oxygenation-sensitive-cardiac-mri-with-vasoactive-breathing-maneuvers

Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction

Oxygenation-sensitive cardiac magnetic resonance imaging (OS-CMR) is a diagnostic technique that uses the inherent paramagnetic properties of ...

McGill University

University of Alberta

An increase of heart rate to physical or mental stress reflects the ability of the autonomous nervous system and the heart to respond adequately. Hyperventilation is a user-controlled breathing maneuver that has a significant impact on coronary function and hemodynamics. Thus, we aimed to investigate if the heart rate response to hyperventilation (HRR) can provide clinically useful information. A pooled analysis of the HRR after 60 s of hyperventilation was conducted in 282 participants including healthy controls; patients with heart failure (HF); coronary artery disease (CAD); a combination of both; or patients suspected of CAD but with a normal angiogram. Hyperventilation significantly increased heart rate in all groups, although healthy controls aged 55 years and older (15 ± 9 bpm) had a larger HRR than each of the disease groups (HF: 6 ± 6, CAD: 8 ± 8, CAD+/HF+: 6 ± 4, and CAD-/HF-: 8 ± 6 bpm, p < 0.001). No significant differences were found between disease groups. The HRR may serve as an easily measurable additional marker of cardiovascular health. Future studies should test its diagnostic potential as a simple, inexpensive pre-screening test to improve patient selection for other diagnostic exams.

Hyperventilation-induced heart rate response as a potential marker for cardiovascular disease.

Radiology has been identified as one of the medical specialties with the least gender, racial, and ethnic diversity. Despite the demonstrated benefits of gender and race diversity in medicine and industry, including innovation, empathy and improved patient outcomes, diversity in radiology in Canada is still lacking. In 2019, women represented around 63% of current medical graduates. However, within Canadian radiology practices, only 31.6% of radiologists are women. Women are also underrepresented in academic positions and the widening gender gap is present at higher academic ranks, indicating that women may not advance through academic hierarchies at the same pace as men. Although data on racial diversity in Canadian radiology practices is currently lacking, the representation of visible minorities in the general Canadian population is not reflected across Canadian radiology practices. Similarly, despite the Canadian Truth and Reconciliation Commission calling for action to increase the number of Indigenous healthcare workers, Indigenous people remain underrepresented in medicine and radiology. The importance of increasing diversity in radiology has gained recognition in recent years. Many solutions and strategies for national associations and radiology departments to improve diversity have been proposed. Leadership commitment is required to implement these programs to increase diversity in radiology in Canada with the ultimate goal of improving patient care. We review the current literature and available data on diversity within radiology in Canada, including the status of gender, race/ethnicity, and Indigenous people. We also present potential solutions to increase diversity.

The Status of Diversity in Canadian Radiology-Where We Stand and What Can We Do About It.

Regional Heterogeneity in the Coronary Vascular Response in Women With Chest Pain and Nonobstructive Coronary Artery Disease.

Cardiac magnetic resonance imaging (CMR) use in the context of heart failure (HF) has increased over the last decade as it is able to provide detailed, quantitative information on function, morphology, and myocardial tissue composition. Furthermore, oxygenation-sensitive CMR (OS-CMR) has emerged as a CMR imaging method capable of monitoring changes of myocardial oxygenation without the use of exogenous contrast agents.

Article	Year
Hyperventilation-induced heart rate response as a potential marker for cardiovascular disease. Scientific reports\| PubMed ID: 31784617	2019
The Status of Diversity in Canadian Radiology-Where We Stand and What Can We Do About It. Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes\| PubMed ID: 33353386	2021
Regional Heterogeneity in the Coronary Vascular Response in Women With Chest Pain and Nonobstructive Coronary Artery Disease. Circulation\| PubMed ID: 33587662	2021
The Potential of Oxygenation-Sensitive CMR in Heart Failure. Current heart failure reports\| PubMed ID: 34378154	2021

Elizabeth Hillier

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