Duchenne muscular dystrophy (DMD) is a myopathy with a natural history of progressive cardiomyopathy and vasogenic edema, fatty infiltration, and myocardial fibrosis. We recently identified a group of patients with DMD who presented with acute onset of chest pain (ACP), troponin leak (TL), and new late gadolinium enhancement (LGE), similar in presentation to acute viral myocarditis (AM). It is unclear if these patients have suffered an episode of AM or if this is a different disease process. Given the presumed acute myocardial necrosis in both processes, we hypothesize that native T1 and T2 values would be elevated in AM and DMD patients with ACP compared to asymptomatic DMD patients. Read More

Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019

Authors: Lee Simon, Krishnamurthy Rajesh, Krishnamurthy Ramkumar, Johnston Thomas, Hor Kan

Keywords: Parametric Mapping, Cardiomyopathy

DMD is X-linked cardiac and skeletal myopathy caused by dystrophin protein deficiency with early death by cardiomyopathy. Cardiac magnetic resonance imaging (CMR) with myocardial fibrosis by late gadolinium enhancement (LGE) precedes decline in ejection fraction (LVEF) and may alter management in DMD. Muscle weakness limits ability to perform consistent breath-hold (BH) in traditional LGE sequences. Free-breathing (FB) LGE with motion correction (MOCO) allows improved visualization. We hypothesize that FB LGE with MOCO provides equivalent diagnostic quality with similar scan time to traditional LGE sequence. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Diaz Eric, Hor Kan, Krishnamurthy Ramkumar, Lee Simon, Krishnamurthy Rajesh

Keywords: LGE, MOCO, CMR

Cardiomyopathy is the leading cause of mortality for Becker Muscular Dystrophy (BMD).Risk stratification is challenging due to the wide variation of cardiomyopathy onset, progression, and severity; with cardiomyopathy developing independent of skeletal myopathy progression. Current guidelines recommend “complete cardiac evaluation” at ten years of age, but do not specify the type of imaging modality. We have been performing cardiac magnetic resonance imaging (CMR) routinely by 10 years of age. We sought to determine the progression of BMD cardiomyopathy during the adolescent years among patients who have evidence of fibrosis by late gadolinium enhancement(LGE). Read More

Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019

Authors: Johnston Thomas, Lee Simon, Krishnamurthy Ramkumar, Krishnamurthy Rajesh, Hor Kan

Keywords: Cardiomyopathy, LGE

Conventional cardiac MRI (CMR) acquisitions in children are limited by long acquisition time, need for sedation, and an inefficient workflow. A conventional cine SSFP short-axis stack typically takes 5-7 minutes to complete and is ineffective for subjects with arrhythmias. Available alternatives like free-breathing, real-time cine (RT-cine) SSFP have suboptimal temporal and spatial resolution. Recent advances in compressed sensing (CS) MRI techniques may overcome this limitation. We hypothesize that a CS-based approach will allow the scan time for a short axis RT-cine stack to be shortened to less than a minute without compromising spatial or temporal resolution. Read More

Meeting name: SPR 2018 Annual Meeting & Postgraduate Course , 2018

Authors: Krishnamurthy Ramkumar, Liu Yingmin, Hu Houchun, Krishnamurthy Rajesh, Hor Kan, Ahmad Rizwan

Keywords: COmpressed Sensing, Cine, MRI