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Cardiac MRI detects myocardial infarction in asymptomatic patients

21 Oct, 12 | by Alistair Lindsay

Unrecognised myocardial infarction (UMI) may be more prevalent than previously suspected.  Although several population studies have described the prevalence of UMI based on ECG findings, this method has limited sensitivity.  Cardiac magnetic resonance (CMR) imaging with late gadolinium enhancement has been extensively validated for the detection of myocardial infarction.  The aim of this study was to determine the prevalence and prognosis of recognised and unrecognised MI diagnosed with CMR in a elderly population, and to compare these findings with the use of ECG. more…

CE-MARC shows strength of perfusion MRI

19 Feb, 12 | by Alistair Lindsay

In recent years it has become clear that treatment of coronary artery disease – and in particular percutaneous coronary intervention (PCI) – must be guided by imaging techniques that give some information on the extent of myocardial ischaemia.  While nuclear medicine techniques such as SPECT (single-photon emission computed tomography) have become widespread, and have a high negative predictive value, they still expose patients to ionising radiation.  Furthermore, the sensitivity of SPECT has been noted to vary.  Cardiac Magnetic Resonance Imaging (MRI), is a potential alternative that uses no ionising radiation, provides high-resolution images, and is capable of assessing various cardiac parameters in one comprehensive examination. more…

MRI study gives new insights into stress (takotsubo) cardiomyopathy

7 Aug, 11 | by Alistair Lindsay

Stress Cardiomyopathy (SC), originally described as takotsubo, is characterised by severe – but reversible – impairment of left ventricular function in the absence of significant coronary artery disease.  The vast majority of patients present with symptoms similar to those of an acute coronary syndrome, and tend to have good outcomes despite the initial severity of presentation.  Although SC is now well recognised, no study to date has comprehensively defined the clinical spectrum and evolution of SC, including tissue characteristics, in a large, multicenter population from Europe and North America using a comprehensive, state-of-the-art CMR imaging protocol. more…

Erythropoietin fails to reduce myocardial damage in STEMI

28 May, 11 | by Alistair Lindsay

Patients who survive STEMI often go on to develop infarct expansion and myocardial thinning which can lead to heart failure and, ultimately, death.  In an attempt to limit this phenomenon, several agents have been proposed, amongst them erythropoietin.  In addition to its effects on red blood cell production, erythropoietin also stimulates angiogenesis and apoptosis, and several animal models have suggested that it can have a cardioprotective role in myocardial ischaemia.  Therefore the purpose of the REVEAL (Reduction of Infarct Expansion and Ventricular Remodelling With Erythropoietin After Large Myocardial Infarction) trial was to evaluate the safety and efficacy of a single intravenous bolus of erythropoietin alfa in patients with STEMI.  Cardiac Magnetic Resonance (CMR) was used to determine infarct size at 2-6 days after study medication administration, and then again 12 weeks later. more…

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