Myocardial Solutions

The Cardiovascular Impact of COVID-19

Physicians are just beginning to understand the effects of COVID-19 on the heart. In fact, a study published in 2020 shows 78% of COVID patients had some form of cardiac involvement following recovery,[1] and 60% had ongoing myocardial inflammation.[2] The majority of patients had recovered at home, and none had prior known cardiovascular issues.[1] Moreover, 25% of recovered COVID patients experience long-lasting symptoms including chest pain, high cholesterol and high blood pressure, all of which may be symptoms of heart disease.[3] As a result, patients with past COVID diagnoses–especially those with preexisting heart conditions–may be at a higher risk of developing worsening cardiovascular complications, such as myocarditis and pericarditis.[2] This highlights the need for highly sensitive, rapid and safe diagnostics to monitor and manage the potential long-term effects of COVID-19 on the heart.

MyoStrain provides a sensitive and accurate heart health assessment for recovered COVID-19 patients.[4] Complete in under 10 minutes, MyoStrain gives clinicians novel cardiac insights to detect the early cardiac effects of COVID-19, enabling opportunities to monitor changes in heart health over time and optimize treatment for improved outcomes and quality of life.

Cardio-oncology Publications

The Role of Advanced Cardiovascular Imaging Modalities in Cardio-Oncology: From Early Detection to Unravelling Mechanisms of Cardiotoxicity

Advances in cancer therapies have led to a global improvement in patient survival rates. Nevertheless, the price to pay is a concomitant increase in cardiovascular (CV) morbidity and mortality in this population. Increased inflammation and disturbances of the immune system are shared by both cancer and CV diseases. Immunological effects of anti-cancer treatments occur with both conventional chemotherapy and, to a greater extent, with novel biological therapies such as immunotherapy. For these reasons, there is growing interest in the immune system and its potential role at the molecular level in determining cardiotoxicity. Early recognition of these detrimental effects could help in identifying patients at risk and improve their oncological management. Non-invasive imaging already plays a key role in evaluating baseline CV risk and in detecting even subclinical cardiac dysfunction during surveillance. The aim of this review is to highlight the role of advanced cardiovascular imaging techniques in the detection and management of cardiovascular complications related to cancer treatment.

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August 12, 2023

Journal of Clinical Medicine

Multiparametric Early Detection and Prediction of Cardiotoxicity Using Myocardial Strain, T1 and T2 Mapping, and Biochemical Markers: A Longitudinal Cardiac Resonance Imaging Study During 2 Years of Follow-Up

This publication features key outcome data from the PREFECT study demonstrating MyoStrain's ability to help clinicians detect and predict early cardiotoxicity in patients undergoing cancer therapy. These findings highlight MyoStrain as an accurate and sensitive assessment that may enable cardio-oncologists to implement cardio-protective strategies for cancer patients.

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Cardio-oncology

June 15, 2021

Circulation: Cardiovascular Imaging

CMR fast-SENC intramyocardial LV & RV segmental strain detects cardiotoxicity during oncology treatment and impact of cardioprotection therapy before echocardiography

This abstract utilizes MyoStrain in the early detection of cardiotoxicity for patients undergoing oncology treatment, as compared to echocardiography. The abstract also examines the effectiveness of cardio-protection, utilizing MyoStrain to monitor and manage the effects of cardioprotective therapy on patient heart function.

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Cardio-oncology

August 31, 2019

Abstract at ESC Congress 2019

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Chronic Disease Publications

Left and right ventricular strain using fast strain-encoded cardiovascular magnetic resonance for the diagnostic classification of patients with chronic non-ischemic heart failure due to dilated, hypertrophic cardiomyopathy or cardiac amyloidosis

The study compared MyoStrain’s ability to quantify and differentiate asymptomatic patients based on their cardiac risk versus traditional ejection faction, reiterating the technology's potential as a critical cardiac risk stratification tool enabling clinicians to identify at-risk patients early for individualized preventative treatment.

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Heart Failure, Chronic Diseases

April 5, 2021

Journal of Cardiovascular Magnetic Resonance

Fast strain-encoded cardiac magnetic resonance for diagnostic classification and risk stratification of heart failure patients

This article demonstrates MyoStrain's ability to identify patients with subclinical LV dysfunction and those at risk for heart failure-related outcomes compared with LVEF, providing an additional diagnostic window for prevention treatments.

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Heart Failure, Chronic Diseases

January 13, 2021

JACC Cardiovascular Imaging

Echocardiography and cardiovascular magnetic resonance based evaluation of myocardial strain and relationship with late gadolinium enhancement

This paper evaluates and compares MyoStrain's ability to detect fibrosis based on late gadolinium enhancement versus speckle tracking echocardiography.

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Chronic Diseases

August 8, 2019

Journal of Cardiovascular Magnetic Resonance

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Stress Testing Publications

Systematic Review and Meta-Analysis for the Value of Cardiac Magnetic Resonance Strain to Predict Cardiac Outcomes

Cardiac magnetic resonance (CMR) is the gold standard for the diagnostic classification and risk stratification in most patients with cardiac disorders. The aim of the present study was to investigate the ability of Strain-encoded MR (SENC) for the prediction of major adverse cardiovascular events (MACE).

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January 11, 2024

Layer-Specific Fast Strain-Encoded Cardiac Magnetic Resonance Imaging Aids in the Identification and Discrimination of Acute Myocardial Injury: A Prospective Proof-of-Concept Study

This study investigated the use of layer-specific fast strain-encoded cardiac magnetic resonance imaging (fSENC) for diagnosing and prognosticating acute myocardial injury in emergency department patients. It found that global longitudinal strain (GLS) and GLSdifference (the difference between epicardial and endocardial GLS) were effective predictors, with GLS showing a high diagnostic accuracy (AUC 91.8%) for myocardial injury. GLSdifference performed well in identifying non-ST-elevation myocardial infarction (NSTEMI) specifically (AUC 83.2%), and combining these measures with assessment of dysfunctional segments improved diagnostic performance further (AUC 87.5%). Incorporating fSENC into standard care enhanced overall diagnostic accuracy significantly (AUC 95.5%) compared to conventional methods alone. The study suggests that layer-specific strain analysis could serve as a valuable diagnostic tool for acute myocardial injuries, offering insights into prognosis and potentially guiding clinical management.

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January 1, 2024

Myocardial Inflammation and Fibrosis Are Associated With Reduced Strain in Collegiate Athletes Recovering From SARS-CoV-2

Several studies show a low (1-3%) but real risk of myocarditis in competitive athletes after SARS-CoV-2 infection.

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November 16, 2023

JACC Cardiovascular Imgaging

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Heart Failure Publications

Reduced Functional Capacity is Associated with the Proportion of Impaired Myocardial Deformation Assessed in Heart Failure Patients by CMR.

Heart failure (HF) does not only reduce the life expectancy in patients, but their life is also often limited by HF symptoms leading to a reduced quality of life (QoL) and a diminished exercise capacity. Novel parameters in cardiac imaging, including both global and regional myocardial strain imaging, promise to contribute to better patient characterization and ultimately to better patient management. However, many of these methods are not part of clinical routine yet, their associations with clinical parameters have been poorly studied. An imaging parameters that also indicate the clinical symptom burden of HF patients would make cardiac imaging more robust toward incomplete clinical information and support the clinical decision process.

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February 5, 2023

Frontiers In Cardiovascular Medicine

CMR detects decreased myocardial deformation in asymptomatic patients at risk for heart failure

A recently published article from Berlin highlights the potential of MyoStress in terms of identifying at-risk patients who have reserve and are therefore not symptomatic compared to patients with heart failure who have a preserved ejection fraction. This article shows that asymptomatic subjects with increased CV risk present with HFpEF like impaired myocardial deformation at rest, while they show results like controls under HG stress.

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Stress Testing

January 25, 2023

Frontiers in Cardiovascular Medicine

CMR Detects Decreased Myocardial Deformation in Asymptomatic Patients At Risk for Heart Failure

The main management strategy of heart failure with preserved ejection fraction (HFpEF) is prevention since HFpEF is associated with many cardiovascular (CV) risk factors, especially since HFpEF is linked to a high risk for both mortality and recurrent heart failure (HF) hospitalizations. Therefore, there is a need for new tools to identify patients with a high risk profile early. Regional strain assessment by CMR seems to be superior in describing deformation impairment in HF. The MyoHealth score is a promising tool to identify cardiac changes early.

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January 5, 2023

Frotiners In Cardiovascular Medicine

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References

[1] Walter, M. (2020). 78% of COVID-19 patients show signs of heart damage after recovery. Cardiovascular Business. https://www.cardiovascularbusiness.com/topics/covid-19/78-covid-19-patients-heart-damage-recovery. [2] Puntmann, V. O., Carerj, M. L., Wieters, I., Fahim, M., Arendt, C., Hoffmann, J., Shchendrygina, A., Escher, F., Vasa-Nicotera, M., Zeiher, A. M., Vehreschild, M., & Nagel, E. (2020). Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19). JAMA cardiology, 5(11), 1265–1273. https://doi.org/10.1001/jamacardio.2020.3557. [3] Ducharme, J (2021). Almost 25% of COVID-19 Patients Develop Long-Lasting Symptoms, According to a New Report. Time. https://time.com/6073522/long-covid-prevalence/. [4] Kelle, S., Society for Cardiovascular Magnetic Resonance (SCMR) recommended CMR protocols for scanning patients with active or convalescent phase COVID-19 infection. 22, 61 (2020). https://doi.org/10.1186/s12968-020-00656-6.et al. J Cardiovasc Magn Reson