Publications by authors named "Benedikt Bernhard"

Accurate quantification of mitral valve regurgitation (MVR) is crucial for patient management. While different MVR quantification methods based on cardiac magnetic resonance imaging (CMR) exist, their reproducibility and reliability remain uncertain. This study aims to evaluate the reproducibility of different CMR 2D-phase contrast (PC) and 4D-flow MVR quantification methods.

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Background/objectives: Myocardial and liver iron overload can be assessed through T2* in magnetic resonance imaging (MRI). It is unclear, how T2* measurements are associated with systolic and diastolic left ventricular function assessed by novel feature tracking (FT) strain.

Methods: Consecutive patients with suspected iron overload undergoing MRI T2* were retrospectively included.

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The objective of this study was to investigate the association between congestive heart failure (CHF) and T1 mapping in both liver lobes using cardiac MRI. This retrospective study included patients who underwent cardiac MRI with T1 mapping sequences on a 1.5 T scanner.

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Aim: In the clinical setting of acute myocarditis, existing guidelines recommend refraining from moderate-intensity to high-intensity sports for 3-6 months, yet the extent to which these recommendations are implemented by clinicians and followed by patients remains unclear.

Methods: From January 2020 to December 2023, consecutive patients with myocarditis according to European Society of Cardiology criteria were prospectively enrolled. Myocarditis was categorised into acute, subacute and non-acute myocarditis.

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Article Synopsis
  • - Patients aged 65 and older have a higher risk of cardiovascular (CV) events, and this study aimed to evaluate the effectiveness of stress cardiac magnetic resonance (CMR) for predicting these events in this age group across multiple centers in the U.S.
  • - The research involved 1,780 seniors, finding that those with inducible ischemia or late gadolinium enhancement (LGE) showed significantly higher rates of serious CV events over nearly 5 years, while those without these conditions had a low event rate.
  • - The study concluded that both inducible ischemia and LGE are strong predictors of primary and secondary CV outcomes, indicating that CMR can be a valuable tool for risk assessment in older patients.
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Background: The European Society of Cardiology (ESC), the American College of Cardiology, the American Heart Association, and expert consensus documents provide different diagnostic criteria for myocarditis. Their overlap and prognostic value have never been compared.

Objectives: This study aims to assess and compare the predictive value of ESC criteria for clinically suspected myocarditis, updated Lake-Louise criteria (LLC), American Heart Association criteria for probable acute myocarditis (pAM), and expert consensus criteria for acute myocarditis (AM) and complicated myocarditis (CM).

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Background: Signs and symptoms of myocarditis may vary among men and women.

Objectives: This study aimed to analyze sex-specific differences in the presentation and outcomes of patients with suspected myocarditis.

Methods: Patients meeting clinical ESC criteria for suspected myocarditis were included from two tertiary centers between 2002 and 2021.

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Article Synopsis
  • This study investigates the use of artificial intelligence to detect transthyretin amyloid cardiomyopathy (ATTR-CM) in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI).
  • Researchers analyzed a variety of data including clinical, lab, and imaging results to develop machine learning models for detection and outcome prediction.
  • Results showed that while echocardiography and 4D-CT-strain had good to high detection performances, the multi-modality model incorporating various data types did not significantly outperform the 4D-CT-strain model alone.
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  • Tafamidis has been shown to decrease cardiovascular issues and mortality in patients with transthyretin amyloid cardiomyopathy (ATTR-CM), but access to the drug varies.
  • A study of 91 ATTR-CM patients found that quicker access to tafamidis led to faster diagnoses and treatment initiation, significantly improving heart function compared to patients who had delayed access.
  • Timely access not only reduced hospitalizations for heart failure but also improved survival rates over time, highlighting the importance of availability and timely diagnosis in managing ATTR-CM.
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Background: Early invasive revascularization guided by moderate to severe ischemia did not improve outcomes over medical therapy alone, underlying the need to identify high-risk patients for a more effective invasive referral. CMR could determine the myocardial extent and matching locations of ischemia and infarction.

Objectives: This study sought to investigate if CMR peri-infarct ischemia is associated with adverse events incremental to known risk markers.

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Aims: Tafamidis improves clinical outcomes in transthyretin amyloid cardiomyopathy (ATTR-CM), yet how tafamidis affects cardiac structure and function remains poorly described. This study prospectively analysed the effect of tafamidis on 12-month longitudinal changes in cardiac structure and function by cardiac magnetic resonance (CMR) compared with the natural course of disease in an untreated historic control cohort.

Methods And Results: ATTR-CM patients underwent CMR at tafamidis initiation and at 12 months.

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Article Synopsis
  • This study investigated whether 4D cardiac computed tomography (4DCCT) could enhance risk assessment and predict reverse remodeling (RRM) and mortality in patients undergoing transcatheter aortic valve implantation (TAVI).
  • A total of 608 patients, mostly elderly, were analyzed before and after TAVI to measure left and right heart dimensions, mass, ejection fraction, and strain to assess outcomes.
  • Results indicated that while immediate post-TAVI measurements didn’t predict RRM, certain 4DCCT-derived metrics, like LV mass and ejection fraction at 12 months, were significant predictors of both RRM and survival.
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According to updated Lake-Louise Criteria, impaired regional myocardial function serves as a supportive criterion in diagnosing myocarditis. This study aimed to assess visual regional wall motional abnormalities (RWMA) and novel quantitative regional longitudinal peak strain (RLS) for risk stratification in the clinical setting of myocarditis. In patients undergoing CMR and meeting clinical criteria for suspected myocarditis global longitudinal strain (GLS), late gadolinium enhancement (LGE), RWMA and RLS were assessed in the anterior, septal, inferior, and lateral regions and correlated to the occurrence of major adverse cardiac events (MACE), including heart failure hospitalization, sustained ventricular tachycardia, recurrent myocarditis, and all-cause death.

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Background: Omega-3 polyunsaturated fatty acids (O3-FA) have been shown to reduce inflammation and adverse cardiac remodeling after acute myocardial infarction (AMI). However, the impact of O3-FA on long-term clinical outcomes remains uncertain.

Aims: To investigate the impact of O3-FA on adverse cardiac events in long-term follow up post AMI in a pilot-study.

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Article Synopsis
  • ATTR amyloidosis is a disease caused by protein misfolding, leading to fibril buildup in tissues, primarily affecting the heart and causing serious health issues.
  • Advanced cardiac imaging techniques, like echocardiography and MRI, are crucial for accurately diagnosing ATTR cardiomyopathy, especially since new treatments are most effective in the early stages of the disease.
  • The review discusses the latest cardiac imaging methods for diagnosing and managing ATTR-CM, and also explores how artificial intelligence could enhance clinical decisions and patient care in the future.
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Background Transthyretin amyloid cardiomyopathy (ATTR-CM) often coexists with severe aortic stenosis (AS). Although strain analysis from cardiac MRI and echocardiography was demonstrated to predict coexisting ATTR-CM, comparable data from four-dimensional (4D) cardiac CT are lacking despite wide availability. Purpose To evaluate the diagnostic performance of 4D cardiac CT-derived parameters in identifying ATTR-CM in older adults considered for transcatheter aortic valve implantation (TAVI).

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Background: Recent evidence underlined the importance of right (RV) involvement in suspected myocarditis. We aim to analyze the possible incremental prognostic value from RV global longitudinal strain (GLS) by CMR.

Methods: Patients referred for CMR, meeting clinical criteria for suspected myocarditis and no other cardiomyopathy were enrolled in a dual-center register cohort study.

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Cardiac magnetic resonance (CMR) four-dimensional (4D) flow is a novel method for flow quantification potentially helpful in management of mitral valve regurgitation (MVR). In this systematic review, we aimed to depict the clinical role of intraventricular 4D-flow in MVR. The reproducibility, technical aspects, and comparison against conventional techniques were evaluated.

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Transcatheter aortic valve implantation (TAVI) has become the standard of care in elderly high-risk patients with symptomatic severe aortic stenosis. Recently, TAVI has been increasingly performed in younger-, intermediate- and lower-risk populations, which underlines the need to investigate the long-term durability of bioprosthetic aortic valves. However, diagnosing bioprosthetic valve dysfunction after TAVI is challenging and only limited evidence-based criteria exist to guide therapy.

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Article Synopsis
  • * Researchers enrolled 736 patients diagnosed with suspected myocarditis and evaluated various cardiac metrics, linking RV abnormalities to the risk of serious cardiovascular events (MACE) over an average follow-up of 3.7 years.
  • * Findings revealed that RV dysfunction, as measured by ejection fraction and imaging techniques, significantly improves the prediction of outcomes in myocarditis, highlighting its importance in patient risk assessment and management.
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Translation of imaging into 3-dimensional (3D) printed patient-specific phantoms (3DPSPs) can help visualize complex cardiovascular anatomy and enable tailoring of therapy. The aim of this paper is to review the entire process of phantom production, including imaging, materials, 3D printing technologies, and the validation of 3DPSPs. A systematic review of published research was conducted using Embase and MEDLINE, including studies that investigated 3DPSPs in cardiovascular medicine.

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Aims: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) improve clinical outcomes in heart failure patients with reduced and preserved left ventricular ejection fraction (LVEF), but have not yet been investigated in transthyretin amyloid cardiomyopathy (ATTR-CM). This study aimed to evaluate tolerability, clinical outcomes, and changes in NT-proBNP levels and glomerular filtration rate (GFR) in ATTR-CM patients treated with dapagliflozin.

Methods And Results: Patients with stable, tafamidis-treated ATTR-CM were retrospectively evaluated at the initiation of dapagliflozin and 3 months thereafter.

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