ABSTRACT
Cardiac imaging is the cornerstone of defining the etiology, quantification, and management of mitral regurgitation (MR). This continues to be even more so the case with emerging transcatheter techniques to manage MR. Transthoracic echocardiography remains the first-line imaging modality to assess MR but has limitations. Cardiac MRI(CMR) provides the advantages of quantitative nonvisual estimation, 3D volumetric data, late gadolinium, T1, and extracellular volume measurements to comprehensively assess mitral valvular pathology, cardiac remodeling, and the prognostic impact of therapies. This review describes the superiority, technical aspects and growing evidence behind CMR, and lays the roadmap for the future of CMR in MR.
Subject(s)
Mitral Valve Insufficiency , Echocardiography , Humans , Magnetic Resonance Imaging , Mitral Valve/diagnostic imaging , Mitral Valve Insufficiency/diagnostic imaging , Radiography , Severity of Illness IndexABSTRACT
Scar-mediated ventricular tachycardia (VT) commonly results from ischemic heart disease. We present a case of recurrent VT, which was initially attributed to ischemic disease; however, the scar location pointed to an alternate pathology. This case demonstrates the utility of multimodality imaging in diagnosing sarcoidosis as a cause of VT. (Level of Difficulty: Intermediate.).
ABSTRACT
BACKGROUND: Osteoarthritis (OA) is a leading cause of pain and disability, and the knee is one of the most commonly affected joints. Many have speculated that injury to the meniscus may play a key role in the development of knee OA; however, the exact relationship of meniscus injury and knee OA is unknown. PURPOSE: To examine the rate of meniscus injuries in patients with and without incident radiographic knee OA and to explore how the type, size, and location of the meniscus injury affects the development of OA. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: A secondary case-control analysis was conducted of the Knee Osteoarthritis Initiative (OAI) database, which is a prospective, longitudinal, multicenter cohort study of knee health in patients at risk for knee OA. Eligible patients included those without radiographic OA at baseline in 1 knee. Thirty-two patients who developed radiographic OA in a previously unaffected knee after 2 years of follow-up were matched to 64 age-, sex-, and body mass index-matched patients who did not develop OA. The study analyzed the relationship between the development of OA and the presence of a meniscus tear or degenerative signal, meniscus extrusion, tear type, and size of injury on the baseline magnetic resonance imaging scans. Conditional logistic regression was used to identify significant predictors of OA. RESULTS: The rate of medial meniscus lesions (tear or degeneration) was not significantly higher in those who developed incident OA (85%) compared with the control patients (68%; P = .07). However, medial meniscus extrusion (odds ratio [OR], 3.03; 95% confidence interval [CI], 1.4-6.5), complex tears (OR, 5.0; 95% CI, 1.0-25), and tears with large radial involvement (OR, 5.92; 95% CI, 1.7-7.5) were more common at baseline in cases compared with controls. CONCLUSION: Knees with meniscus tears with greater radial involvement and extrusion are at greater risk for later development of radiographic OA.
