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Quantitative plaque assessment by coronary computed tomography angiography: An up-to-date review. IMAGING 2021. [DOI: 10.1556/1647.2021.00033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
Coronary computed tomography angiography has an emerging role in the diagnostic workup of coronary artery disease. Due to its high sensitivity and negative predictive value, coronary computed tomography angiography can rule out obstructive coronary artery diseases and substitute invasive coronary angiography in many cases. In addition, coronary computed tomography angiography provides a unique information beyond stenosis grading as it can visualize atherosclerosis and quantify its extent. Qualitative and quantitative plaque assessment provides an incremental value in the prediction of future major adverse cardiac events. Moreover, determining adverse plaque features has a potential to identify advanced atherosclerosis and patients at increased risk of acute coronary syndrome. Nevertheless, challenges may emerge with the process of quantifying coronary plaques due to limited reproducibility, lack of automated, standardized and validated techniques. Therefore, reliable quantified data are scarce due to the various computed tomography scanners and software platforms and investigations with small sample sizes. Radiomics and machine learning-based image processing methods are relatively new in the field of cardiovascular plaque imaging. These techniques hold the promise to improve diagnostic performance, reproducibility and prognostic value of computed tomography based plaque assessment.
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Pereira T, Betriu A, Alves R. Non-invasive imaging techniques and assessment of carotid vasa vasorum neovascularization: Promises and pitfalls. Trends Cardiovasc Med 2018; 29:71-80. [PMID: 29970286 DOI: 10.1016/j.tcm.2018.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/12/2018] [Accepted: 06/14/2018] [Indexed: 12/17/2022]
Abstract
Carotid adventitia vasa vasorum neovascularization (VVn) is associated with the initial stages of arteriosclerosis and with the formation of unstable plaque. However, techniques to accurately quantify that neovascularization in a standard, fast, non-invasive, and efficient way are still lacking. The development of such techniques holds the promise of enabling wide, inexpensive, and safe screening programs that could stratify patients and help in personalized preventive cardiovascular medicine. In this paper, we review the recent scientific literature pertaining to imaging techniques that could set the stage for the development of standard methods for quantitative assessment of atherosclerotic plaque and carotid VVn. We present and discuss the alternative imaging techniques being used in clinical practice and we review the computational developments that are contributing to speed up image analysis and interpretation. We conclude that one of the greatest upcoming challenges will be the use of machine learning techniques to develop automated methods that assist in the interpretation of images to stratify patients according to their risk.
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Affiliation(s)
- T Pereira
- Institute for Biomedical Research in Lleida Dr. Pifarré Foundation, Catalonia, Spain; Departament de Ciències Mèdiques Bàsiques, University of Lleida, Catalonia, Spain.
| | - A Betriu
- Unit for the Detection and Treatment of Atherothrombotic Diseases, Hospital Universitari Arnau de Vilanova de Lleida, Catalonia, Spain; Vascular and Renal Translational Research Group - IRBLleida, Catalonia, Spain
| | - R Alves
- Institute for Biomedical Research in Lleida Dr. Pifarré Foundation, Catalonia, Spain; Departament de Ciències Mèdiques Bàsiques, University of Lleida, Catalonia, Spain
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Baggish AL, Weiner RB, Kanayama G, Hudson JI, Lu MT, Hoffmann U, Pope HG. Cardiovascular Toxicity of Illicit Anabolic-Androgenic Steroid Use. Circulation 2017; 135:1991-2002. [PMID: 28533317 DOI: 10.1161/circulationaha.116.026945] [Citation(s) in RCA: 180] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 03/13/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Millions of individuals have used illicit anabolic-androgenic steroids (AAS), but the long-term cardiovascular associations of these drugs remain incompletely understood. METHODS Using a cross-sectional cohort design, we recruited 140 experienced male weightlifters 34 to 54 years of age, comprising 86 men reporting ≥2 years of cumulative lifetime AAS use and 54 nonusing men. Using transthoracic echocardiography and coronary computed tomography angiography, we assessed 3 primary outcome measures: left ventricular (LV) systolic function (left ventricular ejection fraction), LV diastolic function (early relaxation velocity), and coronary atherosclerosis (coronary artery plaque volume). RESULTS Compared with nonusers, AAS users demonstrated relatively reduced LV systolic function (mean±SD left ventricular ejection fraction = 52±11% versus 63±8%; P<0.001) and diastolic function (early relaxation velocity = 9.3±2.4 cm/second versus 11.1±2.0 cm/second; P<0.001). Users currently taking AAS at the time of evaluation (N=58) showed significantly reduced LV systolic (left ventricular ejection fraction = 49±10% versus 58±10%; P<0.001) and diastolic function (early relaxation velocity = 8.9±2.4 cm/second versus 10.1±2.4 cm/second; P=0.035) compared with users currently off-drug (N=28). In addition, AAS users demonstrated higher coronary artery plaque volume than nonusers (median [interquartile range] 3 [0, 174] mL3 versus 0 [0, 69] mL3; P=0.012). Lifetime AAS dose was strongly associated with coronary atherosclerotic burden (increase [95% confidence interval] in rank of plaque volume for each 10-year increase in cumulative duration of AAS use: 0.60 SD units [0.16-1.03 SD units]; P=0.008). CONCLUSIONS Long-term AAS use appears to be associated with myocardial dysfunction and accelerated coronary atherosclerosis. These forms of AAS-associated adverse cardiovascular phenotypes may represent a previously underrecognized public-health problem.
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Affiliation(s)
- Aaron L Baggish
- From Cardiovascular Performance Program, Division of Cardiology, Massachusetts General Hospital, Boston (A.L.B., R.B.W.); Department of Medicine, Harvard Medical School, Boston, MA (A.L.B., R.B.W.); Biological Psychiatry Laboratory and Psychiatric Epidemiology Research Program, McLean Hospital, Belmont, MA (G.K., J.I.H., H.G.P.); Department of Psychiatry, Harvard Medical School, Boston, MA (G.K., J.I.H., H.G.P.); Cardiac MR PET CT Program, Massachusetts General Hospital and Department of Radiology, Harvard Medical School, Boston (M.T.L., U.H.).
| | - Rory B Weiner
- From Cardiovascular Performance Program, Division of Cardiology, Massachusetts General Hospital, Boston (A.L.B., R.B.W.); Department of Medicine, Harvard Medical School, Boston, MA (A.L.B., R.B.W.); Biological Psychiatry Laboratory and Psychiatric Epidemiology Research Program, McLean Hospital, Belmont, MA (G.K., J.I.H., H.G.P.); Department of Psychiatry, Harvard Medical School, Boston, MA (G.K., J.I.H., H.G.P.); Cardiac MR PET CT Program, Massachusetts General Hospital and Department of Radiology, Harvard Medical School, Boston (M.T.L., U.H.)
| | - Gen Kanayama
- From Cardiovascular Performance Program, Division of Cardiology, Massachusetts General Hospital, Boston (A.L.B., R.B.W.); Department of Medicine, Harvard Medical School, Boston, MA (A.L.B., R.B.W.); Biological Psychiatry Laboratory and Psychiatric Epidemiology Research Program, McLean Hospital, Belmont, MA (G.K., J.I.H., H.G.P.); Department of Psychiatry, Harvard Medical School, Boston, MA (G.K., J.I.H., H.G.P.); Cardiac MR PET CT Program, Massachusetts General Hospital and Department of Radiology, Harvard Medical School, Boston (M.T.L., U.H.)
| | - James I Hudson
- From Cardiovascular Performance Program, Division of Cardiology, Massachusetts General Hospital, Boston (A.L.B., R.B.W.); Department of Medicine, Harvard Medical School, Boston, MA (A.L.B., R.B.W.); Biological Psychiatry Laboratory and Psychiatric Epidemiology Research Program, McLean Hospital, Belmont, MA (G.K., J.I.H., H.G.P.); Department of Psychiatry, Harvard Medical School, Boston, MA (G.K., J.I.H., H.G.P.); Cardiac MR PET CT Program, Massachusetts General Hospital and Department of Radiology, Harvard Medical School, Boston (M.T.L., U.H.)
| | - Michael T Lu
- From Cardiovascular Performance Program, Division of Cardiology, Massachusetts General Hospital, Boston (A.L.B., R.B.W.); Department of Medicine, Harvard Medical School, Boston, MA (A.L.B., R.B.W.); Biological Psychiatry Laboratory and Psychiatric Epidemiology Research Program, McLean Hospital, Belmont, MA (G.K., J.I.H., H.G.P.); Department of Psychiatry, Harvard Medical School, Boston, MA (G.K., J.I.H., H.G.P.); Cardiac MR PET CT Program, Massachusetts General Hospital and Department of Radiology, Harvard Medical School, Boston (M.T.L., U.H.)
| | - Udo Hoffmann
- From Cardiovascular Performance Program, Division of Cardiology, Massachusetts General Hospital, Boston (A.L.B., R.B.W.); Department of Medicine, Harvard Medical School, Boston, MA (A.L.B., R.B.W.); Biological Psychiatry Laboratory and Psychiatric Epidemiology Research Program, McLean Hospital, Belmont, MA (G.K., J.I.H., H.G.P.); Department of Psychiatry, Harvard Medical School, Boston, MA (G.K., J.I.H., H.G.P.); Cardiac MR PET CT Program, Massachusetts General Hospital and Department of Radiology, Harvard Medical School, Boston (M.T.L., U.H.)
| | - Harrison G Pope
- From Cardiovascular Performance Program, Division of Cardiology, Massachusetts General Hospital, Boston (A.L.B., R.B.W.); Department of Medicine, Harvard Medical School, Boston, MA (A.L.B., R.B.W.); Biological Psychiatry Laboratory and Psychiatric Epidemiology Research Program, McLean Hospital, Belmont, MA (G.K., J.I.H., H.G.P.); Department of Psychiatry, Harvard Medical School, Boston, MA (G.K., J.I.H., H.G.P.); Cardiac MR PET CT Program, Massachusetts General Hospital and Department of Radiology, Harvard Medical School, Boston (M.T.L., U.H.).
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Maurovich-Horvat P, Tárnoki DL, Tárnoki ÁD, Horváth T, Jermendy ÁL, Kolossváry M, Szilveszter B, Voros V, Kovács A, Molnár AÁ, Littvay L, Lamb HJ, Voros S, Jermendy G, Merkely B. Rationale, Design, and Methodological Aspects of the BUDAPEST-GLOBAL Study (Burden of Atherosclerotic Plaques Study in Twins-Genetic Loci and the Burden of Atherosclerotic Lesions). Clin Cardiol 2015; 38:699-707. [PMID: 26492817 DOI: 10.1002/clc.22482] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 09/11/2015] [Indexed: 12/18/2022] Open
Abstract
The heritability of coronary atherosclerotic plaque burden, coronary geometry, and phenotypes associated with increased cardiometabolic risk are largely unknown. The primary aim of the Burden of Atherosclerotic Plaques Study in Twins-Genetic Loci and the Burden of Atherosclerotic Lesions (BUDAPEST-GLOBAL) study is to evaluate the influence of genetic and environmental factors on the burden of coronary artery disease. By design this is a prospective, single-center, classical twin study. In total, 202 twins (61 monozygotic pairs, 40 dizygotic same-sex pairs) were enrolled from the Hungarian Twin Registry database. All twins underwent non-contrast-enhanced computed tomography (CT) for the detection and quantification of coronary artery calcium and for the measurement of epicardial fat volumes. In addition, a single non-contrast-enhanced image slice was acquired at the level of L3-L4 to assess abdominal fat distribution. Coronary CT angiography was used for the detection and quantification of plaque, stenosis, and overall coronary artery disease burden. For the primary analysis, we will assess the presence and volume of atherosclerotic plaques. Furthermore, the 3-dimensional coronary geometry will be assessed based on the coronary CT angiography datasets. Additional phenotypic analyses will include per-patient epicardial and abdominal fat quantity measurements. Measurements obtained from monozygotic and dizygotic twin pairs will be compared to evaluate the genetic or environmental effects of the given phenotype. The BUDAPEST-GLOBAL study provides a unique framework to shed some light on the genetic and environmental influences of cardiometabolic disorders.
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Affiliation(s)
- Pál Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Dávid L Tárnoki
- Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary
| | - Ádám D Tárnoki
- Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary
| | - Tamás Horváth
- Department of Hydrodynamic Systems, Budapest University of Technology and Economics, Budapest, Hungary
| | - Ádám L Jermendy
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Márton Kolossváry
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Bálint Szilveszter
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Viktor Voros
- Scientific Affairs, Global Institute for Research, LLC, Richmond, Virginia
| | - Attila Kovács
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Andrea Á Molnár
- Department of Cardiology, Military Hospital, Budapest, Hungary
| | - Levente Littvay
- Department of Political Science, Central European University, Budapest, Hungary
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Szilard Voros
- Scientific Affairs, Global Institute for Research, LLC, Richmond, Virginia
| | - György Jermendy
- Department of Internal Medicine, Bajcsy-Zsilinszky Hospital, Budapest, Hungary
| | - Béla Merkely
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
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Psaltis PJ, Talman AH, Munnur K, Cameron JD, Ko BSH, Meredith IT, Seneviratne SK, Wong DTL. Relationship between epicardial fat and quantitative coronary artery plaque progression: insights from computer tomography coronary angiography. Int J Cardiovasc Imaging 2015; 32:317-328. [PMID: 26335371 DOI: 10.1007/s10554-015-0762-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 08/31/2015] [Indexed: 12/12/2022]
Abstract
Epicardial fat volume (EFV) has been suggested to promote atherosclerotic plaque development in coronary arteries, and has been correlated with both coronary stenosis and acute coronary events. Although associated with progression of coronary calcification burden, a relationship with progression of coronary atheroma volume has not been previously tested. We studied patients who had clinically indicated serial 320-row multi-detector computer tomography coronary angiography with a median 25-month interval. EFV was measured at baseline and follow-up. In vessels with coronary stenosis, quantitative analysis was performed to measure atherosclerotic plaque burden, volume and aggregate plaque volume at baseline and follow-up. The study comprised 64 patients (58.4 ± 12.2 years, 27 males, 192 vessels, 193 coronary segments). 79 (41 %) coronary segments had stenosis at baseline. Stenotic segments were associated with greater baseline EFV than those without coronary stenosis (117.4 ± 45.1 vs. 102.3 ± 51.6 cm(3), P = 0.046). 46 (24 %) coronary segments displayed either new plaque formation or progression of adjusted plaque burden at follow-up. These were associated with higher baseline EFV than segments without stenosis or those segments that had stenoses that did not progress (128.7 vs. 101.0 vs. 106.7 cm(3) respectively, P = 0.006). On multivariate analysis, baseline EFV was the only independent predictor of coronary atherosclerotic plaque progression or new development (P = 0.014). High baseline EFV is associated with the presence of coronary artery stenosis and plaque volume progression. Accumulation of EFV may be implicated in the evolution and progression of coronary atheroma.
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Affiliation(s)
- Peter J Psaltis
- Monash Heart, Monash Cardiovascular Research Centre, Monash University, Clayton, VIC, Australia.,Department of Medicine, University of Adelaide and Heart Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - Andrew H Talman
- Monash Heart, Monash Cardiovascular Research Centre, Monash University, Clayton, VIC, Australia
| | - Kiran Munnur
- Monash Heart, Monash Cardiovascular Research Centre, Monash University, Clayton, VIC, Australia
| | - James D Cameron
- Monash Heart, Monash Cardiovascular Research Centre, Monash University, Clayton, VIC, Australia
| | - Brian S H Ko
- Monash Heart, Monash Cardiovascular Research Centre, Monash University, Clayton, VIC, Australia
| | - Ian T Meredith
- Monash Heart, Monash Cardiovascular Research Centre, Monash University, Clayton, VIC, Australia
| | - Sujith K Seneviratne
- Monash Heart, Monash Cardiovascular Research Centre, Monash University, Clayton, VIC, Australia
| | - Dennis T L Wong
- Monash Heart, Monash Cardiovascular Research Centre, Monash University, Clayton, VIC, Australia. .,Department of Medicine, University of Adelaide and Heart Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia.
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Different Plaque Composition and Progression in Patients with Stable and Unstable Coronary Syndromes Evaluated by Cardiac CT. BIOMED RESEARCH INTERNATIONAL 2015; 2015:401357. [PMID: 26339610 PMCID: PMC4538323 DOI: 10.1155/2015/401357] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 07/07/2015] [Indexed: 11/18/2022]
Abstract
Objective. To compare the quantity, subtype, and progression of atherosclerosis by cardiac computed tomography (CT) and intravascular ultrasound (IVUS) in patients with stable (SAP) and unstable angina pectoris or non-ST-elevation myocardial infarction (UAP/n-STEMI). Methods. Forty patients with SAP and 20 with UAP/n-STEMI underwent cardiac CT and angiography with IVUS at baseline and after one year. Atherosclerotic segments were divided into calcified, mixed, or noncalcified subtypes, and significant stenoses were registered. Results. Thirty-two SAP and 15 UAP/n-STEMI patients completed the CT follow-up. At baseline, the number of atherosclerotic segments was higher in UAP/n-STEMI than in SAP (P = 0.039). UAP/n-STEMI patients had more segments with noncalcified plaques (P = 0.0005) whereas SAP patients had more segments with calcified plaques (P = 0.013). The number of segments with significant stenosis did not differ between the groups, but noncalcified plaques more frequently caused significant stenoses in UAP/n-STEMI than in SAP patients (P = 0.0002). After one year the number of segments with atherosclerosis increased in SAP patients (P = 0.0001). The number of atherosclerotic segments remained unchanged in UAP/n-STEMI patients. However, composition was altered as the number of segments with noncalcified plaques decreased (P = 0.018). IVUS data confirmed the CT findings. Conclusion. Quantity, subtype, and progression of atherosclerosis differ between SAP and UAP/n-STEMI patients.
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High Risk Plaque Features on Coronary CT Angiography. CURRENT CARDIOVASCULAR IMAGING REPORTS 2014. [DOI: 10.1007/s12410-014-9279-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Brolin EB, Jernberg T, Brismar TB, Daniel M, Henareh L, Ripsweden J, Tornvall P, Cederlund K. Coronary plaque burden, as determined by cardiac computed tomography, in patients with myocardial infarction and angiographically normal coronary arteries compared to healthy volunteers: a prospective multicenter observational study. PLoS One 2014; 9:e99783. [PMID: 24937192 PMCID: PMC4061030 DOI: 10.1371/journal.pone.0099783] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 05/19/2014] [Indexed: 12/02/2022] Open
Abstract
Objectives Patients presenting with acute myocardial infarction and angiographically normal coronary arteries (MINCA) represent a diagnostic and a therapeutic challenge. Cardiac computed tomography (CT) allows detection of coronary artery disease (CAD) even in the absence of significant stenosis. We aimed to investigate whether patients suffering from MINCA had a greater coronary plaque burden, as determined by cardiac CT, than a matched group of healthy volunteers. Methods Consecutive patients, aged 45 to 70, with MINCA were enrolled in the Stockholm metropolitan area. Patients with myocarditis were excluded using cardiovascular magnetic resonance imaging. Remaining patients underwent cardiac CT, as did a reference group of healthy volunteers matched by age and gender, with no known cardiovascular disease. Plaque burden was evaluated semi-quantitatively on a per patient and a per segment level. Results Despite a higher prevalence of smoking and hypertension, patients with MINCA did not have more CAD than healthy volunteers. Among 57 MINCA patients and 58 volunteers no signs of CAD were found in 24 (42%) and 25 (43%) respectively. On a per segment level, MINCA patients had less segments with stenosis ≥20% (2% vs. 5%, p<0.01), as well as a smaller proportion of large (2% vs. 4%, p<0.05) and mixed type plaques (1% vs. 4%, p<0.01). The median coronary calcium score did not differ between MINCA patients and healthy volunteers (6 vs. 8, ns). Conclusions MINCA patients with no or minimal angiographic stenosis do not have more coronary atherosclerosis than healthy volunteers, and a large proportion of these patients do not have any signs of CAD, as determined by cardiac CT. The MINCA patient group is probably heterogeneous, with a variety of different underlying mechanisms. Non-obstructive CAD is most likely not the most prevalent cause of myocardial infarction in this patient group.
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Affiliation(s)
- Elin B. Brolin
- Department of Radiology, Karolinska University Hospital Huddinge and Department of Clinical Science, Intervention and Technology, Division of Medical Imaging and Technology at Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Tomas Jernberg
- Department of Medicine, Section of Cardiology, Karolinska University Hospital Huddinge and Karolinska Institutet, Stockholm, Sweden
| | - Torkel B. Brismar
- Department of Radiology, Karolinska University Hospital Huddinge and Department of Clinical Science, Intervention and Technology, Division of Medical Imaging and Technology at Karolinska Institutet, Stockholm, Sweden
| | - Maria Daniel
- Cardiology Unit, Department of Medicine, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden
| | - Loghman Henareh
- Department of Medicine, Section of Cardiology, Karolinska University Hospital Huddinge and Karolinska Institutet, Stockholm, Sweden
| | - Jonaz Ripsweden
- Department of Radiology, Karolinska University Hospital Huddinge and Department of Clinical Science, Intervention and Technology, Division of Medical Imaging and Technology at Karolinska Institutet, Stockholm, Sweden
| | - Per Tornvall
- Institution for Clinical Science and Education at Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Kerstin Cederlund
- Department of Radiology, Karolinska University Hospital Huddinge and Department of Clinical Science, Intervention and Technology, Division of Medical Imaging and Technology at Karolinska Institutet, Stockholm, Sweden
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Accuracy of coronary computed tomography angiography vs intravascular ultrasound for evaluation of vessel area. J Cardiovasc Comput Tomogr 2014; 8:141-8. [DOI: 10.1016/j.jcct.2013.12.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 11/12/2013] [Accepted: 12/16/2013] [Indexed: 11/23/2022]
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Roleder T, Suh W, Sharma R, Hecht H, Kovacic JC, Narula J, Kini AS. Plaques with high lipid burden: keeping the fat out of the fire. Heart 2013; 99:977-8. [PMID: 23349347 DOI: 10.1136/heartjnl-2012-303421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Burke B, Budoff MJ. Insights from CTA with Comparison to Modalities of Intravascular Ultrasound Imaging. CURRENT CARDIOVASCULAR IMAGING REPORTS 2011. [DOI: 10.1007/s12410-011-9091-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nikolaou K, Alkadhi H, Bamberg F, Leschka S, Wintersperger BJ. MRI and CT in the diagnosis of coronary artery disease: indications and applications. Insights Imaging 2010; 2:9-24. [PMID: 22347932 PMCID: PMC3259311 DOI: 10.1007/s13244-010-0049-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Revised: 09/27/2010] [Accepted: 10/19/2010] [Indexed: 01/16/2023] Open
Abstract
In recent years, technical advances and improvements in cardiac computed tomography (CT) and cardiac magnetic resonance imaging (MRI) have provoked increasing interest in the potential clinical role of these techniques in the non-invasive work-up of patients with suspected coronary artery disease (CAD) and correct patient selection for these emerging imaging techniques. In the primary detection or exclusion of significant CAD, e.g. in the patient with unspecific thoracic complaints, and also in patients with known CAD or advanced stages of CAD, both CT and MRI yield specific advantages. In this review, the major aspects of non-invasive MR and CT imaging in the diagnosis of CAD will be discussed. The first part describes the clinical value of contrast-enhanced non-invasive CT coronary angiography (CTCA), including the diagnostic accuracy of CTCA for the exclusion or detection of significant CAD with coronary artery stenoses that may require angioplastic intervention, as well as potentially valuable information on the coronary artery vessel wall. In the second section, the potential of CT for the imaging of myocardial viability and perfusion will be highlighted. In the third and final part, the range of applications of cardiac MRI in CAD patients will be outlined.
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