Bastarrika, G. (Gorka)
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- Función, volúmenes y masa ventricular izquierda por resonancia magnética en estudios realizados en un modelo animal con secuencias SSFPyFLASH: comparación de los resultados(Sociedad Española de Radiología y Electrología, 2009) Bastarrika, G. (Gorka); Gavira, J.J. (Juan José); Alonso-Burgos, A. (Alberto); Abizanda-Sarasa, G. (Gloria)Objetivo: Comparar la exactitud de 2 secuencias cine eco degradiente para cuantificar función, volúmenes y masa ventricular izquierda en un modelo animal. Material y métodos: Se estudiaron 10 cerdos miniatura tipo Goettingen(7 machos,3 hembras; peso medio: 49, 8710, 65 kg; rango: 35–65 kg)en un equipo 1, 5 Tesla con secuencias recesión libre en estado estacionario(SSFP)y ecodegradiente convencionales (FLASH) en respiración libre. Se utilizaron imágenes de 8 mm de grosor obtenidas en el eje corto para cuantificar los parámetros del ventrículo izquierdo. Se calcularon la fracción de eyección (FE), volúmenes (volumen telediastólico [VTD], volumen telesistólico [VTS], volumen latido[VL]), masa ventricular y la relación señal ruido(RSR)con cada secuencia. Se estudiaron la correlación y concordancia entre las distintas secuencias para cada variable.
- Principios básicos de resonancia magnética cardiovascular (RMC): secuencias, planos de adquisición y protocolo de estudio(Gobierno de Navarra. Departamento de Salud, 2007) Bastarrika, G. (Gorka); Villanueva, A. (Alberto); Azcarate, P.M. (Pedro María); Castaño, S. (Sara); Hernandez, C. (C.); Zudaire, B. (B.)ABSTRACT Evaluation of the cardiovascular system with magnetic resonance (CMR) has become one of the most relevant and up-to-the-minute clinical applications of this diagnostic technique, as CMR makes possible an exact and reproducible study of the anatomy and function of the heart and great vessels. The complexity of this technique is mainly due to the anatomical location and orientation of the cardiovascular structures, the specific CMR sequences that have to be used and a lack of familiarity amongst radiologists regarding cardiovascular pathology. In this report the most basic principles of CMR are described. The clinical usefulness of anatomical, functional, and flow quantification sequences are discussed, conventional CMR acquisition planes are described, and an easy CMR study protocol is proposed.
- Comparison of myocardial blood flow quantification models for double ECG gating arterial spin labeling MRI: reproducibility assessment(Wiley Periodicals LLC, 2024) Solis-Barquero, S.M. (Sergio M.); Echeverría-Chasco, R. (Rebeca); Bastarrika, G. (Gorka); Aramendía-Vidaurreta, V. (Verónica); Vidorreta, M. (Marta); Fernández-Seara, M.A. (María A.); Ezponda, A. (Ana)Background: Arterial spin labeling (ASL) allows non-invasive quantification of myocardial blood flow (MBF). Double-ECG gating (DG) ASL is more robust to heart rate variability than single-ECG gating (SG), but its reproducibility requires further investigation. Moreover, the existence of multiple quantification models hinders its application. Frequency-offset-corrected-inversion (FOCI) pulses provide sharper edge profiles than hyperbolic-secant (HS), which could benefit myocardial ASL. Purpose: To assess the performance of MBF quantification models for DG compared to SG ASL, to evaluate their reproducibility and to compare the effects of HS and FOCI pulses. Study Type: Prospective. Subjects: Sixteen subjects (27 8 years). Field Strength/Sequence: 1.5 T/DG and SG flow-sensitive alternating inversion recovery ASL. Assessment: Three models for DG MBF quantification were compared using Monte Carlo simulations and in vivo experiments. Two models used a fitting approach (one using only a single label and control image pair per fit, the other using all available image pairs), while the third model used a T1 correction approach. Slice profile simulations were conducted for HS and FOCI pulses with varying B0 and B1. Temporal signal-to-noise ratio (tSNR) was computed for different acquisition/quantification strategies and inversion pulses. The number of images that minimized MBF error was investigated in the model with highest tSNR. Intra and intersession reproducibility were assessed in 10 subjects. Statistical Tests: Within-subject coefficient of variation, analysis of variance. P-value <0.05 was considered significant. Results: MBF was not different across acquisition/quantification strategies (P = 0.27) nor pulses (P = 0.9). DG MBF quantification models exhibited significantly higher tSNR and superior reproducibility, particularly for the fitting model using multiple images (tSNR was 3.46 2.18 in vivo and 3.32 1.16 in simulations, respectively; wsCV = 16%). Reducing the number of ASL pairs to 13/15 did not increase MBF error (minimum = 0.22 mL/g/min). Data Conclusion: Reproducibility of MBF was better for DG than SG acquisitions, especially when employing a fitting model. Level of Evidence: 2 Technical Efficacy: Stage 1
- Miocarditis aguda: diagnóstico mediante resonancia magnética cardiaca(Gobierno de Navarra. Departamento de Salud, 2009) Bastarrika, G. (Gorka); Gavira, J.J. (Juan José); Azcarate, P.M. (Pedro María); Castaño, S. (Sara); Arias, J. (J.); Pueyo, J. (Jesús)Cardiomyopathies are a common cause of morbidity and mortality. Myocarditis, which is included among specific cardiomyopathies, frequently presents non-specific clinical manifestations and thus may be difficult to diagnose, or even be misdiagnosed. Traditionally employed diagnostic techniques, including endomyocardial biopsy, have been shown to be of limited value. Following its overall implantation in clinical practice, cardiac magnetic resonance imaging (MRI) is nowadays widely considered to be the best non-invasive diagnostic tool available for diagnosing myocarditis
- Cardiometabolic characterization in metabolic dysfunction-associated fatty liver disease(2022) Perdomo-Zelaya, C.M. (Carolina M.); Bastarrika, G. (Gorka); Ampuero, J. (Javier); Frühbeck, G. (Gema); Ezponda, A. (Ana); Mendoza-Ferradas, F.J. (Francisco Javier); Escalada, J. (Javier); Nuñez-Cordoba, J.M. (Jorge M.)BackgroundTo better understand the patient's heterogeneity in fatty liver disease (FLD), metabolic dysfunction-associated fatty liver disease (MAFLD) was proposed by international experts as a new nomenclature for nonalcoholic fatty liver disease (NAFLD). We aimed to evaluate the cardiovascular risk, assessed through coronary artery calcium (CAC) and epicardial adipose tissue (EAT), of patients without FLD and patients with FLD and its different subtypes. MethodsCross sectional study of 370 patients. Patients with FLD were divided into 4 groups: FLD without metabolic dysfunction (non-MD FLD), MAFLD and the presence of overweight/obesity (MAFLD-OW), MAFLD and the presence of two metabolic abnormalities (MAFLD-MD) and MAFLD and the presence of T2D (MAFLD-T2D). MAFLD-OW included two subgroups: metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO). The patients without FLD were divided into 2 groups: patients without FLD and without MD (non-FLD nor MD; reference group) and patients without FLD but with MD (non-FLD with MD). EAT and CAC (measured through the Agatston Score) were determined by computed tomography. ResultsCompared with the reference group (non-FLD nor MD), regarding EAT, patients with MAFLD-T2D and MAFLD-MUHO had the highest risk for CVD (OR 15.87, 95% CI 4.26-59.12 and OR 17.60, 95% CI 6.71-46.20, respectively), patients with MAFLD-MHO were also at risk for CVD (OR 3.62, 95% CI 1.83-7.16), and patients with non-MD FLD did not have a significantly increased risk (OR 1.77; 95% CI 0.67-4.73). Regarding CAC, patients with MAFLD-T2D had an increased risk for CVD (OR 6.56, 95% CI 2.18-19.76). Patients with MAFLD-MUHO, MAFLD-MHO and non-MD FLD did not have a significantly increased risk compared with the reference group (OR 2.54, 95% CI 0.90-7.13; OR 1.84, 95% CI 0.67-5.00 and OR 2.11, 95% CI 0.46-9.74, respectively). ConclusionMAFLD-T2D and MAFLD-OW phenotypes had a significant risk for CVD. MAFLD new criteria reinforced the importance of identifying metabolic phenotypes in populations as it may help to identify patients with higher CVD risk and offer a personalized therapeutic management in a primary prevention setting.
- Safety, feasibility, and hemodynamic response of regadenoson for stress perfusion CMR(Springer, 2023) Bastarrika, G. (Gorka); Gavira, J.J. (Juan José); Ezponda, A. (Ana); Fuente, A. (Ana) de la; Caballeros, M. (Meylin); Muñiz-Sáenz-Diez, J. (Javier)Owing to its pharmacodynamics and posology, the use of regadenoson for stress cardiac magnetic resonance (CMR) has potential advantages over other vasodilators. We sought to evaluate the safety, hemodynamic response and diagnostic performance of regadenoson stress-CMR in routine clinical practice. All regadenoson stress-CMR examinations performed between May 2017 and July 2020 at our institution were retrospectively reviewed. A total of 698 studies were included for the final analysis. A conventional stress/rest protocol was performed using a 1.5T MRI scanner (Magnetom Aera, Siemens Healthineers, Erlangen, Germany). Adverse events, clinical symptoms, and hemodynamic response were assessed. Diagnostic accuracy of the test was evaluated in patients who underwent invasive coronary angiography. Nearly half of patients (48.5%) remained asymptomatic. Most common clinical symptoms included dyspnea (137, 19.6%), chest pain (116, 16.6%) and flushing (44, 6.3%). Two patients (0.28%) could not complete the examination due to severe hypotension or unbearable chest pain. Overall, an increase in heart rate (HR) response (36.2% [IQR: 22.5–50.9]) and a decrease in systolic and diastolic blood pressure (BP) (median systolic BP response of -5% [IQR: -11.5-0.6]; median diastolic BP response of -6.3 mmHg [IQR: -13.4-0]) was observed. Patients with symptoms induced by regadenoson showed higher HR response (40.3%, IQR: 26.4–56.1 vs. 32.4%, IQR: 19-45.6, p<0.001), whereas a blunted HR response was observed in diabetic (29.6%, IQR: 18.4–42 p<0.001), obese (31.7%, IQR: 20.7–46.2 p=0.005) and patients aged 70 years or older (32.9%, IQR: 22.6–43.1 p<0.001). Overall, regadenoson stress-CMR showed 95.65% (IQ 91.49–99.81) sensitivity, 54.84% (IQ 35.71–73.97) specificity, 86.99% (IQ 82.74–94.68) positive predictive value, and 77.27% (IQ 57.49–97.06) negative predictive value for detecting significant coronary stenosis as compared with invasive coronary angiography. Regadenoson is a well-tolerated vasodilator that can be safely employed for stress perfusion CMR, with high diagnostic performance
- Multiparametric renal magnetic resonance imaging: A reproducibility study in renal allografts with stable function(Wiley, 2023) Martín-Moreno, P.L. (Paloma L.); Echeverría-Chasco, R. (Rebeca); Bastarrika, G. (Gorka); Aramendía-Vidaurreta, V. (Verónica); Cano, D. (David); Vidorreta, M. (Marta); Fernández-Seara, M.A. (María A.); Garcia-Fernandez, N. (Nuria); Villanueva, A. (Arantxa)Monitoring renal allograft function after transplantation is key for the early detection of allograft impairment, which in turn can contribute to preventing the loss of the allograft. Multiparametric renal MRI (mpMRI) is a promising noninvasive technique to assess and characterize renal physiopathology; however, few studies have employed mpMRI in renal allografts with stable function (maintained function over a long time period). The purposes of the current study were to evaluate the reproducibility of mpMRI in transplant patients and to characterize normal values of the measured parameters, and to estimate the labeling efficiency of Pseudo-Continuous Arterial Spin Labeling (PCASL) in the infrarenal aorta using numerical simulations considering experimental measurements of aortic blood flow profiles. The subjects were 20 transplant patients with stable kidney function, maintained over 1 year. The MRI protocol consisted of PCASL, intravoxel incoherent motion, and T1 inversion recovery. Phase contrast was used to measure aortic blood flow. Renal blood flow (RBF), diffusion coefficient (D), pseudo-diffusion coefficient (D*), flowing fraction ( f ), and T1 maps were calculated and mean values were measured in the cortex and medulla. The labeling efficiency of PCASL was estimated from simulation of Bloch equations. Reproducibility was assessed with the within-subject coefficient of variation, intraclass correlation coefficient, and Bland-Altman analysis. Correlations were evaluated using the Pearson correlation coefficient. The significance level was p less than 0.05. Cortical reproducibility was very good for T1, D, and RBF, moderate for f , and low for D*, while medullary reproducibility was good for T1 and D. Significant correlations in the cortex between RBF and f (r = 0.66), RBF and eGFR (r = 0.64), and D* and eGFR (r = -0.57) were found. Normal values of the measured parameters employing the mpMRI protocol in kidney transplant patients with stable function were characterized and the results showed good reproducibility of the techniques.
- Long-term prognostic value of coronary CTA in orthotopic heart transplant recipients(ARRS, 2021) García-Baizán, A. (Alejandra); Bastarrika, G. (Gorka); Gavira, J.J. (Juan José); Ezponda, A. (Ana); Rabago, G. (Gregorio); Caballeros, M. (Meylin); Manrique, R. (Rebeca)OBJECTIVE. This study aimed to evaluate the long-term prognostic value of coronary CTA (CCTA) in heart transplant recipients. MATERIALS AND METHODS. The records of 114 patients who had undergone a heart transplant (mean age, 61.7 ± 11.1 [SD] years; 83.3% men) and who underwent CCTA for the surveillance of coronary allograft vasculopathy (CAV) from June 2007 to December 2017 were retrospectively evaluated for the occurrence of major adverse cardiovascular events (MACEs) (cardiac death, nonfatal myocardial infarction, unstable angina requiring hospitalization, coronary revascularization, cardiac arrhythmias, stroke, and retransplant). Patients were classified according to the presence of nonobstructive CAV (lumen reduction < 50%) or obstructive disease (lumen reduction ≥ 50%) and using a coronary segment involvement score (SIS). Differences in MACE rate between groups were compared. RESULTS. Obstructive CAV was observed in 12 heart transplant recipients (10.5%). During a mean follow-up of 67.5 ± 41.4 months the overall rates of MACE were 50% and 14.7% in patients with obstructive and nonobstructive CAV, respectively (p < .05), resulting in an odds ratio for MACE of 6 (95% CI, 1.7–21.2). Comparison of event-free survival showed a hazard ratio (HR) of 5 (95% CI, 1.95–13; p =. 004) for patients with obstructive disease. The presence of four or more stenotic coronary segments (SIS ≥ 4) was associated with a higher rate of events (HR, 3.46; 95% CI, 1.46–8.23). CONCLUSION. In patients who have undergone a heart transplant, CCTA offers a significant long-term prognostic impact on the prediction of MACEs.
- Giant left atrial thrombus 17 years after orthotopic heart transplantation(Oxford University Press, 2010) Bastarrika, G. (Gorka); Dell’Aquila, A.M. (Angelo Maria); Levy-Praschker, B.G. (Beltran G.); Rabago, G. (Gregorio)We present the case of a 66-year-old woman who underwent orthotopic heart transplantation 17 years earlier for dilated cardiomyopathy. After 7 years allograft coronary vasculopathy developed requiring coronary artery angioplasty. In year 15 postoperatively she experienced congestive heart failure and she became symptomatic requiring diuretics and digoxin treatment. In year 16 postoperatively a routine coronary computed tomography (CT) angiography study revealed a giant thrombus in the left atrium. The patient had had no thromboembolicrelated symptoms. Anticoagulation therapy was introduced and the patient has not presented any thromboembolic-related complication. As the symptoms of cardiac insufficiency worsened we decided to evaluate the patient for re-transplantation.
- Tomografía computarizada y práctica clínica(2007) Bastarrika, G. (Gorka)