Is cardiac and hepatic iron status assessed by MRI T2* associated with left ventricular function in patients with idiopathic cardiomyopathy?

Excess accumulation of iron in the heart is known to aggravate cardiac function in some cases of genetic and acquired iron overload. We investigated the possible association between cardiac function and iron content in the heart and liver, estimated non-invasively by T2 star (T2*)-weighted magnetic resonance (MR) imaging among patients with cardiomyopathy. MR images were acquired on a 3.0 T MR imaging system using an 8-channel phased-array cardiac coil. Average T2* values of the heart were estimated at regions of interest that were located on short axis mid-ventricular slices positioned at the cardiac septum. In total, 82 patients were enrolled: 48 patients with dilated cardiomyopathy (DCM), 16 patients with hypertrophic cardiomyopathy (HCM), and 18 patients without apparent cardiovascular abnormalities. Cardiac T2* values were lower in the DCM group (median 18.6 ms) than in the HCM (22.0 ms) and control (21.4 ms) groups, although hepatic T2* values did not differ significantly across the groups. Among the whole population, the highest cardiac T2* tertile (≥21.2 ms) was significantly negatively associated with a low left ventricular ejection fraction (LVEF) of <50 %, and this association retained statistical significance after adjustment for sex, age, renal function, hemoglobin and hepatic T2*. Among DCM patients, both hemoglobin and cardiac T2* were selected as parameters that were, respectively, negatively and positively, associated with LVEF (P < 0.05). DCM patients with lower cardiac T2*, and thus higher iron content, were found to have lower LVEF. The possibility that cardiac iron overload may have a role in reducing the systolic cardiac function in DCM patients who do not have systemic iron overload requires further investigation in the future.

[Quantification and improvement of speech transmission performance using headphones in acoustic stimulated functional magnetic resonance imaging].

Functional magnetic resonance imaging (fMRI) has made a major contribution to the understanding of higher brain function, but fMRI with auditory stimulation, used in the planning of brain tumor surgery, is often inaccurate because there is a risk that the sounds used in the trial may not be correctly transmitted to the subjects due to acoustic noise. This prompted us to devise a method of digitizing sound transmission ability from the accuracy rate of 67 syllables, classified into three types. We evaluated this with and without acoustic noise during imaging. We also improved the structure of the headphones and compared their sound transmission ability with that of conventional headphones attached to an MRI device (a GE Signa HDxt 3.0 T). We calculated and compared the sound transmission ability of the conventional headphones with that of the improved model. The 95 percent upper confidence limit (UCL) was used as the threshold for accuracy rate of hearing for both headphone models. There was a statistically significant difference between the conventional model and the improved model during imaging (p < 0.01). The rate of accuracy of the improved model was 16 percent higher. 29 and 22 syllables were accurate at a 95% UCL in the improved model and the conventional model, respectively. This study revealed the evaluation system used in this study to be useful for correctly identifying syllables during fMRI.

Characterization of carotid artery plaque components on magnetic resonance imaging using signal intensity of the phantom as a reference.

RATIONALE AND OBJECTIVES: To evaluate the properties of plaque by the use of magnetic resonance imaging (MRI), it is necessary to use a material with stable signal intensity (eg, muscle or submandibular gland) as a reference. However, there may be differences between individuals. Therefore, we used a small phantom set on the circumference of the neck as a reference. The signal intensity ratio (SIR) methods using the phantom as a reference were reviewed for discrimination of the properties of plaque in the carotid artery. MATERIALS AND METHODS: Three phantoms (phantom 1: water; phantom 2: 5 µmol gadopentetate dimeglumine; and phantom 3: 2.5 µmol gadopentetate dimeglumine) were set around the neck. SIR was calculated for each region of interest and compared according to pathological grade. RESULTS: The method using a phantom as a reference reduced the standard deviations of tissue ratios to 0.16 from 0.27 in comparison with the method using muscle and showed a close correlation with pathological grade. In addition, the agreement rates with pathological grade and grades from each SIR using signal intensity of the phantom as a reference were higher than using signal intensity of the muscle as a reference to 0.86 from 0.63 for two-dimensional images and to 0.86 from 0.71 for three-dimensional images. CONCLUSIONS: The method described here reduced error compared to the method using muscle as a reference, and the results were closely correlated with pathological grade.

Para-Hisian pacing for a pediatric patient with a congenitally corrected transposition of the great arteries (SLL).

We report a pediatric patient with a congenitally corrected transposition of the great arteries (ccTGA)(SLL) in which permanent para-Hisian pacing (PPHP) could improve dyssynchrony-associated systemic ventricular (SV) dysfunction resulting from permanent morphologic left ventricular pacing for complete atrioventricular block. Since, in patients with ccTGA(SLL), an elongated His-bundle runs medially toward the upper septum to the site of the fibrous continuity between the right-sided mitral valve and pulmonary artery, the His-bundle may easily be captured by a pacing lead, unlike in normal hearts. Thus, PPHP may be an effective therapeutic strategy for the treatment of dyssynchrony-associated SV dysfunction associated with ccTGA (SLL).

Polymorphism in GSTM1, GSTT1, and GSTP1 and Susceptibility to Lung Cancer in a Japanese Population.

Polymorphisms in glutathione S-transferases (GSTs) may predispose to lung cancer through deficient detoxification of carcinogenic or toxic constituents in cigarette smoke, although previous results have been conflicting. Three GST polymorphisms (GSTM1, GSTT1 and GSTP1) were determined among 86 male patients with lung carcinomas and 88 healthy male subjects. We found no significant increase in the risk of lung cancer for any genotypes for the nulled GSTM1 [odds ratio (OR)=2.0; 95% confidence interval (95% CI)= 0.8-5.3], the nulled GSTT1 (OR=2.0; 95% CI=0.8-5.1) or the mutated (the presence of a Val-105 allele) GSTP1 (OR=0.96; 95% CI=0.4-5.5). The GST polymorphisms alone may thus not be associated with susceptibility to lung carcinogenesis in male Japanese. However, individuals with a concurrent lack of GSTM1 and GSTT1 had a significantly increased risk (OR=2.7; 95% CI=1.0-7.4) when compared with those having at least one of these genes. No other combinations were associated with lung cancer risk. These results suggest that there may be carcinogenic intermediates in cigarette smoke that are substrates for both GSTM1 and GSTT1 enzymes and that lung cancer risk is increased for individuals who are doubly deleted at GSTM1 and GSTT1 gene loci. Additional large studies are needed to confirm this observation.