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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cardiac MRI applications for diagnosis and follow-up of patients with acquired heart disease are constantly expanding. This review article presents an overview of the use of cardiac MRI in nonischemic acquired heart disease. The role of MRI in nonischemic acquired heart disease continues to be influenced by perceived capabilities of echocardiography. The applications discussed in this review are: myocardial diseases including cardiomyopathies, arrhythmogenic right ventricular dysplasia and myocarditis; pericardial diseases, especially constrictive pericarditis; cardiac and paracardiac masses; and valvular heart disease. Cine MR is now regarded as the preferred method for evaluation and quantification of right ventricular function.
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PMID:MRI in nonischemic acquired heart disease. 1850 37

Recent advances in MRI have made this modality an important tool for evaluating heart disease. Faster scanning techniques, high spatial resolution, lack of ionizing radiation, lack of dependence on contrast material, and capability for functional imaging have made it an emerging noninvasive diagnostic tool with great potential in younger patients with heart disease. This article discusses the role of cardiac MRI, methods of evaluation, and newer application of MRI in evaluating congenital heart disease in pediatric and young adult patients.
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PMID:Cardiac MRI in the management of congenital heart disease in children, adolescents, and young adults. 1881 31

Noncompaction of the ventricular myocardium is a cardiomyopathy thought to be caused by arrest of normal embryogenesis of the endocardium and myocardium. Non-compaction presents as an isolated form or in association with other congenital anomalies, such as obstruction of the right or left ventricular outflow tracts, complex cyanotic congenital heart disease and coronary artery anomalies. Contrast-enhanced CT is capable of showing the abnormal architecture of the left ventricular wall in non-compaction but is also able to evaluate the coronary arteries to exclude anomalies or significant stenosis, which is usually not possible with MRI or echocardiography.
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PMID:Isolated noncompaction of ventricular myocardium. Diagnosis with multidetector computed tomography. 1881 88

Fabry disease is a lysosomal storage disorder that is caused by mutations in the gene encoding a-galactosidase A on Xq22.1. Typically hemizygous male patients exhibit classic phenotypes such as angiokeratoma, acroparesthesias, episodic pain "crises," hypohidrosis, and whorl-shaped corneal opacities from childhood. However, during adulthood, they gradually develop kidney failure, heart disease, and strokes resulting in early death between 40 to 50 years of age. However, recent studies have indicated a high prevalence of disabling clinical symptoms in heterozygous females patients. Patients having the cardiac variant of Fabry's disease exhibit only left ventricular hypertrophy, while patients having the renal variant exhibit only kidney failure. Individuals affected by these variants show higher residual enzyme activity of alpha-galactosidase A than individuals affected by the classic form of Fabry's disease due to missense mutations of the GLA gene. The cerebrovascular involvement in Fabry disease is not rare in both adult hemizygotes and heterozygotes. Infarctions caused by the occulsion of small vessels involving mostly the vertebrobasilar region in approximately two-thirds of the cases, and that is associated with the deposition glycoshingolipids including GL-3 in the walls of these vessels. In Caucasian patients, elongated, ectatic, and tortuous vertebral and basilar arteries are frequently observed on MRAs. Life-threatening megadolichobasilar anomaly with thrombosis has been identified in a large Hungarian family in which the family members share L16P mutation. On performing MRI, an increased signal intensity was observed in the pulvinar in T1-weighted images; this is the characteristic so-called "pulvinar sign". Enzyme replacement therapy has been approved in Japan since 2004 and 2007 for agalsidase beta and agalsidase alpha, respectively. This treatment modestly improves the small-fiber neuropathy, hypohidrosis, hypertrophic cardiomyopathy, and stabilizes the renal function in the long term for up to 54 months. However, it has not helped in decreasing the incidence of strokes.
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PMID:[Fabry disease in light of recent review]. 1906 57

Cardiac MRI and CT are imaging modalities increasingly employed in the diagnosis and management of structural heart disease. They are powerful imaging tools that have individual strengths and weaknesses. Rational choice between MRI and CT should be based on a sound understanding of these issues. Management guidelines that incorporate the use of MRI and CT are currently being developed, and their utilizations are expected to grow rapidly in the future.
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PMID:MR and CT imaging of the pediatric patient with structural heart disease. 1925 Nov 81

Among children, newborn infants are most vulnerable to development of thrombosis and serious thromboembolic complications. Amongst newborns, those neonates who are critically ill, both term and preterm, are at greatest risk for developing symptomatic thromboembolic disease. The most important risk factors are inflammation, DIC, impaired liver function, fluctuations in cardiac output, and congenital heart disease, as well as exogenous risk factors such as central venous or arterial catheters. In most clinically symptomatic infants, diagnosis is made by ultrasound, venography, or CT or MRI angiograms. However, clinically asymptomatic vessel thrombosis is sometimes picked up by screening investigations or during routine imaging for other indications. Acute management of thrombosis and thromboembolism comprises a variety of approaches, including simple observation, treatment with unfractionated or low molecular weight heparin, as well as more aggressive interventions such as thrombolytic therapy or catheter-directed revascularization. Long-term follow-up is dependent on the underlying diagnosis. In the majority of infants, stabilization of the patients' general condition and hemodynamics, which allows removal of indwelling catheters, renders long-term anticoagulation superfluous. Nevertheless, in certain types of congenital heart disease or inherited thrombophilia, long-term prophylaxis may be warranted. This review article focuses on pathophysiology, diagnosis, and acute and long-term management of thrombosis in critically ill term and preterm neonates.
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PMID:Thrombosis in the critically ill neonate: incidence, diagnosis, and management. 1933 47

Tagged magnetic resonance imaging (tagged MRI or tMRI) provides a means of directly and noninvasively displaying the internal motion of the myocardium. Reconstruction of the motion field is needed to quantify important clinical information, e.g., the myocardial strain, and detect regional heart functional loss. In this paper, we present a three-step method for this task. First, we use a Gabor filter bank to detect and locate tag intersections in the image frames, based on local phase analysis. Next, we use an improved version of the robust point matching (RPM) method to sparsely track the motion of the myocardium, by establishing a transformation function and a one-to-one correspondence between grid tag intersections in different image frames. In particular, the RPM helps to minimize the impact on the motion tracking result of 1) through-plane motion and 2) relatively large deformation and/or relatively small tag spacing. In the final step, a meshless deformable model is initialized using the transformation function computed by RPM. The model refines the motion tracking and generates a dense displacement map, by deforming under the influence of image information, and is constrained by the displacement magnitude to retain its geometric structure. The 2D displacement maps in short and long axis image planes can be combined to drive a 3D deformable model, using the moving least square method, constrained by the minimization of the residual error at tag intersections. The method has been tested on a numerical phantom, as well as on in vivo heart data from normal volunteers and heart disease patients. The experimental results show that the new method has a good performance on both synthetic and real data. Furthermore, the method has been used in an initial clinical study to assess the differences in myocardial strain distributions between heart disease (left ventricular hypertrophy) patients and the normal control group. The final results show that the proposed method is capable of separating patients from healthy individuals. In addition, the method detects and makes possible quantification of local abnormalities in the myocardium strain distribution, which is critical for quantitative analysis of patients' clinical conditions. This motion tracking approach can improve the throughput and reliability of quantitative strain analysis of heart disease patients, and has the potential for further clinical applications.
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PMID:Automated 3D motion tracking using Gabor filter bank, robust point matching, and deformable models. 1936 49

Contrast-enhanced MR angiography is one of the greatest achievements brought about by advances in body MRI. The noninvasive evaluation of arteries and veins can obviate heart catheterization, the administration of iodinated contrast, and exposure to ionizing radiation in many patients and spare them the risks associated with these factors. These gains are even more important in children with congenital heart disease, who will have to undergo numerous vascular studies in their lifetimes and are more susceptible to the effects of ionizing radiation. Contrast-enhanced MR angiography provides abundant information for diagnosis and postoperative follow-up in these patients, who reach advanced age thanks to advances in medical and surgical treatment and thus receive more and more imaging studies during their lifetimes. In this review, we analyze the contrast-enhanced MR angiography technique in these patients, the problems and precautions related to the use of gadolinium, the indications for the test, and the relevant imaging findings in patients with congenital heart disease.
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PMID:[Contrast-enhanced magnetic resonance angiography in congenital heart disease]. 1945 22

Down's syndrome is the most commonly encountered congenital anomaly in medical practice. These patients are of special concern to medical practice because of their associated problems with regard to respiratory, cardiovascular and other systemic problems. As these patients present for repeated surgeries like dental extraction, facial reconstruction and fixation of cervical spine, these patients pose challenges to the anesthesiologist because of their unique set of problems, namely atlantoaxial instability, small trachea, congenital heart disease and repeated chest infections due to lowered immunity. Their reactivity to inhalational anesthetics and atropine is variable. Here we present an interesting case report of a child with Down's syndrome who presented with atlantoaxial instability for MRI of cervical spine under general anesthesia.
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PMID:Anesthetic management of a child with Down's syndrome having atlanto axial instability. 1952 62

Quantitative assessment of regional cardiac function can improve the accuracy of detecting wall motion abnormalities due to heart disease. While recently developed fast cine displacement-encoded with stimulated echoes (DENSE) MRI is a promising modality for the quantification of regional myocardial function, it has not been validated for clinical applications. The purpose of this study, therefore, was to validate the accuracy of fast cine DENSE MRI with numerical simulation and in vivo experiments. A numerical phantom was generated to model physiologically relevant deformation of the heart, and the accuracy of fast cine DENSE was evaluated against the numerical reference. For in vivo validation, 12 controls and 13 heart-disease patients were imaged using both fast cine DENSE and myocardial tagged MRI. Numerical simulation demonstrated that the echo-combination DENSE reconstruction method is relatively insensitive to clinically relevant resonance frequency offsets. The strain measurements by fast cine DENSE and the numerical reference were strongly correlated and in excellent agreement (mean difference = 0.00; 95% limits of agreement were 0.01 and -0.02). The strain measurements by fast cine DENSE and myocardial tagged MRI were strongly correlated (correlation coefficient = 0.92) and in good agreement (mean difference = 0.01; 95% limits of agreement were 0.07 and -0.04).
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PMID:Numerical and in vivo validation of fast cine displacement-encoded with stimulated echoes (DENSE) MRI for quantification of regional cardiac function. 1958 9


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