 40.74% (11/27) of patients. Perfusion defects were found in only 10.52% (2/19) of patients. Positive late enhancement of myocardium were found in 36.84% (7/19) of patients and affecting mainly the wall of RVOT and the free wall associated with lateral wall enhancement of LV. Five patients received heart transplantation and histology on transplanted hearts confirmed the MRI findings.CONCLUSION:"One-stop-shop" MRI scanning can be used for the diagnosis of ARVC. While for some ARVC cases with dominant abnormality in LV, it is difficult for MRI to differentiate ARVC from dilated cardiomyopathy or coronary heart disease. We found fibrosis of lateral wall of LV can be a characteristic sign of ARVC.

[Identification of viable myocardium delayed enhancement magnetic resonance imaging and 99Tcm-sestamibi or 18F-fluorodeoxyglucose single photon emission computed tomography].

OBJECTIVE:The aim of this study was to investigate the feasibility and accuracy of delayed enhancement magnetic resonance imaging (DE-MRI) for the assessment of myocardial viability in patients with myocardial infarction in comparison with (99)Tc(m)-sestamibi (MIBI) single photon emission computed tomography (SPECT) and (18)F-fluorodeoxyglucose (FDG) SPECT. Scar was defined as regionally increased MRI signal intensity 15 minutes after injection of 0.2 mmol/kg gadolinium-diethylenetriamine pentaacetic acid or reduced perfusion and glucose metabolism defined by SPECT.METHODS:A total of 34 patients with myocardial infarction (29 males, 58.0 +/- 9.8 years) were imaged with MRI and SPECT.RESULTS:A total of 578 segments were analyzed. DE-MRI and SPECT identified 431 and 336 viable segments respectively and SPECT also identified 30 ischemic segments. Necrotic segments identified by DE-MRI and SPECT were 147 and 212 respectively. Sensitivity and specificity of DE-MRI in identifying segments with matched flow/metabolism defects (scar tissues) was 61.3% and 95.4%, respectively. Quantitatively assessed relative MRI infarct area correlated well with SPECT infarct size. The value of Kappa was 0.51.CONCLUSION:DE-MRI provides a good tool for differentiating viable myocardium from scar tissues and the detection accuracy is comparable between DE-MRI and SPECT.

[Clinical characterizations of patients with isolated left ventricular noncompaction diagnosed by magnetic resonance imaging].

OBJECTIVE:To observe the clinical and magnetic resonance imaging (MRI) characterizations in patients with isolated left ventricular noncompaction (LVNC).METHODS:All patients were examined by MRI. The LV was divided into 9 segments for localizing non compacted segments. A new value, C/VS, was introduced to assess the degree of non compacted segments.RESULTS:A total of 31 patients was diagnosed as LVNC (23 males; 39.9 +/- 15.7 years). Palpitations presented in 74% of patients, abnormal EKG found in 93.5% of patients, 33.3% segments were affected and most commonly in the mid-ventricular and apical segments, 84% of patients had > or = 2 affected segments. Right ventricle was affected in 2 patients. Left ventricular thrombi were detected in 3 patients. LVEF was 37.2% +/- 16.5% (14% - 70%), N/C was 3.6 +/- 1.4 (2.2 - 9.2) and C/VS was 0.43 +/- 0.11 (0.27 - 0.69).CONCLUSIONS:Cardiac MRI allows accurate LVNC assessment.