Published in:
Open Access
01-03-2012 | Editorial Comment
Aortic stiffness in type-1 diabetes mellitus; beware of hypertension
Authors:
E. E. van der Wall, H. M. Siebelink, A. J. Scholte, M. J. Schalij
Published in:
The International Journal of Cardiovascular Imaging
|
Issue 3/2012
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Excerpt
Over the past years considerable progress has been made in the field of cardiovascular magnetic resonance (CMR), providing accurate evaluation of left ventricular mass, volumes and function [
1‐
9]. CMR has shown unique abilities in characterizing myocardial tissue composition. In particular, high-resolution contrast-enhanced CMR has been used to visualize myocardial fibrosis with a high accuracy [
10‐
16]. For instance, in patients with acute myocardial infarction, the injured myocardium shows increased CMR contrast compared to normal myocardium when imaged by delayed gadolinium enhancement. The transmural extent of delayed gadolinium enhancement predicts functional outcome after interventional procedures performed in patients with acute myocardial infarction and chronic ischemic heart disease [
16‐
21]. Not only in the setting of an acute myocardial infarction, but also in patients with various manifestations of cardiomyopathy, evidence of delayed gadolinium enhancement may have important clinical and prognostic implications [
22‐
30]. Magnetic resonance angiography (MRA) has been introduced as a method that can provide visualization of all three major coronary arteries, coronary bypasses and the aorta within a single three-dimensional acquisition [
31‐
40]. CMR has become the first choice imaging modality in complex congenital heart disease and imaging great vessels [
41‐
46]. In particular, CMR has proven to be of indispensable value in identifying aortic stiffness in Marfan patients using pulse wave velocity measurements [
47,
48]. In these patients pulse wave velocity is the propagation speed of the pressure or flow wave front traveling along the aorta. For instance, it has been shown that aortic stiffness in Marfan syndrome, together with mean blood pressure, is reduced by beta-blocker therapy, and CMR is well suited to detect these changes by measuring aortic distensibility and pulse wave velocity. …