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Minjie Lu,
Shihua Zhao,
Gang Yin,
Shiliang Jiang,
Tao Zhao,
Xiuyu Chen,
Liangxin Tian,
Yan Zhang,
Yunqing Wei, Qiong Liu,
Zuoxiang He,
Hui Xue,
Jing An,
Saurabh Shah
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ABSTRACT: PURPOSE: To investigate the diagnostic value of T1 mapping imaging of evaluating fibrosis in patients with hypertrophic cardiomyopathy (HCM). MATERIALS AND METHODS: 21 subjects with HCM and 18 healthy volunteers underwent conventional late gadolinium enhancement (LGE) imaging and T1 mapping imaging. The region of myocardium in HCM is divided into remote area of LGE, peri-LGE, LGE (halo-like LGE and typical patchy LGE). These regions combined with normal volunteers' myocardium were calculated by the reduced percent of T1 value (RPTV). RESULTS: The RPTV in healthy volunteers was no significant comparing with that in the remote area of LGE in HCM subjects (3.98±3.19 vs. 3.34±2.75, P>0.05). There were significant statistical differences in pairwise among the remote area of LGE, peri-LGE, halo-like LGE and typical patchy LGE in the RPTV (P<0.0001). ROC curves indicated that the T1 mapping imaging has a greater area under the curve comparing with that of traditional LGE imaging (0.975±0.07 vs. 0.753±0.26, P<0.0001). CONCLUSIONS: HCM has a high prevalence of fibrosis and with varying severity. T1 mapping imaging can be a useful method to evaluate the severity of the fibrosis in HCM.
European journal of radiology 01/2013; · 2.65 Impact Factor
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Minjie Lu,
Shihua Zhao, Qiong Liu,
Shiliang Jiang,
Peng Song,
Haiyan Qian,
Yan Zhang,
Jian Ling,
Chaowu Yan,
Huaibing Cheng,
Ning Ma,
Hong Zhao,
Yuqing Liu
[show abstract]
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ABSTRACT: The purpose of this study was to track and investigate the effects of autologous bone marrow-derived mesenchymal stem cells (MSCs) transplantation after acute myocardial infarction in swine assessed by magnetic resonance imaging (MRI).
Twenty-four Chinese mini-pigs (27±3 kg) were divided into 4 groups, including control groups (groups 1 and 3) and MSCs transplantation groups (group 2, super paramagnetic iron oxide labeled and group 4, 4',6-diamidino-2-phenylindole labeled). Super paramagnetic iron oxide-labeled and 4',6-diamidino-2-phenylindole-labeled MSCs (3.0×10⁶ cells/mL) with a volume of 10 mL were injected into the left anterior descending artery by a catheter at 1 week after acute myocardial infarction, respectively. Cell distribution, cardiac functions, and scar tissue were quantitatively assessed by MRI.
The reduction of the T2* value in the myocardium, spleen, and liver in group 2 was significantly greater than that in group 1. MRI showed that function and scar size at baseline and 3 days after cell infusion were not significantly different between groups 1 and 2. Six weeks later left ventricular ejection fraction (P<0.0001), end-systolic volume (P<0.05), the number of dyskinetic segments (P<0.0001), left ventricular weight index (P<0.0001), and the infarcted size (P<0.0001) in group 4 were all improved comparing with those in group 3.
The majority of MSCs entrapped by the extracardial organs were mainly in the spleen. Catheter-based delivery of autologous bone marrow-derived MSCs into infarcted myocardium is feasible and effective.
Journal of thoracic imaging 02/2011; 27(2):125-35. · 1.42 Impact Factor
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Huaibing Cheng,
Shihua Zhao,
Shiliang Jiang,
Minjie Lu,
Chaowu Yan,
Jian Ling,
Yan Zhang, Qiong Liu,
Ning Ma,
Gang Yin,
Renate Jerecic,
Zuoxiang He
[show abstract]
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ABSTRACT: The differentiation of constrictive pericarditis (CP) from restrictive cardiomyopathy (RCM) is often difficult. This study sought to determine the clinical utility of cardiovascular magnetic resonance imaging (CMR) for differentiating both these disorders.
Twenty-three patients with surgically documented CP, 22 patients with RCM and 25 normal subjects were included in the study. CMR yielded information about cardiac morphology, function and tissue characteristics. The left (LA) and right atrial (RA) volume was calculated using the area-length method. The relative atrial volume ratio (RAR) was defined as the LA volume divided by RA volume. Receiver operating characteristic curve analysis was used to test the ability of different variables in differentiating CP from RCM.
The maximal pericardial thickness in CP patients was significantly larger than in normal subjects and RCM patients. The RA volume index in RCM patients (90.5 ± 35.3 mL/m2) was significantly larger than in CP patients (71.4 ± 15.7 mL/m2, p = 0.006) and normal subjects (38.1 ± 9.0 mL/m2, p < 0.001). The LA volume index in RCM (96.0 ± 37.0 mL/m2) and CP patients (105.6 ± 25.1 mL/m2) was significantly larger than in normal subjects (39.5 ± 9.5 mL/m2, p < 0.001 for all). The RAR in CP patients (1.50 ± 0.29) was significantly larger than in RCM patients (1.12 ± 0.33, p < 0.001) and normal subjects (1.06 ± 0.20, p < 0.001). There were no differences between RCM patients and normal subjects in the RAR (p = 0.452). At a cut-off value of 1.32 for the RAR, the sensitivity was 82.6%, and the specificity was 86.4% in the detection of CP. Septal bounce was identified in 95.7% CP patients, in none of RCM patients and normal subjects. Late gadolinium enhancement (LGE) was present in 31.8% RCM patients and absence in all CP patients and normal subjects.
CMR with LGE and RAR can facilitate differentiation of CP from RCM.
Journal of Cardiovascular Magnetic Resonance 02/2011; 13:15. · 3.72 Impact Factor
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Huaibing Cheng,
Shihua Zhao,
Shiliang Jiang,
Jinchao Yu,
Minjie Lu,
Jian Ling,
Yan Zhang,
Chaowu Yan, Qiong Liu,
Shiguo Li,
Lixin Jin,
Renate Jerecic,
Zuoxiang He
[show abstract]
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ABSTRACT: To analyze cardiac magnetic resonance imaging (CMR) characteristics in patients with isolated left ventricular noncompaction (IVNC) and assess its value in the diagnosis of IVNC in a Chinese adult Han population. We collected a consecutive series of 30 patients with IVNC from January 1, 2007, to December 31, 2008. During the same period, we prospectively included patients drawn from groups given a potential differential diagnosis for IVNC. All magnetic resonance images were analyzed using 17-segment model. Left ventricular ejection fraction was significantly lower for patients with DCM (16.2 ± 5.2%, P < 0.001) and higher in AR (47.6 ± 16.2%, P = 0.009), AS (54.6 ± 21.1%, P = 0.001) and HHD (62.4 ± 6.8%, P < 0.001) compared with IVNC (33.0 ± 14.1%). The two-layered structure was most frequently seen at the apical segments, followed by the mid-cavity and basal segments in patients with INVC. The anterior and lateral walls were more commonly involved in patients with IVNC. The number of noncompacted segments and end-diastolic ratio of non-compacted to compacted myocardium (NC/C ratio) was greater in patients with IVNC than in other five groups. The end-diastolic NC/C ratio of >2.5 had 96.4% sensitivity and 97.4% specificity for identifying patients with IVNC. CMR provides an accurate and reliable evaluation of the localization and extent of noncompacted myocardium at end-diastole. The end-diastolic NC/C ratio of >2.5 had high diagnostic accuracy for IVNC in a Chinese adult Han population.
The international journal of cardiovascular imaging 11/2010; 27(7):979-87. · 2.15 Impact Factor
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Min-Jie Lu,
Shi-Hua Zhao,
Peng Song,
Shi-Liang Jiang, Qiong Liu,
Chao-Wu Yan,
Yan Zhang,
Jian Ling,
Huai-Bing Cheng,
Ning Ma,
Gang Yin,
Lin-Lin Wang,
Yue Tang
[show abstract]
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ABSTRACT: To analyze the stem cell re-distribution after intra-coronary infusion (ICI) into arrested and beating hearts in a swine myocardial infarction (MI) model using magnetic resonance imaging (MRI).
Bone marrow-derived mesenchymal stem cells were obtained from male swine and labeled with iron oxide during culture. One week after MI in female swine, the survivors were randomly divided into 4 groups. Cardiopulmonary bypass was set up to arrest the heart, and then SPIO labeled male stem cells (1 × 10(8)) were infused through coronary of beating heart (n = 6) and the arrested heart (n = 6). Saline was injected in either the beating or arresting heart as respective controls. Three days later, cell distribution was assessed by T2(*) change with magnetic resonance imaging and Y-chromosome (SRY) was detected with quantitative polymerase chain reaction.
The reduction of T2(*) values was significantly different in the hearts, spleens, livers and lung between the transplantation groups and the control groups. Only few transplanted cells were localized in the heart and T2(*) values were similar between beating and arrest heart groups [(-7.81 ± 2.03) ms vs. (-6.56 ± 1.72) ms, P > 0.05], while T2(*) value reduction was more significant in the spleen and liver in arrest heart group than in beating heart group [spleen: (-16.72 ± 2.83) ms vs. (-22.18 ± 3.98) ms, P < 0.01, liver: (-2.40 ± 0.44) ms vs. (-5.32 ± 3.40) ms, P < 0.05]. T2(*) value was similar in kidney among the four groups. qRT-PCR detected SRY gene was similar in the heart, less in the spleen and liver while more in the lung in beating heart group compared to arrested heart group. In vitro Prussian blue stained positively transplanted cells were found in the above organs in transplantation group.
The majority of stem cells transplanted by ICI would be entrapped by the extracardiac organs. Stem cell transplantation via ICI into the arrested heart does not favor more cells retention in the injured myocardium. Further investigation is needed to optimize the approach of stem cell delivery.
Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 11/2010; 38(11):1014-8.
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Jin-chao Yu,
Shi-hua Zhao,
Shi-liang Jiang,
Li-ming Wang,
Zhen-fu Wang,
Min-jie Lu,
Jian Ling,
Yan Zhang,
Chao-wu Yan, Qiong Liu,
Huai-bing Cheng
[show abstract]
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ABSTRACT: To characterize the clinical and cardiac MRI features of dilated cardiomyopathy (DCM) and left ventricular noncompaction (LVNC).
Compared the clinical and MRI features between 25 patients with LVNC and 21 patients with DCM. The MRI derived diastolic left ventricular wall thickness and the number and degree of noncompaction (NC) were evaluated using the 17-segment model.
Chest distress, shortness of breath and abnormal ECG were presented in all DCM patients, abnormal ECG was evidenced in 22 LVNC patients and 21 out of 25 LVNC patients presented similar clinical symptoms as DCM patients while the rest 4 LVNC patients were asymptomatic. Left atrial and ventricular dimensions were significantly smaller in LVNC patients compared to DCM patients. The degree of left ventricular (LV) spherical remodeling was significantly greater in patients with DCM (sphericity index, SI = 0.81 +/- 0.06) than in patients with LVNC (SI = 0.74 +/- 0.11, P < 0.05). The LV ejection fraction (LVEF) was significantly higher in patients with LVNC (32.7% +/- 14.2%) than that in patients with DCM (15.0% +/- 5.1%). The number of NC segments in LVNC patients (9 +/- 1) was significantly higher than the number of hypertrabeculation segment in DCM patients (5 +/- 2). The left ventricular apex (the 17th segment) was unexceptionally involved in all LVNC patients, while hypertrabeculation was absent in the 17th segment of DCM patients. The NC was more common in the apical and mid segments (16th, 12th and 11th segments) than in basal and mid septal segments (2nd, 3rd, 8th and 9th segments) in both LVNC and DCM patients. The thickness of compacted myocardium of the segments associated with noncompaction appeared thin in two groups. The wall thickness of noncompaction myocardium segments was thicker in LVNC patients than in DCM patients. The end-diastolic NC/C ratio was, on average, higher in patients with LVNC (3.3 +/- 0.6) than in patients with DCM (1.9 +/- 0.3).
The clinical manifestation is similar while there are significant differences in the morphology and function of left atria and left ventricle between the LVNC and DCM patients. The different distribution and degree of NC were helpful to differentiate LVNC from DCM.
Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 05/2010; 38(5):392-7.
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ABSTRACT: We sought to compare delayed-enhancement MRI (DE-MRI) with 99mTc-sestamibi and 18F-fluorodeoxyglucose (18F-FDG) single-photon emission computed tomography (SPECT) for the assessment of myocardial viability.
Thirty-four patients with prior myocardial infarction underwent DE-MRI and 99mTc-sestamibi/18F-FDG SPECT. The area of delayed enhancement by DE-MRI was defined as scar tissue. The region with concordantly reduced perfusion and glucose metabolism was defined as nonviable myocardium. In a 17-segment model, the segmental extent of hyperenhancement was compared with segmental 99mTc-sestamibi and 18F-FDG uptake defect. All segments were divided into five different severities by segmental extent of hyperenhancement in DE-MRI and were classified into different viability situations by segmental 99mTc-sestamibi and 18F-FDG uptake in SPECT.
A total of 578 segments were studied. Sensitivity and specificity of DE-MRI in identifying segments with flow/metabolism match were 61.32 and 95.35%, respectively. Semiquantitatively assessed relative MRI scar tissue correlated well with 99mTc-sestamibi and 18F-FDG SPECT (r = 0.63, P = 0.0284). However, of the 431 segments defined as normal by DE-MRI, 82 segments (19%) were scored as nonviable by 18F-FDG SPECT. During these segments, 48 showed less than 50% reduced 18F-FDG uptake, 25 showed 50-75% reduced 18F-FDG uptake, and nine showed no 18F-FDG uptake.
MRI hyperenhancement as a marker of myocardial scar closely agrees with 99mTc-sestamibi and 18F-FDG SPECT. Nuclear technology and DE-MRI show their own predominance and limitation in assessment of myocardial viability and detecting irreversibly injured tissue.
Nuclear Medicine Communications 06/2009; 30(8):610-6. · 1.40 Impact Factor
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ABSTRACT: Femoral artery thrombosis is one of the most common complications of catheterizations in infants and young children. This study was conducted to investigate the feasibility and effectiveness of thrombolytic therapy for femoral artery thrombosis after left cardiac catheterization in children.
Thrombolytic therapy with urokinase was carried out in children with femoral artery thrombosis after left cardiac catheterization. Each patient was given a bolus injection of heparin (100 U/kg). A bolus of urokinase (30,000 - 100,000 U) was injected intravenously, and then a continuous infusion of 10 000 - 50 000 U/h was administered. Transcatheter thrombolysis was performed once previous procedures failed.
Eight patients (aged (3.1 +/- 2.3) years (8 months to 7 years), body weight (13.1 +/- 4.2) kg (7 to 20 kg)) presented lower limbs ischemia after left cardiac catheterizations was performed. Seven patients accepted thrombolytic therapy with urokinase. In 5 patients, peripheral intravenous thrombolysis was successful with restoration of a normal pulse. In the other 3 cases, peripheral intravenous thrombolysis failed, followed by successful transcatheter thrombolysis. The average duration of therapy was (7.25 +/- 5.31) hours (1 - 17 hours). The average doses of heparin and urokinase were (1600 +/- 723) U (800 - 3000 U) and (268 571 +/- 177 240) U (50 000 - 500 000 U), respectively. There were no statistically significant differences in partial thromboplastin time before and during urokinase therapy ((40.6 +/- 22.3) to (49.9 +/- 39.2) seconds). However, the prothrombin time was significantly longer ((12.7 +/- 2.58) to (48.1 +/- 18.6) seconds, P < 0.05). Patency of the target vessel was evaluated in all the patients for 2 weeks and no occlusion recurred.
Thrombolytic therapy with urokinase is a safe and useful modality in children with femoral artery thrombosis after left cardiac catheterization.
Chinese medical journal 04/2009; 122(8):931-4. · 0.86 Impact Factor
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Qiong Liu,
Shi-Hua Zhao,
Min-Jie Lu,
Shi-Liang Jiang,
Chao-Wu Yan,
Yan Zhang,
Liang Meng,
Yue Tang,
Xian-Min Meng,
Ying-Jie Wei,
Lin-Lin Wang,
Hong-Jun Dai,
Jian Xu
[show abstract]
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ABSTRACT: To investigate the efficacy of transplantation of mesenchymal stem cells (MSC) with gelatin microspheres containing vascular endothelial growth factor in ischemic regions in infracted swine hearts.
Twelve Chinese mini swines with infarction were randomized to receive autogenetic MSC injection to the peri-infarction area of left ventricular wall (MSC group, n = 6) or MSC transplantation with gelatin hydrogel microspheres incorporating vascular endothelial growth factor (VEGF-MSC group, n = 6). Three weeks later, left ventricular function was assessed by magnetic resonance imaging (MRI). The contrast of the MSC hypointense lesion was determined using the difference in signal intensity between the hypointense and normal myocardium divided by signal intensity of the normal region. Myocardial capillary density, the number of DAPI positive MSC and the apoptotic MSC were also determined.
The diameter of the microspheres averaged (104.0 +/- 22.6) microm. At 24 hours after transplantation, MSC were identified by MRI as large intramyocardial signal voids at injection sites which persisted up to 3 weeks. There was no significant difference in the contrast of the lesions and in the size of the lesions at 24 hours between two groups. At 3 weeks after injection, the size of the lesions and the contrast of the lesion were decreased (P < 0.05) in both groups. The capillary density of the injection site was significantly more in the MSC-VEGF microsphere group than that in MSC group [(15.2 +/- 5.4)/HPF vs. (10.2 +/- 5.0)/HPF, t = 2.43, P < 0.05], and there were more dense DAPI labeled MSC per high power fields in injection sites of MSC-VEGF microsphere group than that in MSC group [(354 +/- 83)/HPF vs. (278 +/- 97)/HPF, t = 3.14, P < 0.05]. Moreover, the apoptosis rate of MSCs of MSCs-VEGF microsphere group was less than that of MSC group [(6.4 +/- 4.1)% vs. (11.9 +/- 4.8)%, t = 2.97, P < 0.05].
MSC transplantation with gelatin hydrogel microspheres incorporating VEGF enhanced the efficacy of MSC in this swine model of myocardial infarction. MRI tracking of MSC is feasible and represents a preferred method for studying the engraftment of MSCs in infracted tissue.
Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 03/2009; 37(3):233-9.
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Min-jie Lu,
Shi-hua Zhao,
Sheng Liu,
Pu-hong Zhang,
Shi-liang Jiang,
Yan Zhang,
Chao-wu Yan, Qiong Liu,
Jian Ling,
Lian-jun Huang,
Zuo-xiang He,
Min-fu Yang,
Sheng-shou Hu
[show abstract]
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ABSTRACT: To evaluate the therapeutic effects of stem cell transplantation in heart failure patients with old myocardial infarction (OMI) by MRI.
Heart failure patients [NYHA 2.7 +/- 0.7, male = 18, mean age (59.5 +/- 10.1) y] with OMI were randomly divided into 2 groups (group A: CABG + stem cell transplantation, group B: CABG; n = 10 each). Left ventricular (LV) function was measured by MRI, viable myocardium was detected by (18)F-FDG myocardial metabolism imaging and late contrast-enhanced at baseline and 6 months post intervention.
LVEF and LVEDV at baseline for group A were (20.71 +/- 6.09)% and (172.73 +/- 32.74) ml, and for group B were (27.59 +/- 2.31)% and (155.13 +/- 28.36) ml, respectively (P > 0.05). The LVEF was equally improved in group A and B (mean 8.63% vs. 10.37%, P > 0.05) while DeltaLVEDV was significant higher in group A than that in group B [(9.91 +/- 39.50) ml vs. (-22.34 +/- 31.35) ml, P < 0.05]. Ventricular wall thickening ratio at 6 months post intervention was significantly higher in group A than that in group B [(11.40 +/- 11.53)% vs. (2.27 +/- 7.20)%, P < 0.05]. Late contrast-enhanced MRI results correlated with (18)F-FDG myocardial metabolism imaging SPECT well in assessment of myocardial viability (kappa value: 0.446, P < 0.001; sensitivity: 68.3% and specificity: 92.5%).
Stem cell therapy on top of CABG aggravated LV remodeling in heart failure patients with old myocardial infarction. The specificity of MRI is similar to (18)F-FDG SPECT while the sensitivity is inferior to (18)F-FDG SPECT on detecting viable myocardium.
Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 11/2008; 36(11):969-74.
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ABSTRACT: The aim of this study was to investigate the feasibility and accuracy of delayed enhancement magnetic resonance imaging (DE-MRI) for the assessment of myocardial viability in patients with myocardial infarction in comparison with (99)Tc(m)-sestamibi (MIBI) single photon emission computed tomography (SPECT) and (18)F-fluorodeoxyglucose (FDG) SPECT. Scar was defined as regionally increased MRI signal intensity 15 minutes after injection of 0.2 mmol/kg gadolinium-diethylenetriamine pentaacetic acid or reduced perfusion and glucose metabolism defined by SPECT.
A total of 34 patients with myocardial infarction (29 males, 58.0 +/- 9.8 years) were imaged with MRI and SPECT.
A total of 578 segments were analyzed. DE-MRI and SPECT identified 431 and 336 viable segments respectively and SPECT also identified 30 ischemic segments. Necrotic segments identified by DE-MRI and SPECT were 147 and 212 respectively. Sensitivity and specificity of DE-MRI in identifying segments with matched flow/metabolism defects (scar tissues) was 61.3% and 95.4%, respectively. Quantitatively assessed relative MRI infarct area correlated well with SPECT infarct size. The value of Kappa was 0.51.
DE-MRI provides a good tool for differentiating viable myocardium from scar tissues and the detection accuracy is comparable between DE-MRI and SPECT.
Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 01/2007; 34(12):1072-6.
