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Dear Friends and Colleagues,
SCMR has been a trailblazer in promoting appropriate use of CMR by means of multidisciplinary society position statements and guidelines. Following this direction, I am excited to announce the newest SCMR sponsored position statement: Cardiac Magnetic Resonance in Women With Cardiovascular Disease: Position Statement from the Society of Cardiac Magnetic Resonance, soon to be published at the Journal of Cardiovascular Magnetic Resonance (JCMR).
The intent of this document is to provide guidance for imagers, clinicians and the community on the utility of CMR for imaging women cardiovascular diseases in specific clinical scenarios, providing published evidence when available and expert consensus otherwise. The document was prepared by the SCMR Consensus Group on Cardiac MR Imaging for Female Patients with Cardiovascular Disease which includes radiologists, cardiologists and scientists with special interest and expertise in the field.
Sincerely,
Karen Ordovas
Treasurer, SCMR
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Dear Friends and Colleagues,
As Chair of the Women in CMR working group of SCMR, I am honored to follow in the footsteps of Barbara Monvadi Srichai, Karen Ordovas and many others who have previously served in this role and have contributed to making our Women working group strong and successful. Thanks to these great women and the rest of the team, our Women working group published in JCMR the first paper about the role of CMR in the evaluation of heart involvement in female diseases.
Our working group has also created new opportunities for promoting the active female participation in SCMR through scientific networking, exchange of ideas, CMR training activities, equal participation in SCMR scientific program and new educational opportunities, specifically for women coming from countries under development.
We have also created special interest working groups within the Women working group including Cardio-Oncology, Cardio-Rheumatology and Women in pregnancy/Fetal MRI. In an effort to expand the field and emphasize the role of CMR in the evaluation of female diseases, we work to create guidelines regarding the role of CMR in Cardio-Oncology and Cardio-Rheumatology. During the last SCMR in February 2021 we have created special sessions about the role of CMR in female diseases. Furthermore, we have also organized the first Cardio-Rheumatology session in SCMR 2021 bringing together cardiologists, radiologists and rheumatologists to emphasize the role of CMR as an early diagnostic tool for cardiac involvement in rheumatic diseases.
As chair of the Women working group, I look forward to the upcoming meetings of our working group in order to increase the female participation and promote the development of multicenter studies in female diseases.
Please stay tuned for further announcements regarding our new activities.
Sophie Mavrogeni
Chair, SCMR Women in CMR Working Group
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On February 20, the Women in CMR Section of SCMR hosted "It's Happy Hour Somewhere" networking session. The event was hosted by Niti Aggarwal and Barbara Srichai and over 50 women attended. Group leaders led discussions in break-outs discussing Imposter Syndrome, Tiara Syndrome, and "I can do everything myself" Syndrome. The women shared practical tips on overcoming these syndromes. |
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Connecticut Children’s Medical Center is the latest institution to join the SCMR Registry, and is the first dedicated pediatric hospital among the fifteen participating centers. Dr. Olga Toro-Salazar, Head of Non-Invasive Imaging in the Division of Pediatric Cardiology at Connecticut Children’s, is also a member of the SCMR Registry Committee. Dr. Toro- Salazar stated, "Connecticut Children’s Medical Center is the latest institution to join the SCMR Registry, and is the first dedicated pediatric hospital among the fifteen participating centers". Dr. Olga Toro-Salazar, Head of Non-Invasive Imaging in the Division of Pediatric Cardiology at Connecticut Children’s, is also a member of the SCMR Registry Committee. Dr. Salazar added, “I welcome the opportunity to contribute to the promotion and development of multi-center collaborations in pediatric cardiology through the SCMR Registry. I believe this platform has great potential to expand pediatric CMR research, education, and quality control at a national and international level to improve pediatric and young adult cardiovascular health in support to the SCMR mission. In addition it provides the opportunity for all pediatric centers, large and small to participate in advancing the field of CMR.”
CMR is critical to the diagnosis and evaluation of pediatric congenital cardiovascular disease, yet many of the conditions are rare enough that data aggregation across multiple centers is needed to assess accuracy and outcomes. The SCMR Registry Committee is actively working to bring additional pediatric hospitals on board as participating data contributors.
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LAST FEW DAYS TO REGISTER! |
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THANK YOU TO OUR SPONSORS! |
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Just Breathe the Strain – A Rapid, Simple CMR Stress Protocol |
Despite its proven benefits, CMR stress testing is not widely adopted. This is partly due to the need for contrast agents and vasodilatory stress, both adding cost, safety issues, and complexity. A research team around Marco Ochs (Mannheim, Heidelberg) and Matthias Friedrich (Montreal, Heidelberg) now reports on a novel, rapid approach that can identify inducible ischemia without contrast agents, and without pharmacological or physical stress.
The researchers based their strategy on the fact that breathing maneuvers modify coronary blood flow, with CO2 acting as a vasodilator on the coronary vasculature, with a breath-hold mimicking the hyperemic effect of adenosine. The mechanism is well known and clinical studies using Oxygenation-Sensitive CMR have recently confirmed the feasibility and safety of a hyperventilation/breath-hold maneuver (1, 2). Ochs and Friedrich combined such a maneuver with CMR strain imaging using fast Strain-ENCoded (fSENC) imaging in order to detect ischemia-induced subtle wall motion abnormalities (3). The results of this prospective clinical trial indicate an excellent diagnostic accuracy of this approach when compared to quantitative coronary angiography. The protocol appears to be particularly beneficial in patients with multivessel disease or past CABG and reduces the stress part of the test duration from 172±59s (adenosine perfusion) to 64±2s (breathing/fSENC). The protocol will now be tested in larger trials. |
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1.Fischer K. Response of myocardial oxygenation to breathing manoeuvres and adenosine infusion. Eur Heart J - Cardiovasc Imaging 2015;16(4):395. Doi: 10.1093/ehjci/jeu202.
2. Fischer K. Breathing Maneuvers as a Vasoactive Stimulus for Detecting Inducible Myocardial Ischemia - An Experimental Cardiovascular Magnetic Resonance Study. Plos One 2016;11(10):e0164524. Doi: 10.1371/journal.pone.0164524.
3. Ochs M. Hyperventilation/Breath-Hold Maneuver to Detect Myocardial Ischemia by Strain-Encoded CMR Diagnostic Accuracy of a Needle-Free Stress Protocol. J Am Coll Cardiol: CV Img 2021. Doi: 10.1016/j.jcmg.2021.02.022.
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SCMR 2020 Memberships
expired on December 31st.
The 90-day grace period has now
ended for all 2020 memberships.
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Click here to see a list of brand new SCMR members!
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Now Accepting Applications
Deadline June 1, 2021
The FSCMR designation provides a way for physicians, scientists, and technologists to be recognized for their dedication to the SCMR and the field of CMR. The FSCMR designation distinguishes those with a significant level of involvement, dedication, and accomplishments consistent with the overall mission of the Society.
FSCMR BENEFITS:
- Entitlement to use designation of Fellow (FSCMR) on business cards, curriculum vitae, and other professional documents.
- Ability to promote your status. FSCMR members receive an FSCMR certificate to display in their office.
- Recognition in the SCMR community. New FSCMR awardees will be publicized in the SCMR Newsletter. List of all FSCMRs will be visibly and permanently posted on the SCMR website.
- Listing on the SCMR on-line Patient Information Portal (under development) to help guide patients seeking a CMR expert.
- FSCMR recognition on name badges at SCMR meetings and in the SCMR Scientific Sessions Final Program
- FSCMR lapel pin
- Recognition as a new FSCMR designee at SCMR’s Annual Business Meeting during the SCMR Scientific Sessions
BASIC CRITERIA
All applicants will be Regular or Technologist members of SCMR in good standing for the past three (3) consecutive years with a distinguished record of CMR science, education, or clinical practice. Find out more about criteria for each track.
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Those who wish to be considered should:
- Have web and/or social media experience
- Include a one page cover letter with relevant experience
- Be a member in good standing for five consecutive years (three years for Early Career candidates)
Deadline to apply is April 30, 2021
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What caught our cardiac MR eyes this month?
by Manish Motwani, Newsletter Editor
Twitter-based #WhyCMR journal watch 🧲 - join the online discussion!
1. SMINC-2 study - CMR in MINOCA - better early than late (3 vs 12 days). ❤⏳⌚🩺🧲
7. EXPLORER-HCM CMR: mavacamten reduces LV mass but no ECV or LGE change. 🤷♂️🤯
11. ESC position statement on diagnosis & treatment of cardiac amyloid. 👴👵💚🍏
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CMR in Chile, Spinning Fast
CMR IN CHILE
The development of high-quality clinical CMR programs in Chile is at a very early stage. Although CMR has been around for nearly a decade, it was rarely performed for diverse reasons. In contrast, CMR in the research field is far more developed thanks to institutions as Millennium Nucleus in Cardiovascular Magnetic Resonance ( https://cardiomr.cl), a government-funded program that leads the way in CMR research.
PRESENT TIME
In recent years, the situation has improved dramatically due to a collaborative approach of a group of young Cardiologists that have formally trained abroad in CMR. These cardiac imaging experts initially worked at different sites. Because of a shared long-term vision and methods, they converged naturally under the umbrella of the newly created Chilean Institute of Cardiac Imaging (INCIC | www.incic.org). INCIC's main objective is to develop high-quality patient center cardiac imaging programs at various Chilean Hospitals, using state-of-the-art magnets and sequences, including Strain, 4D Flow, and mapping. In line with this new trend, a public Hospital in Santiago de Chile (Sótero del Río) has created the first-of-its-kind integrated CARD-RADS CMR program in the Country, highlighting the central role of CMR in the modern Cardiology practice. |
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THE FUTURE
INCIC is expanding and constructing the most ambitious high-quality CMR program in Chile, roughly performing one hundred CMR monthly. Regarding diagnosis, INCIC maintains an international scientific advisory board, where challenging cases are comprehensively discussed. This collaborative approach allows surpassing 8K CMR cases experience. On the immediate horizon, INCIC will expand its reach to the teaching and research fields, initiating the first CMR fellowship in Chile.
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Javier Lopez-Opitz
EXECUTIVE DIRECTOR
@LopezOpitz
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Hugo Martínez
ADMINISTRATIVE DIRECTOR
@HugoMartinezCMR
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Julián Vega-Adauy
ACADEMIC DIRECTOR
@ecocardio_cl
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Daniel Lorenzatti
SCIENTIFIC ADVISOR
@danilorenzatti
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Javier Urmeneta
SCIENTIFIC ADVISOR
@javierurmeneta1
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Diego Lowenstein
SCIENTIFIC ADVISOR
@lowediego
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Each live session was offered to anyone who purchased the 2020 CBCMR Review Course. They were all an hour in length, and included quizzes and time to ask questions. These recorded sessions will now be available for all who purchase the 2020 CBCMR Review Course in the future.
ONE LIVE SESSION STILL AVAILABLE - April 30! Click here to register.
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Imaging Claustrophobic Patients
Claustrophobic patients – one of the tougher patient groups to perform a cardiac MRI on. (Well, maybe not the toughest!) The scan is hard on the patient, they know they have been referred for a reason, but the scanner is a scary place. Especially when it’s on your heart.
Talk to you patient. Explain the exam, tell them how you are prepping them. Explain how long they will be in the scanner. Tell them what the next step is – ie you are using some cool scratchy gel to prepare their skin for the ecg, you are starting an IV. Let them know it’s a long study, but that they will be listening to breathing instructions throughout. Tell them to focus on the voice. Potentially scan your patient prone, it can reduce stress for the patient by limiting their vision. Or scan the patient into the scanner feet first.
Some patients can become rude when anxious, but this is just a response to the worry, try to reassure them with compassion. Offer patients a cloth to cover their eyes or offer them the mirror if equipped. Make the patient as comfortable as possible, by explaining and making them a part of the process. Speak to them throughout the study, let them know when to expect the scanner being quiet. Try and scan as quickly as possible, giving the patient the best possible exam, for the quickest time period. Speak with your cardiologist/ radiologist – if the patient is claustrophobic, is there a sequence that isn’t needed? Have an imaging strategy that answers the clinical question as quickly as possible, prioritize the relevant sequences.
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Online Educational Opportunities |
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Online – MS Teams
May 11-13, 2021
Virtual
June 26-27, 2021
Online
October 2-4, 2021
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Let’s chat about... interesting cases
- “It would be nice to share this interesting case with others.”
- “What on earth is this? I am frankly clueless. SOS!”
- "Such a challenging case. I wonder what experts would think?”
If any of the statements above have ever crossed your mind, we have just the webinar for you!
Join us as interesting cases are presented from your colleagues around the world, with viewpoints provided by renowned experts in congenital CMR.
There may be no ‘right answer’, but together we can learn from each other in this informal setting and improve our understanding of complex cases that come our way.
Stay tuned for future case webinars where we will invite you to submit your exciting, challenging, or interesting cases for review!
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CMR Practice Advisory Group |
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Attention: Early Career Physicians
The CMR Practice Advisory Group, a group of experienced CMR volunteers, can be contacted with issues or questions about running your CMR program. The group will provide advice, assistance, and mentoring. If you're a physician starting and developing a Cardiovascular MRI program and/or are a physician interested in receiving CMR program advice, this is the perfect resource for you.
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A 52 year old male with no significant past medical history had been having intermittent fevers, chills, dry cough, left scapular and pleuritic chest pain associated with exertional dyspnea for more than one month. He had three prior hospitalizations since his symptoms began. He was initially diagnosed with right middle lobe pneumonia when hospitalized at an outside facility, treated with antibiotics and had subsequent mild symptom relief on discharge. He was hospitalized twice again for the same complaints at the outside institution. CT angiography of the chest was done on both admissions and showed no pulmonary embolism or pneumonia, but revealed a pericardial effusion and small left pleural effusion. His severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR test was negative but his SARS-CoV-2 antibody was positive. He was given a short course of antibiotics during one of those hospitalizations without benefit.
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April 1 to April 25, 2021
#WhyCMR Activity
by Daniel Lorenzatti
Each month our social media committee correspondents update us on the latest #WhyCMR activity stats, most popular tweets or threads. Join the conversation and use the #WhyCMR in your social media posts!
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Research
van Hout, et al.
Published on 19th of April 2021
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Research
Pezel, et al.
Published on 8th of April 2021
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Research
Steen, et al.
Published on 5th of April 2021
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Research
Chan, et al.
Published on 5th of April 2021
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Research
Salatzki, et al.
Published on 1st of April 2021
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Review
Dahiya, et al.
Published on 1st of April 2021
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Please use this link for a filtered PubMed list of all CMR-related manuscripts for April 2021 – more than 300 in total!
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Manish Motwani
Newsletter Editor
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