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Xu R, Yang H, Zhang J, Chen S, Pang L, Wu Y, Pei Z, Shi H, Li C, Ge J. Dynamic perfusion SPECT for functional evaluation in symptomatic patients with myocardial bridging. J Nucl Cardiol 2023; 30:2058-2067. [PMID: 37095328 DOI: 10.1007/s12350-023-03241-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/28/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND The aim of this study was to investigate the feasibility and diagnostic value of myocardial flow reserve (MFR) assessed by rest/stress myocardial perfusion imaging with dynamic single-photon emission computed tomography (SPECT) in the functional evaluation of myocardial bridge (MB). METHODS From May 2017 to July 2021, patients with angiographically confirmed isolated MB on the left anterior descending artery (LAD) who underwent dynamic SPECT myocardial perfusion imaging were retrospectively included. The assessment of semiquantitative indices of myocardial perfusion (summed stress scores, SSS) and quantitative parameters (MFR) was performed. RESULTS A total of 49 patients were enrolled. The mean age of the subjects was 61.0 ± 9.0 years. All of the patients were symptomatic, and 16 cases (32.7%) presented with typical angina. SPECT-derived MFR showed a borderline significantly negative correlation with SSS (r = 0.261, P = .070). There was a trend of higher prevalence of impaired myocardial perfusion defined as MFR < 2 than as SSS ≥ 4 (42.9% vs 26.5%; P = .090). CONCLUSION Our data support that SPECT MFR may be a useful parameter for the functional assessment of MB. In patients with MB, the use of dynamic SPECT could be a potential method for hemodynamic assessment.
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Affiliation(s)
- Rende Xu
- Department of Cardiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Hao Yang
- Department of Cardiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Jie Zhang
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Shuguang Chen
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Lifang Pang
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Yizhe Wu
- Department of Cardiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Zhiqiang Pei
- Department of Cardiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Chenguang Li
- Department of Cardiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
| | - Junbo Ge
- Department of Cardiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
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Nguyen MB, Zhang N, Baranger J, Aguet J, Friedberg MK, Barron DJ, Honjo O, Mertens LL, Villemain O. Ultrafast Power Doppler for Detecting Intraoperative Myocardial Perfusion in Infants With Critical Congenital Heart Disease. JACC. ADVANCES 2023; 2:100290. [PMID: 38939593 PMCID: PMC11198034 DOI: 10.1016/j.jacadv.2023.100290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Affiliation(s)
| | | | | | | | | | | | | | | | - Olivier Villemain
- Division of Cardiology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada @Villemain_Team
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Recent Advances in Cardiovascular Diseases Research Using Animal Models and PET Radioisotope Tracers. Int J Mol Sci 2022; 24:ijms24010353. [PMID: 36613797 PMCID: PMC9820417 DOI: 10.3390/ijms24010353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
Cardiovascular diseases (CVD) is a collective term describing a range of conditions that affect the heart and blood vessels. Due to the varied nature of the disorders, distinguishing between their causes and monitoring their progress is crucial for finding an effective treatment. Molecular imaging enables non-invasive visualisation and quantification of biological pathways, even at the molecular and subcellular levels, what is essential for understanding the causes and development of CVD. Positron emission tomography imaging is so far recognized as the best method for in vivo studies of the CVD related phenomena. The imaging is based on the use of radioisotope-labelled markers, which have been successfully used in both pre-clinical research and clinical studies. Current research on CVD with the use of such radioconjugates constantly increases our knowledge and understanding of the causes, and brings us closer to effective monitoring and treatment. This review outlines recent advances in the use of the so-far available radioisotope markers in the research on cardiovascular diseases in rodent models, points out the problems and provides a perspective for future applications of PET imaging in CVD studies.
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Venet M, Friedberg MK, Mertens L, Baranger J, Jalal Z, Tlili G, Villemain O. Nuclear Imaging in Pediatric Cardiology: Principles and Applications. Front Pediatr 2022; 10:909994. [PMID: 35874576 PMCID: PMC9301385 DOI: 10.3389/fped.2022.909994] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
Abstract
Nuclear imaging plays a unique role within diagnostic imaging since it focuses on cellular and molecular processes. Using different radiotracers and detection techniques such as the single photon emission scintigraphy or the positron emission tomography, specific parameters can be assessed: myocardial perfusion and viability, pulmonary perfusion, ventricular function, flow and shunt quantification, and detection of inflammatory processes. In pediatric and congenital cardiology, nuclear imaging can add complementary information compared to other imaging modalities such as echocardiography or magnetic resonance imaging. In this state-of-the-art paper, we appraise the different techniques in pediatric nuclear imaging, evaluate their advantages and disadvantages, and discuss the current clinical applications.
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Affiliation(s)
- Maelys Venet
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Mark K. Friedberg
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Luc Mertens
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Jerome Baranger
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Zakaria Jalal
- Department of Congenital and Pediatric Cardiology, Hôpital du Haut-Lévêque, CHU de Bordeaux, Bordeaux-Pessac, France
| | - Ghoufrane Tlili
- Department of Nuclear Medicine, Hôpital du Haut-Lévêque, CHU de Bordeaux, Bordeaux-Pessac, France
| | - Olivier Villemain
- Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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Zhang N, Nguyen MB, Mertens L, Barron DJ, Villemain O, Baranger J. Improving coronary ultrafast Doppler angiography using fractional moving blood volume and motion-adaptive ensemble length. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac7430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 05/27/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Coronary microperfusion assessment is a key parameter for understanding cardiac function. Currently, coronary ultrafast Doppler angiography is the only non-invasive clinical imaging technique able to assess coronary microcirculation quantitatively in humans. In this study, we propose to use fractional moving blood volume (FMBV), proportional to the red blood cell concentration, as a metric for perfusion. FMBV compares the power Doppler in a region of interest (ROI) inside the myocardium to the power Doppler of a reference area in the heart chamber, fully filled with blood. This normalization gives then relative values of the ROI blood filling. However, due to the impact of ultrasound attenuation and elevation focus on power Doppler values, the reference area and the ROI need to be at the same depth to allow this normalization. This condition is rarely satisfied in vivo due to the cardiac anatomy. Hereby, we propose to locally compensate the attenuation between the ROI and the reference, by measuring the attenuation law on a phantom. We quantified the efficiency of this approach by comparing FMBV with and without compensation on a flow phantom. Compensated FMBV was able to estimate the ground-truth FMBV with less than 5% variation. This method was then adapted to the in vivo case of myocardial perfusion imaging during heart surgery on human neonates. The translation from in vitro to in vivo required an additional clutter filtering step to ensure that blood signals could be correctly identified in the fast-moving myocardium. We applied the singular value decomposition filter on temporal sliding windows whose lengths were a function of myocardium motion. This motion-adaptive temporal sliding window approach was able to improve blood and tissue separation in terms of contrast-to-noise ratio, as compared to well-established constant-length sliding window approaches. Therefore, compensated FMBV and singular value decomposition assisted with motion-adaptive temporal sliding windows improves the quantification of blood volume in coronary ultrafast Doppler angiography.
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Coronary Flow Assessment Using 3-Dimensional Ultrafast Ultrasound Localization Microscopy. JACC: CARDIOVASCULAR IMAGING 2022; 15:1193-1208. [DOI: 10.1016/j.jcmg.2022.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 01/24/2022] [Accepted: 02/17/2022] [Indexed: 11/23/2022]
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Nguyen MB, Mital S, Mertens L, Jeewa A, Friedberg MK, Aguet J, Adler A, Lam CZ, Dragulescu A, Rakowski H, Villemain O. Pediatric Hypertrophic Cardiomyopathy: Exploring the Genotype-Phenotype Association. J Am Heart Assoc 2022; 11:e024220. [PMID: 35179047 PMCID: PMC9075072 DOI: 10.1161/jaha.121.024220] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 01/11/2022] [Indexed: 11/19/2022]
Abstract
Pediatric hypertrophic cardiomyopathy (HCM) is the most common form of cardiomyopathy in children and a leading cause of sudden cardiac death. Yet, the association between genotype variation, phenotype expression, and adverse events in pediatric HCM has not been fully elucidated. Although the literature on this topic is evolving in adult HCM, the evidence in children is lacking. Solidifying our understanding of this relationship could improve risk stratification as well as improve our comprehension of the underlying pathophysiological characteristics of pediatric HCM. In this state-of-the-art review, we examine the current literature on genetic variations in HCM and their association with outcomes in children, discuss the current approaches to identifying cardiovascular phenotypes in pediatric HCM, and explore possible avenues that could improve sudden cardiac death risk assessment.
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Affiliation(s)
- Minh B. Nguyen
- Division of CardiologyLabatt Family Heart CentreHospital for Sick ChildrenUniversity of TorontoOntarioCanada
| | - Seema Mital
- Division of CardiologyLabatt Family Heart CentreHospital for Sick ChildrenUniversity of TorontoOntarioCanada
| | - Luc Mertens
- Division of CardiologyLabatt Family Heart CentreHospital for Sick ChildrenUniversity of TorontoOntarioCanada
| | - Aamir Jeewa
- Division of CardiologyLabatt Family Heart CentreHospital for Sick ChildrenUniversity of TorontoOntarioCanada
| | - Mark K. Friedberg
- Division of CardiologyLabatt Family Heart CentreHospital for Sick ChildrenUniversity of TorontoOntarioCanada
| | - Julien Aguet
- Department of Diagnostic ImagingHospital for Sick ChildrenUniversity of TorontoOntarioCanada
| | - Arnon Adler
- Division of CardiologyPeter Munk Cardiac CentreToronto General HospitalUniversity of TorontoOntarioCanada
| | - Christopher Z. Lam
- Division of CardiologyLabatt Family Heart CentreHospital for Sick ChildrenUniversity of TorontoOntarioCanada
| | - Andreea Dragulescu
- Division of CardiologyLabatt Family Heart CentreHospital for Sick ChildrenUniversity of TorontoOntarioCanada
| | - Harry Rakowski
- Division of CardiologyPeter Munk Cardiac CentreToronto General HospitalUniversity of TorontoOntarioCanada
| | - Olivier Villemain
- Division of CardiologyLabatt Family Heart CentreHospital for Sick ChildrenUniversity of TorontoOntarioCanada
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Gać P, Poręba R. Significant Stenosis of the Brachiocephalic Trunk and Moderate Stenosis of the Left Circumflex Artery in Computed Tomography Angiography Images. Diagnostics (Basel) 2022; 12:diagnostics12010200. [PMID: 35054367 PMCID: PMC8775095 DOI: 10.3390/diagnostics12010200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 01/06/2022] [Accepted: 01/13/2022] [Indexed: 02/01/2023] Open
Abstract
Atherosclerosis, as a civilization disease, is a serious epidemiological problem. Significant carotid disease and significant coronary artery disease result in acute consequences, such as ischemic stroke and myocardial infarction, which are the major causes of cardiovascular mortality. Typically, atherosclerosis of the aortic arch branches involves the bulbs of the common carotid arteries and the proximal segments of the internal carotid arteries, and can be effectively assessed by ultrasonography. Computed tomography angiography enables the identification of patients with less typical clinical manifestations of atherosclerosis, e.g., brachiocephalic trunk stenosis with symptoms of the steal syndrome and moderate stenosis in the coronary arteries. We present examples of computed tomography angiography images of this type of changes.
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Affiliation(s)
- Paweł Gać
- Centre for Diagnostic Imaging, 4th Military Hospital, Weigla 5, PL 50-981 Wroclaw, Poland
- Department of Population Health, Division of Environmental Health and Occupational Medicine, Wroclaw Medical University, Mikulicza-Radeckiego 7, PL 50-368 Wroclaw, Poland
- Correspondence: or ; Tel.: +48-261660480
| | - Rafał Poręba
- Department of Internal and Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, PL 50-556 Wroclaw, Poland;
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