Johanna Contreras

Clinical Utility of Combined FDG-PET/MR to Assess Myocardial Disease

The assessment of both the pattern and activity of myocardial injury has important implications for the clinical management of patients with cardiovascular disease. Comprehensive evaluation of these has previously been challenging using a single imaging modality. Cardiac magnetic resonance (CMR)

18F-Sodium Fluoride PET/MR for the Assessment of Cardiac Amyloidosis

Cardiac amyloidosis exists in 2 predominant forms: acquired monoclonal immunoglobulin light-chain (AL) and transthyretin-related (familial and wild-type/senile) amyloid (ATTR). Differentiation is important because they have different prognoses and are amenable to different treatment strategies.

Antithrombotic potency of ticagrelor versus clopidogrel in type-2 diabetic patients with cardiovascular disease

Type-2 Diabetes Mellitus [T2DM] is associated with increased platelet reactivity and hypo-response to antiplatelet drugs. Ticagrelor, with its faster and more potent antiplatelet effects, was shown to reduce adverse events more than clopidogrel in the overall CAD patient population of PLATO trial, but the benefits did not reach statistical significance in the T2DM subgroup. To better understand these findings, we compared the antithrombotic effects of ticagrelor versus with clopidogrel in T2DM patients with cardiovascular disease. In a randomized, 2 treatment-sequence, crossover-design, T2DM patients (n=20, 57±8 years, 60 % male) received a loading-dose [LD] plus one week of daily-therapy [DT] of clopidogrel or ticagrelor. Treatment effects were assessed by measuring thrombus formation (Badimon Chamber) and platelet aggregation (Multiple Electrode Aggregometry (MEA) Analyzer and VerifyNow®) at 2- and 6-hour post-LD and on Day-7 of DT, in comparison with pre-treatment baseline. After 2 weeks of washout, patients switched to the second treatment under identical testing conditions. Ticagrelor significantly reduced thrombus formation versus baseline at 2- and 6-hour post-LD and Day-7 of DT (33 %, 40 % and 31 %, respectively, p<0.01 for all) whereas thrombus reductions with clopidogrel were much lower and significant only at 6-hour post-LD (16 %, 20 % and 17 %, respectively). Antithrombotic effect of ticagrelor at 6-hour was significantly stronger than clopidogrel (p<0.05). Platelet aggregation (MEA and VerifyNow®) was inhibited by both treatments but effects of ticagrelor were significantly stronger at each time-point. Ticagrelor exhibits a faster and more potent antithrombotic effect than clopidogrel in T2DM patients with cardiovascular disease, supporting its use in this population.

T1 MAPPING IN PATIENTS WITH HEART FAILURE WITH PRESERVED EJECTION FRACTION DETECTS INCREASED INTERSTITIAL MYOCARDIAL FIBROSIS AND ASSESSES THE SEVERITY OF HEART FAILURE

Introduction: The mechanism causing heart failure with preserved ejection fraction (HFPEF) is not clear, but interstitial myocardial fibrosis (IMF) has been proposed to have a causal role. T1 mapping is able to quantify IMF non-invasively. The aim of our study was to assess IMF in HFPEF patients

ANTITHROMBOTIC EFFECTS OF TICAGRELOR VERSUS CLOPIDOGREL LOADING DOSE IN DIABETIC PATIENTS

Diabetic patients have higher platelet reactivity and reduced sensitivity to clopidogrel. Ticagrelor, with its faster and more potent antiplatelet effects, lowers adverse events more than clopidogrel in CAD patients, but its effectiveness in diabetic population did not show significant improvement