Browsing by Author "Kunze, Karl-Philipp"

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    Cardiovascular magnetic resonance reveals myocardial involvement in patients with active stage of inflammatory bowel disease
    (2024) Fenski, Maximilian; Abazi, Endri; Groeschel, Jan; Hadler, Thomas; Kappelmayer, Diane; Kolligs, Frank; Prieto, Claudia; Botnar, Rene; Kunze, Karl-Philipp; Schulz-Menger, Jeanette
    Background Active inflammatory bowel disease (A-IBD) but not remission (R-IBD) has been associated with an increased risk of cardiovascular death and hospitalization for heart failure. Objectives Using cardiovascular magnetic resonance (CMR), this study aims to assess adverse myocardial remodeling in patients with IBD in correlation with disease activity. Methods Forty-four IBD patients without cardiovascular disease (24 female, median-age: 39.5 years, 26 A-IBD, 18 R-IBD) and 44 matched healthy volunteers (HV) were prospectively enrolled. The disease stage was determined by endoscopic and patient-reported criteria. Participants underwent CMR for cardiac phenotyping: cine imaging and strain analysis were performed to assess ventricular function. T1 mapping, extracellular volume and late-gadolinium enhanced images were obtained to assess focal and diffuse myocardial fibrosis. Simultaneous T1 and T2 elevation (T1 > 1049.3 ms, T2 > 54 ms) was considered to indicate a myocardial segment was inflamed. Results 16/44 (16.4%) IBD patients described dyspnea on exertion and 10/44 (22.7%) reported chest pain. A-IBD patients showed impaired ventricular function, indicated by reduced global circumferential and radial strain despite preserved left-ventricular ejection fraction. 16% of all IBD patients had focal fibrosis in a non-ischemic pattern. A-IDB patients had increased markers of diffuse left ventricular fibrosis (T1-values: A-IBD: 1022.0 +/- 34.83 ms, R-IBD: 1010.10 +/- 32.88 ms, HV: 990.61 +/- 29.35 ms, p < .01). Significantly more participants with A-IDB (8/26, 30.8%) had at least one inflamed myocardial segment than patients in remission (0/18) and HV (1/44, 2.3%, p < .01). Markers of diffuse fibrosis correlated with disease activity. Conclusion This study, using CMR, provides evidence of myocardial involvement and patterns of adverse left ventricular remodeling in patients with IBD.
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    High-resolution automated free-breathing coronary magnetic resonance angiography in comparison with coronary computed tomography angiography
    (2025) Wood, Gregory; Uglebjerg Pedersen, Alexandra; Linde Nørgaard, Bjarne; Alcaraz Frederiksen, Christian; Møller Jensen, Jesper; Kunze, Karl-Philipp; Neji, Radhouene; Wetzl, Jens; Prieto Vásquez, Claudia Del Carmen; Botnar, Rene Michael; Yong Kim, Won
    Aims Clinical implementation of coronary magnetic resonance angiography (CMRA) is limited due to variability in image quality. A protocol utilizing an image navigator (iNAV) integrated with automated scan planning has been developed to facilitate consistent diagnostic image quality. The aim of this study was to evaluate the agreement of automated iNAV CMRA compared with coronary computed tomography angiography (CCTA) using Coronary Artery Disease-Reporting and Data System (CAD-RADS) to classify coronary artery disease (CAD). Methods and results Ninety-five individuals underwent automated iNAV CMRA at a resolution of 0.7 mm3 with a deep learning–assisted automated scan planning and trigger-delay detection protocol. CMRA and CCTA data sets were analysed using CAD-RADS to classify the per-patient severity of CAD. Additionally, the accuracy of both imaging modalities in predicting referral for invasive coronary angiography (ICA) and coronary revascularization was assessed. CMRA classification for CAD-RADS ≥ 1, ≥2, ≥3, and ≥4 agreed with CCTA for 80%, 73%, 63%, and 70% of cases, respectively. The area under the receiver operating characteristic curves with CAD-RADS ≥ 4 and ≥3 for CMRA and CCTA were comparable in predicting ICA referral (0.75 vs. 0.70, P = 0.687, and 0.70 vs. 0.70, P = 0.945) and revascularization (0.72 vs. 0.74, P = 0.811, and 0.68 vs. 0.76, P = 0.089). Conclusion A novel automated iNAV CMRA protocol was implemented, investigating individuals at risk of CAD. Using the CAD-RADS classification, there was moderate to good agreement between CMRA and CCTA. In patients with CAD-RADS ≥ 4 and ≥3, CMRA was as effective as CCTA in predicting ICA referral and revascularization.