Multimodal Imaging Evaluation of Myocardial Involvement in Rare Oculoleptomeningeal Hereditary Transthyretin Amyloidosis.

Background: In hereditary (variant) transthyretin amyloidosis (vATTR), cardiomyopathy leads to worse outcomes. Of 140 identified TTR gene mutations, few are associated with oculoleptomeningeal amyloidosis. It remains unclear whether these mutations are linked to a cardiac phenotype.

Artificial intelligence-based cardiac transthyretin amyloidosis detection and scoring in scintigraphy imaging: multi-tracer, multi-scanner, and multi-center development and evaluation study.

Introduction: Providing tools for comprehensively evaluating scintigraphy images could enhance transthyretin amyloid cardiomyopathy (ATTR-CM) diagnosis. This study aims to automatically detect and score ATTR-CM in total body scintigraphy images using deep learning on multi-tracer, multi-scanner, and multi-center datasets.

Methods: In the current study, we employed six datasets (from 12 cameras) for various tasks and purposes.

Prognostic Implications of Clinical and Imaging Diagnostic Criteria for Myocarditis.

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).

Sex- specific differences in suspected myocarditis presentations and outcomes.

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.

[Treatment of Acute Coronary Syndromes].

Despite significant advances in the detection and rapid management of acute coronary syndromes (ACS), it continues to lead the cause of death statistics and they continuously represent the leading cause of death and living with disabilities, globally. Since ACS combine a spectrum of different diagnoses, a high degree of variability in possible clinical presentation and relevant gender differences, Individualised treatment is not always easy and is constantly changing due to novel evidence from research studies. Therefore, the aim of this article is therefore to explain relevant treatment options and to present the current state of science in the context of clinical patient treatment.

Compartment-based reconstruction of acquisition-weighted P cardiac MRSI reduces sensitivity to cardiac motion and scan planning.

P magnetic resonance spectroscopic imaging (P MRSI) is a powerful technique for investigating the metabolic effects of treatments for heart failure , allowing a better understanding of their mechanism of action in patient cohorts. Unfortunately, cardiac P MRSI is fundamentally limited by low SNR, which leads to compromises in acquisition, such as no cardiac or respiratory gating or low spatial resolution, in order to achieve reasonable scan times. Spectroscopy with linear algebra modeling (SLAM) reconstruction may be able to address these challenges and therefore improve repeatability by incorporating a segmented localizer into the reconstruction.

Diagnosing post-capillary hypertension in patients with left heart disease: impact of new guidelines.

Background: In 2022, the definition of pulmonary hypertension (PH) in the presence of left heart disease was updated according to the new joint guidelines of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). The impact of the new ESC/ERS definition on the prevalence of post-capillary PH (pc-PH) and its subgroups of isolated post-capillary (Ipc-PH) and combined pre- and post-capillary PH (Cpc-PH) in patients with left heart disease is unclear.

Methods: We retrospectively identified N = 242 patients with left heart disease with available data on right heart catheterisation (RHC) and cardiac magnetic resonance imaging (CMR).

Assessment of Cardiac Energy Metabolism, Function, and Physiology in Patients With Heart Failure Taking Empagliflozin: The Randomized, Controlled EMPA-VISION Trial.

Background: Sodium-glucose co-transporter 2 inhibitors (SGLT2i) have emerged as a paramount treatment for patients with heart failure (HF), irrespective of underlying reduced or preserved ejection fraction. However, a definite cardiac mechanism of action remains elusive. Derangements in myocardial energy metabolism are detectable in all HF phenotypes, and it was proposed that SGLT2i may improve energy production.

Left ventricular remodelling post-myocardial infarction: pathophysiology, imaging, and novel therapies.

Most patients survive acute myocardial infarction (MI). Yet this encouraging development has certain drawbacks: heart failure (HF) prevalence is increasing and patients affected tend to have more comorbidities worsening economic strain on healthcare systems and impeding effective medical management. The heart's pathological changes in structure and/or function, termed myocardial remodelling, significantly impact on patient outcomes.

Energetic Basis for Exercise-Induced Pulmonary Congestion in Heart Failure With Preserved Ejection Fraction.

Background: Transient pulmonary congestion during exercise is emerging as an important determinant of reduced exercise capacity in heart failure with preserved ejection fraction (HFpEF). We sought to determine whether an abnormal cardiac energetic state underpins this process.

Methods: We recruited patients across the spectrum of diastolic dysfunction and HFpEF (controls, n=11; type 2 diabetes, n=9; HFpEF, n=14; and severe diastolic dysfunction attributable to cardiac amyloidosis, n=9).

Design and rationale of the EMPA-VISION trial: investigating the metabolic effects of empagliflozin in patients with heart failure.

Aims: Despite substantial improvements over the last three decades, heart failure (HF) remains associated with a poor prognosis. The sodium-glucose co-transporter-2 inhibitor empagliflozin demonstrated significant reductions of HF hospitalization in patients with HF independent of the presence or absence of type 2 diabetes mellitus in the EMPEROR-Reduced trial and cardiovascular mortality in the EMPA-REG OUTCOME trial. To further elucidate the mechanisms behind these positive outcomes, this study aims to determine the effects of empagliflozin treatment on cardiac energy metabolism and physiology using magnetic resonance spectroscopy (MRS) and cardiovascular magnetic resonance (CMR).

Quantifying the effect of dobutamine stress on myocardial Pi and pH in healthy volunteers: A P MRS study at 7T.

Purpose: Phosphorus spectroscopy ( P-MRS) is a proven method to probe cardiac energetics. Studies typically report the phosphocreatine (PCr) to adenosine triphosphate (ATP) ratio. We focus on another P signal: inorganic phosphate (Pi), whose chemical shift allows computation of myocardial pH, with Pi/PCr providing additional insight into cardiac energetics.

Cardiac Energetics in Patients With Aortic Stenosis and Preserved Versus Reduced Ejection Fraction.

Background: Why some but not all patients with severe aortic stenosis (SevAS) develop otherwise unexplained reduced systolic function is unclear. We investigate the hypothesis that reduced creatine kinase (CK) capacity and flux is associated with this transition.

Methods: We recruited 102 participants to 5 groups: moderate aortic stenosis (ModAS) (n=13), SevAS, left ventricular (LV) ejection fraction ≥55% (SevAS-preserved ejection fraction, n=37), SevAS, LV ejection fraction <55% (SevAS-reduced ejection fraction, n=15), healthy volunteers with nonhypertrophied hearts with normal systolic function (normal healthy volunteer, n=30), and patients with nonhypertrophied, non-pressure-loaded hearts with normal systolic function undergoing cardiac surgery and donating LV biopsy (non-pressure-loaded heart biopsy, n=7).

as Cause of Fatal Sepsis.

A rare consequence of dog bites is the infection with , and only a few cases have been documented. We describe a 41-year-old, formerly healthy woman who died from septic shock and multiorgan failure. It is the first case of a young individual without obvious immunosuppression.

Localized rest and stress human cardiac creatine kinase reaction kinetics at 3 T.

Changes in the kinetics of the creatine kinase (CK) shuttle are sensitive markers of cardiac energetics but are typically measured at rest and in the prone position. This study aims to measure CK kinetics during pharmacological stress at 3 T, with measurement in the supine position. A shorter "stressed saturation transfer" (StreST) extension to the triple repetition time saturation transfer (TRiST) method is proposed.

Eya4 Induces Hypertrophy via Regulation of p27kip1.

Background: E193, a heterozygous truncating mutation in the human transcription cofactor Eyes absent 4 (Eya4), causes hearing impairment followed by dilative cardiomyopathy.

Methods And Results: In this study, we first show Eya4 and E193 alter the expression of p27(kip1) in vitro, suggesting Eya4 is a negative regulator of p27. Next, we generated transgenic mice with cardiac-specific overexpression of Eya4 or E193.