Objective To evaluate the diagnostic value of cardiac magnetic resonance (MR) for acute heart failure (AHF) with unknown cause. Methods A retrospective study was conducted, eleven patients with AHF with unknown cause admitted to Tianjin First Center Hospital from September 2017 to August 2018 were enrolled, and all the patients underwent complete cardiac MR imaging (plain MR and delayed enhancement imaging) with satisfactory image quality fulfilled the diagnostic requirement. Additionally, all of them had no history of heart disease and lack of diagnostic laboratory tests (routine blood test, blood biochemistry and myocardial enzyme), electrocardiogram (ECG) changes and echocardiography abnormality. Besides, 10 patients had completed invasive coronary angiography or coronary CT angiography (CCTA); the results of laboratory tests, ECG abnormality, echocardiography and cardiac MR were recorded, and the values of echocardiography and cardiac MR examination in the diagnosis and exploring the cause of patients with AHF with unknown cause were analyzed. Results Nine of 11 patients with AHF with unknown cause had positive finding on cardiac MR examination; there were 3 patients with chronic myocardial infarction, 3 with dilated cardiomyopathy, 2 with cardiac involvement of amyloidosis and 1 with myocarditis. The left ventricular end systolic volume (LVESV) measured on cardial MR was significantly higher than that on echocardiography (mL: 120.68±57.47 vs. 108.84±50.49, P < 0.05), the left ventricular ejection fraction (LVEF) and myocardial valvular regurgitation measured on MR were less than those on echocardiography (LVEF: 0.36±0.09 vs. 0.43±0.10; regurgitation: 11 vs. 22, both P < 0.05); while, the differences of the end diastolic volume (LVEDV) and the number of patients with pericardial effusions between MR and echocardiography had no statistical significant differences [LVEDV (mL): 183.37±65.26 vs. 182.26±70.44; pericardial effusion: 6 cases vs. 6 cases, all P > 0.05]. Conclusion Cardiac MR could synthetically evaluate the heart by its morphology, function as well as accompanied sign (pericardial effusion) and cardiac tissue characteristics; eventually, it may provide valuable information concerning the selection of proper clinical therapeutic strategies and improvement of AHF patients' prognose.

Objective: To understand the pathogenic spectrum characteristics of enteroviruses of non-enterovirus (EV) 71 and non-coxsackievirus (CV) A16 associated with hand, foot and mouth disease (HFMD) in Xinjiang. Methods: Specimens were collected from HFMD patients infected with non-EV-A71 non-CV-A16 enterovirus from 2011 to 2016 in Xinjiang. The virion protein (VP)1 gene sequence was amplified by reverse transcription polymerase chain reaction (RT-PCR) and sequenced. Sequencing and genotyping were performed through erterovirus genotyping tool. Results: A total of 119 sequences were obtained, 15 human enterovirus serotypes were identified including CV-A6, CV-A10, CV-A4, CV-A8, CV-B1, CV-B3 (4 strains), CV-B4, CV-B5, ECHO30, ECHO12, ECHO14, CV-A9, CV-A24, PV1 and PV3. The composition ratio of CV-A6 among non-EV-A71 non-CV-A16 enterovirus in 2013, 2015 and 2016 was 87.9%, 79.5% and 88.3% respectively. Conclusions The pathogens causing HFMD in Xinjiang included more than 17 kinds of human enterovirus serotypes. Since 2013, CV-A6 has become the main pathogen of HFMD simultaneously or alternately with EV-A71 and CV-A16.