Dr Valentina Puntmann |
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Dr Valentina Puntmann is Deputy Head of Department and senior clinical investigator with subspecialty interest in mutimodality cardiovascular imaging and conduct of clinical trials using imaging biomarkers. Her research projects focus on the development of novel imaging biomarkers for the detection of cardiovascular injury, supporting risk stratification, prevention and therapy. She is chief investigator of the International T1 Multicentre CMR Study on validation, standardization and translation of T1 mapping imaging for clinical use. She has authored over 50 papers and over 100 conference presentations. She has been lecturing on cardiovascular imaging and translational medicine on undergraduate and postgraduate levels, and has trained >30 fellows to SCMR level II or above.
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T1 mapping - a biomarker of diffuse myocardial disease T1 mapping by CMR is emerging as a quantifiable biomarker supporting the non-invasive characterisation of diffuse myocardial disease, which underscores the underlying pathophysiology of non-ischaemic cardiomyopathies. We undertook the International T1 Multicentre CMR Study, focusing on validation, standardization and translation of T1 mapping imaging for clinical use.
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Myocarditis and inflammatory cardiomyopathiesMyocarditis is a major cause of cardiac morbidity and mortality and a condition with spectrum of challenges from establishing the diagnosis to effective treatment. Endomyo-cardial biopsy remains the diagnostic gold standard, despite its invasiveness, low diagnostic yield and a paucity of consequential management path-ways. CMR based on Lake Louise criteria partially provides a non-invasive diagnostic alternative allowing confirmation, but not exclusion of disease. T1 mapping now allows a high diagnostic accuracy in confirmation and exclusion of disease, staging and activity of disease.
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Proof of concept drug studies (Phase II)Recent scientific advances have considerably improved our insight into the mecha-nisms and potential thera-peutic targets in myocarditis and inflammatory cardio-myopathies. Cardiac magnetic resonance based on T1 mapping and late gadolinium enhancement may support a modern diagnostic pathway identifying patients that might benefit from anti-inflammatory intervention.
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Key publications
1. Nagel E, Greenwood JP, McCann GP, Bettencourt N, Shah AM, Hussain ST, Perera D, Plein S, Bucciarelli-Ducci C, Paul M, Westwood MA, Marber M, Richter WS, Puntmann VO, Schwenke C, Schulz-Menger J, Das R, Wong J, Hausenloy DJ, Steen H, Berry C; MR-INFORM Investigators. Magnetic Resonance Perfusion or Fractional Flow Reserve in Coronary Disease. N Engl J Med. 2019 Jun 20;380(25):2418-2428.
2.. Winau L, Hinojar Baydes R, Braner A, Drott U, Burkhardt H, Sangle S, D'Cruz DP, Carr-White G, Marber M, Schnoes K, Arendt C, Klingel K, Vogl TJ, Zeiher AM, Nagel E, Puntmann VO. High-sensitive troponin is associated with subclinical imaging biosignature of inflammatory cardiovascular involvement in systemic lupus erythematosus. Ann Rheum Dis. 2018 Nov;77(11):1590-1598.
3. Puntmann VO, Carr-White G, Jabbour A, Yu CY, Gebker R, Kelle S, Rolf A, Zitzmann S, Peker E, D'Angelo T, Pathan F, Elen, Valbuena S, Hinojar R, Arendt C, Narula J, Herrmann E, Zeiher AM, Nagel E; International T1 Multicentre CMR Outcome Study. Native T1 and ECV of Noninfarcted Myocardium and Outcome in Patients With Coronary Artery Disease. J Am Coll Cardiol. 2018 Feb 20;71(7):766-778.
4. Puntmann VO, Valbuena S, Hinojar R, Petersen SE, Greenwood JP, Kramer CM, Kwong RY, McCann GP, Berry C, Nagel E; SCMR Clinical Trial Writing Group. Society for Cardiovascular Magnetic Resonance (SCMR) expert consensus for CMR imaging endpoints in clinical research: part I - analytical validation and clinical qualification. J Cardiovasc Magn Reson. 2018 Sep 20;20(1):67.
5. Puntmann VO, Carr-White G, Jabbour A, Yu CY, Gebker R; Kelle S, Hinojar R, Doltra A, Varma N ,Child N; Rogers T; Arroyo Ucar E, Goodman B, Suna G; Khan S; Dabir D, Herrmann E, Zeiher AM, Nagel E. T1-mapping and outcome in nonischaemic cardiomyopathy: all-cause mortality and heart failure. JACC Cardiovascular Imaging 2016;9(1):40-50.
6. Hinojar R, Varma N, Child N, Goodman B, Jabbour A, Yu CY, Gebker R, Doltra A, Kelle S, Khan S, Rogers T, Arroyo Ucar E, Cummins C, Carr-White G, Nagel E, Puntmann VO. T1 Mapping in Discrimination of Hypertrophic Phenotypes: Hypertensive Heart Disease and Hypertrophic Cardiomyopathy: Findings From the International T1 Multicenter Cardiovascular Magnetic Resonance Study. Circ Cardiovasc Imaging. 2015 Dec;8(12).
7. Hinojar R, Foote L, Arroyo Ucar E, Jackson T, Jabbour A, Yu CY, McCrohon J, Higgins DM, Carr-White G, Mayr M, Nagel E, Puntmann VO. Native T1 in discrimination of acute and convalescent stages in patients with clinical diagnosis of myocarditis: a proposed diagnostic algorithm using CMR. JACC Cardiovasc Imaging. 2015;8(1):37-46.
8. Varma N, Hinojar R, D'Cruz D, Arroyo Ucar E, Indermuehle A, Peel S, Greil G, Gaddum N, Chowienczyk P, Nagel E, Botnar RM, Puntmann VO.Coronary vessel wall contrast enhancement imaging as a potential direct marker of coronary involvement: integration of findings from CAD and SLE patients. JACC Cardiovasc Imaging. 2014 Aug;7(8):762-70
9. Puntmann VO, D'Cruz D, Smith Z, Pastor A, Choong P, Voigt T, Carr-White G, Sangle S, Schaeffter T, Nagel E. Native myocardial T1 mapping by cardiovascular magnetic resonance imaging in subclinical cardiomyopathy in patients with systemic lupus erythematosus. Circ Cardiovasc Imaging. 2013;6(2):295-301.
10. Puntmann VO, Voigt T, Chen Z, Mayr M, Karim R, Rhode K, Pastor A, Carr-White G, Razavi R, Schaeffter T, Nagel E. Native T1 mapping in differentiation of normal myocardium from diffuse disease in hypertrophic and dilated cardiomyopathy. JACC Cardiovasc Imaging. 2013;6(4):475-84.
2.. Winau L, Hinojar Baydes R, Braner A, Drott U, Burkhardt H, Sangle S, D'Cruz DP, Carr-White G, Marber M, Schnoes K, Arendt C, Klingel K, Vogl TJ, Zeiher AM, Nagel E, Puntmann VO. High-sensitive troponin is associated with subclinical imaging biosignature of inflammatory cardiovascular involvement in systemic lupus erythematosus. Ann Rheum Dis. 2018 Nov;77(11):1590-1598.
3. Puntmann VO, Carr-White G, Jabbour A, Yu CY, Gebker R, Kelle S, Rolf A, Zitzmann S, Peker E, D'Angelo T, Pathan F, Elen, Valbuena S, Hinojar R, Arendt C, Narula J, Herrmann E, Zeiher AM, Nagel E; International T1 Multicentre CMR Outcome Study. Native T1 and ECV of Noninfarcted Myocardium and Outcome in Patients With Coronary Artery Disease. J Am Coll Cardiol. 2018 Feb 20;71(7):766-778.
4. Puntmann VO, Valbuena S, Hinojar R, Petersen SE, Greenwood JP, Kramer CM, Kwong RY, McCann GP, Berry C, Nagel E; SCMR Clinical Trial Writing Group. Society for Cardiovascular Magnetic Resonance (SCMR) expert consensus for CMR imaging endpoints in clinical research: part I - analytical validation and clinical qualification. J Cardiovasc Magn Reson. 2018 Sep 20;20(1):67.
5. Puntmann VO, Carr-White G, Jabbour A, Yu CY, Gebker R; Kelle S, Hinojar R, Doltra A, Varma N ,Child N; Rogers T; Arroyo Ucar E, Goodman B, Suna G; Khan S; Dabir D, Herrmann E, Zeiher AM, Nagel E. T1-mapping and outcome in nonischaemic cardiomyopathy: all-cause mortality and heart failure. JACC Cardiovascular Imaging 2016;9(1):40-50.
6. Hinojar R, Varma N, Child N, Goodman B, Jabbour A, Yu CY, Gebker R, Doltra A, Kelle S, Khan S, Rogers T, Arroyo Ucar E, Cummins C, Carr-White G, Nagel E, Puntmann VO. T1 Mapping in Discrimination of Hypertrophic Phenotypes: Hypertensive Heart Disease and Hypertrophic Cardiomyopathy: Findings From the International T1 Multicenter Cardiovascular Magnetic Resonance Study. Circ Cardiovasc Imaging. 2015 Dec;8(12).
7. Hinojar R, Foote L, Arroyo Ucar E, Jackson T, Jabbour A, Yu CY, McCrohon J, Higgins DM, Carr-White G, Mayr M, Nagel E, Puntmann VO. Native T1 in discrimination of acute and convalescent stages in patients with clinical diagnosis of myocarditis: a proposed diagnostic algorithm using CMR. JACC Cardiovasc Imaging. 2015;8(1):37-46.
8. Varma N, Hinojar R, D'Cruz D, Arroyo Ucar E, Indermuehle A, Peel S, Greil G, Gaddum N, Chowienczyk P, Nagel E, Botnar RM, Puntmann VO.Coronary vessel wall contrast enhancement imaging as a potential direct marker of coronary involvement: integration of findings from CAD and SLE patients. JACC Cardiovasc Imaging. 2014 Aug;7(8):762-70
9. Puntmann VO, D'Cruz D, Smith Z, Pastor A, Choong P, Voigt T, Carr-White G, Sangle S, Schaeffter T, Nagel E. Native myocardial T1 mapping by cardiovascular magnetic resonance imaging in subclinical cardiomyopathy in patients with systemic lupus erythematosus. Circ Cardiovasc Imaging. 2013;6(2):295-301.
10. Puntmann VO, Voigt T, Chen Z, Mayr M, Karim R, Rhode K, Pastor A, Carr-White G, Razavi R, Schaeffter T, Nagel E. Native T1 mapping in differentiation of normal myocardium from diffuse disease in hypertrophic and dilated cardiomyopathy. JACC Cardiovasc Imaging. 2013;6(4):475-84.
Patent of Invention
A method for differentiation of normal myocardium from diffuse disease using T1-mapping in nonischemic cardiomyopathies and others (based on PR-MS 33.297, PR-MS 33.837, PR-MS 33.654).
