Heart Failure Clinical Trial
Diffusion MRI in Heart Failure
Summary
The development of symptomatic heart failure is frequently preceded by a pre-clinical period of structural remodeling in the heart. The remodeling process driving this transition, however, remains poorly understood. The investigators hypothesize that imaging the diffusion of water in the heart with MRI will allow its microstructure to be resolved. The investigators further hypothesize that the characterization of microstructural changes in the heart will help elucidate the pathogenesis of heart failure and the transition from a compensated to a decompensated state. Patients with recent myocardial infarcts and left ventricular hypertrophy, who are at risk for the development of heart failure, will be enrolled. The participants will undergo serial diffusion tensor MRI (DTI) imaging of the heart to characterize changes in myocardial microstructure over time.
Eligibility Criteria
Inclusion Criteria:
Healthy adults with no history of hypertension, diabetes or heart disease
Patients with ST Elevation MI within last 6-10 weeks who are angina free, and have been seen by a cardiologist since discharge
Patients with episode of heart failure within last 12 months and left ventricular hypertrophy, documented by echocardiogram or MRI.
Exclusion Criteria:
Presence of metallic foreign bodies/objects
Selected medical devices and implants
Pacemakers, implantable defibrillators, life vests
Coronary artery stent within last 6 weeks (unless the stent is a MRI-inert chromium-cobalt stent)
Known untreated ventricular arrhythmia such as sustained ventricular tachycardia within last 12 months
Atrial fibrillation that is not well rate controlled (heart rate >125)
Unstable angina within last 2 months that has not been fully evaluated by a cardiologist
Syncope within last 6 weeks
Hemodynamic instability (Systolic BP less than 100 or greater than 180)
Decompensated heart failure (inability to lie flat and perform a breath-hold).
Glomerular filtration rate (GFR) < 60 for those receiving gadolinium.
Labile GFR that is not stable/similar on last 2 measurements (for those receiving gadolinium).
Patients with GFR < 20 or on any form of dialysis.
Infiltrative cardiomyopathy (amyloid, sarcoid, hemachromatosis)
Recent surgery (within the last 3 months)
Prior stroke with large residual deficit
Presence of liver or respiratory failure
Pregnancy and nursing mothers
Claustrophobia
Known seizure disorder
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There is 1 Location for this study
Charlestown Massachusetts, 02129, United States
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