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Publisher: Oxford University Press   (Total: 396 journals)

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Showing 1 - 200 of 396 Journals sorted alphabetically
ACS Symposium Series     Full-text available via subscription   (SJR: 0.189, CiteScore: 0)
Acta Biochimica et Biophysica Sinica     Hybrid Journal   (Followers: 5, SJR: 0.79, CiteScore: 2)
Adaptation     Hybrid Journal   (Followers: 9, SJR: 0.143, CiteScore: 0)
Advances in Nutrition     Hybrid Journal   (Followers: 46, SJR: 2.196, CiteScore: 5)
Aesthetic Surgery J.     Hybrid Journal   (Followers: 6, SJR: 1.434, CiteScore: 1)
African Affairs     Hybrid Journal   (Followers: 64, SJR: 1.869, CiteScore: 2)
Age and Ageing     Hybrid Journal   (Followers: 91, SJR: 1.989, CiteScore: 4)
Alcohol and Alcoholism     Hybrid Journal   (Followers: 18, SJR: 1.376, CiteScore: 3)
American Entomologist     Full-text available via subscription   (Followers: 7)
American Historical Review     Hybrid Journal   (Followers: 153, SJR: 0.467, CiteScore: 1)
American J. of Agricultural Economics     Hybrid Journal   (Followers: 41, SJR: 2.113, CiteScore: 3)
American J. of Clinical Nutrition     Hybrid Journal   (Followers: 145, SJR: 3.438, CiteScore: 6)
American J. of Epidemiology     Hybrid Journal   (Followers: 175, SJR: 2.713, CiteScore: 3)
American J. of Hypertension     Hybrid Journal   (Followers: 25, SJR: 1.322, CiteScore: 3)
American J. of Jurisprudence     Hybrid Journal   (Followers: 18, SJR: 0.281, CiteScore: 1)
American J. of Legal History     Full-text available via subscription   (Followers: 8, SJR: 0.116, CiteScore: 0)
American Law and Economics Review     Hybrid Journal   (Followers: 27, SJR: 1.053, CiteScore: 1)
American Literary History     Hybrid Journal   (Followers: 15, SJR: 0.391, CiteScore: 0)
Analysis     Hybrid Journal   (Followers: 21, SJR: 1.038, CiteScore: 1)
Animal Frontiers     Hybrid Journal  
Annals of Behavioral Medicine     Hybrid Journal   (Followers: 15, SJR: 1.423, CiteScore: 3)
Annals of Botany     Hybrid Journal   (Followers: 36, SJR: 1.721, CiteScore: 4)
Annals of Oncology     Hybrid Journal   (Followers: 42, SJR: 5.599, CiteScore: 9)
Annals of the Entomological Society of America     Full-text available via subscription   (Followers: 10, SJR: 0.722, CiteScore: 1)
Annals of Work Exposures and Health     Hybrid Journal   (Followers: 32, SJR: 0.728, CiteScore: 2)
AoB Plants     Open Access   (Followers: 4, SJR: 1.28, CiteScore: 3)
Applied Economic Perspectives and Policy     Hybrid Journal   (Followers: 18, SJR: 0.858, CiteScore: 2)
Applied Linguistics     Hybrid Journal   (Followers: 56, SJR: 2.987, CiteScore: 3)
Applied Mathematics Research eXpress     Hybrid Journal   (Followers: 1, SJR: 1.241, CiteScore: 1)
Arbitration Intl.     Full-text available via subscription   (Followers: 20)
Arbitration Law Reports and Review     Hybrid Journal   (Followers: 14)
Archives of Clinical Neuropsychology     Hybrid Journal   (Followers: 30, SJR: 0.731, CiteScore: 2)
Aristotelian Society Supplementary Volume     Hybrid Journal   (Followers: 3)
Arthropod Management Tests     Hybrid Journal   (Followers: 2)
Astronomy & Geophysics     Hybrid Journal   (Followers: 43, SJR: 0.146, CiteScore: 0)
Behavioral Ecology     Hybrid Journal   (Followers: 52, SJR: 1.871, CiteScore: 3)
Bioinformatics     Hybrid Journal   (Followers: 302, SJR: 6.14, CiteScore: 8)
Biology Methods and Protocols     Hybrid Journal  
Biology of Reproduction     Full-text available via subscription   (Followers: 10, SJR: 1.446, CiteScore: 3)
Biometrika     Hybrid Journal   (Followers: 20, SJR: 3.485, CiteScore: 2)
BioScience     Hybrid Journal   (Followers: 29, SJR: 2.754, CiteScore: 4)
Bioscience Horizons : The National Undergraduate Research J.     Open Access   (Followers: 1, SJR: 0.146, CiteScore: 0)
Biostatistics     Hybrid Journal   (Followers: 17, SJR: 1.553, CiteScore: 2)
BJA : British J. of Anaesthesia     Hybrid Journal   (Followers: 165, SJR: 2.115, CiteScore: 3)
BJA Education     Hybrid Journal   (Followers: 64)
Brain     Hybrid Journal   (Followers: 68, SJR: 5.858, CiteScore: 7)
Briefings in Bioinformatics     Hybrid Journal   (Followers: 48, SJR: 2.505, CiteScore: 5)
Briefings in Functional Genomics     Hybrid Journal   (Followers: 3, SJR: 2.15, CiteScore: 3)
British J. for the Philosophy of Science     Hybrid Journal   (Followers: 35, SJR: 2.161, CiteScore: 2)
British J. of Aesthetics     Hybrid Journal   (Followers: 26, SJR: 0.508, CiteScore: 1)
British J. of Criminology     Hybrid Journal   (Followers: 585, SJR: 1.828, CiteScore: 3)
British J. of Social Work     Hybrid Journal   (Followers: 88, SJR: 1.019, CiteScore: 2)
British Medical Bulletin     Hybrid Journal   (Followers: 7, SJR: 1.355, CiteScore: 3)
British Yearbook of Intl. Law     Hybrid Journal   (Followers: 32)
Bulletin of the London Mathematical Society     Hybrid Journal   (Followers: 4, SJR: 1.376, CiteScore: 1)
Cambridge J. of Economics     Hybrid Journal   (Followers: 62, SJR: 0.764, CiteScore: 2)
Cambridge J. of Regions, Economy and Society     Hybrid Journal   (Followers: 11, SJR: 2.438, CiteScore: 4)
Cambridge Quarterly     Hybrid Journal   (Followers: 9, SJR: 0.104, CiteScore: 0)
Capital Markets Law J.     Hybrid Journal   (Followers: 2, SJR: 0.222, CiteScore: 0)
Carcinogenesis     Hybrid Journal   (Followers: 2, SJR: 2.135, CiteScore: 5)
Cardiovascular Research     Hybrid Journal   (Followers: 14, SJR: 3.002, CiteScore: 5)
Cerebral Cortex     Hybrid Journal   (Followers: 45, SJR: 3.892, CiteScore: 6)
CESifo Economic Studies     Hybrid Journal   (Followers: 17, SJR: 0.483, CiteScore: 1)
Chemical Senses     Hybrid Journal   (Followers: 1, SJR: 1.42, CiteScore: 3)
Children and Schools     Hybrid Journal   (Followers: 5, SJR: 0.246, CiteScore: 0)
Chinese J. of Comparative Law     Hybrid Journal   (Followers: 4, SJR: 0.412, CiteScore: 0)
Chinese J. of Intl. Law     Hybrid Journal   (Followers: 23, SJR: 0.329, CiteScore: 0)
Chinese J. of Intl. Politics     Hybrid Journal   (Followers: 9, SJR: 1.392, CiteScore: 2)
Christian Bioethics: Non-Ecumenical Studies in Medical Morality     Hybrid Journal   (Followers: 10, SJR: 0.183, CiteScore: 0)
Classical Receptions J.     Hybrid Journal   (Followers: 25, SJR: 0.123, CiteScore: 0)
Clean Energy     Open Access   (Followers: 1)
Clinical Infectious Diseases     Hybrid Journal   (Followers: 65, SJR: 5.051, CiteScore: 5)
Clinical Kidney J.     Open Access   (Followers: 3, SJR: 1.163, CiteScore: 2)
Communication Theory     Hybrid Journal   (Followers: 22, SJR: 2.424, CiteScore: 3)
Communication, Culture & Critique     Hybrid Journal   (Followers: 27, SJR: 0.222, CiteScore: 1)
Community Development J.     Hybrid Journal   (Followers: 27, SJR: 0.268, CiteScore: 1)
Computer J.     Hybrid Journal   (Followers: 9, SJR: 0.319, CiteScore: 1)
Conservation Physiology     Open Access   (Followers: 2, SJR: 1.818, CiteScore: 3)
Contemporary Women's Writing     Hybrid Journal   (Followers: 9, SJR: 0.121, CiteScore: 0)
Contributions to Political Economy     Hybrid Journal   (Followers: 5, SJR: 0.906, CiteScore: 1)
Critical Values     Full-text available via subscription  
Current Developments in Nutrition     Open Access   (Followers: 1)
Current Legal Problems     Hybrid Journal   (Followers: 27)
Current Zoology     Full-text available via subscription   (Followers: 2, SJR: 1.164, CiteScore: 2)
Database : The J. of Biological Databases and Curation     Open Access   (Followers: 8, SJR: 1.791, CiteScore: 3)
Digital Scholarship in the Humanities     Hybrid Journal   (Followers: 14, SJR: 0.259, CiteScore: 1)
Diplomatic History     Hybrid Journal   (Followers: 20, SJR: 0.45, CiteScore: 1)
DNA Research     Open Access   (Followers: 5, SJR: 2.866, CiteScore: 6)
Dynamics and Statistics of the Climate System     Open Access   (Followers: 4)
Early Music     Hybrid Journal   (Followers: 15, SJR: 0.139, CiteScore: 0)
Economic Policy     Hybrid Journal   (Followers: 39, SJR: 3.584, CiteScore: 3)
ELT J.     Hybrid Journal   (Followers: 24, SJR: 0.942, CiteScore: 1)
English Historical Review     Hybrid Journal   (Followers: 52, SJR: 0.612, CiteScore: 1)
English: J. of the English Association     Hybrid Journal   (Followers: 14, SJR: 0.1, CiteScore: 0)
Environmental Entomology     Full-text available via subscription   (Followers: 11, SJR: 0.818, CiteScore: 2)
Environmental Epigenetics     Open Access   (Followers: 3)
Environmental History     Hybrid Journal   (Followers: 27, SJR: 0.408, CiteScore: 1)
EP-Europace     Hybrid Journal   (Followers: 2, SJR: 2.748, CiteScore: 4)
Epidemiologic Reviews     Hybrid Journal   (Followers: 9, SJR: 4.505, CiteScore: 8)
ESHRE Monographs     Hybrid Journal  
Essays in Criticism     Hybrid Journal   (Followers: 17, SJR: 0.113, CiteScore: 0)
European Heart J.     Hybrid Journal   (Followers: 57, SJR: 9.315, CiteScore: 9)
European Heart J. - Cardiovascular Imaging     Hybrid Journal   (Followers: 9, SJR: 3.625, CiteScore: 3)
European Heart J. - Cardiovascular Pharmacotherapy     Full-text available via subscription   (Followers: 1)
European Heart J. - Quality of Care and Clinical Outcomes     Hybrid Journal  
European Heart J. : Case Reports     Open Access  
European Heart J. Supplements     Hybrid Journal   (Followers: 8, SJR: 0.223, CiteScore: 0)
European J. of Cardio-Thoracic Surgery     Hybrid Journal   (Followers: 9, SJR: 1.681, CiteScore: 2)
European J. of Intl. Law     Hybrid Journal   (Followers: 186, SJR: 0.694, CiteScore: 1)
European J. of Orthodontics     Hybrid Journal   (Followers: 4, SJR: 1.279, CiteScore: 2)
European J. of Public Health     Hybrid Journal   (Followers: 20, SJR: 1.36, CiteScore: 2)
European Review of Agricultural Economics     Hybrid Journal   (Followers: 10, SJR: 1.172, CiteScore: 2)
European Review of Economic History     Hybrid Journal   (Followers: 29, SJR: 0.702, CiteScore: 1)
European Sociological Review     Hybrid Journal   (Followers: 40, SJR: 2.728, CiteScore: 3)
Evolution, Medicine, and Public Health     Open Access   (Followers: 11)
Family Practice     Hybrid Journal   (Followers: 15, SJR: 1.018, CiteScore: 2)
Fems Microbiology Ecology     Hybrid Journal   (Followers: 12, SJR: 1.492, CiteScore: 4)
Fems Microbiology Letters     Hybrid Journal   (Followers: 24, SJR: 0.79, CiteScore: 2)
Fems Microbiology Reviews     Hybrid Journal   (Followers: 30, SJR: 7.063, CiteScore: 13)
Fems Yeast Research     Hybrid Journal   (Followers: 14, SJR: 1.308, CiteScore: 3)
Food Quality and Safety     Open Access   (Followers: 1)
Foreign Policy Analysis     Hybrid Journal   (Followers: 23, SJR: 1.425, CiteScore: 1)
Forest Science     Hybrid Journal   (Followers: 7, SJR: 0.89, CiteScore: 2)
Forestry: An Intl. J. of Forest Research     Hybrid Journal   (Followers: 16, SJR: 1.133, CiteScore: 3)
Forum for Modern Language Studies     Hybrid Journal   (Followers: 6, SJR: 0.104, CiteScore: 0)
French History     Hybrid Journal   (Followers: 33, SJR: 0.118, CiteScore: 0)
French Studies     Hybrid Journal   (Followers: 20, SJR: 0.148, CiteScore: 0)
French Studies Bulletin     Hybrid Journal   (Followers: 10, SJR: 0.152, CiteScore: 0)
Gastroenterology Report     Open Access   (Followers: 2)
Genome Biology and Evolution     Open Access   (Followers: 12, SJR: 2.578, CiteScore: 4)
Geophysical J. Intl.     Hybrid Journal   (Followers: 35, SJR: 1.506, CiteScore: 3)
German History     Hybrid Journal   (Followers: 22, SJR: 0.161, CiteScore: 0)
GigaScience     Open Access   (Followers: 4, SJR: 5.022, CiteScore: 7)
Global Summitry     Hybrid Journal   (Followers: 1)
Glycobiology     Hybrid Journal   (Followers: 14, SJR: 1.493, CiteScore: 3)
Health and Social Work     Hybrid Journal   (Followers: 56, SJR: 0.388, CiteScore: 1)
Health Education Research     Hybrid Journal   (Followers: 15, SJR: 0.854, CiteScore: 2)
Health Policy and Planning     Hybrid Journal   (Followers: 24, SJR: 1.512, CiteScore: 2)
Health Promotion Intl.     Hybrid Journal   (Followers: 22, SJR: 0.812, CiteScore: 2)
History Workshop J.     Hybrid Journal   (Followers: 31, SJR: 1.278, CiteScore: 1)
Holocaust and Genocide Studies     Hybrid Journal   (Followers: 28, SJR: 0.105, CiteScore: 0)
Human Communication Research     Hybrid Journal   (Followers: 13, SJR: 2.146, CiteScore: 3)
Human Molecular Genetics     Hybrid Journal   (Followers: 8, SJR: 3.555, CiteScore: 5)
Human Reproduction     Hybrid Journal   (Followers: 71, SJR: 2.643, CiteScore: 5)
Human Reproduction Open     Open Access  
Human Reproduction Update     Hybrid Journal   (Followers: 20, SJR: 5.317, CiteScore: 10)
Human Rights Law Review     Hybrid Journal   (Followers: 56, SJR: 0.756, CiteScore: 1)
ICES J. of Marine Science: J. du Conseil     Hybrid Journal   (Followers: 52, SJR: 1.591, CiteScore: 3)
ICSID Review     Hybrid Journal   (Followers: 10)
ILAR J.     Hybrid Journal   (Followers: 2, SJR: 1.732, CiteScore: 4)
IMA J. of Applied Mathematics     Hybrid Journal   (SJR: 0.679, CiteScore: 1)
IMA J. of Management Mathematics     Hybrid Journal   (SJR: 0.538, CiteScore: 1)
IMA J. of Mathematical Control and Information     Hybrid Journal   (Followers: 2, SJR: 0.496, CiteScore: 1)
IMA J. of Numerical Analysis - advance access     Hybrid Journal   (SJR: 1.987, CiteScore: 2)
Industrial and Corporate Change     Hybrid Journal   (Followers: 10, SJR: 1.792, CiteScore: 2)
Industrial Law J.     Hybrid Journal   (Followers: 35, SJR: 0.249, CiteScore: 1)
Inflammatory Bowel Diseases     Hybrid Journal   (Followers: 44, SJR: 2.511, CiteScore: 4)
Information and Inference     Free  
Integrative and Comparative Biology     Hybrid Journal   (Followers: 8, SJR: 1.319, CiteScore: 2)
Interacting with Computers     Hybrid Journal   (Followers: 11, SJR: 0.292, CiteScore: 1)
Interactive CardioVascular and Thoracic Surgery     Hybrid Journal   (Followers: 7, SJR: 0.762, CiteScore: 1)
Intl. Affairs     Hybrid Journal   (Followers: 60, SJR: 1.505, CiteScore: 3)
Intl. Data Privacy Law     Hybrid Journal   (Followers: 25)
Intl. Health     Hybrid Journal   (Followers: 6, SJR: 0.851, CiteScore: 2)
Intl. Immunology     Hybrid Journal   (Followers: 3, SJR: 2.167, CiteScore: 4)
Intl. J. for Quality in Health Care     Hybrid Journal   (Followers: 37, SJR: 1.348, CiteScore: 2)
Intl. J. of Constitutional Law     Hybrid Journal   (Followers: 63, SJR: 0.601, CiteScore: 1)
Intl. J. of Epidemiology     Hybrid Journal   (Followers: 228, SJR: 3.969, CiteScore: 5)
Intl. J. of Law and Information Technology     Hybrid Journal   (Followers: 5, SJR: 0.202, CiteScore: 1)
Intl. J. of Law, Policy and the Family     Hybrid Journal   (Followers: 26, SJR: 0.223, CiteScore: 1)
Intl. J. of Lexicography     Hybrid Journal   (Followers: 9, SJR: 0.285, CiteScore: 1)
Intl. J. of Low-Carbon Technologies     Open Access   (Followers: 1, SJR: 0.403, CiteScore: 1)
Intl. J. of Neuropsychopharmacology     Open Access   (Followers: 3, SJR: 1.808, CiteScore: 4)
Intl. J. of Public Opinion Research     Hybrid Journal   (Followers: 9, SJR: 1.545, CiteScore: 1)
Intl. J. of Refugee Law     Hybrid Journal   (Followers: 35, SJR: 0.389, CiteScore: 1)
Intl. J. of Transitional Justice     Hybrid Journal   (Followers: 11, SJR: 0.724, CiteScore: 2)
Intl. Mathematics Research Notices     Hybrid Journal   (Followers: 1, SJR: 2.168, CiteScore: 1)
Intl. Political Sociology     Hybrid Journal   (Followers: 37, SJR: 1.465, CiteScore: 3)
Intl. Relations of the Asia-Pacific     Hybrid Journal   (Followers: 23, SJR: 0.401, CiteScore: 1)
Intl. Studies Perspectives     Hybrid Journal   (Followers: 9, SJR: 0.983, CiteScore: 1)
Intl. Studies Quarterly     Hybrid Journal   (Followers: 45, SJR: 2.581, CiteScore: 2)
Intl. Studies Review     Hybrid Journal   (Followers: 23, SJR: 1.201, CiteScore: 1)
ISLE: Interdisciplinary Studies in Literature and Environment     Hybrid Journal   (Followers: 2, SJR: 0.15, CiteScore: 0)
ITNOW     Hybrid Journal   (Followers: 1, SJR: 0.103, CiteScore: 0)
J. of African Economies     Hybrid Journal   (Followers: 15, SJR: 0.533, CiteScore: 1)
J. of American History     Hybrid Journal   (Followers: 46, SJR: 0.297, CiteScore: 1)
J. of Analytical Toxicology     Hybrid Journal   (Followers: 14, SJR: 1.065, CiteScore: 2)
J. of Antimicrobial Chemotherapy     Hybrid Journal   (Followers: 15, SJR: 2.419, CiteScore: 4)
J. of Antitrust Enforcement     Hybrid Journal   (Followers: 1)
J. of Applied Poultry Research     Hybrid Journal   (Followers: 4, SJR: 0.585, CiteScore: 1)
J. of Biochemistry     Hybrid Journal   (Followers: 40, SJR: 1.226, CiteScore: 2)
J. of Burn Care & Research     Hybrid Journal   (Followers: 9, SJR: 0.768, CiteScore: 2)
J. of Chromatographic Science     Hybrid Journal   (Followers: 18, SJR: 0.36, CiteScore: 1)
J. of Church and State     Hybrid Journal   (Followers: 11, SJR: 0.139, CiteScore: 0)
J. of Communication     Hybrid Journal   (Followers: 53, SJR: 4.411, CiteScore: 5)
J. of Competition Law and Economics     Hybrid Journal   (Followers: 35, SJR: 0.33, CiteScore: 0)
J. of Complex Networks     Hybrid Journal   (Followers: 2, SJR: 1.05, CiteScore: 4)
J. of Computer-Mediated Communication     Open Access   (Followers: 26, SJR: 2.961, CiteScore: 6)
J. of Conflict and Security Law     Hybrid Journal   (Followers: 12, SJR: 0.402, CiteScore: 0)
J. of Consumer Research     Full-text available via subscription   (Followers: 43, SJR: 5.856, CiteScore: 5)

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Journal Cover
European Heart Journal - Cardiovascular Imaging
Journal Prestige (SJR): 3.625
Citation Impact (citeScore): 3
Number of Followers: 9  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 2047-2404 - ISSN (Online) 2047-2412
Published by Oxford University Press Homepage  [396 journals]
  • ESC CardioMed
    • Authors: Tofield A.
      Pages: 959 - 961
      Abstract: The new ESC Textbook of Cardiovascular Medicine, ESC CardioMed, is a continuously updating electronic database (Figure 1) 
      PubDate: Sat, 09 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey087
      Issue No: Vol. 19, No. 9 (2018)
  • Hybrid positron emission tomography–magnetic resonance of the heart:
           current state of the art and future applications
    • Authors: Nazir M; Ismail T, Reyes E, et al.
      Pages: 962 - 974
      Abstract: AbstractHybrid positron emission tomography–magnetic resonance (PET-MR) imaging is a novel imaging modality with emerging applications for cardiovascular disease. PET-MR aims to combine the high-spatial resolution morphological and functional assessment afforded by magnetic resonance imaging (MRI) with the ability of positron emission tomography (PET) for quantification of metabolism, perfusion, and inflammation. The fusion of these two modalities into a single imaging platform not only represents an opportunity to acquire complementary information from a single scan, but also allows motion correction for PET with reduction in ionising radiation. This article presents a brief overview of PET-MR technology followed by a review of the published literature on the clinical cardio-vascular applications of PET and MRI performed separately and with hybrid PET-MR.
      PubDate: Thu, 12 Jul 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey090
      Issue No: Vol. 19, No. 9 (2018)
  • Lung abscess seen on echocardiography
    • Authors: Crawford M; Moscona J.
      Pages: 974 - 974
      Abstract: A 68-year-old woman presented with worsening shortness of breath on exertion. She had a past medical history significant for heart failure with preserved ejection fraction and pulmonary Mycobacterium abscessus infection. Chest radiograph showed bilateral pleural effusions with bibasilar airspace disease. Transthoracic echocardiography (TTE) showed a normal ejection fraction but also revealed a hyperechoic mass in the pleural space lateral to the left ventricle (Panels A and B). Given these findings, computed tomography (CT) scan of the chest was ordered and showed a left lower lobe consolidation with interval areas of low attenuation concerning for abscess formation (Panels C and D). In addition to treatment for heart failure exacerbation, she received antibiotic therapy for suspected pulmonary M. abscessus infection. Invasive interventions were avoided given her several comorbidities.
      PubDate: Sat, 26 May 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey073
      Issue No: Vol. 19, No. 9 (2018)
  • The effect of blood pressure on left atrial size and function assessed by
           3-dimensional echocardiography
    • Authors: Abou R; Delgado V.
      Pages: 975 - 976
      Abstract: This editorial refers to ‘Cumulative blood pressure from early adulthood to middle age is associated with left atrial remodelling and subclinical dysfunction assessed by three-dimensional echocardiography: a prospective post hoc analysis from the coronary artery risk development in young adults study’ by H.D. Vasconcellos et al., pp. 977–984.
      PubDate: Mon, 16 Jul 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey098
      Issue No: Vol. 19, No. 9 (2018)
  • Cumulative blood pressure from early adulthood to middle age is associated
           with left atrial remodelling and subclinical dysfunction assessed by
           three-dimensional echocardiography: a prospective post hoc analysis from
           the coronary artery risk development in young adults study
    • Authors: Vasconcellos H; Moreira H, Ciuffo L, et al.
      Pages: 977 - 984
      Abstract: AbstractAimsTo evaluate the association of cumulative blood pressure (BP) from young adulthood to middle age with left atrial (LA) structure/function as assessed by three-dimensional echocardiography (3DE) in a large longitudinal bi-racial population study.Methods and resultsWe conducted a prospective post hoc analysis of individuals enrolled at the Coronary Artery Risk Development in Young Adults, which is a multi-centre bi-racial cohort with 30 years of follow-up. Cumulative systolic and diastolic BP levels were defined by summing the product of average millimetres of mercury and the years between each two consecutive clinic visits over 30 years of follow-up. Multivariable linear regression analyses were used to assess the relationship between cumulative systolic and diastolic BP with 3DE LA structure and function, adjusting for demographics and traditional cardiovascular risk factors. A total of 1033 participants were included, mean age was 55.4 ± 3.5 years, 55.2% women, 43.9% blacks. Cumulative systolic BP had stronger correlations than cumulative diastolic BP. Higher cumulative systolic BP was independently associated with higher 3D LA volumes: maximum (β = 1.74, P = 0.004), pre-atrial contraction (β = 1.87, P < 0.001), minimum (β = 0.76, P = 0.04), total emptying (β = 0.98, P = 0.006), active emptying (β = 1.12, P < 0.001), and lower magnitude 3D LA early diastolic strain rate (β = 0.05, P = 0.02). Higher cumulative diastolic BP was independently associated with higher 3D LA active emptying volume (β = 0.66, P = 0.002), lower magnitude 3D LA early diastolic strain rate (β = 0.05, P = 0.004), and higher magnitude 3D LA late diastolic strain rate (β = −0.04, P = 0.05).ConclusionHigher cumulative BP from early adulthood throughout middle age was associated with adverse LA remodelling evaluated by 3D echocardiography.
      PubDate: Fri, 29 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey086
      Issue No: Vol. 19, No. 9 (2018)
  • Prognostic relevance of mitral and tricuspid regurgitation in patients
           with severe aortic stenosis
    • Authors: Zilberszac R; Gleiss A, Binder T, et al.
      Pages: 985 - 992
      Abstract: AbstractAimsAlthough concomitant mitral regurgitation (MR) and tricuspid regurgitation (TR) are frequently present in patients with aortic stenosis (AS), outcome data are scarce and treatment strategies are controversial. The aim of the present study was to assess the presentation and outcome of patients with AS and coexisting MR and TR.Methods and resultsEighty-nine consecutive patients with severe AS and at least moderate MR (72 functional and 17 degenerative) were included and followed. Seventy-five patients were symptomatic at presentation. Sixty of these had severe symptoms (New York Heart Association class ≥3). Nine additional patients had an indication for valve procedures during follow-up. However, 35 patients were managed conservatively. Isolated aortic valve intervention was performed in 29 patients (22 valve replacement and 7 transcatheter aortic valve replacement) and concomitant mitral valve surgery in 20 patients. For the assessment of outcome, overall survival (i.e. time from study entry to death from any cause) was assessed: adjusted survival was significantly higher for patients undergoing any valve procedure as compared with patients managed conservatively (P = 0.032). Surgical treatment of severe concomitant MR was associated with improved survival in an unadjusted population but did not reach statistical significance after propensity adjustment. 14 of 36 patients who had concomittant moderate-to-severe tricuspid regurgitation (TR) underwent surgery of which 7 (50 %) died within 3 months postoperatively. On the other hand, only 1 of 35 (3%) with no or mild TR undergoing surgery died within 3 months post-operatively (P < 0.001).ConclusionPresence of MR in patients with severe AS characterizes a high-risk population. Timely aortic valve intervention confers a survival benefit and concomitant mitral valve surgery should be considered according to operative risk. The additional presence of significant TR is associated with dismal outcomes, regardless of the treatment strategy.
      PubDate: Thu, 01 Mar 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey027
      Issue No: Vol. 19, No. 9 (2018)
  • Tricuspid regurgitation in acute heart failure: is there any incremental
    • Authors: Mutlak D; Lessick J, Khalil S, et al.
      Pages: 993 - 1001
      Abstract: AbstractAimSignificant tricuspid regurgitation (TR) is common in heart failure (HF) and portends poor prognosis. We sought to determine whether the poor outcome results from the TR itself, or whether the TR is a surrogate marker of advanced left-sided myocardial or valvular heart disease.Methods and resultsWe studied 639 patients admitted for acute HF. The relationship between TR severity and the endpoint of readmission for HF or mortality was assessed after adjustment for multiple clinical and echocardiographic parameters. Higher TR grade was associated with higher congestion score and with other cardiac abnormalities including reduced left ventricular systolic function, moderate or severe mitral regurgitation, pulmonary hypertension (PH, defined as pulmonary artery systolic pressure ≥ 50 mmHg), and right ventricular dysfunction (all P < 0.001). Only 7% of patients with moderate or severe TR were free of other cardiac lesions. In adjusted models, moderate or severe TR was not associated with readmission for HF or mortality [hazard ratio (HR) 1.24, 95% confidence interval (95% CI) 0.97–1.57]. Patients with moderate/severe TR had similar risk for HF readmission or death compared with patients with trivial/mild TR when PH was not present (HR 1.17; 95% CI 0.78–1.75, P = 0.40) whereas the risk was higher in moderate/severe TR and PH (HR 1.78; 95% CI 1.34–2.36, P < 0.0001).ConclusionPatients presenting with symptomatic HF and significant TR have multiple coexisting cardiac abnormalities. TR provides no additive risk in the presence of normal or mildly elevated pulmonary pressures. However, it is associated with excess rehospitalizations and mortality in patients with PH.
      PubDate: Mon, 15 Jan 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jex343
      Issue No: Vol. 19, No. 9 (2018)
  • Left atrial geometry and outcome of atrial fibrillation ablation: results
           from the multicentre LAGO-AF study
    • Authors: Bisbal F; Alarcón F, Ferrero-de-Loma-Osorio A, et al.
      Pages: 1002 - 1009
      Abstract: AbstractAimsLeft atrial (LA) remodelling is a key determinant of atrial fibrillation (AF) ablation outcome. Optimal methods to assess this process are scarce. LA sphericity is a shape-based parameter shown to be independently associated to procedural success. In a multicentre study, we aimed to test the feasibility of assessing LA sphericity and evaluate its capability to predict procedural outcomes.Methods and resultsThis study included consecutive patients undergoing first AF ablation during 2013. A 3D model of the LA chamber, excluding pulmonary veins and LA appendage, was used to quantify LA volume (LAV) and LA sphericity (≥82.1% was considered spherical LA). In total, 243 patients were included across 9 centres (71% men, aged 56 ± 10 years, 44% with hypertension and 76% CHA2DS2-VASc ≤ 1). Most patients had paroxysmal AF (66%) and underwent radiofrequency ablation (60%). Mean LA diameter (LAD), LAV, and LA sphericity were 42 ± 6 mm, 100 ± 33 mL, and 82.6 ± 3.5%, respectively. Adjusted Cox models identified paroxysmal AF [hazard ratio (HR 0.54, P = 0.032)] and LA sphericity (HR 1.87, P = 0.035) as independent predictors for AF recurrence. A combined clinical-imaging score [Left Atrial Geometry and Outcome (LAGO)] including five items (AF phenotype, structural heart disease, CHA2DS2-VASc ≤ 1, LAD, and LA sphericity) classified patients at low (≤2 points) and high risk (≥3 points) of procedural failure (35% vs. 82% recurrence at 3-year follow-up, respectively; HR 3.10, P < 0.001).ConclusionIn this multicentre, real-life cohort, LA sphericity and AF phenotype were the strongest predictors of AF ablation outcome after adjustment for covariates. The LAGO score was easy to implement, identified high risk of procedural failure, and could help select optimal candidates.Clinical Trial Registration InformationNCT02373982 (
      PubDate: Thu, 12 Apr 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey060
      Issue No: Vol. 19, No. 9 (2018)
  • Active cardiac sarcoidosis on standard chest computed tomography
    • Authors: Murphy D; Subesinghe M, Rashid I, et al.
      Pages: 1025 - 1025
      Abstract: A 50-year old female patient underwent a standard non-electrocardiogram (ECG) gated computed tomography (CT) thorax with intravenous contrast for worsening constitutional symptoms. She had a known diagnosis of extra-cardiac sarcoidosis from a previous lymph node biopsy and was not on immunosuppression. A standard chest CT demonstrated multistation mediastinal lymphadenopathy and multiple peribronchovascular pulmonary nodules. There was also a focal, hypoattenuating, thickened appearance of the left ventricular (LV) basal anteroseptum (A, axial CT thorax, arrow; B, LV short axis CT multi-planar reformat, arrow), which raised the suspicion of cardiac sarcoid involvement. A [18F]fluoro-D-glucose (FDG) positron emission tomography-computed tomography (PET-CT) scan demonstrated increased myocardial metabolic activity in the basal septum (C, arrow), with a cardiac magnetic resonance imaging (CMR) scan showing corresponding oedema in the basal septum, as demonstrated on this quantitative colour T2 map (D, arrow). These findings confirmed the diagnosis of active cardiac sarcoidosis and the patient was placed on immunosuppression.
      PubDate: Wed, 30 May 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey075
      Issue No: Vol. 19, No. 9 (2018)
  • Exercise cardiac magnetic resonance to differentiate athlete’s heart
           from structural heart disease
    • Authors: Claessen G; Schnell F, Bogaert J, et al.
      Pages: 1062 - 1070
      Abstract: AbstractAimsThe distinction between left ventricular (LV) dilation with mildly reduced LV ejection fraction (EF) in response to regular endurance exercise training and an early cardiomyopathy is a frequently encountered and difficult clinical conundrum. We hypothesized that exercise rather than resting measures would provide better discrimination between physiological and pathological LV remodelling and that preserved exercise capacity does not exclude significant LV damage.Methods and resultsWe prospectively included 19 subjects with LVEF between 40 and 52%, comprising 10 ostensibly healthy endurance athletes (EA-healthy) and nine patients with dilated cardiomyopathy (DCM). In addition, we recruited five EAs with a region of subepicardial LV. Receiver operating characteristic fibrosis (EA-fibrosis). Cardiac magnetic resonance (CMR) imaging was performed at rest and during supine bicycle exercise. Invasive afterload measures were obtained to enable calculations of biventricular function relative to load (an estimate of contractility). In DCM and EA-fibrosis subjects there was diminished augmentation of LVEF (5 ± 6% vs. 4 ± 3% vs. 14 ± 3%; P = 0.001) and contractility [LV end-systolic pressure–volume ratio, LVESPVR; 1.4 (1.3–1.6) vs. 1.5 (1.3–1.6) vs. 1.8 (1.7–2.7); P < 0.001] during exercise relative to EA-healthy. Receiver-operator characteristic curves demonstrated that a cut-off value of 11.2% for ΔLVEF differentiated DCM and EA-fibrosis patients from EA-healthy [area under the curve (AUC) = 0.92, P < 0.001], whereas resting LVEF and VO2max were not predictive. The AUC value for LVESPVR ratio was similar to that of ΔLVEF.ConclusionsFunctional cardiac evaluation during exercise is a promising tool in differentiating healthy athletes with borderline LVEF from those with an underlying cardiomyopathy. Excellent exercise capacity does not exclude significant LV damage.
      PubDate: Mon, 26 Mar 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey050
      Issue No: Vol. 19, No. 9 (2018)
  • An unusual case of cerebrovascular accident in a child
    • Authors: Ghosh G; Rajan R, Leena R, et al.
      Pages: 1071 - 1071
      Abstract: A 14 months old girl with history of right sided hemiparesis presented to us with mild cyanosis. The child was born by a non-consanguineous marriage and her infancy was uneventful. Cardiovascular examination was unremarkable. Oxygen saturation was 78–80% in room air.
      PubDate: Thu, 10 May 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey070
      Issue No: Vol. 19, No. 9 (2018)
  • Atretic aortic valvular cusp causing severe aortic regurgitation
    • Authors: Wong R; Yip J, Tay E, et al.
      Pages: 1072 - 1073
      Abstract: Case report 
      PubDate: Wed, 23 May 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey074
      Issue No: Vol. 19, No. 9 (2018)
  • Intracardiac bronchogenic cyst associated with ventricular septal defect:
           an extremely rare feature in children
    • Authors: Blesneac C; Horvath E, Muntean I, et al.
      Pages: 1074 - 1074
      Abstract: A 10-year-old girl presented with arrhythmic heart sounds, incidentally discovered during evaluation for a digestive disorder. Electrocardiogram (ECG) and 24-h ECG Holter monitoring revealed atrial and ventricular premature complexes. Echocardiogram revealed, beside a small perimembraneous ventricular septal defect (VSD), a large, irregular, hypoechoic, aneurysmal structure with hyperechogenic borders, located in the membraneous part of the interventricular septum (IVS), bulging into the right atrium (RA), with a maximum diameter of 4, 35 cm (A, Supplementary dataSupplementary data online). Computed tomography (CT) scan showed a hypodense mass at the level of the IVS with protrusion to the RA (Panels B and C). The patient underwent open-heart surgery, with excision of the intracardiac mass and closure of the VSD. Based on morphology and immunohistochemical profile, the histologic diagnosis was intracardiac bronchogenic cyst (Panels D, E, F, and G). The post-operative recovery was uneventful, and the patient remained asymptomatic following surgery.
      PubDate: Mon, 11 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey078
      Issue No: Vol. 19, No. 9 (2018)
  • Corrigendum to: Left atrial geometry and outcome of atrial fibrillation
           ablation: results from the multicentre LAGO-AF study
    • Pages: 1075 - 1075
      Abstract: [Eur Heart J Cardiovasc Imaging 2018;19:1002–1009]
      PubDate: Mon, 04 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey076
      Issue No: Vol. 19, No. 9 (2018)
  • Role of myocardial constructive work in the identification of responders
           to CRT
    • Authors: Galli E; Leclercq C, Hubert A, et al.
      Pages: 1010 - 1018
      Abstract: AbstractAimsCardiac resynchronization therapy (CRT) plays a pivotal role in the management of patients with heart failure (HF) and wide QRS complex. However, the treatment is plagued by numerous non-responders. Aim of the study is to evaluate the role myocardial work estimated by pressure-strain loops (PSLs) in the comprehension of physiological mechanisms associated with CRT and in the prediction of CRT response.Methods and resultsNinety-seven patients with symptomatic HF (ejection fraction: 27 ± 6%, QRS duration 164 ± 18 ms) undergoing CRT implantation according to current recommendations were retrospectively included in the study. Standard 2D and speckle tracking echocardiography were performed before CRT and at the 6-month follow-up (FU). PSL analysis allowed the calculation of global and regional myocardial constructive work (CW) and wasted work (WW). A > 15% reduction in left ventricular (LV) end-systolic volume at FU defined CRT-positive response (CRT-PR). At FU, 63 (65%) patients responded to CRT. Global CW (CWtot) was significantly increased in CRT-responders. At multivariate analysis, CWtot > 1057 mmHg% (OR 14.69, P = 0.005) and septal flash (OR 8.05, P = 0.004) were the only significant predictors of CRT-PR. CWtot was associated with the entity of CRT-induced myocardial remodelling in both ischaemic (r = −0.55, P < 0.0001) and non-ischaemic patients (r = 0.65, P < 0.0001). A CWtot < 1057 mmHg% identified 85% of non-responders with a positive predictive value of 88%.ConclusionPatients with higher CWtot exhibit a favourable response to CRT. These data encourage further studies for the assessment of the myocardial substrate related to the functional response to CRT.
      PubDate: Mon, 07 Aug 2017 00:00:00 GMT
      DOI: 10.1093/ehjci/jex191
      Issue No: Vol. 19, No. 9 (2017)
  • Even mild reversible myocardial perfusion defects predict mortality in
           patients evaluated for kidney transplantation
    • Authors: Helve S; Laine M, Sinisalo J, et al.
      Pages: 1019 - 1025
      Abstract: AbstractAimsThe value of single-photon emission tomography (SPECT) in patients with severe chronic kidney disease is controversial, and the implications of SPECT finding with lower level of ischaemia are unknown. We assessed the prognostic value of SPECT in patients evaluated for kidney transplantation.Methods and resultsFive hundred and forty-eight patients underwent SPECT as a part of routine evaluation for kidney transplantation. During the median follow-up of 43.7 months (IQR 22.4–68.4 months), 112 patients (20.4%) died, 49 of cardiovascular (CV) causes (8.9%). In comparison to those with no perfusion defects, mild perfusion abnormalities (1%–9.9%) had an adjusted Cox hazard ratio (HR) of 1.80 [95% confidence interval (95% CI) 1.02–3.17, P = 0.041] for all-cause mortality, while large perfusion defects (≥10%) demonstrated an HR of 2.20 (95% CI 1.38–3.50, P = 0.001). A competing risk analysis produced a similar prognostic capacity for CV mortality. SPECT also offered incremental prognostic impact with two reclassification methods. Revascularization was performed clearly more often on patients with severely than mildly abnormal or normal SPECT (28.0%, 4.3%, and 1.3%, respectively, P < 0.001). However, revascularization was not linked with better survival. Patients with a normal SPECT received a kidney transplant more often than patients with a mildly or severely abnormal SPECT (50.5%, 36.2%, and 36.6%, respectively, P = 0.010).ConclusionMyocardial ischaemia in SPECT is clearly linked with mortality in patients screened for kidney transplantation. Contrary to populations with coronary artery disease, even a mild perfusion defect in SPECT predicts poor prognosis in this patient population. The finding deserves further attention in forthcoming trials.
      PubDate: Fri, 04 Aug 2017 00:00:00 GMT
      DOI: 10.1093/ehjci/jex200
      Issue No: Vol. 19, No. 9 (2017)
  • 3D echocardiographic evaluation of right ventricular function and strain:
           a prognostic study in paediatric pulmonary hypertension
    • Authors: Jone P; Schäfer M, Pan Z, et al.
      Pages: 1026 - 1033
      Abstract: AbstractAimsTo evaluate right ventricular functional indices using 3D echocardiography (3DE) between normal children and paediatric pulmonary hypertension (PH) patients, and to evaluate these indices as outcome predictors in children with PH.Methods and resultsNinety-six paediatric PH patients from 2014 to 2016 were compared with 40 normal controls. All patients underwent 3DE and off-line analysis generated 3D end-diastolic volume, 3D end-systolic volume, 3D stroke volume, 3D right ventricular (RV) ejection fraction (EF), RV longitudinal strain (LS) free wall and septum, tricuspid annular plane systolic excursion (TAPSE), and fractional area change (FAC). PH patients had higher RV volumes, lower RV EF, lower free wall and septal RVLS, lower TAPSE, and lower FAC compared with normal controls (all P < 0.001). 3D RV EF, free wall RVLS, and FAC are predictors of adverse clinical outcomes [hazard ratio (confidence interval) 0.1 (0.03–0.27], P < 0.001; 0.17 (0.07–0.45), P < 0.001; 0.08 (0.03–0.22); P < 0.001, respectively).ConclusionPaediatric PH patients have impaired RV function compared with normal children. 3D RV EF, volumes, FAC, and free wall RV strain serve as outcome predictors for paediatric PH patients.
      PubDate: Fri, 25 Aug 2017 00:00:00 GMT
      DOI: 10.1093/ehjci/jex205
      Issue No: Vol. 19, No. 9 (2017)
  • Presence of micro- and macroalbuminuria and the association with cardiac
           mechanics in patients with type 2 diabetes
    • Authors: Jørgensen P; Biering-Sørensen T, Mogelvang R, et al.
      Pages: 1034 - 1041
      Abstract: AbstractAimsAlbuminuria—a marker of generalized vascular dysfunction—is a strong predictor of heart failure in patients with type 2 diabetes which may be caused by concomitant myocardial dysfunction reflecting the same underlying pathogenesis.Methods and resultsWe included 915 patients with type 2 diabetes from two secondary care centres and stratified according to albuminuria status in normo-, micro-, and macroalbuminuria. We performed comprehensive echocardiography including conventional imaging, tissue Doppler imaging, and 2D speckle tracking. Cardiac remodelling occurred in patients with increasing left ventricular (LV) mass index and LV wall thicknesses with increasing severity of albuminuria. Diastolic measures worsened across groups of albuminuria severity (normo-, micro-, and macroalbuminuria, respectively): septal e′ velocity [mean: 6.9 cm/s (SD 1.9), 6.4 (1.7), and 5.9 (1.7), P < 0.001], septal E/e′ (median: 10.6 [interquartile range: 8.9–13.2], 12.1 [10.3–14.8], and 12.7 [10.4–16.6], P < 0.001), and left atrial volume index (24.3 mL/m2 [19.1–29.9], 25.7 [20.0–31.6], and 29.0 [22.2–34.9], P < 0.001) In contrast, systolic measures were only impaired in patients with macroalbuminuria: global longitudinal strain (GLS): [−14.6% (2.7) in normo- and −13.3 (2.9) in macroalbuminuria, P < 0.001] and GLS rate [mean: −0.79 s−1 (0.17) in normo- and −0.72 (0.16) in macroalbuminuria, P = 0.001]. The findings persisted in subgroup analyses of patients without known coronary heart disease and with normal ejection fraction and in multivariable adjusted analyses.ConclusionIn patients with type 2 diabetes, microalbuminuria is associated with decreased diastolic function whereas decreased systolic function was only associated with macroalbuminuria supporting the notion of similar pathogenic mechanisms of albuminuria and impaired myocardial function.
      PubDate: Tue, 03 Oct 2017 00:00:00 GMT
      DOI: 10.1093/ehjci/jex231
      Issue No: Vol. 19, No. 9 (2017)
  • Carotid plaque thickness and carotid plaque burden predict future
           cardiovascular events in asymptomatic adult Americans
    • Authors: Sillesen H; Sartori S, Sandholt B, et al.
      Pages: 1042 - 1050
      Abstract: AbstractIntroductionPrediction of cardiovascular events improves using imaging, i.e. coronary calcium score and ultrasound assessment of carotid plaque. This study analysed the predictive value of two ultrasound measures of carotid plaque size: carotid plaque thickness and carotid and intima–media thickness (IMT).Methods and resultsA total of 6102 asymptomatic persons underwent assessment of conventional risk factors and imaging by carotid ultrasound. Carotid plaque burden (cPB) and maximum carotid plaque thickness (cPTmax) were measured from ‘cross-sectional sweep’ video acquisition of the carotid artery. IMT was measured from distal common carotid artery images. All participants were followed up for ∼3 years, and major cardiovascular events (MACE) were collected and adjudicated. All data were available for 5808 participants, in whom 216 first MACE events were observed. Increasing both cPB and cPTmax were associated with increasing the risk of future MACE when compared with participants without carotid atherosclerosis. Fully adjusted for risk factors, hazard ratios for cPTmax were 1.96 [95% confidence interval (CI) 0.91–4.25, P = 0.015] for primary MACE and 3.13 (95% CI 1.80–5.51, P < 0.001) for secondary MACE, similar to that of cPB. IMT did not improve risk prediction significantly. Non-categorical net reclassification index (NRI) for cPTmax was 0.178 (95% CI 0.027–0.299, P = 0.032) for primary MACE and 0.173 (95% CI 0.109–0.243, P < 0.001) for secondary MACE, which is almost similar to cPB. IMT assessment did not result in significant NRI.ConclusionThe simpler cPTmax predicted cardiovascular events similarly to the more comprehensive cPB, whereas IMT did not. Awaiting true 3D ultrasound technology cPTmax may be a simple useful measure for prediction of future ASCVD.
      PubDate: Fri, 20 Oct 2017 00:00:00 GMT
      DOI: 10.1093/ehjci/jex239
      Issue No: Vol. 19, No. 9 (2017)
  • Cardiovascular magnetic resonance imaging in patients with cardiac
           implantable electronic devices: a device-dependent imaging strategy for
           improved image quality
    • Authors: Hilbert S; Jahnke C, Loebe S, et al.
      Pages: 1051 - 1061
      Abstract: AbstractAimsTo prospectively determine evaluability of routine cardiovascular magnetic resonance (CMR) diagnostic modules in a referral population of implanted rhythm device all-comers, and to establish a device-dependent CMR imaging strategy to achieve optimal image quality.Methods and resultsOne hundred and twenty-eight patients with cardiac implantable electronic devices [insertable cardiac monitoring system, n = 14; implantable loop-recorder, n = 21; pacemaker, n = 31; implantable cardioverter-defibrillator (ICD), n = 50; and cardiac resynchronization therapy defibrillator (CRT-D), n = 12] underwent clinically indicated CMR at 1.5 T. CMR protocols were tailored to the clinical indication and consisted of cine, perfusion, T1-/T2-weighted, late-gadolinium enhancement (LGE), 3D angiographic, and post-contrast cine spoiled gradient echo (SGE) scans. Image quality was determined using a 4-grade visual score per myocardial segment. Segmental evaluability was strongly influenced by device type and location with the highest proportion of non-diagnostic images encountered in the presence of ICD/CRT-D systems. Cine steady-state free-precession (SSFP) imaging was found to be mostly non-diagnostic in ICD/CRT-D patients, but a significant improvement of image quality was demonstrated when using SGE sequences with a further incremental improvement post-contrast resulting in an overall four-fold higher likelihood of achieving good image quality. LGE scans were found to be non-diagnostic in about one-third of left-ventricular segments of ICD/CRT-D patients but were artefact-free in > 94% for all other device types.ConclusionDevice type and location constitute the main independent predictors of CMR image quality and thus, need to be considered during protocol adaptation. Most notably, post-contrast SGE cine imaging proved superior to conventionally used SSFP sequences. Thus, following the proposed device-dependent CMR imaging strategy, diagnostic image quality can be achieved in the majority of device patients.
      PubDate: Wed, 18 Oct 2017 00:00:00 GMT
      DOI: 10.1093/ehjci/jex243
      Issue No: Vol. 19, No. 9 (2017)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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Fax: +00 44 (0)131 4513327
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