Publications by authors named "Malgorzata Polacin"

7 Publications

  • Page 1 of 1

Myocardial edema in COVID-19 on cardiac MRI.

J Heart Lung Transplant 2020 07 28;39(7):730-732. Epub 2020 May 28.

Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

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http://dx.doi.org/10.1016/j.healun.2020.04.025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7834291PMC
July 2020

Novel Magnetic Resonance Late Gadolinium Enhancement With Fixed Short Inversion Time in Ischemic Myocardial Scars.

Invest Radiol 2020 07;55(7):445-450

From the Institute of Diagnostic and Interventional Radiology.

Aims: Late gadolinium enhancement (LGE) visualizes scar tissue after myocardial infarction. However, in clinically used LGE sequences, subendocardial infarcts can be missed due to low contrast between blood pool and subendocardium. The purpose of his study was to compare scar visibility in a novel 3-dimensional (3D) single breath-hold inversion recovery sequence with fixed, short inversion time (TI = 100 milliseconds) (short LGE) and standard 3D LGE imaging with individually adjusted TI (LGE).

Methods: Short LGE and LGE (both sequences with the same settings: spatial resolution, 1.2 × 1.2 mm; slice thickness, 8 mm; field of view, 350 × 350 mm; single breath-hold) were acquired in 64 patients with previous MI (13 female; mean age, 57 ± 19 years) at 1.5 T. Inversion time was set to 100 milliseconds in short LGE and adjusted individually in LGE according to the Look-Locker sequence. Two independent readers evaluated 1088 segments (17-segment model), identified infarcted segments, and categorized scar visibility (5 = excellent, 1 = poor scar visibility) and scar transmurality (4 = transmural, 0 = no scar) using a 5-point Likert scale. Signal intensity ratios between short LGE and LGE for scar and blood pool, for scar and remote myocardium, and for remote myocardium and blood pool were calculated.

Results: Short LGE showed 197 infarcted segments out of 1088 (18.1%); LGE revealed 191 segments (17.6%). Short LGE with dark scar and bright blood pool demonstrated better overall scar visibility, especially in subendocardially infarcted segments compared with LGE (4.2 vs 3.0, 5 = excellent visibility; P = 0.01). Signal intensity ratios for short LGE relative to LGE were 1.42 for scar/blood pool, 0.8 for scar/remote myocardium, and 0.22 for remote myocardium/blood.Overall transmurality was not rated higher in short LGE compared with LGE (P = 0.8). More fibrous tissue and total fibrous percentage (P = 0.04) were measured in short LGE compared with LGE, whereas myocardial mass was not significantly different (P = 0.5). Acquisition time was similar between short LGE and LGE (26 ± 4 seconds vs 25 ± 9 seconds, P = 0.7).

Conclusions: Short LGE is a fast, single breath-hold 3D LGE sequence with no need for myocardial nulling due to fixed inversion time with improved scar visibility, especially in subendocardial infarcts.
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http://dx.doi.org/10.1097/RLI.0000000000000655DOI Listing
July 2020

Cardiovascular magnetic resonance T2* mapping for the assessment of cardiovascular events in hypertrophic cardiomyopathy.

Open Heart 2020 15;7(1):e001152. Epub 2020 Mar 15.

Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.

Background: Hypertrophic cardiomyopathy (HCM) is associated with an increased risk of adverse cardiac events. Beyond classic risk factors, relative myocardial ischaemia and succeeding myocardial alterations, which can be detected using either contrast agents or parametric mapping in cardiovascular magnetic resonance (CMR) imaging, have shown an impact on outcome in HCM. CMR may help to risk stratify using parametric T2* mapping. Therefore, the aim of the present study was to evaluate the association of T2* values or fibrosis with cardiovascular events in HCM.

Methods: The relationship between T2* with supraventricular, ventricular arrhythmia or heart failure was retrospectively assessed in 91 patients with HCM referred for CMR on a 1.5T MR imaging system. Fibrosis as a reference was added to the model. Patients were subdivided into groups according to T2* value quartiles.

Results: 47 patients experienced an event of ventricular arrhythmia, 25 of atrial fibrillation/flutter and 17 of heart failure. T2*≤28.7 ms yielded no association with ventricular events in the whole HCM cohort. T2* of non-obstructive HCM showed a significant association with ventricular events in univariate analysis, but not in multivariate analysis. For the combined endpoint of arrhythmic events, there was already an association for the whole HCM cohort, but again only in univariate analyses. Fibrosis stayed the strongest predictor in all analyses. There was no association for T2* and fibrosis with heart failure.

Conclusions: Decreased T2* values by CMR only provide a small association with arrhythmic events in HCM, especially in non-obstructive HCM. No information is added for heart failure.
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http://dx.doi.org/10.1136/openhrt-2019-001152DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7076262PMC
June 2020

Determinants of myocardial function characterized by CMR-derived strain parameters in left ventricular non-compaction cardiomyopathy.

Sci Rep 2019 11 4;9(1):15882. Epub 2019 Nov 4.

Department of Cardiology, University Heart Center, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.

Clinical presentation of left ventricular non-compaction cardiomyopathy (LVNC) can be heterogeneous from asymptomatic expression to congestive heart failure. Deformation indices assessed by cardiovascular magnetic resonance (CMR) can determine subclinical alterations of myocardial function and have been reported to be more sensitive to functional changes than ejection fraction. The objective of the present study was to investigate the determinants of myocardial deformation indices in patients with LVNC. Twenty patients with LVNC (44.7 ± 14.0 years) and twenty age- and gender-matched controls (49.1 ± 12.4 years) underwent functional CMR imaging using an ECG-triggered steady state-free-precession sequence (SSFP). Deformation indices derived with a feature tracking algorithm were calculated including end-systolic global longitudinal strain (GLS), circumferential strain (GCS), longitudinal and circumferential strain rate (SR and SR). Twist and rotation were determined using an in-house developed post-processing pipeline. Global deformation indices (GLS, GCS, SR and SR) were significantly lower in patients with LVNC compared to healthy controls (all, p < 0.01), especially for midventricular and apical regions. Apical rotation and twist were impaired for LVNC (p = 0.007 and p = 0.012), but basal rotation was preserved. Deformation indices of strain, strain rate and twist correlated well with parameters of the non-compacted myocardium, but not with the total myocardial mass or the thinning of the compacted myocardium, e.g. r = 0.595 between GLS and the non-compacted mass (p < 0.001). In conclusion, CMR deformation indices are reduced in patients with LVNC especially in affected midventricular and apical slices. The impairment of all strain and twist parameters correlates well with the extent of non-compacted myocardium.
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http://dx.doi.org/10.1038/s41598-019-52161-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6828801PMC
November 2019

Cardiovascular magnetic resonance T2* mapping for structural alterations in hypertrophic cardiomyopathy.

Eur J Radiol Open 2019 4;6:78-84. Epub 2019 Feb 4.

Department of Cardiology, University Heart Center, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.

Purpose: Hypertrophic cardiomyopathy (HCM) is characterized by a heterogeneous morphology and variable prognosis. A mismatch between left ventricular mass (LVM) and microvascular circulation with corresponding relative ischemia has been implicated to cause myocardial replacement fibrosis that deteriorates prognosis. Besides parametric T1 mapping, Cardiovascular Magnetic Resonance (CMR) T2* mapping is able to identify ischemia as well as fibrosis in cardiac and extracardiac diseases. Therefore, we aimed to investigate the value of T2* mapping to characterize structural alterations in patients with HCM.

Methods: CMR was performed on a 1.5 T MR imaging system (Achieva, Philips, Best, Netherlands) using a 5-channel coil in patients with HCM (n = 103, 50.6 ± 16.4 years) and in age- and gender-matched controls (n = 20, 44.8 ± 16.9 years). T2* mapping (1 midventricular short axis slice) was acquired in addition to late gadolinium enhancement (LGE). T2* values were compared between patients with HCM and controls as well as between HCM patients with- and without fibrosis.

Results: HCM patients showed significantly decreased T2* values compared to controls (26.2 ± 4.6 vs. 31.3 ± 4.3 ms, p < 0.001). Especially patients with myocardial fibrosis presented with decreased T2* values in comparison to those without fibrosis (25.2 ± 4.0 vs. 28.7 ± 5.3 ms, p = 0.003). A regression model including maximum wall thickness, LVM and T2* values provided good overall diagnostic accuracy of 80% to diagnose HCM with and without fibrosis.

Conclusion: In this study, parametric mapping identified lower T2* values in HCM patients compared to controls, especially in a sub-group of patients with myocardial fibrosis. As myocardial fibrosis has been suggested to influence prognosis of patients with HCM, T2* mapping may add information for identifying a higher risk sub-group of HCM patients.
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http://dx.doi.org/10.1016/j.ejro.2019.01.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365365PMC
February 2019

Elevated Cardiac Troponin T in Patients With Skeletal Myopathies.

J Am Coll Cardiol 2018 04;71(14):1540-1549

Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria. Electronic address:

Background: Cardiac troponins are often elevated in patients with skeletal muscle disease who have no evidence of cardiac disease.

Objectives: The goal of this study was to characterize cardiac troponin concentrations in patients with myopathies and derive insights regarding the source of elevated troponin T measurements.

Methods: Cardiac troponin T (cTnT) and cardiac troponin I (cTnI) concentrations were determined by using high sensitivity assays in 74 patients with hereditary and acquired skeletal myopathies. Patients underwent comprehensive cardiac evaluation, including 12-lead electrocardiogram, 24-h electrocardiogram, cardiac magnetic resonance imaging, and coronary artery computed tomography. cTnT and cTnI protein expression was determined in skeletal muscle samples of 9 patients and in control tissues derived from autopsy using antibodies that are used in commercial assays. Relevant Western blot bands were subjected to liquid chromatography tandem mass spectrometry for protein identification.

Results: Levels of cTnT (median: 24 ng/l; interquartile range: 11 to 54 ng/l) were elevated (>14 ng/l) in 68.9% of patients; cTnI was elevated (>26 ng/l) in 4.1% of patients. Serum cTnT levels significantly correlated with creatine kinase and myoglobin (r = 0.679 and 0.786, respectively; both p < 0.001). Based on cTnT serial testing, 30.1% would have fulfilled current rule-in criteria for myocardial infarction. Noncoronary cardiac disease was present in 23%. Using cTnT antibodies, positive bands were found in both diseased and healthy skeletal muscle at molecular weights approximately 5 kDa below cTnT. Liquid chromatography tandem mass spectrometry identified the presence of skeletal troponin T isoforms in these bands.

Conclusions: Measured cTnT concentrations were chronically elevated in the majority of patients with skeletal myopathies, whereas cTnI elevation was rare. Our data indicate that cross-reaction of the cTnT immunoassay with skeletal muscle troponin isoforms was the likely cause.
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http://dx.doi.org/10.1016/j.jacc.2018.01.070DOI Listing
April 2018

Hypoplastisches Linksherzsyndrom beim adulten Patienten mit Heterotaxie.

Rofo 2017 Jul 26;189(7):673-675. Epub 2017 Jun 26.

Departement of Radiology, University Hospital Ulm, Germany.

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http://dx.doi.org/10.1055/s-0043-106584DOI Listing
July 2017