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      Myocardial tissue tagging with cardiovascular magnetic resonance

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          Abstract

          Cardiovascular magnetic resonance (CMR) is currently the gold standard for assessing both global and regional myocardial function. New tools for quantifying regional function have been recently developed to characterize early myocardial dysfunction in order to improve the identification and management of individuals at risk for heart failure. Of particular interest is CMR myocardial tagging, a non-invasive technique for assessing regional function that provides a detailed and comprehensive examination of intra-myocardial motion and deformation. Given the current advances in gradient technology, image reconstruction techniques, and data analysis algorithms, CMR myocardial tagging has become the reference modality for evaluating multidimensional strain evolution in the human heart. This review presents an in depth discussion on the current clinical applications of CMR myocardial tagging and the increasingly important role of this technique for assessing subclinical myocardial dysfunction in the setting of a wide variety of myocardial disease processes.

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          Most cited references68

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          SENSE: Sensitivity encoding for fast MRI

          New theoretical and practical concepts are presented for considerably enhancing the performance of magnetic resonance imaging (MRI) by means of arrays of multiple receiver coils. Sensitivity encoding (SENSE) is based on the fact that receiver sensitivity generally has an encoding effect complementary to Fourier preparation by linear field gradients. Thus, by using multiple receiver coils in parallel scan time in Fourier imaging can be considerably reduced. The problem of image reconstruction from sensitivity encoded data is formulated in a general fashion and solved for arbitrary coil configurations and k-space sampling patterns. Special attention is given to the currently most practical case, namely, sampling a common Cartesian grid with reduced density. For this case the feasibility of the proposed methods was verified both in vitro and in vivo. Scan time was reduced to one-half using a two-coil array in brain imaging. With an array of five coils double-oblique heart images were obtained in one-third of conventional scan time. Magn Reson Med 42:952-962, 1999. Copyright 1999 Wiley-Liss, Inc.
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            Simultaneous acquisition of spatial harmonics (SMASH): fast imaging with radiofrequency coil arrays.

            SiMultaneous Acquisition of Spatial Harmonics (SMASH) is a new fast-imaging technique that increases MR image acquisition speed by an integer factor over existing fast-imaging methods, without significant sacrifices in spatial resolution or signal-to-noise ratio. Image acquisition time is reduced by exploiting spatial information inherent in the geometry of a surface coil array to substitute for some of the phase encoding usually produced by magnetic field gradients. This allows for partially parallel image acquisitions using many of the existing fast-imaging sequences. Unlike the data combination algorithms of prior proposals for parallel imaging, SMASH reconstruction involves a small set of MR signal combinations prior to Fourier transformation, which can be advantageous for artifact handling and practical implementation. A twofold savings in image acquisition time is demonstrated here using commercial phased array coils on two different MR-imaging systems. Larger time savings factors can be expected for appropriate coil designs.
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              Hypertrophic cardiomyopathy: a systematic review.

              Throughout the past 40 years, a vast and sometimes contradictory literature has accumulated regarding hypertrophic cardiomyopathy (HCM), a genetic cardiac disease caused by a variety of mutations in genes encoding sarcomeric proteins and characterized by a broad and expanding clinical spectrum. To clarify and summarize the relevant clinical issues and to profile rapidly evolving concepts regarding HCM. Systematic analysis of the relevant HCM literature, accessed through MEDLINE (1966-2000), bibliographies, and interactions with investigators. Diverse information was assimilated into a rigorous and objective contemporary description of HCM, affording greatest weight to prospective, controlled, and evidence-based studies. Hypertrophic cardiomyopathy is a relatively common genetic cardiac disease (1:500 in the general population) that is heterogeneous with respect to disease-causing mutations, presentation, prognosis, and treatment strategies. Visibility attached to HCM relates largely to its recognition as the most common cause of sudden death in the young (including competitive athletes). Clinical diagnosis is by 2-dimensional echocardiographic identification of otherwise unexplained left ventricular wall thickening in the presence of a nondilated cavity. Overall, HCM confers an annual mortality rate of about 1% and in most patients is compatible with little or no disability and normal life expectancy. Subsets with higher mortality or morbidity are linked to the complications of sudden death, progressive heart failure, and atrial fibrillation with embolic stroke. Treatment strategies depend on appropriate patient selection, including drug treatment for exertional dyspnea (beta-blockers, verapamil, disopyramide) and the septal myotomy-myectomy operation, which is the standard of care for severe refractory symptoms associated with marked outflow obstruction; alcohol septal ablation and pacing are alternatives to surgery for selected patients. High-risk patients may be treated effectively for sudden death prevention with the implantable cardioverter-defibrillator. Substantial understanding has evolved regarding the epidemiology and clinical course of HCM, as well as novel treatment strategies that may alter its natural history. An appreciation that HCM, although an important cause of death and disability at all ages, does not invariably convey ominous prognosis and is compatible with normal longevity should dictate a large measure of reassurance for many patients.
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                Author and article information

                Journal
                J Cardiovasc Magn Reson
                Journal of Cardiovascular Magnetic Resonance
                BioMed Central
                1097-6647
                1532-429X
                2009
                21 December 2009
                : 11
                : 1
                : 55
                Affiliations
                [1 ]Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
                [2 ]Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
                [3 ]Department of Radiology, National Institutes of Health, Bethesda, MD, USA
                Article
                1532-429X-11-55
                10.1186/1532-429X-11-55
                2809051
                20025732
                71c61b60-463d-4db8-9669-df18766ca72e
                Copyright ©2009 Shehata et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 23 April 2009
                : 21 December 2009
                Categories
                Review

                Cardiovascular Medicine
                Cardiovascular Medicine

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