JCMR Articles (CME)
Collapse Prognostic utility of differential tissue characterization of cardiac neoplasm and thrombus via late gadolinium enhancement cardiovascular magnetic resonance among patients with advanced systemic cancer (CME)

Purpose/ Objective

A variety of cardiac imaging tests can be used to assess cardiac masses. Cardiac magnetic resonance provides particular utility for this purpose, as it enables assessment of mass location, size, and tissue properties with high spatial and temporal resolution. This study (JCMR paper) provides a comprehensive evaluation of state of the art CMR methods for assessment of cardiac neoplasm and thrombus among a broad cohort of patients with systemic cancer. This JCMR paper and associated CMR materials will provide the reader with an understanding of the incremental utility of late gadolinium enhancement CMR for identification and prognostic risk stratification of patients with cardiac neoplasm and thrombus. Following this activity, learners will better understand incremental utility of late gadolinium enhancement CMR tissue characterization (as compared to conventional cine-CMR) for identification and prognostic risk stratification of cancer-associated cardiac neoplasm and thrombus.

 

Accreditation Statement
The Society for Cardiovascular Magnetic Resonance (SCMR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

 

Credit Designation Statement
The Society for Cardiovascular Magnetic Resonance (SCMR) designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

 

Instructions for Claiming CME

  • Attend the sessions in full for which credit is sought
  • Complete the post-activity evaluation
  • A certificate of completion will be available once the evaluation is submitted

 

Financial Disclosures
The planners and faculty for this activity did not have any relationships to disclose.

 

Disclosure of Commercial Support
SCMR received funding to support this activity from the following organizations:

 

Bibliography
Please see the bibliography at the end of the journal article.

 

 

Formats Available: Streaming
Original Course Date: November 01, 2017
On-Demand Release Date: Available Now

Approved Credit:
  • ACCME: 1 hour Total General Hours

  • REGISTERREGISTER Prognostic utility of differential tissue characterization of cardiac neoplasm and thrombus via late gadolinium enhancement cardiovascular magnetic resonance among patients with advanced systemic cancer (CME)
    Collapse Cardiac amyloidosis is prevalent in older patients with aortic stenosis and carries worse prognosis (CME)

    Purpose/ Objective

    Octogenarians presenting with cardiac symptoms and moderate-severe aortic stenosis were found to have concomitant cardiac amyloidosis by CMR. Importantly, the presence of cardiac amyloidosis was associated with nearly 3-fold higher mortality. Following this activity, learners will better understand that cardiac amyloidosis is commonly seen in elderly patients with aortic stenosis, that it is typically present in elderly male octogenarians, with lowflow, low-gradient aortic stenosis and mid-range LVEF, and is consider an identification of cardiac amyloidosis in such patients since mortality was nearly 3-fold higher, despite transcatheter aortic valve replacement.

     

    Accreditation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

     

    Credit Designation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

     

    Instructions for Claiming CME

    • Attend the sessions in full for which credit is sought
    • Complete the post-activity evaluation
    • A certificate of completion will be available once the evaluation is submitted

     

    Financial Disclosures
    The planners and faculty for this activity did not have any relationships to disclose.

     

    Disclosure of Commercial Support
    SCMR received funding to support this activity from the following organizations:

     

    Bibliography
    Please see the bibliography at the end of the journal article.

     

     

    Formats Available: Streaming
    Original Course Date: January 08, 2018

    Approved Credit:
  • ACCME: 1 hour Total General Hours

  • REGISTERREGISTER Cardiac amyloidosis is prevalent in older patients with aortic stenosis and carries worse prognosis (CME)
    Collapse Quantification of mitral regurgitation in patients with hypertrophic cardiomyopathy using aortic and pulmonary flow data: impacts of left ventricular outflow tract obstruction and different left ventricular segmentation methods (CME)

    Purpose/ Objective

    Following this session, learners will be better prepared to assess mitral regurgitation using cardiac magnetic resonance imaging by applying a few tactics:

    1. Being aware that left ventricular outflow tract obstruction causing turbulent, non-laminar flow in the ascending aorta may impact the accuracy of aortic flow quantification, leading to false conclusions regarding mitral regurgitation severity.
    2. Being aware that particular care must be taken in assessing mitral regurgitation using different left ventricular segmentation approaches – namely, with or without the inclusion of papillary muscles and trabeculae.
    3. Using pulmonary flow data as internal (intrapatient) validation of the aortic phase-contrast data acquired under turbulent flow conditions.

     

    Accreditation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

     

    Credit Designation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

     

    Instructions for Claiming CME

    • Attend the sessions in full for which credit is sought
    • Complete the post-activity evaluation
    • A certificate of completion will be available once the evaluation is submitted

     

    Financial Disclosures
    The planners and faculty for this activity did not have any relationships to disclose.

     

    Disclosure of Commercial Support
    SCMR received funding to support this activity from the following organizations:

     

    Bibliography
    Please see the bibliography at the end of the journal article.

     

     

    Formats Available: Streaming
    Original Course Date: January 08, 2018

    Approved Credit:
  • ACCME: 1 hour Total General Hours

  • REGISTERREGISTER Quantification of mitral regurgitation in patients with hypertrophic cardiomyopathy using aortic and pulmonary flow data: impacts of left ventricular outflow tract obstruction and different left ventricular segmentation methods (CME)
    Collapse Impact of bileaflet mitral valve prolapse on quantification of mitral regurgitation with cardiac magnetic resonance: a single-center study (CME)

    Purpose/ Objective

    With CMR, the left ventricular systolic volume is measured as the volume contained within the LV cavity between the apex and the mitral annular plane. In the presence of a significant mitral valve prolapse, the blood volume contained within the prolapsing leaflets is not measured as a part of the LV systolic volume. A correction of the LV end-systolic volume consisting in adding the blood volume contained between the mitral annular plane and the prolapsing mitral leaflets is proposed, in order to better assess mitral regurgitation severity by a more accurate quantification the mitral regurgitant volume. Following this activity, learners will be better prepared to recognize the usual method of disks is inaccurate for the measurement of the LV endsystolic volume in the presence of a significant mitral valve prolapse, that results in an inaccurate calculation of the LV stroke volume and, as a consequence, in an overestimation of the grade of mitral regurgitation severity, and the use of a simple correction method may improve the accuracy of LV endsystolic volume measurement and mitral regurgitation assessment with CMR.

     

    Accreditation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

     

    Credit Designation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

     

    Instructions for Claiming CME

    • Attend the sessions in full for which credit is sought
    • Complete the post-activity evaluation
    • A certificate of completion will be available once the evaluation is submitted

     

    Financial Disclosures
    The planners and faculty for this activity did not have any relationships to disclose.

     

    Disclosure of Commercial Support
    SCMR received funding to support this activity from the following organizations:

     

    Bibliography
    Please see the bibliography at the end of the journal article.

     

     

    Formats Available: Streaming
    Original Course Date: July 15, 2017

    Approved Credit:
  • ACCME: 1 hour Total General Hours

  • REGISTERREGISTER Impact of bileaflet mitral valve prolapse on quantification of mitral regurgitation with cardiac magnetic resonance: a single-center study (CME)
    Collapse The Reproducibility of Late Gadolinium Enhancement Cardiovascular Magnetic Resonance Imaging of Post-Ablation Atrial Scar: A Cross-Over Study (CME)

    Purpose/ Objective

    Cardiac magnetic resonance imaging of post-ablation atrial scar is a powerful tool to analyze the results of ablation procedures. However, many different imaging parameter sets are used between studies. This paper aims to understand the determinants of imaging quality Imaging of post-ablation atrial scar would be performed with techniques that optimize detection of permanent scar. This study assesses the impact of different imaging parameters. Following this activity, learners will be better able to improve their imaging parameters, with particular regard to:

    1. Timing of imaging post-gadolinium administration
    2. Selection of an appropriate threshold for scar detection
    3. Selection of an appropriate contrast dose

     

    Accreditation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

     

    Credit Designation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

     

    Instructions for Claiming CME

    • Attend the sessions in full for which credit is sought
    • Complete the post-activity evaluation
    • A certificate of completion will be available once the evaluation is submitted

     

    Financial Disclosures
    The planners and faculty for this activity did not have any relationships to disclose.

     

    Disclosure of Commercial Support
    SCMR received funding to support this activity from the following organizations:

     

    Bibliography
    Please see the bibliography at the end of the journal article.

    Formats Available: Streaming
    Original Course Date: May 01, 2018

    Approved Credit:
  • ACCME: 1 hour Total General Hours

  • REGISTERREGISTER The Reproducibility of Late Gadolinium Enhancement Cardiovascular Magnetic Resonance Imaging of Post-Ablation Atrial Scar: A Cross-Over Study (CME)
    Collapse A Comparison of Both DENSE and Feature Tracking Techniques with Tagging for the Cardiovascular Magnetic Resonance Assessment of Myocardial Strain (CME)

    Purpose/ Objective
    There are three major techniques available for strain evaluation by cardiac MRI, namely tagging, DENSE and feature tracking. Due to differences in image acquisition and post processing the strain values are different from technique to technique. Hence, a reference must be established not only for each technique but also for each analytical program in the case of feature tracking. Following this activity, learners will be better prepared to assess the differences of strain values acquired using different technique and establish reference range for each strain technique by cardiac MRI.

     

    Accreditation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

     

    Credit Designation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

     

    Instructions for Claiming CME

    • Attend the sessions in full for which credit is sought
    • Complete the post-activity evaluation
    • A certificate of completion will be available once the evaluation is submitted

     

    Financial Disclosures
    The planners and faculty for this activity did not have any relationships to disclose.

     

    Disclosure of Commercial Support
    SCMR received funding to support this activity from the following organizations:

     

    Bibliography
    Please see the bibliography at the end of the journal article.

    Formats Available: Streaming
    Original Course Date: May 01, 2018

    Approved Credit:
  • ACCME: 1 hour Total General Hours

  • REGISTERREGISTER A Comparison of Both DENSE and Feature Tracking Techniques with Tagging for the Cardiovascular Magnetic Resonance Assessment of Myocardial Strain (CME)
    Collapse Cardiovascular magnetic resonance black-blood thrombus imaging for the diagnosis of acute deep vein thrombosis at 1.5 Tesla (CME)

    Purpose/ Objective

    There is a gap in technological development. Several medical imaging techniques have been developed for diagnosing DVT in recent decades. X-ray contrast venography has traditionally been the gold standard; however, the need for iodinated contrast agent and radiation exposure, as well as the technique’s invasive nature, have led to its rare use in purely diagnostic settings. Ultrasonography is currently a first-line technique used for the diagnosis in patients with clinically suspected DVT because of operation convenience, low cost, and high diagnostic sensitivity (94%) and specificity (98%). However, the disadvantages of ultrasound include operator dependence, limited visualization in the pelvis station, and an inability to differentiate the phases of thrombus. Cardiovascular MRI may serve as an alternative or complementary imaging tool to ultrasound. Previous studies have demonstrated that contrast-enhanced MR venography is reliable for assessing deep and superficial venous systems and has a high sensitivity and specificity for detecting DVT. However, this technique may be contraindicated in patients with an allergy to gadolinium, and in pregnancy or severe renal dysfunction.

    Following this activity, learners will be able to describe the limitations of current imaging techniques for the diagnosis of DVT; understand the underlying mechanisms of BBTI for detecting acute thrombus; and describe the advantages and disadvantages of BBTI when compared to contrast-enhanced MR venography.

     

    Accreditation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

     

    Credit Designation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

     

    Instructions for Claiming CME

    • Attend the sessions in full for which credit is sought
    • Complete the post-activity evaluation
    • A certificate of completion will be available once the evaluation is submitted

     

    Financial Disclosures
    The planners and faculty for this activity did not have any relationships to disclose.

     

    Disclosure of Commercial Support
    SCMR received funding to support this activity from the following organizations:

     

    Bibliography
    Please see the bibliography at the end of the journal article.

     

    Formats Available: Streaming
    Original Course Date: July 01, 2018

    Approved Credit:
  • ACCME: 1 hour Total General Hours

  • REGISTERREGISTER Cardiovascular magnetic resonance black-blood thrombus imaging for the diagnosis of acute deep vein thrombosis at 1.5 Tesla (CME)
    Collapse Aortic flow patterns and wall shear stress maps by 4D-flow cardiovascular magnetic resonance in the assessment of aortic dilatation in bicuspid aortic valve disease (CME)

    Purpose/ Objective

    This manuscript explores the different components of flow, wall shear stress (axial and circumferential) and flow vortices, globally, along the ascending aorta (using 3D maps). Also, we investigated the different behavior of these parameters in the different valvular phenotypes and in the different ascending aortic morphotypes to obtain the main determinants of aortic dilatation in this population. We concluded that an eccentric jet and increased axial wall shear stress in the proximal aorta, mainly observed in the RL-phenotype, may determine the root dilatation morphotype, whereas increased rotational and vortical flow and circumferential WSS in mid and distal ascending aorta in the RN-phenotype may determine the ascending dilatation morphotype.

     

    To close the gap outlined above, learners 'need' to know other risk factors associated to aortic dilatation in bicuspid aortic valve patients:

     

    1. We explored for the first time the global distribution (using 3D maps) of the different parameters of flow and deformation.
    2. We obtained through multivariate analysis the main determinants associated with aortic dilatation.
    3. Our findings may constitute the basis of future longitudinal studies that allow the selection of patients at greater risk of aortic dilatation and events at follow-up.

     

    Accreditation Statement

    The Society for Cardiovascular Magnetic Resonance (SCMR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

     

    Credit Designation Statement

    The Society for Cardiovascular Magnetic Resonance (SCMR) designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

     

    Instructions for Claiming CME

    1. Attend the sessions in full for which credit is sought
    2. Complete the post-activity evaluation
    3. A certificate of completion will be available once the evaluation is submitted

     

    Financial Disclosures

    The planners and faculty for this activity did not have any relationships to disclose.

     

    Bibliography

    Please see the bibliography at the end of the journal article.

    Formats Available: Streaming
    Original Course Date: October 01, 2018

    Approved Credit:
  • ACCME: 1 hour AMA PRA Category 1 Credit(s)

  • REGISTERREGISTER Aortic flow patterns and wall shear stress maps by 4D-flow cardiovascular magnetic resonance in the assessment of aortic dilatation in bicuspid aortic valve disease (CME)
    Collapse Incidence and predictors of left ventricular thrombus by cardiovascular magnetic resonance in acute ST-setment elevation myocardial infarction treated by primary percutaneous coronary intervention: a meta-analysis (CME)

    Purpose/ Objective

    The incidence of LV thrombus in STEMI patients is not clear and TTE performs poorly in its detection. LV thrombus, if undetected, can have catastrophic consequences and therefore, it is imperative to identify those at risk and they are investigated with the right tool. CMR can play a valuable role in this setting and is highlighted in this CME. Following this activity learners will:

    1. Have a better understanding of the strength of CMR to detect LV thrombus
    2. Be able to identify patients most likely to be at risk
    3. Be able to improve their interpretation of CMR to differentiate between microvascular obstruction and LV thrombus.

     

    Accreditation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

     

    Credit Designation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

     

    Instructions for Claiming CME

    • Attend the sessions in full for which credit is sought
    • Complete the post-activity evaluation
    • A certificate of completion will be available once the evaluation is submitted

     

    Financial Disclosures
    The planners and faculty for this activity did not have any relationships to disclose.

     

    Disclosure of Commercial Support
    SCMR received funding to support this activity from the following organizations:

     

    Bibliography
    Please see the bibliography at the end of the journal article.

     

    Formats Available: Streaming
    Original Course Date: December 01, 2018

    Approved Credit:
  • ACCME: 1 hour AMA PRA Category 1 Credit(s)

  • REGISTERREGISTER Incidence and predictors of left ventricular thrombus by cardiovascular magnetic resonance in acute ST-setment elevation myocardial infarction treated by primary percutaneous coronary intervention: a meta-analysis (CME)
    Collapse Importance of operator training and rest perfusion on the diagnostic accuracy of stress perfusion cardiovascular magnetic resonance (CME)

    Purpose/ Objective

    Accurate assessment of stress perfusion CMR can be challenging. Appropriate training, the use of rest perfusion and the help of quantitative analysis will help and improve the diagnostic accuracy. Following this activity learners will have a better understanding of the importance of appropriate training, rest perfusion, and the quantitative assessment of stress perfusion CMR.

     

    Accreditation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

     

    Credit Designation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

     

    Instructions for Claiming CME

    • Attend the sessions in full for which credit is sought
    • Complete the post-activity evaluation
    • A certificate of completion will be available once the evaluation is submitted

     

    Financial Disclosures
    The planners and faculty for this activity did not have any relationships to disclose.

     

    Disclosure of Commercial Support
    SCMR received funding to support this activity from the following organizations:

     

    Bibliography
    Please see the bibliography at the end of the journal article.

     

    Formats Available: Streaming
    Original Course Date: December 01, 2018

    Approved Credit:
  • ACCME: 1 hour AMA PRA Category 1 Credit(s)

  • REGISTERREGISTER Importance of operator training and rest perfusion on the diagnostic accuracy of stress perfusion cardiovascular magnetic resonance (CME)
    Collapse Asymptomatic myocardial ischemia forecasts adverse events in cardiovascular magnetic resonance dobutamine stress testing of high-risk middle-aged and elderly individuals (CME)

    Purpose/ Objective

    Clinical cardiology guidelines often direct decision making based on patient symptoms.  However, there is little data and direction on the most appropriate situations to evaluate for myocardial ischemia without classical symptoms.  Further, even less data exists to inform clinicians on how best to mitigate any risks related to asymptomatic myocardial ischemia.  To fill this gap, further prospective studies would be helpful to identify thresholds on when to identify asymptomatic myocardial ischemia and how best to improve outcomes in those who have it. Following this activity learners will be able to appreciate the potential reality and clinical risk related to asymptomatic myocardial ischemia and identify the risk factors in a higher risk cohort which were associated with asymptomatic myocardial ischemia.

     

    Accreditation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

     

    Credit Designation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

     

    Instructions for Claiming CME

    • Attend the sessions in full for which credit is sought
    • Complete the post-activity evaluation
    • A certificate of completion will be available once the evaluation is submitted

     

    Financial Disclosures
    The planners and faculty for this activity did not have any relationships to disclose.

     

    Disclosure of Commercial Support
    SCMR received funding to support this activity from the following organizations:

     

    Bibliography
    Please see the bibliography at the end of the journal article.

     

    Formats Available: Streaming
    Original Course Date: December 01, 2018

    Approved Credit:
  • ACCME: 1 hour AMA PRA Category 1 Credit(s)

  • REGISTERREGISTER Asymptomatic myocardial ischemia forecasts adverse events in cardiovascular magnetic resonance dobutamine stress testing of high-risk middle-aged and elderly individuals (CME)
    Collapse Association of left atrial volume index and all-cause mortality in patients referred for routine cardiovascular magnetic resonance: a multicenter study (CME)

    Purpose/ Objective

    While there is some data defining normal reference values for left atrial (LA) volumes by cardiac magnetic resonance (CMR), these data have all originated from European volunteers. There are no normal reference values based on volunteers from United States (US) using the biplane area-length method. While there are data in specific subgroups, there are currently no data linking routinely derived LA volumes by CMR with overall mortality in a general clinical patient cohort. Additionally, there is a lack of categorization of severity of LA enlargement, by CMR, based on outcome data.

    In this article we determine normal reference valves for LA volume using biplane area-length method using routine cine-CMR performed. We also propose partitions for mild, moderate, and severe LA enlargement based on mortality by validating the independent prognostic significance of these proposed partitions in a large multicenter cohort.

     

    Accreditation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

     

    Credit Designation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

     

    Instructions for Claiming CME

    • Attend the sessions in full for which credit is sought
    • Complete the post-activity evaluation
    • A certificate of completion will be available once the evaluation is submitted

     

    Financial Disclosures
    The planners and faculty for this activity did not have any relationships to disclose.

     

    Disclosure of Commercial Support
    SCMR received funding to support this activity from the following organizations:

     

    Bibliography
    Please see the bibliography at the end of the journal article.

     

    Formats Available: Streaming
    Original Course Date: March 01, 2019

    Approved Credit:
  • ACCME: 1 hour AMA PRA Category 1 Credit(s)

  • REGISTERREGISTER Association of left atrial volume index and all-cause mortality in patients referred for routine cardiovascular magnetic resonance: a multicenter study (CME)
    Collapse Comparison of myocardial fibrosis quantification methods by cardiovascular magnetic resonance imaging for risk stratification of patients with suspected myocarditis (CME)

    Purpose/ Objective

    Animal experiments had established the validation for infarct size using CMR late gadolinium enhancement imaging.  However, there is no reliable animal model that can reliably characterize clinical myocarditis.  Furthermore, diverse clinical outcomes of patients with suspected myocarditis also require a large clinical cohort with sufficient number of adverse clinical events in order to meaningfully determine the association with various methods of LGE quantitation.  The comparative assessment of various LGE semi-quantitative methodologies presented provides an understanding of the most logical approach using current LGE techniques in estimating the risk of adverse cardiac outcomes in this clinical setting.

    Following this activity, learners will be able to recognize the steps of performing LGE sizing using various standard deviation based methods and the full-width half maximum methods and the reasons why the measured LGE sizes differ and how they differ 3. which of the above semi-quantitative methods and visual manual sizing, can be used to estimate clinical patient risks.

     

    Accreditation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

     

    Credit Designation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

     

    Instructions for Claiming CME

    • Attend the sessions in full for which credit is sought
    • Complete the post-activity evaluation
    • A certificate of completion will be available once the evaluation is submitted

     

    Financial Disclosures
    The planners and faculty for this activity did not have any relationships to disclose.

     

    Disclosure of Commercial Support
    SCMR received funding to support this activity from the following organizations:

     

    Bibliography
    Please see the bibliography at the end of the journal article.

     

    Formats Available: Streaming
    Original Course Date: March 01, 2019
    On-Demand Release Date: Available Now

    Approved Credit:
  • ACCME: 1 hour Total General Hours

  • REGISTERREGISTER Comparison of myocardial fibrosis quantification methods by cardiovascular magnetic resonance imaging for risk stratification of patients with suspected myocarditis (CME)
    Collapse The amount of late gadolinium enhancement outperforms current guideline-recommended criteria in the identification of patients with hypertrophic cardiomyopathy at risk of sudden cardiac death (CME)

    Purpose/ Objective

    At the moment, risk stratification in Hypertrophic Cardiomyopathy relies on the application of clinical scores which have been shown to have only a moderate discriminative capacity in predicting sudden cardiac death and/or arrhythmic events. Cardiac magnetic resonance can estimate the amount of myocardial fibrosis which is thought to constitute the substrate for life-threatening ventricular arrhythmias. This CME will help to understand the role of cardiac magnetic resonance in improving risk stratification of Hypertrophic Cardiomyopathy. After this activity learners will understand the capability of cardiac magnetic resonance in detecting myocardial fibrosis, correctly estimate the amount of late gadolinium enhancement, and understand how cardiac magnetic resonance can improve risk stratification in patients with Hypertrophic Cardiomyopathy.

     

    Accreditation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

     

    Credit Designation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

     

    Instructions for Claiming CME

    • Attend the sessions in full for which credit is sought
    • Complete the post-activity evaluation
    • A certificate of completion will be available once the evaluation is submitted

     

    Financial Disclosures
    The planners and faculty for this activity did not have any relationships to disclose.

     

    Disclosure of Commercial Support
    SCMR received funding to support this activity from the following organizations:

     

    Bibliography
    Please see the bibliography at the end of the journal article.

     

    Formats Available: Streaming
    Original Course Date: July 01, 2019
    On-Demand Release Date: Available Now

    Approved Credit:
  • ACCME: 1 hour Total General Hours

  • REGISTERREGISTER The amount of late gadolinium enhancement outperforms current guideline-recommended criteria in the identification of patients with hypertrophic cardiomyopathy at risk of sudden cardiac death (CME)
    Collapse Quantification of Lung Water in Heart Failure Using Magnetic Resonance Imaging (CME)

    Purpose/ Objective

    The gold standard for imaging pulmonary congestion is chest radiography however this test provides largely qualitative information. BNP, a plasma biomarker of raised intra-cardiac pressure, is also used to evaluate patients with heart failure however pulmonary congestion is also influenced by other components of Starling's equation as well as lymphatic drainage. Therefore, there are few methods that directly measure pulmonary congestion, one of the cardinal features of heart failure. MRI is well suited to image pulmonary edema given that signal intensity is directional proportional to water content and cardiac MRI is increasingly used to evaluate patients with heart failure. Following this activity, learns will understand that MRI signal intensity in the lung can be used as a surrogate for pulmonary congestion, MRI derived lung water has moderate correlation with measures of intra-cardiac pressures (BNP and catheter derived) and are associated with outcome in patients with heart failure, and lung water imaging could be easily added to existing cardiac MRI protocols.

     

    Accreditation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

     

    Credit Designation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

     

    Instructions for Claiming CME

    • Attend the sessions in full for which credit is sought
    • Complete the post-activity evaluation
    • A certificate of completion will be available once the evaluation is submitted

     

    Financial Disclosures
    The planners and faculty for this activity did not have any relationships to disclose.

     

    Disclosure of Commercial Support
    SCMR received funding to support this activity from the following organizations:

     

    Bibliography
    Please see the bibliography at the end of the journal article.

    Formats Available: Streaming
    Original Course Date: September 01, 2019
    On-Demand Release Date: Available Now

    Approved Credit:
  • ACCME: 1 hour Total General Hours

  • REGISTERREGISTER Quantification of Lung Water in Heart Failure Using Magnetic Resonance Imaging (CME)
    Collapse Multiparametric cardiovascular magnetic resonance imaging in acute myocarditis: a comparison of different measurement approaches.

    Purpose/ Objective

    The diagnosis of acute myocarditis can be challenging in daily clinical routine. CMR is a very reliable non-invasive examination tool for suspected myocarditis cases. However, pulse sequences, crucial for providing the diagnosis of disease (STIR, relative enhancement) often suffer from image artifacts. Recently, the CMR guidelines (Lake-Louise-criteria) for detection of myocarditis have been supplemented by quantitative imaging parameters (myocardial tissue mapping) in order to facilitate diagnosis. Different measurement approaches (i.e. global, SAX, ConSept) have been proposed for the assessment of T1 and T2 relaxation times from mapping pulse sequences, yet, their diagnostic performance has not been compared until today. Our recommendation of the global measurement approach will contribute to a future better diagnosis. Following this session, learners will be up to date regarding the possibility to asses T1 and T2 relaxation times derived from myocardial mapping, be able to consider T1 and T2 mapping methods for decision making in acute myocarditis, and understand the advantages of the global measurement approach for use in myocardial tissue mapping in myocarditis to assess the presence of acute myocarditis

     

    Accreditation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

     

    Credit Designation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

     

    Instructions for Claiming CME

    • Attend the sessions in full for which credit is sought
    • Complete the post-activity evaluation
    • A certificate of completion will be available once the evaluation is submitted

     

    Financial Disclosures
    The planners and faculty for this activity did not have any relationships to disclose.

     

    Disclosure of Commercial Support
    SCMR received funding to support this activity from the following organizations:

     

    Bibliography
    Please see the bibliography at the end of the journal article.

     

    Formats Available: Streaming
    Original Course Date: September 01, 2019
    On-Demand Release Date: Available Now

    Approved Credit:
  • ACCME: 1 hour Total General Hours

  • REGISTERREGISTER Multiparametric cardiovascular magnetic resonance imaging in acute myocarditis: a comparison of different measurement approaches.
    Collapse Clinical value of dark-blood late gadolinium enhancement cardiovascular magnetic resonance without additional magnetization preparation.

    Purpose/ Objective

    Bright-blood late gadolinium enhancement (LGE) MRI has been considered the reference standard in the non-invasive assessment of myocardial viability for almost two decades now. Its ability to clearly depict areas of myocardial infarction from viable myocardium is well established, making LGE a widely accepted component of standard clinical CMR protocols. By nulling the magnetization level of viable myocardium, its dark appearance can easily be distinguished from the bright appearance of scar tissue. However, as the adjacent LV blood pool can have similar T1 values at 10 min post-injection with almost equally bright signal, the border between scar and blood can be difficult to delineate. In particular patients with thin subendocardial scarring patterns in this border zone are susceptible to this limitation, where the apparent volume of scar tissue can be significantly reduced, or even completely obscured. Furthermore, blood pool signal can mimic scar tissue and lead to false positive observations. This makes subendocardial scar patterns difficult to detect and clearly delineate using conventional bright-blood LGE. Various novel LGE methods have been proposed, using additional magnetization preparation schemes to improve scar-to-blood contrast and thus subendocardial scar visibility. However, these methods are often not widely available and require software/scanner adjustments, extensive optimizations, and/or additional training. Following this activity, learns will understand how to perform the proposed dark-blood LGE approach without additional magnetization preparation. And taht this can be done by adjusting your standard LGE sequence as follows: Perform a Look-Locker / TI scout with a 2 heartbeat interval (if not already used); Find the inversion time where LV blood pool is nulled instead of myocardium; Set this inversion time in the LGE sequence; Enable phase-sensitive inversion-recovery (PSIR) for the LGE sequence (if not already used); and After scanning, use PSIR image for analysis

     

    Accreditation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

     

    Credit Designation Statement
    The Society for Cardiovascular Magnetic Resonance (SCMR) designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

     

    Instructions for Claiming CME

    • Attend the sessions in full for which credit is sought
    • Complete the post-activity evaluation
    • A certificate of completion will be available once the evaluation is submitted

     

    Financial Disclosures
    The planners and faculty for this activity did not have any relationships to disclose.

     

    Disclosure of Commercial Support
    SCMR received funding to support this activity from the following organizations:

     

    Bibliography
    Please see the bibliography at the end of the journal article.

    Formats Available: Streaming
    Original Course Date: October 09, 2019
    On-Demand Release Date: Available Now

    Approved Credit:
  • ACCME: 1 hour Total General Hours

  • REGISTERREGISTER Clinical value of dark-blood late gadolinium enhancement cardiovascular magnetic resonance without additional magnetization preparation.