Scholars@Duke
Igor Klem

Igor Klem

Associate Professor of Medicine
Medicine, Cardiology
igor.klem@duke.edu
Duke Box 3943, Durham, NC 27710
Trent Drive, Duke Clinic, Orange Zone, Rm 4229, Durham, NC 27710

Selected Publications

Cardiovascular impact of near complete estrogen deprivation in premenopausal women with breast cancer: The CROWN study.

Journal Article Am Heart J · January 2024 Survival with operable breast cancer has improved markedly in recent decades, however, treatment-related cardiovascular toxicities threaten to offset these gains. Ovarian function suppression paired with aromatase inhibition, for premenopausal women with h ... Full text Link to item Cite

Stress Perfusion Cardiac Magnetic Resonance vs SPECT Imaging for Detection of Coronary Artery Disease.

Journal Article J Am Coll Cardiol · November 7, 2023 BACKGROUND: GadaCAD2 was 1 of 2 international, multicenter, prospective, Phase 3 clinical trials that led to U.S. Food and Drug Administration approval of gadobutrol to assess myocardial perfusion and late gadolinium enhancement (LGE) in adults with known ... Full text Link to item Cite

Impact of late gadolinium-enhanced cardiac MRI on arrhythmic and mortality outcomes in nonischemic dilated cardiomyopathy: updated systematic review and meta-analysis.

Journal Article Scientific reports · August 2023 Risk stratification based mainly on the impairment of left ventricular ejection fraction has limited performance in patients with nonischemic dilated cardiomyopathy (NIDCM). Evidence is rapidly growing for the impact of myocardial scar identified by late g ... Full text Cite

Myocardial Contractile Mechanics in Ischemic Mitral Regurgitation: Multicenter Data Using Stress Perfusion Cardiovascular Magnetic Resonance.

Journal Article JACC Cardiovasc Imaging · July 2022 BACKGROUND: Left ventricular (LV) ischemia has been variably associated with functional mitral regurgitation (FMR). Determinants of FMR in patients with ischemia are poorly understood. OBJECTIVES: This study sought to test whether contractile mechanics in ... Full text Link to item Cite

Cardiometabolic Comorbidities in Cancer Survivors: JACC: CardioOncology State-of-the-Art Review.

Journal Article JACC CardioOncol · June 2022 There are nearly 17 million cancer survivors in the United States, including those who are currently receiving cancer therapy with curative intent and expected to be long-term survivors, as well as those with chronic cancers such as metastatic disease or c ... Full text Open Access Link to item Cite

Descending Aortic Distensibility and Cardiovascular Outcomes: A Cardiac Magnetic Resonance Imaging Study.

Journal Article Vasc Health Risk Manag · 2022 BACKGROUND: Aortic distensibility (AD) is an important determinant of cardiovascular (CV) morbidity and mortality. There is scant data on the association between AD measured within the descending thoracic aorta and CV outcomes. OBJECTIVE: We evaluated the ... Full text Link to item Cite

Double spectral attenuated inversion recovery (DSPAIR)-an efficient fat suppression technique for late gadolinium enhancement at 3 tesla.

Journal Article NMR Biomed · October 2021 Despite clinical use of late gadolinium enhancement (LGE) for two decades, an efficient, robust fat suppression (FS) technique still does not exist for this CMR mainstay. In ischemic and non-ischemic heart disease, differentiating fibrotic tissue from infi ... Full text Link to item Cite

The Incidence and Natural Progression of New-Onset Postoperative Atrial Fibrillation.

Journal Article JACC Clin Electrophysiol · September 2021 OBJECTIVES: This study aimed to characterize the natural progression and recurrence of new-onset postoperative atrial fibrillation (POAF) during an intermediate-term follow-up post cardiac surgery by using continuous event monitoring. BACKGROUND: New-onset ... Full text Link to item Cite

Progression of Myocardial Fibrosis in Nonischemic DCM and Association With Mortality and Heart Failure Outcomes.

Journal Article JACC Cardiovasc Imaging · July 2021 OBJECTIVES: The purpose of this study was to assess whether the presence and extent of fibrosis changes over time in patients with nonischemic, dilated cardiomyopathy (DCM) receiving optimal medical therapy and the implications of any such changes on left ... Full text Link to item Cite

Segment Length in Cine Strain Analysis Predicts Cardiac Resynchronization Therapy Outcome Beyond Current Guidelines.

Journal Article Circ Cardiovasc Imaging · July 2021 BACKGROUND: Patients with a class I recommendation for cardiac resynchronization therapy (CRT) are likely to benefit, but the effect of CRT in class II patients is more heterogeneous and additional selection parameters are needed in this group. The recentl ... Full text Link to item Cite

Relationship of LVEF and Myocardial Scar to Long-Term Mortality Risk and Mode of Death in Patients With Nonischemic Cardiomyopathy.

Journal Article Circulation · April 6, 2021 BACKGROUND: Nonischemic cardiomyopathy is a leading cause of reduced left ventricular ejection fraction (LVEF) and is associated with high mortality risk from progressive heart failure and arrhythmias. Myocardial scar on cardiovascular magnetic resonance i ... Full text Link to item Cite

Ischemia-Mediated Dysfunction in Subpapillary Myocardium as a Marker of Functional Mitral Regurgitation.

Journal Article JACC Cardiovasc Imaging · April 2021 OBJECTIVES: The goal of this study was to test whether ischemia-mediated contractile dysfunction underlying the mitral valve affects functional mitral regurgitation (FMR) and the prognostic impact of FMR. BACKGROUND: FMR results from left ventricular (LV) ... Full text Link to item Cite

Using Cardiac Magnetic Resonance Imaging to Evaluate Patients with Chest Pain in the Emergency Department.

Journal Article J Cardiovasc Imaging · April 2021 Chest pain is one of the most common presenting symptoms in the emergency department (ED). Among patients with abnormal troponins, it is imperative to quickly and accurately distinguish type 1 acute myocardial infarction (AMI) from other etiologies of myoc ... Full text Link to item Cite

Instantaneous wave-free ratio guided multivessel revascularisation during percutaneous coronary intervention for acute myocardial infarction: study protocol of the randomised controlled iMODERN trial.

Journal Article BMJ Open · January 15, 2021 INTRODUCTION: Recent randomised clinical trials showed benefit of non-culprit lesion revascularisation in ST-elevation myocardial infarction (STEMI) patients. However, it remains unclear whether revascularisation should be performed at the index procedure ... Full text Link to item Cite

OUTpatient intravenous LASix Trial in reducing hospitalization for acute decompensated heart failure (OUTLAST).

Conference PLoS One · 2021 BACKGROUND: Hospitalization for acute decompensated heart failure (ADHF) remains a major source of morbidity and mortality. The current study aimed to investigate the feasibility, safety, and efficacy of outpatient furosemide intravenous (IV) infusion foll ... Full text Link to item Cite

Early impairment of myocardial deformation assessed by regional speckle-tracking echocardiography in the indeterminate form of Chagas disease without fibrosis detected by cardiac magnetic resonance.

Journal Article PLoS Negl Trop Dis · November 2020 UNLABELLED: Chagas disease (CD) will account for 200,000 cardiovascular deaths worldwide over the next 5 years. Early detection of chronic Chagas cardiomyopathy (CCC) is a challenge. We aimed to test if speckle-tracking echocardiography (STE) can detect in ... Full text Link to item Cite

A care pathway for the cardiovascular complications of COVID-19: Insights from an institutional response.

Journal Article Am Heart J · July 2020 The infection caused by severe acute respiratory syndrome coronavirus-2, or COVID-19, can result in myocardial injury, heart failure, and arrhythmias. In addition to the viral infection itself, investigational therapies for the infection can interact with ... Full text Link to item Cite

Risk of Cardiomyopathy in Breast Cancer: How Can We Attenuate the Risk of Heart Failure from Anthracyclines and Anti-HER2 Therapies?

Journal Article Curr Treat Options Cardiovasc Med · May 31, 2019 PURPOSE OF REVIEW: To review cardiotoxicity of and strategies to prevent cardiotoxicity from anthracyclines and anti-HER2 agents used to treat breast cancer. RECENT FINDINGS: Although not common, cardiotoxicity from anthracyclines and anti-HER2 therapies i ... Full text Link to item Cite

Low lead one ratio predicts clinical outcomes in left bundle branch block.

Journal Article J Cardiovasc Electrophysiol · May 2019 INTRODUCTION: We evaluated the association between a novel electrocardiographic (ECG) marker of late, rightward electrocardiographic forces (termed the lead one ratio [LOR]), and left ventricular ejection fraction (LVEF), myocardial scar, and clinical outc ... Full text Link to item Cite

Identifying the Infarct-Related Artery in Patients With Non-ST-Segment-Elevation Myocardial Infarction.

Journal Article Circ Cardiovasc Interv · May 2019 BACKGROUND: Determining the infarct-related artery (IRA) in non-ST-segment-elevation myocardial infarction (MI) can be challenging. Delayed-enhancement cardiac magnetic resonance (DE-CMR) can accurately identify small MIs. The purpose of this study was to ... Full text Link to item Cite

Prognostic Value of Vasodilator Stress Cardiac Magnetic Resonance Imaging: A Multicenter Study With 48 000 Patient-Years of Follow-up.

Journal Article JAMA Cardiol · March 1, 2019 IMPORTANCE: Stress cardiac magnetic resonance imaging (CMR) is not widely used in current clinical practice, and its ability to predict patient mortality is unknown. OBJECTIVE: To determine whether stress CMR is associated with patient mortality. DESIGN, S ... Full text Link to item Cite

Association of left atrial volume index and all-cause mortality in patients referred for routine cardiovascular magnetic resonance: a multicenter study.

Journal Article J Cardiovasc Magn Reson · January 7, 2019 BACKGROUND: Routine cine cardiovascular magnetic resonance (CMR) allows for the measurement of left atrial (LA) volumes. Normal reference values for LA volumes have been published based on a group of European individuals without known cardiovascular diseas ... Full text Link to item Cite

Dark-Blood Delayed Enhancement Cardiac Magnetic Resonance of Myocardial Infarction.

Journal Article JACC Cardiovasc Imaging · December 2018 OBJECTIVES: This study introduced and validated a novel flow-independent delayed enhancement technique that shows hyperenhanced myocardium while simultaneously suppressing blood-pool signal. BACKGROUND: The diagnosis and assessment of myocardial infarction ... Full text Open Access Link to item Cite

Size Matters: Normalization of QRS Duration to Left Ventricular Dimension Improves Prediction of Long-Term Cardiac Resynchronization Therapy Outcome.

Journal Article Circ Arrhythm Electrophysiol · December 2018 BACKGROUND: In patients with left bundle branch block (LBBB), QRS duration (QRSd) depends on left ventricular (LV) dimension. Previously, we demonstrated that normalizing QRSd to LV dimension, to adjust for variations in LV size, improved prediction of hem ... Full text Link to item Cite

Feature-Tracking Global Longitudinal Strain Predicts Death in a Multicenter Population of Patients With Ischemic and Nonischemic Dilated Cardiomyopathy Incremental to Ejection Fraction and Late Gadolinium Enhancement.

Journal Article JACC Cardiovasc Imaging · October 2018 OBJECTIVES: The aim of this study was to evaluate the prognostic value of cardiac magnetic resonance (CMR) feature-tracking-derived global longitudinal strain (GLS) in a large multicenter population of patients with ischemic and nonischemic dilated cardiom ... Full text Link to item Cite

Left Ventricular Long-Axis Function Assessed with Cardiac Cine MR Imaging Is an Independent Predictor of All-Cause Mortality in Patients with Reduced Ejection Fraction: A Multicenter Study.

Journal Article Radiology · February 2018 Purpose To evaluate the prognostic value of a simple index of left ventricular (LV) long-axis function-lateral mitral annular plane systolic excursion (MAPSE)-in a large multicenter population of patients with reduced ejection fraction (EF) who were underg ... Full text Link to item Cite

The ability of the electrocardiogram in left bundle branch block to detect myocardial scar determined by cardiovascular magnetic resonance.

Journal Article J Electrocardiol · 2018 AIMS: We aimed to improve the electrocardiographic 2009 left bundle branch block (LBBB) Selvester QRS score (2009 LBSS) for scar assessment. METHODS: We retrospectively identified 325 LBBB patients with available ECG and cardiovascular magnetic resonance i ... Full text Link to item Cite

Ejection fraction in left bundle branch block is disproportionately reduced in relation to amount of myocardial scar.

Journal Article J Electrocardiol · 2018 INTRODUCTION: The relationship between left ventricular (LV) ejection fraction (EF) and LV myocardial scar can identify potentially reversible causes of LV dysfunction. Left bundle branch block (LBBB) alters the electrical and mechanical activation of the ... Full text Link to item Cite

Systemic involvement in ACS: Using CMR imaging to compare the aortic wall in patients with and without acute coronary syndrome.

Journal Article PLoS One · 2018 BACKGROUND/OBJECTIVES: Previous studies have demonstrated that in acute coronary syndrome (ACS), plaque destabilization and vessel inflammation, represented by vessel edema, often occur simultaneously in multiple coronaries, as well as extend to the cerebr ... Full text Link to item Cite

The Prevalence, Correlates, and Impact on Cardiac Mortality of Right Ventricular Dysfunction in Nonischemic Cardiomyopathy.

Journal Article JACC. Cardiovascular imaging · October 2017 ObjectivesThis study sought to determine the prevalence, correlates, and impact on cardiac mortality of right ventricular (RV) dysfunction in nonischemic cardiomyopathy.BackgroundCurrent heart failure guidelines place little emphasis on R ... Full text Cite

Prevalence and Prognostic Significance of Left Ventricular Noncompaction in Patients Referred for Cardiac Magnetic Resonance Imaging.

Journal Article Circ Cardiovasc Imaging · September 2017 BACKGROUND: Presence of prominent left ventricular trabeculation satisfying criteria for left ventricular noncompaction (LVNC) on routine cardiac magnetic resonance examination is frequently encountered; however, the clinical and prognostic significance of ... Full text Link to item Cite

Sources of variability in quantification of cardiovascular magnetic resonance infarct size - reproducibility among three core laboratories.

Journal Article J Cardiovasc Magn Reson · August 11, 2017 BACKGROUND: Acute myocardial infarct (AMI) size depicted by late gadolinium enhancement cardiovascular magnetic resonance (CMR) is increasingly used as an efficacy endpoint in randomized trials comparing AMI therapies. Infarct size is quantified using manu ... Full text Open Access Link to item Cite

Accuracy of left ventricular ejection fraction by contemporary multiple gated acquisition scanning in patients with cancer: comparison with cardiovascular magnetic resonance.

Journal Article J Cardiovasc Magn Reson · March 24, 2017 BACKGROUND: Multiple gated acquisition scanning (MUGA) is a common imaging modality for baseline and serial assessment of left ventricular ejection fraction (LVEF) for cardiotoxicity risk assessment prior to, surveillance during, and surveillance after adm ... Full text Link to item Cite

Late Gadolinium Enhancement and the Risk for Ventricular Arrhythmias or Sudden Death in Dilated Cardiomyopathy: Systematic Review and Meta-Analysis.

Journal Article JACC Heart Fail · January 2017 OBJECTIVES: The aim of this study was to evaluate the association between late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging and ventricular arrhythmias or sudden cardiac death (SCD) in patients with dilated cardiomyopathy (DCM). BACKG ... Full text Link to item Cite

The Systematic Evaluation of Identifying the Infarct Related Artery Utilizing Cardiac Magnetic Resonance in Patients Presenting with ST-Elevation Myocardial Infarction.

Journal Article PLoS One · 2017 BACKGROUND: Identification of the infarct-related artery (IRA) in patients with STEMI using coronary angiography (CA) is often based on the ECG and can be challenging in patients with severe multi-vessel disease. The current study aimed to determine how of ... Full text Link to item Cite

Review and Analysis of Publication Trends over Three Decades in Three High Impact Medicine Journals.

Journal Article PLoS One · 2017 CONTEXT: Over the past three decades, industry sponsored research expanded in the United States. Financial incentives can lead to potential conflicts of interest (COI) resulting in underreporting of negative study results. OBJECTIVE: We hypothesized that o ... Full text Link to item Cite

Right atrial volume by cardiovascular magnetic resonance predicts mortality in patients with heart failure with reduced ejection fraction.

Journal Article PLoS One · 2017 BACKGROUND: Right Atrial Volume Index (RAVI) measured by echocardiography is an independent predictor of morbidity in patients with heart failure (HF) with reduced ejection fraction (HFrEF). The aim of this study is to evaluate the predictive value of RAVI ... Full text Link to item Cite

Introduction to cardiovascular magnetic resonance imaging

Chapter · January 1, 2017 CNR Contrast-to-noise ratio CSI Chemical shift imaging CSPAMM Complementary SPAMM CT Computed tomography DANTE Delays alternating with nutations for tailored excitation DE Delayed enhancement DENSE Displacement encoding with stimulated echoes DWI Diffusion ... Full text Cite

Importance of papillary muscle infarction detected by cardiac magnetic resonance imaging in predicting cardiovascular events.

Journal Article Int J Cardiol · October 1, 2016 BACKGROUND: Recent studies suggest that papillary muscle infarction (PMI) following recent myocardial infarction (MI) correlates with adverse cardiovascular outcomes. The purpose of this study is to determine the prevalence and prognostic significance of P ... Full text Link to item Cite

Prognostic Value of Cardiac MR Imaging for Preoperative Assessment of Patients with Severe Functional Tricuspid Regurgitation.

Journal Article Radiology · September 2016 Purpose To explore the prognostic value of cardiac magnetic resonance (MR) imaging in predicting postoperative cardiac death in patients with severe functional tricuspid regurgitation (TR). Materials and Methods This study was approved by the institutional ... Full text Link to item Cite

Comparison of stress cardiovascular magnetic resonance imaging (CMR) with stress nuclear perfusion for the diagnosis of coronary artery disease.

Journal Article J Nucl Cardiol · April 2016 OBJECTIVES: To assess the diagnostic performance of stress cardiac magnetic resonance (stress CMR) vs stress single-photon emission computed tomography (SPECT) in patients presenting to the emergency department (ED) with chest pain. BACKGROUND: SPECT imagi ... Full text Link to item Cite

Left ventricular regional contraction abnormalities by echocardiographic speckle tracking in combined right bundle branch with left anterior fascicular block compared to left bundle branch block.

Journal Article J Electrocardiol · 2016 BACKGROUND: In contrast to LBBB patients less is known about patients with RBBB+LAFB regarding LV contractile abnormalities and the potential role of CRT. This study investigated whether patients with RBBB+LAFB morphology have echocardiographic mechanical ... Full text Link to item Cite

Evaluation of Selvester QRS score for use in presence of conduction abnormalities in a broad population.

Journal Article Am Heart J · August 2015 BACKGROUND: The Selvester QRS score is an electrocardiographic tool designed to quantify myocardial scar. It was updated in 2009 to expand its usefulness in patients with conduction abnormalities such as bundle-branch and fascicular blocks. There is need t ... Full text Link to item Cite

Relationship of T2-Weighted MRI Myocardial Hyperintensity and the Ischemic Area-At-Risk.

Journal Article Circ Res · July 17, 2015 RATIONALE: After acute myocardial infarction (MI), delineating the area-at-risk (AAR) is crucial for measuring how much, if any, ischemic myocardium has been salvaged. T2-weighted MRI is promoted as an excellent method to delineate the AAR. However, the ev ... Full text Open Access Link to item Cite

Correlation between pericardial, mediastinal, and intrathoracic fat volumes with the presence and severity of coronary artery disease, metabolic syndrome, and cardiac risk factors.

Journal Article Eur Heart J Cardiovasc Imaging · January 2015 AIMS: To investigate the association of pericardial, mediastinal, and intrathoracic fat volumes with the presence and severity of coronary artery disease (CAD), metabolic syndrome (MS), and cardiac risk factors (CRFs). METHODS AND RESULTS: Two hundred and ... Full text Link to item Cite

Cardiac Magnetic Resonance Scar Imaging for Sudden Cardiac Death Risk Stratification in Patients with Non-Ischemic Cardiomyopathy.

Journal Article Korean J Radiol · 2015 In patients with non-ischemic cardiomyopathy (NICM), risk stratification for sudden cardiac death (SCD) and selection of patients who would benefit from prophylactic implantable cardioverter-defibrillators remains challenging. We aim to discuss the evidenc ... Full text Link to item Cite

Specificity for each of the 46 criteria of the Selvester QRS score for electrocardiographic myocardial scar sizing in left bundle branch block.

Journal Article J Electrocardiol · 2015 BACKGROUND: The Selvester QRS score consists of a set of electrocardiographic criteria designed to identify, quantify and localize scar in the left ventricle using the morphology of the QRS complex. These criteria were updated in 2009 to expand their use t ... Full text Link to item Cite

Routine cine-CMR for prosthesis-associated mitral regurgitation: a multicenter comparison to echocardiography.

Journal Article J Heart Valve Dis · September 2014 BACKGROUND AND AIM OF THE STUDY: Mitral regurgitation (MR) is an important complication after prosthetic mitral valve (PMV) implantation. Transthoracic echocardiography is widely used to screen for native MR, but can be limited with PMV. Cine-cardiac magne ... Link to item Cite

Stress cardiac MR imaging compared with stress echocardiography in the early evaluation of patients who present to the emergency department with intermediate-risk chest pain.

Journal Article Radiology · April 2014 PURPOSE: To compare the utility and efficacy of stress cardiac magnetic resonance (MR) imaging and stress echocardiography in an emergency setting in patients with acute chest pain (CP) and intermediate risk of coronary artery disease (CAD). MATERIALS AND ... Full text Link to item Cite

Pulmonary venous stenosis on ventilation-perfusion scintigraphy: a correlation with dynamic magnetic resonance pulmonary angiography.

Journal Article Clin Nucl Med · March 2014 A case of pulmonary vein stenosis as a result of prior atrial fibrillation focus procedures for atrial fibrillation, correlated with magnetic resonance (MR) pulmonary angiography, is presented. Restricted flow to the right lung in similar quantities measur ... Full text Link to item Cite

Pulmonary venous stenosis on ventilation-perfusion scintigraphy: a correlation with dynamic magnetic resonance pulmonary angiography.

Journal Article Clinical nuclear medicine · January 1, 2014 A case of pulmonary vein stenosis as a result of prior atrial fibrillation focus procedures for atrial fibrillation, correlated with magnetic resonance (MR) pulmonary angiography, is presented. Restricted flow to the right lung in similar quantities measur ... Cite

Motion and flow insensitive adiabatic T2 -preparation module for cardiac MR imaging at 3 Tesla.

Journal Article Magn Reson Med · November 2013 A versatile method for generating T2 -weighting is a T2 -preparation module, which has been used successfully for cardiac imaging at 1.5T. Although it has been applied at 3T, higher fields (B0 ≥ 3T) can degrade B0 and B1 homogeneity and result in nonunifor ... Full text Link to item Cite

Assessment of myocardial scarring improves risk stratification in patients evaluated for cardiac defibrillator implantation.

Journal Article J Am Coll Cardiol · July 31, 2012 OBJECTIVES: We tested whether an assessment of myocardial scarring by cardiac magnetic resonance imaging (MRI) would improve risk stratification in patients evaluated for implantable cardioverter-defibrillator (ICD) implantation. BACKGROUND: Current sudden ... Full text Link to item Cite

Comparison of exercise electrocardiography and stress perfusion CMR for the detection of coronary artery disease in women.

Journal Article J Cardiovasc Magn Reson · June 14, 2012 BACKGROUND: Exercise electrocardiography (ECG) is frequently used in the work-up of patients with suspected coronary artery disease (CAD), however the accuracy is reduced in women. Cardiovascular magnetic resonance (CMR) stress testing can accurately diagn ... Full text Link to item Cite

Quantifying the area at risk using the infarct lateral border: importance of infarct transmurality

Journal Article Journal of Cardiovascular Magnetic Resonance · February 1, 2012 Full text Cite

Clinical application of cine-MRI in the visual assessment of mitral regurgitation compared to echocardiography and cardiac catheterization.

Journal Article PLoS One · 2012 BACKGROUND: Detecting and quantifying the severity of mitral regurgitation is essential for risk stratification and clinical decision-making regarding timing of surgery. Our objective was to assess specific visual parameters by cine-magnetic resonance imag ... Full text Link to item Cite

Imaging in acute coronary syndrome

Journal Article Cardiology Research and Practice · December 1, 2011 Full text Cite

Prognostic value of routine cardiac magnetic resonance assessment of left ventricular ejection fraction and myocardial damage: an international, multicenter study.

Journal Article Circ Cardiovasc Imaging · November 2011 BACKGROUND: Cardiac magnetic resonance (CMR) is considered the reference standard for assessment of left ventricular ejection fraction (LVEF) and myocardial damage. However, few studies have evaluated the relationship between CMR findings and patient outco ... Full text Link to item Cite

LV thrombus detection by routine echocardiography: insights into performance characteristics using delayed enhancement CMR.

Journal Article JACC Cardiovasc Imaging · July 2011 OBJECTIVES: This study sought to evaluate performance characteristics of routine echo for left ventricular thrombus (LVT). BACKGROUND: Although the utility of dedicated echocardiography (echo) for LVT is established, echo is widely used as a general test f ... Full text Link to item Cite

Papillary muscle infarction and cardiovascular outcomes

Journal Article Journal of Cardiovascular Magnetic Resonance · January 10, 2011 Full text Cite

Cardiovascular complications of breast cancer therapy in older adults.

Journal Article Oncologist · 2011 Older adults frequently have pre-existing and cancer-related risk factors for cardiovascular toxicity from cancer treatment. In this review, we discuss the risk factors and strategies for prevention and management of cardiovascular complications in older w ... Full text Link to item Cite

The accuracy of the electrocardiogram during exercise stress test based on heart size.

Journal Article PLoS One · 2011 BACKGROUND: Multiple studies have shown that the exercise electrocardiogram (ECG) is less accurate for predicting ischemia, especially in women, and there is additional evidence to suggest that heart size may affect its diagnostic accuracy. HYPOTHESIS: The ... Full text Link to item Cite

The aorta wall of patients presenting to the emergency department with acute myocardial infarction by cardiac magnetic resonance.

Journal Article Atherosclerosis · September 2010 BACKGROUND: Inflammation has been shown to be a major component in the pathophysiology of acute coronary syndrome (ACS). In patients presenting with acute myocardial infarction (AMI), a critical component of the ACS spectrum, multiple coronary arteries are ... Full text Link to item Cite

Surprising finding of a primary pericardial mesothelioma.

Journal Article Int J Cardiovasc Imaging · August 2010 In this report, we describe a case of primary pericardial mesothelioma, which is an extremely rare tumor arising from mesothelial cells lining the pericardium and is associated with a dismal prognosis. ... Full text Link to item Cite

Incidence of caffeine in serum of patients undergoing dipyridamole myocardial perfusion stress test by an intensive versus routine caffeine history screening.

Journal Article Am J Cardiol · May 15, 2010 The coronary vasodilatory effect of dipyridamole is competitively blocked by caffeine. The purposes of this study were to (1) assess the incidence of having detectable serum caffeine and (2) evaluate whether an intensive caffeine history screening strategy ... Full text Link to item Cite

Detection of myocardial damage in patients with sarcoidosis.

Journal Article Circulation · November 17, 2009 BACKGROUND: In patients with sarcoidosis, sudden death is a leading cause of mortality, which may represent unrecognized cardiac involvement. Delayed-enhancement cardiovascular magnetic resonance (DE-CMR) can detect minute amounts of myocardial damage. We ... Full text Link to item Cite

Unrecognized non-Q-wave myocardial infarction: prevalence and prognostic significance in patients with suspected coronary disease.

Journal Article PLoS Med · April 21, 2009 BACKGROUND: Unrecognized myocardial infarction (UMI) is known to constitute a substantial portion of potentially lethal coronary heart disease. However, the diagnosis of UMI is based on the appearance of incidental Q-waves on 12-lead electrocardiography. T ... Full text Link to item Cite

Assessment of microvascular injury after acute myocardial infarction: importance of the area at risk.

Journal Article Nat Clin Pract Cardiovasc Med · December 2008 Microvascular obstruction after acute myocardial infarction has been associated with adverse ventricular remodeling, arrhythmias, and poor clinical outcome. Hirsch et al. demonstrate a moderate concordance between abnormal intracoronary Doppler flow charac ... Full text Link to item Cite

Detection of left ventricular thrombus by delayed-enhancement cardiovascular magnetic resonance prevalence and markers in patients with systolic dysfunction.

Journal Article J Am Coll Cardiol · July 8, 2008 OBJECTIVES: This study sought to assess the prevalence and markers of left ventricular (LV) thrombus among patients with systolic dysfunction. BACKGROUND: Prior studies have yielded discordant findings regarding prevalence and markers of LV thrombus. Delay ... Full text Link to item Cite

Value of cardiovascular magnetic resonance stress perfusion testing for the detection of coronary artery disease in women.

Journal Article JACC Cardiovasc Imaging · July 2008 OBJECTIVES: We wanted to assess the value of cardiovascular magnetic resonance (CMR) stress testing for evaluation of women with suspected coronary artery disease (CAD). BACKGROUND: A combined perfusion and infarction CMR examination can accurately diagnos ... Full text Link to item Cite

MRI for the Assessment of Myocardial Viability

Journal Article Magnetic Resonance Imaging Clinics of North America · November 1, 2007 Accurate distinction between viable and infarcted myocardium is important for assessment of patients who have cardiac dysfunction. Through the technique of delayed-enhancement MRI (DE-MRI), viable and infarcted myocardium can be simultaneously identified i ... Full text Cite

Detection of myocardial ischemia by stress perfusion cardiovascular magnetic resonance.

Journal Article Magn Reson Imaging Clin N Am · November 2007 With recent technical and clinical advances, adenosine stress perfusion MRI has evolved from a promising research tool to an everyday clinical test. This article reviews the current state of stress perfusion MRI. Specifically, it addresses the following to ... Full text Link to item Cite

Diagnostic usefulness and prognostic implications of the mitral E/E' ratio in patients with heart failure and severe secondary mitral regurgitation.

Journal Article Am J Cardiol · September 1, 2007 In patients with chronic heart failure (CHF) and severe secondary mitral regurgitation (MR), the diagnostic usefulness and prognostic impact of tissue Doppler imaging (TDI) is unknown. This prospective study enrolled 370 patients with stable CHF. Severe se ... Full text Link to item Cite

MRI for the assessment of myocardial viability.

Journal Article Cardiol Clin · February 2007 Accurate distinction between viable and infarcted myocardium is important for assessment of patients who have cardiac dysfunction. Through the technique of delayed-enhancement MRI (DE-MRI), viable and infarcted myocardium can be simultaneously identified i ... Full text Link to item Cite

Detection of myocardial ischemia by stress perfusion cardiovascular magnetic resonance.

Journal Article Cardiol Clin · February 2007 With recent technical and clinical advances, adenosine stress perfusion MRI has evolved from a promising research tool to an everyday clinical test. This article reviews the current state of stress perfusion MRI. Specifically, it addresses the following to ... Full text Link to item Cite

Rapid detection of myocardial infarction by subsecond, free-breathing delayed contrast-enhancement cardiovascular magnetic resonance.

Journal Article Circulation · January 16, 2007 BACKGROUND: An ultrafast, delayed contrast-enhancement cardiovascular magnetic resonance technique that can acquire subsecond, "snapshot" images during free breathing (subsecond) is becoming widely available. This technique provides myocardial infarction ( ... Full text Link to item Cite

MR angiography of the thoracic aorta with protocols

Chapter · January 1, 2007 Magnetic resonance imaging (MRI) plays a pivotal role in the diagnostic work-up of a broad spectrum of aortic diseases. In this chapter we will describe the MRI pulse sequences commonly used in the comprehensive assessment of the thoracic aorta, including ... Cite

MR angiography of the lower extremity circulation with protocols

Chapter · January 1, 2007 Peripheral arterial disease (PAD) is a common problem worldwide, with an estimated 20 million patients in the US alone. Although most patients with PAD are asymptomatic, it is common to present with lower extremity symptoms such as claudication and sometim ... Cite

Improved detection of coronary artery disease by stress perfusion cardiovascular magnetic resonance with the use of delayed enhancement infarction imaging.

Journal Article J Am Coll Cardiol · April 18, 2006 OBJECTIVES: We tested a pre-defined visual interpretation algorithm that combines cardiovascular magnetic resonance (CMR) data from perfusion and infarction imaging for the diagnosis of coronary artery disease (CAD). BACKGROUND: Cardiovascular magnetic res ... Full text Link to item Cite

Where's the flap?

Journal Article J Cardiovasc Magn Reson · 2006 We present a case of aortic intramural hematoma (IMH) in an elderly woman who presented with sudden onset of mid-scapular pain. The patient underwent a series of multimodality imaging studies before the diagnosis of IMH was evident by cardiovascular magnet ... Full text Link to item Cite

Noninvasive assessment of blood flow based on magnetic resonance global coherent free precession.

Journal Article Circulation · March 1, 2005 BACKGROUND: Magnetic resonance global coherent free precession (GCFP) is a new technique that produces cine projection angiograms directly analogous to those of x-ray angiography noninvasively and without a contrast agent. In this study, we compared GCFP b ... Full text Link to item Cite

The case of the disappearing myxoma.

Journal Article J Cardiovasc Magn Reson · 2005 We present a case demonstrating the utility of cardiovascular magnetic resonance (CMR) in the diagnosis of a cardiac mass. A 70-year-old female who presented with chest pressure and left sided jaw pain was found to have a cardiac mass on transthoracic and ... Full text Link to item Cite

[Is coronary magnetic resonance angiography already a clinically useful diagnostic tool?].

Journal Article Dtsch Med Wochenschr · December 10, 2004 Magnetic resonance imaging (MRI) allows the evaluation of coronary arteries non-invasively and without the use of ionizing radiation. Coronary magnetic resonance angiography (MRA) is technically demanding due to the small size, tortuous course, and bulk mo ... Full text Link to item Cite

Video-assisted thoracoscopic transplantation of myoblasts into the heart.

Journal Article Ann Thorac Surg · July 2004 PURPOSE: Currently, cells are transplanted into injured myocardium either through thoracotomy for open surgical delivery or through catheterization for endoventricular or intracoronary delivery; both methods have limitations. Open surgical delivery limits ... Full text Link to item Cite

Mortality and rate of stroke or embolism in atrial fibrillation during long-term follow-up in the embolism in left atrial thrombi (ELAT) study.

Journal Article Clin Cardiol · January 2004 BACKGROUND: Patients with atrial fibrillation (AF) have a higher mortality and risk of stroke/embolism than patients with sinus rhythm. HYPOTHESIS: The aim of the study was to assess the association of clinical and echocardiographic characteristics with mo ... Full text Link to item Cite

Diabetic atrial fibrillation patients: mortality and risk for stroke or embolism during a 10-year follow-up.

Journal Article Diabetes Metab Res Rev · 2003 BACKGROUND: To compare in atrial fibrillation patients with and without diabetes, (1) baseline characteristics, (2) additional risk factors for stroke or peripheric or visceral embolism (hypertension, previous stroke, age >75 years), (3) mortality, (4) str ... Full text Link to item Cite