1
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Carney JP, Bianco RW. Multimodal preoperative imaging for transcatheter mitral valve replacement in the domestic sheep model. Sci Rep 2024; 14:11745. [PMID: 38778204 PMCID: PMC11111800 DOI: 10.1038/s41598-024-62646-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 05/20/2024] [Indexed: 05/25/2024] Open
Abstract
Preclinical in vivo evaluation is an essential step in the progression of new cardiac devices into patient use, with studies predominantly performed in the domestic sheep model. A growing area of interest in cardiac device development is transcatheter mitral valve replacement (TMVR). Clinically, multimodal imaging, or computed tomography (CT) and echocardiography (echo) are used extensively to preoperatively determine mitral valve morphology prior to an intervention, but there is no description on how these modalities can be implemented to support preclinical studies. The purpose of this study is to apply clinically relevant CT and echo acquisition and assessment techniques to a large group of naive research sheep in order to analyze and report modality-related effects on mitral valve dimensional reference intervals in the sheep model. To this end, fifty-five adult domestic sheep underwent preoperative CT and echo exams and resultant images were analyzed using a landmark-based multiplanar measurement protocol and compiled into a master dataset for statistical analysis. We found moderate agreement between CT and echo-derived measurements of the mitral valve in sheep and propose the first clinically-relevant dimensional indices for the sheep's naive mitral valve which can be used to guide future studies evaluating novel TMVR devices. This study is the first of its kind in proposing a reproducible method for detailed examination of the mitral valve in the sheep model using clinically-relevant multimodal imaging. As in patients, CT and echo can reveal accurate native mitral valve dimensions in the sheep prior to preclinical TMVR studies.
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Affiliation(s)
- John P Carney
- Experimental Surgical Services Laboratory, Department of Surgery, University of Minnesota Minneapolis, 425 East River Parkway KE B18, Minneapolis, MN, 55455, USA.
| | - Richard W Bianco
- Experimental Surgical Services Laboratory, Department of Surgery, University of Minnesota Minneapolis, 425 East River Parkway KE B18, Minneapolis, MN, 55455, USA
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Khachatryan A, Chow RT, Srivastava MC, Cinar T, Alejandro J, Sargsyan M, Shaik MR, Tamazyan V, Haque RU, Harutyunyan H. The Ramus Intermedius: A Bridge to Survival in the Setting of Triple-Vessel Total Occlusion. Cureus 2024; 16:e61288. [PMID: 38947610 PMCID: PMC11211964 DOI: 10.7759/cureus.61288] [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] [Accepted: 05/29/2024] [Indexed: 07/02/2024] Open
Abstract
Coronary artery disease continues to remain the leading cause of mortality worldwide. Coronary blood supply is provided through the right and left main coronary arteries. The left main coronary artery (LMCA) in turn gives rise to the left anterior descending (LAD) and left circumflex (LCX) arteries. In some cases, LMCA may trifurcate into the ramus intermedius (RI) in addition to the LAD and LCX arteries. Atherosclerotic plaque formation and rupture with subsequent clot formation and occlusion of coronary arteries are the underlying mechanisms of myocardial infarction. Though the clinical implications of the presence of ramus intermedius (RI) are controversial some data suggest that the RI is associated with an increased risk of atherosclerotic plaque formation in the LMCA and the proximal LAD. Conversely, it has been proposed that the RI provides an additional collateral source of blood supply to the myocardium and may potentially contribute to improved survival. Case reports tout the benefits of RI, specifically in the setting of multivessel coronary artery occlusions. Whether it increases the risk of atherosclerotic plaque formation or whether it is protective has yet to be determined. We present a case of a 58-year-old male who presented with acute coronary syndrome and cardiogenic shock due to total ostial occlusion of LAD. The patient had also chronic total occlusions of the right coronary artery and LCX but a patent RI, which was the only source of blood supply to the myocardium and practically determined the patient's survival. Additionally, we performed a literature review to identify similar cases, to support RI's potentially protective role in enhancing survival.
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Affiliation(s)
- Aleksan Khachatryan
- Department of Internal Medicine, University of Maryland Medical Center, Midtown Campus, Baltimore, USA
| | - Robert Td Chow
- Department of Internal Medicine, University of Maryland School of Medicine, Baltimore, USA
- Department of Internal Medicine, University of Maryland Medical Center, Midtown Campus, Baltimore, USA
| | - Mukta C Srivastava
- Department of Interventional Cardiology, University of Maryland Medical Center, Baltimore, USA
| | - Tufan Cinar
- Department of Internal Medicine, University of Maryland Medical Center, Midtown Campus, Baltimore, USA
| | - Joel Alejandro
- Department of Internal Medicine, University of Maryland Medical Center, Midtown Campus, Baltimore, USA
| | | | - Mohammed Rifat Shaik
- Department of Internal Medicine, University of Maryland Medical Center, Midtown Campus, Baltimore, USA
| | - Vahagn Tamazyan
- Department of Internal Medicine, Maimonides Medical Center, New York, USA
| | - Reyaz U Haque
- Department of Cardiology, University of Maryland Medical Center, Midtown Campus, Baltimore, USA
| | - Hakob Harutyunyan
- Department of Internal Medicine, Maimonides Medical Center, New York, USA
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Yafasov M, Olsen FJ, Skaarup KG, Lassen MCH, Johansen ND, Lindgren FL, Jensen GB, Schnohr P, Møgelvang R, Søgaard P, Biering-Sørensen T. Normal values for left atrial strain, volume, and function derived from 3D echocardiography: the Copenhagen City Heart Study. Eur Heart J Cardiovasc Imaging 2024; 25:602-612. [PMID: 38261728 DOI: 10.1093/ehjci/jeae018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 12/18/2023] [Accepted: 01/05/2024] [Indexed: 01/25/2024] Open
Abstract
AIMS 3D echocardiographic (3DE) assessment of the left atrium (LA) is a new modality of potential clinical value. Age- and sex-based normative values are needed to benchmark these parameters for clinical use. METHODS AND RESULTS Of 4466 participants in the 5th Copenhagen City Heart Study, a prospective longitudinal cohort study on the general population, 2082 participants underwent 3DE of the LA. Healthy participants were included to establish normative values for LA strain, volume, and function by 3DE. The effects of age and sex were also evaluated. After excluding participants with comorbidities, 979 healthy participants (median age 44 years, 39.6% males) remained. The median and limits of normality (2.5th and 97.5th percentiles) for functional and volumetric measures were as follows: LA reservoir strain (LASr) 30.8% (18.4-44.2%), LA conduit strain (LAScd) 19.1% (6.8-32.0%), LA contractile strain 11.7% (4.3-22.2%), total LA emptying fraction (LAEF) 61.4% (47.8-71.0%), passive LAEF 37.7% (17.4-53.9%), active LAEF 37.4% (22.2-52.5%), LA minimum volume index (LAVimin) 10.2 (5.9-18.5) mL/m2, and LA maximum volume index (LAVimax) 26.8 (16.5-40.1) mL/m2. All parameters changed significantly with increasing age (P value for all <0.001). Significant sex-specific differences were observed for all parameters except active LAEF and LAVimax. Sex significantly modified the association between age and LASr (P for interaction < 0.001), LAScd (P for interaction < 0.001), LAVimin (P for interaction = 0.037), and total LAEF (P for interaction = 0.034) such that these parameters deteriorated faster with age in females than males. CONCLUSION We present age- and sex-specific reference material including limits of normality for LA strain, volume, and function by 3DE.
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Affiliation(s)
- Marat Yafasov
- Department of Cardiology, Copenhagen University Hospital-Herlev and Gentofte, Gentofte Hospitalsvej 1, 2900 Hellerup, Denmark
- The Copenhagen City Heart Study, Copenhagen University Hospital- Herlev Hospital, Borgmester Ib Juuls Vej 73, opgang 7, 4. etage, M1, 2730 Herlev, Copenhagen, Denmark
| | - Flemming Javier Olsen
- Department of Cardiology, Copenhagen University Hospital-Herlev and Gentofte, Gentofte Hospitalsvej 1, 2900 Hellerup, Denmark
- The Copenhagen City Heart Study, Copenhagen University Hospital- Herlev Hospital, Borgmester Ib Juuls Vej 73, opgang 7, 4. etage, M1, 2730 Herlev, Copenhagen, Denmark
| | - Kristoffer Grundtvig Skaarup
- Department of Cardiology, Copenhagen University Hospital-Herlev and Gentofte, Gentofte Hospitalsvej 1, 2900 Hellerup, Denmark
- The Copenhagen City Heart Study, Copenhagen University Hospital- Herlev Hospital, Borgmester Ib Juuls Vej 73, opgang 7, 4. etage, M1, 2730 Herlev, Copenhagen, Denmark
| | - Mats Christian Højbjerg Lassen
- Department of Cardiology, Copenhagen University Hospital-Herlev and Gentofte, Gentofte Hospitalsvej 1, 2900 Hellerup, Denmark
- The Copenhagen City Heart Study, Copenhagen University Hospital- Herlev Hospital, Borgmester Ib Juuls Vej 73, opgang 7, 4. etage, M1, 2730 Herlev, Copenhagen, Denmark
| | - Niklas Dyrby Johansen
- Department of Cardiology, Copenhagen University Hospital-Herlev and Gentofte, Gentofte Hospitalsvej 1, 2900 Hellerup, Denmark
- The Copenhagen City Heart Study, Copenhagen University Hospital- Herlev Hospital, Borgmester Ib Juuls Vej 73, opgang 7, 4. etage, M1, 2730 Herlev, Copenhagen, Denmark
- Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Filip Lyng Lindgren
- The Copenhagen City Heart Study, Copenhagen University Hospital- Herlev Hospital, Borgmester Ib Juuls Vej 73, opgang 7, 4. etage, M1, 2730 Herlev, Copenhagen, Denmark
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Gorm Boje Jensen
- The Copenhagen City Heart Study, Copenhagen University Hospital- Herlev Hospital, Borgmester Ib Juuls Vej 73, opgang 7, 4. etage, M1, 2730 Herlev, Copenhagen, Denmark
| | - Peter Schnohr
- The Copenhagen City Heart Study, Copenhagen University Hospital- Herlev Hospital, Borgmester Ib Juuls Vej 73, opgang 7, 4. etage, M1, 2730 Herlev, Copenhagen, Denmark
| | - Rasmus Møgelvang
- The Copenhagen City Heart Study, Copenhagen University Hospital- Herlev Hospital, Borgmester Ib Juuls Vej 73, opgang 7, 4. etage, M1, 2730 Herlev, Copenhagen, Denmark
- Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Peter Søgaard
- The Copenhagen City Heart Study, Copenhagen University Hospital- Herlev Hospital, Borgmester Ib Juuls Vej 73, opgang 7, 4. etage, M1, 2730 Herlev, Copenhagen, Denmark
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Tor Biering-Sørensen
- Department of Cardiology, Copenhagen University Hospital-Herlev and Gentofte, Gentofte Hospitalsvej 1, 2900 Hellerup, Denmark
- The Copenhagen City Heart Study, Copenhagen University Hospital- Herlev Hospital, Borgmester Ib Juuls Vej 73, opgang 7, 4. etage, M1, 2730 Herlev, Copenhagen, Denmark
- Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Barry M, Gun M, Chabry Y, Trojette F, Chardon K, Padurean P, Peltier J, Havet E, Caus T. Optimizing coronary artery opacification and 3D reconstruction from human cadaver hearts in anatomy research. Curr Probl Cardiol 2024; 49:102216. [PMID: 37993008 DOI: 10.1016/j.cpcardiol.2023.102216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 11/18/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVE This study seeks to identify the ideal dilution rate of a radiopaque product to optimize the visualization of coronary arteries and their branches within human cadaver hearts. The process involves obtaining images in the anatomy laboratory and subsequently constructing a three-dimensional model. MATERIALS AND METHODS We utilized 30 human hearts fixed in 10 % formalin (9 females and 21 males) with a mean age of 79 ± 5 years. The initial experiment, involving the first four hearts (referred to as "group 1"), encountered difficulties in opacifying coronary arteries. In this phase, a probabilistic injection of 20 % Visipaque and 80 % latex, with coronary sinus ostium closure, was performed. The optimal mixture ratio was then determined as 33 % Visipaque and 66 % latex. Recognizing the need for on-site injection at the CT Scan table, this protocol was applied to the subsequent 11 hearts in "group 2." Closure of the coronary sinus was deemed unnecessary. The final 15 hearts, constituting "group 3," revealed that the injection should be gradual, maintaining controlled pressure between 120 and 150 mm Hg. Post-injection, hearts were scanned with the injected coronary arteries using an Optima 660 CT scanner. Two-dimensional images were acquired with parameters set at 64 × 0.625 mm, 100 kV, 300-400 mA, and a rotation of 0.5 s. Subsequently, 3D reconstruction was conducted using Advantage Workstation 4.7 (GE Healthcare) and volume rendering with Volume Viewer software, version 15. RESULTS Significant differences in the percentage of opacified coronaries were observed among the three groups (p < 0.005). This variation underscores the learning curve and comprehension required before establishing a reliable method. Group 1 (N = 4) demonstrated minimal opacification, group 2 (N = 11) displayed partial opacification, while group 3 (N = 15) achieved 100 % opacification of coronary arteries. CONCLUSION The successive experiments culminated in the development of a protocol for CT imaging, enabling accurate three-dimensional reconstruction of the normal anatomy of the main and secondary coronary arteries. Our work is grounded in a series of progressively refined and successful experiments.
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Affiliation(s)
- Misbaou Barry
- Laboratory of Anatomy, Faculty of Medicine, University of Picardie-Jule Vernes, France; Department of Cardiac Surgery, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens, Cedex1, France.
| | - Mesut Gun
- Department of Cardiology, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens, Cedex1, France
| | - Yuthiline Chabry
- Department of Cardiac Surgery, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens, Cedex1, France
| | - Faouzi Trojette
- Department of Cardiology, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens, Cedex1, France
| | - Karen Chardon
- Perinatality and Toxic Risks Laboratory, University of Picardie, CHU Amiens - CURS Building, Avenue René Laënnec, Salouël, 80480, France
| | - Paul Padurean
- Department of Cardiac Surgery, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens, Cedex1, France
| | - Johann Peltier
- Laboratory of Anatomy, Faculty of Medicine, University of Picardie-Jule Vernes, France
| | - Eric Havet
- Laboratory of Anatomy, Faculty of Medicine, University of Picardie-Jule Vernes, France
| | - Thierry Caus
- Department of Cardiac Surgery, Amiens Picardie University Hospital Center, 1 Rue du Professeur Christian CABROL, 80054, Amiens, Cedex1, France
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5
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Tanba C, Bandaru S, Alhaddad Z, Iskander F. Spontaneous coronary artery dissection of ramus intermedius in an elderly woman. Radiol Case Rep 2022; 17:4165-4167. [PMID: 36105840 PMCID: PMC9464771 DOI: 10.1016/j.radcr.2022.07.092] [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: 07/20/2022] [Accepted: 07/24/2022] [Indexed: 11/17/2022] Open
Abstract
Spontaneous coronary artery dissection (SCAD) is a rare cause of myocardial ischemia commonly seen in younger patients, particularly women. Patients often present similar to those with acute coronary syndrome (ACS); however, they often are missing the classic risk factors that are typically associated with coronary artery disease. Differentiating between SCAD and ACS is vital as they are managed differently with up to 80% of SCAD being managed conservatively. We present a case of 61-year-old woman with no previous cardiac history presenting with chest pain and was found to have spontaneous coronary artery dissection on coronary angiography.
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Affiliation(s)
- Carl Tanba
- Department of Internal Medicine, Medstar Union Memorial Hospital, 301 E University Pkwy, Baltimore, MD 21218, USA
- Corresponding author.
| | - Sumanth Bandaru
- Department of Internal Medicine, Medstar Union Memorial Hospital, 301 E University Pkwy, Baltimore, MD 21218, USA
| | - Zayd Alhaddad
- Department of Internal Medicine, Medstar Union Memorial Hospital, 301 E University Pkwy, Baltimore, MD 21218, USA
| | - Fady Iskander
- Department of Cardiology, Medstar Union Memorial Hospital, 3333 North Calvert Street Johnston Professional Bldg Ste LL08, Baltimore, MD, 21218, USA
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6
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Figliozzi S, Georgiopoulos G, Pateras K, Sianis A, Previtero M, Tondi L, Petropoulos Ι, Bragato RM, Papachristidis A, Condorelli G, Takeuchi M. Normal ranges of left atrial volumes and ejection fraction by 3D echocardiography in adults: a systematic review and meta-analysis. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2022; 38:1329-1340. [PMID: 34994882 DOI: 10.1007/s10554-021-02520-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/30/2021] [Indexed: 11/05/2022]
Abstract
Increased sizes and dysfunction of the left atrium have been related to adverse outcomes. 3D-echocardiography is more accurate than 2D-echocardiography in estimating LA volumes and ejection fraction. However, the use of 3DE for LA analysis is limited by the absence of established reference values. We performed a systematic review and meta-analysis to provide reference ranges of LA maximum and minimum volumes indexed for body surface area (LAVi max and LAVi min, respectively), and LA-EF assessed by 3DE in healthy adults. Data search was conducted from inception through September 15, 2021, using the following Medical Subject Heading terms: left atrial/atrium, three-dimensional/3D echocardiography. The study protocol was registered in the PROSPERO database (CRD42021252428). 15 studies including 4,226 healthy adults (51% males) and reporting 3DE values of LAVi max, LAVi min and LA-EF were selected. LAVi max, LAVi min and LA-EF mean and reference values were equal to 25.18 ml/m2 (95% CI 23.10, 27.26), 11.10 ml/m2 (10.01, 12.18) and 55.94% (51.92, 59.96), respectively. No influential studies were identified. Pooled estimates per age group- and sex were also estimated. By meta-regression analyses, we identified variability in LA volumes and LA-EF depending on participants' age, ethnicity and number of heart cycles at 3D multi-beat acquisition. At individual patient data analysis conducted on 374 subjects, a software effect on LA-EF was shown. This systematic review and meta-analysis provides reference values of LAVi max, LAVi min and LA-EF assessed by 3DE in healthy adults, encouraging 3DE evaluation of the LA evaluation in daily practice.
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Affiliation(s)
- Stefano Figliozzi
- Clinical Echocardiography Diagnostic Service, Cardio Center, Humanitas Research Hospital IRCCS, Via Alessandro Manzoni, 56, 20089, Rozzano, MI, Italy.
| | - Georgios Georgiopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Kostantinos Pateras
- Department of Biostatistics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Faculty of Public Health, University of Thessaly, Volos, Greece
| | - Alexandros Sianis
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
| | - Marco Previtero
- Cardiology Unit, Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Lara Tondi
- Multimodality Imaging Section IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Ιoannis Petropoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
| | - Renato Maria Bragato
- Clinical Echocardiography Diagnostic Service, Cardio Center, Humanitas Research Hospital IRCCS, Via Alessandro Manzoni, 56, 20089, Rozzano, MI, Italy
| | | | - Gianluigi Condorelli
- Clinical Echocardiography Diagnostic Service, Cardio Center, Humanitas Research Hospital IRCCS, Via Alessandro Manzoni, 56, 20089, Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy
| | - Masaaki Takeuchi
- Department of Laboratory and Transfusion Medicine, Hospital of University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
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7
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Li Y, Li Z, Feng J, Feng R, Zhou J, Jing Z. A Novel Solution for Distal Dilation of Chronic Dissection After Repair Involving Visceral Branches: The Road Block Strategy. Front Cardiovasc Med 2022; 9:821260. [PMID: 35355962 PMCID: PMC8959700 DOI: 10.3389/fcvm.2022.821260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 01/31/2022] [Indexed: 12/02/2022] Open
Abstract
Aim Notwithstanding that unprecedented endovascular progress has been achieved in recent years, it remains unclear what is the best strategy to preserve the blood perfusion of abdominal visceral arteries and promote positive aortic remodeling in patients with distal dilatation of chronic aortic dissection in abdominal visceral part (CADAV) after aortic repair. The present study developed a Road Block Strategy (RBS) to solve this conundrum. Methods and Results This prospective single-center clinical study included patients suffering from symptomatic distal dilatation of CADAV after aortic repair treated with RBS from January 2015 to December 2019 and followed up regularly for at least 2 years. Stent grafts were implanted first to cover distal tears and expand the true lumen. Device embolization was performed to induce proximal and distal segmental false lumen thrombosis (FLT) apart from the level of the ostia of vital branches. Successful RBS was performed in 13 patients. Significant differences were found in maximum true lumen diameter (p < 0.05), blood flow area in false lumen (FL) (p < 0.001), and the ratio of blood lumen to FL area (p < 0.05) between the pre-procedure and the latest follow-up results. No aortic rupture, vital branches occlusion, thoracic and abdominal pain, or death occurred during hospitalization and follow-up. Conclusions Our findings suggest that RBS is feasible in treating distal dilatation of chronic aortic dissection after prior proximal repair, inducing false lumen thrombosis, preventing deterioration of aortic dissection, and maintaining the patency of abdominal visceral arteries.
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Affiliation(s)
- Yiming Li
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China
- Endovascular Diagnosis and Treatment Center for Aortic Diseases, Department of Vascular Surgery, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Zhenjiang Li
- Department of Vascular Surgery, The First Affiliated Hospital of the Medical School of Zhejiang University, Hangzhou, China
| | - Jiaxuan Feng
- Endovascular Diagnosis and Treatment Center for Aortic Diseases, Department of Vascular Surgery, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Rui Feng
- Department of Vascular Surgery, Shanghai General Hospital, Affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Jian Zhou
- Endovascular Diagnosis and Treatment Center for Aortic Diseases, Department of Vascular Surgery, Changhai Hospital, Navy Medical University, Shanghai, China
- *Correspondence: Zaiping Jing
| | - Zaiping Jing
- Endovascular Diagnosis and Treatment Center for Aortic Diseases, Department of Vascular Surgery, Changhai Hospital, Navy Medical University, Shanghai, China
- Jian Zhou
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8
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Lee HJ, Kim JY. Coronary Artery Anomaly, What Radiologist Should Know? JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2022; 83:84-101. [PMID: 36237368 PMCID: PMC9238192 DOI: 10.3348/jksr.2021.0169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 12/17/2021] [Accepted: 12/24/2021] [Indexed: 11/15/2022]
Abstract
심장 전산화단층촬영(이하 CT)은 현재 관상동맥기형을 진단하고, 평가하는 가장 정확한 진단 도구로 자리매김하였으며, 심장 CT 촬영 건수가 증가함에 따라 관상동맥기형을 종종 관찰할 수 있다. 본 종설은 관상동맥기형에서 영상의학과 의사들이 꼭 알아야 할 대표적인 기형의 CT 소견들에 대해 다루었다. 관상동맥기형의 종류를 3부분 즉, 기시부, 동맥 내, 그리고 연결 부위로 나누어 설명하였으며, 임상에서 볼 수 있는 대표적인 기형들 중심으로 다루었다. 특히 혈역학적 이상을 유발하거나, 급사의 위험이 있는 기형들의 CT상 위험한 해부학적 소견에 대해서는 자세히 기술하였다.
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Affiliation(s)
- Hyun Jin Lee
- Department of Radiology, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
| | - Jin Young Kim
- Department of Radiology, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
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9
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Meetham K, Taerujjirakul T, Garitjirapath N, Navic P, Shinlapawittayatorn K, Mahakkanukrauh P. The morphometric study of the moderator band in Thais. Anat Sci Int 2021; 97:188-196. [PMID: 34825348 DOI: 10.1007/s12565-021-00641-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 11/16/2021] [Indexed: 10/19/2022]
Abstract
A moderator band, also known as the septomarginal trabecula, is a group of muscle bundles located in the ventricle of almost all human hearts. The morphology of the moderator band has various forms and several studies have focused mostly on its structure. Thus, in the present study, we sought to study the morphology and morphometry of the moderator band and tried to rearrange the criteria based on the previous studies to classify the moderator band in Thais. The study investigated 67 formalin-fixed human hearts of both sexes obtained from Thai donors aged 24-101 years with mean age at death 69.92 years. The moderator band was evident in 66 of the 67 specimens (98.51%). The moderator band had the mean or median of overall length, thickness, distance to the base of the tricuspid valve, distance to the base of the pulmonary valve, distance to the apex of the right ventricle, the angle at the septal connection, and angle of the papillary, which were 18.9 ± 6.4 mm, 3.17 (2.04-4.55) mm, 33.0 ± 7.97 mm, 38.8 ± 9.62 mm, 56.4 ± 8.09 mm, 50 (30-105)°, 73.9 ± 30.1°, respectively. The mean distance originating point from the supraventricular crest to the anterior papillary muscle was 0.396 ± 0.07 of the distance from the base of the tricuspid valve to the apex of the right ventricle. Our present classification found that crest-like and thick moderator band with complex secondary branching at high origin (type IVc), and low origin (type IVd) were the most common subtypes. This study provided both anatomical and clinical information that should be useful in cardiac surgery, radiology, and cardiac electrophysiological interventions.
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Affiliation(s)
- Kantapit Meetham
- Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | | | | | - Pagorn Navic
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Krekwit Shinlapawittayatorn
- Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.,Cardiac Electrophysiology Research and Training (CERT) Center, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Pasuk Mahakkanukrauh
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand. .,Excellence in Osteology Research and Training Center (ORTC), Chiang Mai University, Chiang Mai, 50200, Thailand.
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10
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Ma P, Shang Y, Hu Y, Liu J, Zhou X, Wang J. Linear late gadolinium enhancement in the basal anterior septum and lateral wall may represent the contrast enhancement of vessels: A CMR and CCTA comparison study. J Cardiol 2021; 79:581-587. [PMID: 34815134 DOI: 10.1016/j.jjcc.2021.10.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/09/2021] [Accepted: 10/11/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND The purpose of this paper was to verify that the linear high-intensity signal on late gadolinium enhancement-cardiac magnetic resonance (LGE-CMR) may represent the contrast enhancement of vessels rather than scars or fibrosis, and to assess whether this linear high-intensity signal will affect the quantification of myocardial fibrosis in patients with hypertrophic cardiomyopathy (HCM). METHODS A total of 58 patients who underwent both coronary computed tomography angiography (CCTA) and LGE-CMR in our hospital were ultimately enrolled. The definitions of positive linear LGE (LLGE+) were as follows: (1) LLGE in the basal anterior septum or lateral wall, and (2) LLGE observable at 10 mm or more. All other patients were regarded as negative LLGE (LLGE-). In LLGE+ patients, the length of the LLGE located in the anterior septum and lateral wall was compared with the length of the septal perforator artery and the circumflex artery on CCTA, respectively. For nine patients with HCM, the LGE% was measured before and after removal of LLGE. RESULTS Among the 58 patients, 40 showed LLGE+ and 18 showed LLGE-. For patients with LLGE in the anterior septum, there was a strong correlation between LLGE and anterior septal perforator arteries in length (r=0.887, p<0.001). For patients with LLGE in the lateral wall, LLGE also correlated well with the circumflex arteries in length (r=0.962, p<0.001). In nine patients with HCM, the LGE% decreased significantly after the removal of LLGE [9.50 (7.70 - 17.35)% vs. 8.80 (6.20 - 15.55)%, p<0.05]. CONCLUSIONS The LLGE in the anterior septum and lateral wall may represent contrast enhancement of the anterior septal perforator artery and the circumflex artery, respectively. This LLGE may overestimate the extent of myocardial fibrosis in patients with HCM.
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Affiliation(s)
- Peisong Ma
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yongning Shang
- Department of Ultrasound, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
| | - Yurou Hu
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Juan Liu
- Department of Ultrasound, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | | | - Jian Wang
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
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11
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Florescu DR, Badano LP, Tomaselli M, Torlasco C, Târtea GC, Bălșeanu TA, Volpato V, Parati G, Muraru D. Automated left atrial volume measurement by two-dimensional speckle-tracking echocardiography: feasibility, accuracy, and reproducibility. Eur Heart J Cardiovasc Imaging 2021; 23:85-94. [PMID: 34606605 DOI: 10.1093/ehjci/jeab199] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 09/23/2021] [Indexed: 11/14/2022] Open
Abstract
AIMS A byproduct of left atrial (LA) strain analysis is the automated measurement of LA maximal volume (LAVmax), which may decrease the time of echocardiography reporting, and increase the reproducibility of the LAVmax measurement. However, the automated measurement of LAVmax by two-dimensional speckle-tracking analysis (2DSTE) has never been validated. Accordingly, we sought to (i) assess the feasibility of automated LAVmax measurement by 2DSTE; (ii) compare the automated LAVmax by 2DSTE with conventional two-dimensional (2DE) biplane and three-dimensional echocardiography (3DE) measurements; and (iii) evaluate the accuracy and reproducibility of the three echocardiography techniques. METHODS AND RESULTS LAVmax (34-197 mL) were obtained from 198/210 (feasibility 94%) consecutive patients (median age 67 years, 126 men) by 2DSTE, 2DE, and 3DE. 2DE and 2DSTE measurements resulted in similar LAVmax values [bias = 1.5 mL, limits of agreement (LOA) ± 7.5 mL], and slightly underestimated 3DE LAVmax (biases = -5 mL, LOA ± 17 mL and -6 mL, LOA ± 16 mL, respectively). LAVmax by 2DSTE and 2DE were strongly correlated to those obtained by cardiac magnetic resonance (CMR) (r = 0.946 and r = 0.935, respectively; P < 0.001). However, LAVmax obtained by 2DSTE (bias = -9.5 mL, LOA ± 16 mL) and 2DE (bias = -8 mL, LOA ± 17 mL) were significantly smaller than those measured by CMR. Conversely, 3DE LAVmax were similar to CMR (bias = -2 mL, LOA ± 10 mL). Excellent intra- and inter-observer intraclass correlations were found for 3DE (0.995 and 0.995), 2DE (0.990 and 0.988), and 2DSTE (0.990 and 0.989). CONCLUSION Automated LAVmax measurement by 2DSTE is highly feasible, highly reproducible, and provided similar values to conventional 2DE calculations in consecutive patients with a wide range of LAVmax.
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Affiliation(s)
- Diana R Florescu
- Department of Cardiology, University of Medicine and Pharmacy of Craiova, Strada Petru Rareș 2, Craiova 200349, Romania.,Department of Cardiac, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, S. Luca Hospital Piazzale Brescia 20, 20149 Milan, Italy.,Department of Physiology, University of Medicine and Pharmacy of Craiova, Strada Petru Rareș 2, Craiova 200349, Romania
| | - Luigi P Badano
- Department of Cardiac, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, S. Luca Hospital Piazzale Brescia 20, 20149 Milan, Italy.,Department of Medicine and Surgery, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126 Milano, Italy
| | - Michele Tomaselli
- Department of Cardiac, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, S. Luca Hospital Piazzale Brescia 20, 20149 Milan, Italy
| | - Camilla Torlasco
- Department of Cardiac, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, S. Luca Hospital Piazzale Brescia 20, 20149 Milan, Italy
| | - Georgică C Târtea
- Department of Cardiology, University of Medicine and Pharmacy of Craiova, Strada Petru Rareș 2, Craiova 200349, Romania.,Department of Physiology, University of Medicine and Pharmacy of Craiova, Strada Petru Rareș 2, Craiova 200349, Romania
| | - Tudor A Bălșeanu
- Department of Physiology, University of Medicine and Pharmacy of Craiova, Strada Petru Rareș 2, Craiova 200349, Romania
| | - Valentina Volpato
- Department of Cardiac, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, S. Luca Hospital Piazzale Brescia 20, 20149 Milan, Italy.,Department of Medicine and Surgery, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126 Milano, Italy
| | - Gianfranco Parati
- Department of Cardiac, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, S. Luca Hospital Piazzale Brescia 20, 20149 Milan, Italy.,Department of Medicine and Surgery, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126 Milano, Italy
| | - Denisa Muraru
- Department of Cardiac, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, S. Luca Hospital Piazzale Brescia 20, 20149 Milan, Italy.,Department of Medicine and Surgery, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126 Milano, Italy
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12
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Gong X, Huang Z, Sun Z, Wang Q, Qian J, Ge L, Ge J. Role of IVUS in the rectification of angiographically judged ramus intermedius and its clinical significance. BMC Cardiovasc Disord 2021; 21:218. [PMID: 33931019 PMCID: PMC8086063 DOI: 10.1186/s12872-021-02034-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 04/16/2021] [Indexed: 11/25/2022] Open
Abstract
Background Due to the technical limitations of coronary artery angiography (CAG), ramus intermedius (RI) is sometimes difficult to distinguish from a high-origin obtuse marginal branch or a high-origin diagonal branch. This study sought to investigate the role of intravascular ultrasonography (IVUS) in the rectification of angiographically judged RI. Methods This study retrospectively analyzed 165 patients who were reported to have an RI based on CAG and underwent IVUS implementation from 02/01/2009 to 31/12/2019 in Zhongshan Hospital, Fudan University. Taking IVUS as the gold standard, we calculated the accuracy of RI identification by CAG and evaluated the impact of RI on revascularization strategy. Results Among the 165 patients, 89 patients (54%) were demonstrated to have an RI on IVUS (IVUS-RI), 32 patients (19%) were identified to have a high-origin diagonal branch on IVUS (IVUS-h-D), and 44 patients (27%) had an actual high-origin obtuse marginal artery on IVUS (IVUS-h-OM). Among 84 patients who underwent one-stent crossover stenting because of left main furcation lesions (48 patients in the IVUS-RI group, 12 patients in the IVUS-h-D group, and 24 in the IVUS-h-OM group), 14.6% of patients in the IVUS-RI group, 33.3% in the IVUS-h-D group and 0% in the IVUS-h-OM group had CAG-RI compromise (P = 0.02), which was defined as severe stenosis of the RI ostium (> 75%) or significant RI flow impairment (TIMI < 3). Conclusions Only 54% of CAG-RIs were confirmed by IVUS, which indicates the necessity of preintervention IVUS to distinguish real RIs from other branches in LM furcation lesions.
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Affiliation(s)
- Xue Gong
- Department of Cardiology, Deltahealth Hospital, Shanghai, 201702, People's Republic of China.,Department of Cardiology, Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China
| | - Zheyong Huang
- Department of Cardiology, Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China
| | - Zhonghan Sun
- Human Phenome Institute, Fudan University, Shanghai, 200438, People's Republic of China
| | - Qibing Wang
- Department of Cardiology, Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China
| | - Juying Qian
- Department of Cardiology, Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China
| | - Lei Ge
- Department of Cardiology, Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China.
| | - Junbo Ge
- Department of Cardiology, Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China.
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13
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Nakamura M, Kido T, Hirai K, Tabo K, Tanabe Y, Kawaguchi N, Kurata A, Kido T, Yamaguchi O, Mochizuki T. What is the mid-wall linear high intensity "lesion" on cardiovascular magnetic resonance late gadolinium enhancement? J Cardiovasc Magn Reson 2020; 22:66. [PMID: 32921308 PMCID: PMC7488664 DOI: 10.1186/s12968-020-00665-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 08/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiovascular magnetic resonance (CMR) late gadolinium enhancement (LGE) is a valuable technique for detecting myocardial disorders and fibrosis. However, we sometimes observe a linear, mid-wall high intensity signal in the basal septum in the short axis view, which often presents diagnostic difficulties in the clinical setting. The purpose of this study was to compare the linear, mid-wall high intensity in the basal septum identified by LGE with the anterior septal perforator arteries identified by coronary computed tomography angiography (CorCTA). METHODS We retrospectively selected 148 patients who underwent both CorCTA and CMR LGE within 1 year. In the interpretation of LGE, we defined a positive linear high intensity (LHI+) as follows: ① LHI in the basal septum and ② observable for 1.5 cm or more. All other patients were defined as a negative LHI (LHI-). In LHI+ patients, we assessed the correlation between the LHI length and the septal perforator artery length on CorCTA. We also compared the length of the septal perforator artery on CorCTA between LHI+ patients and LHI- patients. RESULTS A population of 111 patients were used for further analysis. Among these , there were 55 LHI+ patients and 56 LHI- patients. In LHI+ patients, linear regression analysis revealed that there was a good agreement between LGE LHI and septal perforator arteries by CorCTA in terms of length measurements. The measured length of the anterior septal perforator arteries was significantly shorter in LHI- patients than in LHI+ patients (10 ± 8 mm vs. 21 ± 8 mm; P < 0.05). CONCLUSIONS The LHI observed in the basal septum on short axis LGE may reflect contrast enhancement of the anterior septal perforator arteries. It is important to interpret this septal LHI against knowledge of anatomic structure, to avoid misinterpretations of LGE and prevent misdiagnosis.
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Affiliation(s)
- Masashi Nakamura
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Tomoyuki Kido
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Kuniaki Hirai
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Kohei Tabo
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Yuki Tanabe
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Naoto Kawaguchi
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Akira Kurata
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Teruhito Kido
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Osamu Yamaguchi
- Department of Cardiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
| | - Teruhito Mochizuki
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan
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Thakkar AB, Goldschlager N. Right Coronary Artery Vasospasm Presenting as Complete Atrioventricular Block. JAMA Intern Med 2020; 180:1244-1245. [PMID: 32716481 DOI: 10.1001/jamainternmed.2020.2361] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Nora Goldschlager
- Division of Cardiology, Department of Medicine, University of California, San Francisco.,Division of Cardiology, Department of Medicine, Zuckerberg San Francisco General Hospital and Trauma Center San Francisco, San Francisco, California.,Section Editor, JAMA Internal Medicine
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15
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A fully automated software platform for structural mitral valve analysis. Eur Radiol 2020; 30:6528-6536. [PMID: 32617689 DOI: 10.1007/s00330-020-06983-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 04/10/2020] [Accepted: 05/26/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate a novel fully automated mitral valve analysis software platform for cardiac computer tomography angiography (CCTA)-based structural heart therapy procedure planning. METHODS The study included 52 patients (25 women; mean age, 66.9 ± 12.4 years) who had undergone CCTA prior to transcatheter mitral valve replacement (TMVR) or surgical mitral valve intervention (replacement or repair). Therapeutically relevant mitral valve annulus parameters (projected area, circumference, trigone-to-trigone (T-T) distance, anterior-posterior (AP) diameter, and anterolateral-posteromedial (AL-PM) diameter) were measured. Results of the fully automated mitral valve analysis software platform with and without manual adjustments were compared with the reference standard of a user-driven measurement program (3mensio, Pie Medical Imaging). Measurements were compared between the fully automated software, both with and without manual adjustment, and the user-driven program using intraclass correlation coefficients (ICC). A secondary analysis included the time to obtain all measurements. RESULTS Fully automated measurements showed a good to excellent agreement (circumference, ICC = 0.70; projected area, ICC = 0.81; T-T distance, ICC = 0.64; AP, ICC = 0.62; and AL-PM diameter, ICC = 0.78) compared with the user-driven analysis. There was an excellent agreement between fully automated measurement with manual adjustments and user-driven analysis regarding circumference (ICC = 0.91), projected area (ICC = 0.93), T-T distance (ICC = 0.80), AP (ICC = 0.78), and AL-PM diameter (ICC = 0.79). The time required for mitral valve analysis was significantly lower using the fully automated software with manual adjustments compared with the standard assessment (134.4 ± 36.4 s vs. 304.3 ± 77.7 s) (p < 0.01). CONCLUSION The fully automated mitral valve analysis software, when combined with manual adjustments, demonstrated a strong correlation compared with the user-driven software while reducing the total time required for measurement. KEY POINTS • The novel software platform allows for a fully automated analysis of mitral valve structures. • An excellent agreement was found between the fully automated measurement with manual adjustments and the user-driven analysis. • The software showed quicker measurement time compared with the standard analysis of the mitral valve.
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16
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Rat N, Muntean I, Opincariu D, Gozar L, Togănel R, Chițu M. Cardiovascular Imaging for Guiding Interventional Therapy in Structural Heart Diseases. Curr Med Imaging 2020; 16:111-122. [DOI: 10.2174/1573405614666180612081736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 10/05/2017] [Accepted: 03/19/2018] [Indexed: 11/22/2022]
Abstract
Development of interventional methods has revolutionized the treatment of structural
cardiac diseases. Given the complexity of structural interventions and the anatomical variability of
various structural defects, novel imaging techniques have been implemented in the current clinical
practice for guiding the interventional procedure and for selection of the device to be used. Three–
dimensional echocardiography is the most used imaging method that has improved the threedimensional
assessment of cardiac structures, and it has considerably reduced the cost of complications
derived from malalignment of interventional devices. Assessment of cardiac structures with
the use of angiography holds the advantage of providing images in real time, but it does not allow
an anatomical description. Transesophageal Echocardiography (TEE) and intracardiac ultrasonography
play major roles in guiding Atrial Septal Defect (ASD) or Patent Foramen Ovale (PFO)
closure and device follow-up, while TEE is the procedure of choice to assess the flow in the Left
Atrial Appendage (LAA) and the embolic risk associated with a decreased flow. On the other hand,
contrast CT and MRI have high specificity for providing a detailed description of structure, but
cannot assess the flow through the shunt or the valvular mobility. This review aims to present the
role of modern imaging techniques in pre-procedural assessment and intraprocedural guiding of
structural percutaneous interventions performed to close an ASD, a PFO, an LAA or a patent ductus
arteriosus.
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Affiliation(s)
- Nora Rat
- Department of Cardiology, University of Medicine and Pharmacy of Targu Mures, Targu Mures, Romania
| | - Iolanda Muntean
- Clinic of Pediatric Cardiology, Institute of Cardiovascular Disease and Transplantation, University of Medicine and Pharmacy of Targu Mures, Targu Mures, Romania
| | - Diana Opincariu
- Department of Cardiology, University of Medicine and Pharmacy of Targu Mures, Targu Mures, Romania
| | - Liliana Gozar
- Clinic of Pediatric Cardiology, Institute of Cardiovascular Disease and Transplantation, University of Medicine and Pharmacy of Targu Mures, Targu Mures, Romania
| | - Rodica Togănel
- Clinic of Pediatric Cardiology, Institute of Cardiovascular Disease and Transplantation, University of Medicine and Pharmacy of Targu Mures, Targu Mures, Romania
| | - Monica Chițu
- Department of Cardiology, University of Medicine and Pharmacy of Targu Mures, Targu Mures, Romania
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Ko SM, Kim TH, Chun EJ, Kim JY, Hwang SH. Assessment of Left Ventricular Myocardial Diseases with Cardiac Computed Tomography. Korean J Radiol 2019; 20:333-351. [PMID: 30799565 PMCID: PMC6389818 DOI: 10.3348/kjr.2018.0280] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 10/03/2018] [Indexed: 01/09/2023] Open
Abstract
Rapid advances in cardiac computed tomography (CT) have enabled the characterization of left ventricular (LV) myocardial diseases based on LV anatomical morphology, function, density, and enhancement pattern. Global LV function and regional wall motion can be evaluated using multi-phasic cine CT images. CT myocardial perfusion imaging facilitates the identification of hemodynamically significant coronary artery disease. CT delayed-enhancement imaging is used to detect myocardial scar in myocardial infarction and to measure the extracellular volume fraction in non-ischemic cardiomyopathy. Multi-energy cardiac CT allows the mapping of iodine distribution in the myocardium. This review summarizes the current techniques of cardiac CT for LV myocardial assessment, highlights the key findings in various myocardial diseases, and presents future applications to complement echocardiography and cardiovascular magnetic resonance.
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Affiliation(s)
- Sung Min Ko
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
| | - Tae Hoon Kim
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Ju Chun
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jin Young Kim
- Department of Radiology, Dongsan Medical Center, Keimyung University College of Medicine, Daegu, Korea
| | - Sung Ho Hwang
- Department of Radiology, Korea University Anam Hospital, Seoul, Korea
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18
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Nasr VG, Callahan R, Wichner Z, Odegard KC, DiNardo JA. Intraluminal Pulmonary Vein Stenosis in Children. Anesth Analg 2019; 129:27-40. [DOI: 10.1213/ane.0000000000003924] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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19
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Perrier M, Deffarges S. ECG d’occlusion coronaire aiguë d’une artère bissectrice. ANNALES FRANCAISES DE MEDECINE D URGENCE 2019. [DOI: 10.3166/afmu-2019-0129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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20
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Bhambhani A, John N, Mathew A. Real-time three-dimensional echocardiographic left heart parameters in healthy indian adults. Indian Heart J 2018; 70:642-648. [PMID: 30392502 PMCID: PMC6204452 DOI: 10.1016/j.ihj.2017.11.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 11/03/2017] [Accepted: 11/20/2017] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Cardiac chamber dimensions are race and anthropometry dependent. We determined the age and gender specific 3-Dimensional echocardiographic (3DE) reference values for dimensions and function of left ventricle (LV) and left atrium (LA) in normal Indian adults. METHODS This single center prospective study enrolled 133 adult Indians free of heart disease and/or hypertensions, subjecting them to 3DE measurements of left atrial (LA) & left ventricular (LV) volumes, function and left ventricular mass (LVM). The higher limits of normal cut-offs were determined for these parameters and their dependency on age, gender and anthropometry were analyzed. RESULTS The body surface area (BSA) corrected higher limit cut-offs were: 59.37ml/m2 for LV end diastolic volume (59.19ml/m2 and 59.61ml/m2 for men and women, respectively; P=NS); 23.48ml/m2 for LV end systolic volume (23.27ml/m2 and 23.11ml/m2 for men and women, P=NS). Mean LVEF was 64.79%±7.26 (62.99%±6.51 and 67.05%±7.58 in men and women, P=NS). Men had higher LVM than women (119.79g±23.95 vs. 103.26g±23.76, P<0.001), this difference disappeared after BSA indexing. The higher limit cut-offs for normal LA volumes were 20.49ml for minimum volume (21.18ml and 19.46ml for men and women, P=NS) and 39.76ml for maximum volume (39.60ml and 40.03ml in men and women, P=NS). The parameters were smaller compared to western populations but the differences attenuated after BSA indexing. CONCLUSIONS The study reports normal 3DE parameters of size and function of left heart chambers in Indians.
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Affiliation(s)
- Anupam Bhambhani
- Department of Cardiology, Whitefield, Bangalore, 560066, India; Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bangalore, 560066, India.
| | - Nelson John
- Department of Community Medicine, Whitefield, Bangalore, 560066, India; Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bangalore, 560066, India
| | - Amalu Mathew
- Department of Cardiology, Whitefield, Bangalore, 560066, India; Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bangalore, 560066, India
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21
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Juan YH, Tsay PK, Shen WC, Yeh CS, Wen MS, Wan YL. Comparison of the Left Main Coronary Bifurcating Angle among Patients with Normal, Non-significantly and Significantly Stenosed Left Coronary Arteries. Sci Rep 2017; 7:1515. [PMID: 28473705 PMCID: PMC5431433 DOI: 10.1038/s41598-017-01679-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 03/31/2017] [Indexed: 01/25/2023] Open
Abstract
We evaluated the correlation of the left main coronary bifurcating angle (LCBA) with the severity of coronary atherosclerosis, risk factors of coronary artery disease (CAD) and the feasibility of measuring the LBCA using the axial plane. Coronary Computed tomography angiographies (CTAs) of 313 patients between Nov. 2006 and Oct. 2013 were reviewed and separated into three groups. Group I (211 patients) had significant stenosis (≥50%) of the left anterior descending coronary artery (LAD) and/or left circumflex coronary artery (LCX). Group II (62 subjects) had atherosclerosis without significant stenosis. Group III (40 subjects) had unremarkable coronary CTAs. Both Group I and II patients received conventional catheter angiography to confirm the severities of coronary stenoses. Significant differences were found among the groups with respect to risk factors, such as male gender, hypertension and body mass index. Axial plane measurement was feasible in most patients (82.1%), without significant differences among the groups. The mean LCBA was 84.7° among all patients, and significantly differed among groups I, II and III (87.34°, 81.16° and 75.53°, P < 0.001). The LCBA of group I was significantly higher than group III (P < 0.001) in univariate analysis, but insignificant in multivariate analysis (P = 0.064).
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Affiliation(s)
- Yu-Hsiang Juan
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Institute for Radiological Research, College of Medicine, Chang Gung University, (333), Taoyuan, Taiwan
| | - Pei-Kwei Tsay
- Department of Public Health and Center of Biostatistics, College of Medicine, Chang Gung University, (333), Taoyuan, Taiwan
| | - Wei-Chih Shen
- Department of Medical Research, China Medical University Hospital, China Medical University, (40447), Taichung, Taiwan
| | - Chih-Seng Yeh
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Institute for Radiological Research, College of Medicine, Chang Gung University, (333), Taoyuan, Taiwan
| | - Ming-Shien Wen
- Section of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, (333), Taoyuan, Taiwan
| | - Yung-Liang Wan
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Institute for Radiological Research, College of Medicine, Chang Gung University, (333), Taoyuan, Taiwan.
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22
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Duane F, Aznar MC, Bartlett F, Cutter DJ, Darby SC, Jagsi R, Lorenzen EL, McArdle O, McGale P, Myerson S, Rahimi K, Vivekanandan S, Warren S, Taylor CW. A cardiac contouring atlas for radiotherapy. Radiother Oncol 2017; 122:416-422. [PMID: 28233564 PMCID: PMC5356506 DOI: 10.1016/j.radonc.2017.01.008] [Citation(s) in RCA: 183] [Impact Index Per Article: 26.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 12/16/2016] [Accepted: 01/11/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND PURPOSE The heart is a complex anatomical organ and contouring the cardiac substructures is challenging. This study presents a reproducible method for contouring left ventricular and coronary arterial segments on radiotherapy CT-planning scans. MATERIAL AND METHODS Segments were defined from cardiology models and agreed by two cardiologists. Reference atlas contours were delineated and written guidelines prepared. Six radiation oncologists tested the atlas. Spatial variation was assessed using the DICE similarity coefficient (DSC) and the directed Hausdorff average distance (d→H,avg). The effect of spatial variation on doses was assessed using six different breast cancer regimens. RESULTS The atlas enabled contouring of 15 cardiac segments. Inter-observer contour overlap (mean DSC) was 0.60-0.73 for five left ventricular segments and 0.10-0.53 for ten coronary arterial segments. Inter-observer contour separation (mean d→H,avg) was 1.5-2.2mm for left ventricular segments and 1.3-5.1mm for coronary artery segments. This spatial variation resulted in <1Gy dose variation for most regimens and segments, but 1.2-21.8Gy variation for segments close to a field edge. CONCLUSIONS This cardiac atlas enables reproducible contouring of segments of the left ventricle and main coronary arteries to facilitate future studies relating cardiac radiation doses to clinical outcomes.
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Affiliation(s)
- Frances Duane
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, UK; Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, UK.
| | - Marianne C Aznar
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, UK
| | - Freddie Bartlett
- Department of Oncology and Haematology, Queen Alexandra Hospital, Portsmouth, UK
| | - David J Cutter
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, UK
| | - Sarah C Darby
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, UK
| | - Reshma Jagsi
- Department of Radiation Oncology, University of Michigan, Ann Arbor, USA
| | - Ebbe L Lorenzen
- Laboratory of Radiation Physics, Odense University Hospital, Denmark
| | - Orla McArdle
- St. Luke's Radiation Oncology Network, Dublin, Ireland
| | - Paul McGale
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, UK
| | - Saul Myerson
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, UK
| | - Kazem Rahimi
- George Institute for Global Health, University of Oxford, UK
| | - Sindu Vivekanandan
- CRUK/MRC Oxford Institute for Radiation Oncology, Gray Laboratories, University of Oxford, UK
| | - Samantha Warren
- University of Birmingham NHS Foundation Trust, Birmingham, UK
| | - Carolyn W Taylor
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, UK
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23
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Bozlar U, Uğurel MŞ, Sarı S, Akgün V, Örs F, Taşar M. Prevalence of dual left anterior descending artery variations in CT angiography. Diagn Interv Radiol 2016; 21:34-41. [PMID: 25333217 DOI: 10.5152/dir.2014.14275] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE We aimed to evaluate the frequency and features of dual left anterior descending artery (LAD) variants using computed tomography (CT) angiography. METHODS A total of 1337 consecutive coronary CT angiography examinations performed between April 2010 and December 2013 were retrospectively evaluated for the presence of dual LAD. CT examinations were performed with either 64- or 320-row multidetector CT scanners. All CT angiography images were evaluated for the presence and morphologic features of dual LAD subtypes. RESULTS Fifty-six dual LAD variations (4%) were identified in this study population. Type 1 was the most common type of dual LAD (n=48), while Type 3 (n=3) and Type 4 (n=2) were infrequent and Type 2 was not detected. Additionally, we detected previously unclassified dual LAD variations in three cases. CONCLUSION Dual LAD may be a relatively more common variant than described in the medical literature, which is mostly based on catheter angiography studies. Coronary CT angiography seems markedly efficacious for detecting and documenting the anatomical details of dual LAD subtypes, as well as showing other associated cardiocoronary anomalies.
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Affiliation(s)
- Uğur Bozlar
- Department of Radiology, Gülhane Military Medical Academy, Ankara, Turkey.
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24
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Bhat V, Belaval V, Gadabanahalli K, Raj V, Shah S. Illustrated Imaging Essay on Congenital Heart Diseases: Multimodality Approach Part II: Acyanotic Congenital Heart Disease and Extracardiac Abnormalities. J Clin Diagn Res 2016; 10:TE01-6. [PMID: 27504381 DOI: 10.7860/jcdr/2016/21442.8040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 04/02/2016] [Indexed: 11/24/2022]
Abstract
Acyanotic heart disease constitutes a significant majority of patient who may present with non-cardiac symptoms. Either they are detected incidentally or present with respiratory complaints. Equipped with knowledge of anatomy by echocardiography and radiographic methods described in previous part of this presentation, diagnosis may be confidently attempted. On plain radiography acyanotic congenital heart diseases have variable appearance depending upon severity of disease. Cardiac size, chamber enlargement and pulmonary vascular pattern are key elements. Typically left to right shunts with large volume flow are associated with pulmonary plethora. Plain radiography has an important role in detecting manifestation of pulmonary arterial hypertension. Severe stenosis of pulmonary valve is associated with pulmonary oligemia. Small intra-cardiac shunts and anomalies of coronary arteries generally present with normal cardiac size and pulmonary arterial pattern. Disease spectrum presented in this illustration demands thorough scrutiny of pulmonary, osseous and abdominal abnormalities. This section illustrates some commonly encountered spectrum of acyanotic cardiac disease.
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Affiliation(s)
- Venkatraman Bhat
- Director of Imaging Services, Head of Radiology, Department of Radiology and Imaging services, Narayana Health, Narayana Hrudayalaya, Multispeciality Hospital-Shaw Mazumdar Medical Centre , Bengaluru, India
| | - Vinay Belaval
- Junior Consultant, Department of Radiology and Imaging services, Narayana Health, Narayana Hrudayalaya, Multispeciality Hospital-Shaw Mazumdar Medical Centre , Bengaluru, India
| | - Karthik Gadabanahalli
- Consultant Radiology, Department of Radiology and Imaging services, Narayana Health, Narayana Hrudayalaya, Multispeciality Hospital-Shaw Mazumdar Medical Centre , Bengaluru, India
| | - Vimal Raj
- Consultant Radiology, Department of Radiology and Imaging services, Narayana Health, Narayana Hrudayalaya, Multispeciality Hospital-Shaw Mazumdar Medical Centre , Bengaluru, India
| | - Sejal Shah
- Senior Consultant Paediatric Cardiology, Department of Pediatric cardiology, Narayana Health, Narayana Hrudayalaya , Bengaluru, India
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25
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Bhat V, Belaval V, Gadabanahalli K, Raj V, Shah S. Illustrated Imaging Essay on Congenital Heart Diseases: Multimodality Approach Part I: Clinical Perspective, Anatomy and Imaging Techniques. J Clin Diagn Res 2016; 10:TE01-6. [PMID: 27376034 DOI: 10.7860/jcdr/2016/16779.7871] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 04/02/2016] [Indexed: 12/26/2022]
Abstract
Rapid evolution in technology in the recent years has lead to availability of multiple options for cardiac imaging. Availability of multiple options of varying capability, poses a challenge for optimal imaging choice. While new imaging choices are added, some of the established methods find their role re-defined. State of the art imaging practices are limited to few specialist cardiac centres, depriving many radiologists and radiologist in-training of optimal exposure to the field. This presentation is aimed at providing a broad idea about complexity of clinical problem, imaging options and a large library of images of congenital heart disease. Some emphasis is made as to the need of proper balance between performing examination with technical excellence in an ideal situation against the need of the majority of patients who are investigated with less optimal resources. Cases of congenital cardiac disease are presented in an illustrative way, showing imaging appearances in multiple modalities, highlighting specific observations in given instance.
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Affiliation(s)
- Venkatraman Bhat
- Director of Imaging Services, HOD, Department of Radiology and Imaging Services, Narayana Health, Narayana Hrudayalaya, Multispecialty Hospital-Shaw Mazumdar Medical Centre , Bengaluru, India
| | - Vinay Belaval
- Junior Consultant, Department of Radiology and Imaging Services, Narayana Health, Narayana Hrudayalaya, Multispecialty Hospital-Shaw Mazumdar Medical Centre , Bengaluru, India
| | - Karthik Gadabanahalli
- Consultant, Department of Radiology and Imaging Services, Narayana Health, Narayana Hrudayalaya, Multispecialty Hospital-Shaw Mazumdar Medical Centre , Bengaluru, India
| | - Vimal Raj
- Consultant, Department of Radiology and Imaging Services, Narayana Health, Narayana Hrudayalaya, Multispecialty Hospital-Shaw Mazumdar Medical Centre , Bengaluru, India
| | - Sejal Shah
- Senior Consultant, Department of Paediatric Cardiology, Narayana Health, Narayana Hrudayalaya , Bengaluru, India
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26
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Badano LP, Miglioranza MH, Mihăilă S, Peluso D, Xhaxho J, Marra MP, Cucchini U, Soriani N, Iliceto S, Muraru D. Left Atrial Volumes and Function by Three-Dimensional Echocardiography. Circ Cardiovasc Imaging 2016; 9:CIRCIMAGING.115.004229. [DOI: 10.1161/circimaging.115.004229] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 05/18/2016] [Indexed: 02/05/2023]
Abstract
Background—
Our study sought to (1) identify reference values for left atrial (LA) volumes and phasic function indices by 3-dimensional echocardiography (3DE) and compare them with those measured by 2-dimensional echocardiography (2DE) and (2) analyze their relationship with age, sex, body size, and left ventricular function. Accuracy and reproducibility of 3DE and 2DE have been also tested to evaluate the robustness of our data.
Methods and Results—
We obtained maximal, minimal, and preA LA volumes by 3DE and 2DE in 276 healthy volunteers (18–79 years; 57% women). Limits of normality for LA volumes and total LA emptying fraction were larger with 3DE than with 2DE (maximal LA volume: 43 versus 35 mL/m
2
; preA LA volume: 31 versus 25 mL/m
2
; minimal LA volume: 18 versus 14 mL/m
2
; 53 versus 48%, respectively;
P
<0.001). 3DE LA volumes indexed by body surface area were similar in men and women and increased with age. On multivariable analysis, age, weight, and left ventricular systolic and diastolic function indices resulted as correlates of LA 3DE indices. LA volumes were tightly correlated with cardiac magnetic resonance measurements, yet more underestimated by 2DE versus 3DE (bias±SD: −17±16 versus −7±15 mL, respectively). Among all LA parameters, maximal LA volume and total emptying fraction were the most reproducible, including at test-retest and at expert versus trainee comparisons.
Conclusions—
This study provides reference values for LA 3DE volumes and function from a relatively large cohort of healthy subjects with a wide age range. Our data may help clinicians to identify LA remodeling and dysfunction.
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Affiliation(s)
- Luigi P. Badano
- From the Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy (L.P.B., D.P., J.X, M.P.M., U.C., N.S., S.I., D.M.); Cardiology Institute of Rio Grande do Sul, Porto Alegre, Brazil (M.H.M.); and Carol Davila University of Medicine and Pharmacy, Emergency University Hospital, Bucharest, Romania (S.M.)
| | - Marcelo H. Miglioranza
- From the Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy (L.P.B., D.P., J.X, M.P.M., U.C., N.S., S.I., D.M.); Cardiology Institute of Rio Grande do Sul, Porto Alegre, Brazil (M.H.M.); and Carol Davila University of Medicine and Pharmacy, Emergency University Hospital, Bucharest, Romania (S.M.)
| | - Sorina Mihăilă
- From the Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy (L.P.B., D.P., J.X, M.P.M., U.C., N.S., S.I., D.M.); Cardiology Institute of Rio Grande do Sul, Porto Alegre, Brazil (M.H.M.); and Carol Davila University of Medicine and Pharmacy, Emergency University Hospital, Bucharest, Romania (S.M.)
| | - Diletta Peluso
- From the Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy (L.P.B., D.P., J.X, M.P.M., U.C., N.S., S.I., D.M.); Cardiology Institute of Rio Grande do Sul, Porto Alegre, Brazil (M.H.M.); and Carol Davila University of Medicine and Pharmacy, Emergency University Hospital, Bucharest, Romania (S.M.)
| | - Jola Xhaxho
- From the Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy (L.P.B., D.P., J.X, M.P.M., U.C., N.S., S.I., D.M.); Cardiology Institute of Rio Grande do Sul, Porto Alegre, Brazil (M.H.M.); and Carol Davila University of Medicine and Pharmacy, Emergency University Hospital, Bucharest, Romania (S.M.)
| | - Martina Perazzolo Marra
- From the Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy (L.P.B., D.P., J.X, M.P.M., U.C., N.S., S.I., D.M.); Cardiology Institute of Rio Grande do Sul, Porto Alegre, Brazil (M.H.M.); and Carol Davila University of Medicine and Pharmacy, Emergency University Hospital, Bucharest, Romania (S.M.)
| | - Umberto Cucchini
- From the Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy (L.P.B., D.P., J.X, M.P.M., U.C., N.S., S.I., D.M.); Cardiology Institute of Rio Grande do Sul, Porto Alegre, Brazil (M.H.M.); and Carol Davila University of Medicine and Pharmacy, Emergency University Hospital, Bucharest, Romania (S.M.)
| | - Nicola Soriani
- From the Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy (L.P.B., D.P., J.X, M.P.M., U.C., N.S., S.I., D.M.); Cardiology Institute of Rio Grande do Sul, Porto Alegre, Brazil (M.H.M.); and Carol Davila University of Medicine and Pharmacy, Emergency University Hospital, Bucharest, Romania (S.M.)
| | - Sabino Iliceto
- From the Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy (L.P.B., D.P., J.X, M.P.M., U.C., N.S., S.I., D.M.); Cardiology Institute of Rio Grande do Sul, Porto Alegre, Brazil (M.H.M.); and Carol Davila University of Medicine and Pharmacy, Emergency University Hospital, Bucharest, Romania (S.M.)
| | - Denisa Muraru
- From the Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy (L.P.B., D.P., J.X, M.P.M., U.C., N.S., S.I., D.M.); Cardiology Institute of Rio Grande do Sul, Porto Alegre, Brazil (M.H.M.); and Carol Davila University of Medicine and Pharmacy, Emergency University Hospital, Bucharest, Romania (S.M.)
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27
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Terpenning S, Ketai LH, Teague SD, Rissing SM. Prevalence of left atrial abnormalities in atrial fibrillation versus normal sinus patients. Acta Radiol Open 2016; 5:2058460116651899. [PMID: 27358747 PMCID: PMC4904345 DOI: 10.1177/2058460116651899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 04/22/2016] [Indexed: 11/17/2022] Open
Abstract
Background Atrial fibrillation (AF) may be the cause or sequela of left atrial abnormalities and variants. Purpose To determine the prevalence of left atrial (LA) abnormalities in AF patients compared to normal sinus rhythm (NSR) patients. Material and Methods We retrospectively reviewed 281 cardiac CT examinations from 2010 to 2012, excluding patients with prior pulmonary vein ablation, known coronary artery disease, prior coronary stent placement, or coronary artery bypass grafts. The first group consisted of 159 AF patients undergoing cardiac CT prior to pulmonary vein ablation and the second group consisted of 122 NSR patients evaluated with coronary CT angiography. Demographic data were collected. LA abnormalities were analyzed. Left atrial diameter was measured on an axial view. Results A total of 281 patients were included. The male gender has significantly higher prevalence of AF than female gender, P value <0.001. Patients with AF were significantly older (mean age, 57.4 years; standard deviation [SD], 11.8 years) than NSR patients (mean age, 53.4 years; SD, 13.6 years), P value, 0.01. The left atrial diameter was greater in the AF patients (mean diameter, 4.3 cm; SD, 0.82 cm) versus the NSR patients (3.4 cm; SD, 0.58 cm), P value, <0.0001. LA diverticulum was the most prevalent variant, occurring in 28.4% of the entire patient population followed by LA pouch, occurring in 24%. There was no significant between group differences in the prevalence of these or the remainder of the LA variants. Conclusion AF patients differed significantly from NSR patients in LA size, gender, and mean age. There was no statistical significance between the two groups with regard to the LA morphologic abnormalities other than size.
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Affiliation(s)
| | - Loren H Ketai
- Department of Radiology, University of New Mexico Albuquerque, NM, USA
| | - Shawn D Teague
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Stacy M Rissing
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN, USA
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28
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Barba-J L, Moya-Albor E, Escalante-Ramírez B, Brieva J, Vallejo Venegas E. Segmentation and optical flow estimation in cardiac CT sequences based on a spatiotemporal PDM with a correction scheme and the Hermite transform. Comput Biol Med 2016; 69:189-202. [PMID: 26773943 DOI: 10.1016/j.compbiomed.2015.12.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 12/21/2015] [Accepted: 12/21/2015] [Indexed: 11/25/2022]
Abstract
PURPOSE The left ventricle and the myocardium are two of the most important parts of the heart used for cardiac evaluation. In this work a novel framework that combines two methods to isolate and display functional characteristics of the heart using sequences of cardiac computed tomography (CT) is proposed. A shape extraction method, which includes a new segmentation correction scheme, is performed jointly with a motion estimation approach. METHODS For the segmentation task we built a Spatiotemporal Point Distribution Model (STPDM) that encodes spatial and temporal variability of the heart structures. Intensity and gradient information guide the STPDM. We present a novel method to correct segmentation errors obtained with the STPDM. It consists of a deformable scheme that combines three types of image features: local histograms, gradients and binary patterns. A bio-inspired image representation model based on the Hermite transform is used for motion estimation. The segmentation allows isolating the structure of interest while the motion estimation can be used to characterize the movement of the complete heart muscle. RESULTS The work is evaluated with several sequences of cardiac CT. The left ventricle was used for evaluation. Several metrics were used to validate the proposed framework. The efficiency of our method is also demonstrated by comparing with other techniques. CONCLUSION The implemented tool can enable physicians to better identify mechanical problems. The new correction scheme substantially improves the segmentation performance. Reported results demonstrate that this work is a promising technique for heart mechanical assessment.
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Affiliation(s)
- Leiner Barba-J
- Universidad Nacional Autónoma de México, Facultad de Ingeniería, Edificio de Posgrado en Ingeniería, Departamento de Procesamiento de Señales, Laboratorio Avanzado de Procesamiento de Imágenes, C.U., México, D.F., México.
| | | | - Boris Escalante-Ramírez
- Universidad Nacional Autónoma de México, Facultad de Ingeniería, Edificio de Posgrado en Ingeniería, Departamento de Procesamiento de Señales, Laboratorio Avanzado de Procesamiento de Imágenes, C.U., México, D.F., México
| | - Jorge Brieva
- Universidad Panamericana, Facultad de Ingeniería, México, D.F., México
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29
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Klimek-Piotrowska W, Koziej M, Hołda MK, Sałapa K, Kuniewicz M, Lelakowski J. The Thebesian valve height/coronary sinus ostium diameter ratio (H/D-Ratio) as a new indicator for specifying the morphological shape of the valve itself in multisliced computed tomography. Int J Cardiol 2015; 201:595-600. [PMID: 26340123 DOI: 10.1016/j.ijcard.2015.08.144] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 08/13/2015] [Accepted: 08/19/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND The coronary sinus ostium (CSO) is covered by the Thebesian valve (ThebV), which has a variable shape when assessed subjectively. The ThebV is an anatomical barrier during CS cannulation, which may be complicated due to the valves' size. The types of valves are: cord, remnant, semilunar, fold, and mesh/fenestrated. The ThebV can be visible using multisliced computed tomography (MSCT), however, this method cannot show the ThebV's morphological shape, only its size. METHODS 301 randomly selected autopsied human hearts were examined. The shape of the valve was subjectively assessed, whereas the ThebV height (H) and the CSO diameter (D) were measured. The H/D-Ratio was computed as the ThebV height divided by the CSO diameter, afterwards k-means cluster analysis was performed to estimate H/D-Ratio's range of values between valves. MSCT scans from 114 patients that underwent CSO cannulation were objectively evaluated based on similar measured parameters in accordance with received H/D-Ratio values. RESULTS Boundaries of ratio evaluations between remnant and semilunar, and semilunar and fold types were 0.35 and 0.65 respectively. In MSCT scans, the ThebV was recorded in 61 cases (remnant=5.3%, semilunar=24.6%, fold=16.7%, cord=0.0%, mesh/fenestrated=7.9%). Except for the remnant and cord types, the other types appear similarly as in the cadaveric and MSCT studies. There were no differences between ThebV height and the CSO diameter in cadavers and MSCT studies. CONCLUSION The H/D-Ratio can be useful in assessing ThebV shape as visualized in MSCT. We give threshold values for the H/D-Ratio which easily allow the ThebV shape to be determined.
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Affiliation(s)
| | - Mateusz Koziej
- Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland.
| | - Mateusz K Hołda
- Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
| | - Kinga Sałapa
- Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Cracow, Poland
| | - Marcin Kuniewicz
- Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland; Department of Electrocardiology, Institute of Cardiology, The John Paul II Hospital in Cracow, Jagiellonian University Medical College, Cracow, Poland
| | - Jacek Lelakowski
- Department of Electrocardiology, Institute of Cardiology, The John Paul II Hospital in Cracow, Jagiellonian University Medical College, Cracow, Poland
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30
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Affiliation(s)
- V.Y. Wang
- Auckland Bioengineering Institute and
| | - P.M.F. Nielsen
- Auckland Bioengineering Institute and
- Department of Engineering Science, Faculty of Engineering, University of Auckland, Auckland 1010, New Zealand; , ,
| | - M.P. Nash
- Auckland Bioengineering Institute and
- Department of Engineering Science, Faculty of Engineering, University of Auckland, Auckland 1010, New Zealand; , ,
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31
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Cincin A, Sari I, Sunbul M, Kepez A, Oguz M, Sert S, Sahin A, Ozben B, Tigen K, Basaran Y. Effect of acute sleep deprivation on left atrial mechanics assessed by three-dimensional echocardiography. Sleep Breath 2015; 20:227-35; discussion 235. [PMID: 26077190 DOI: 10.1007/s11325-015-1211-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 05/17/2015] [Accepted: 05/28/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Although sleep deprivation (SD) affects cardiovascular system in many ways, physio-pathological changes in cardiac chamber volume and function have not been described well. The aim of the present study was to investigate the effect of SD on left atrial (LA) and ventricular function with three-dimensional (3D) echocardiography. METHODS Thirty-two healthy individuals (12 females, mean age 33.25 ± 8.18) were evaluated. Echocardiographic examination was performed once after a night of regular sleep and a night of sleep debt. Beside conventional parameters, 3D phasic volumes and function were measured using a commercially available 3D echocardiography system and offline analysis software. RESULTS Mean sleep duration of the study group was 8.15 ± 2.19 h in the day of regular sleep and 2.56 ± 2.25 h in the day of sleep deprivation. There was a significant prolongation in deceleration time (180.83 ± 15.34 vs. 166.44 ± 26.12; p = 0.044) and increase in E/e' (6.95 ± 1.26 vs. 6.38 ± 0.85; p = 0.005). Among 3D measurements, the difference in left ventricular ejection fraction (EF), LA EF, LA reservoir function and LA active EF were not significant. Mean LA passive EF of the individuals was significantly lower after night shift (24.10 ± 7.66 vs. 31.49 ± 7.75; p = 0.006). CONCLUSION Acute SD is associated with a reduction in LA passive emptying function in healthy adults. 3D-derived indices were sufficient to show subclinical diastolic dysfunction according to impairment in passive phase of LA ejection. Prospective large-scale studies are needed to enlighten this issue.
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Affiliation(s)
- Altug Cincin
- Department of Cardiology, Marmara University Faculty of Medicine, Pendik, Istanbul, Turkey.
| | - Ibrahim Sari
- Department of Cardiology, Marmara University Faculty of Medicine, Pendik, Istanbul, Turkey
| | - Murat Sunbul
- Department of Cardiology, Marmara University Faculty of Medicine, Pendik, Istanbul, Turkey
| | - Alper Kepez
- Department of Cardiology, Marmara University Faculty of Medicine, Pendik, Istanbul, Turkey
| | - Mustafa Oguz
- Department of Cardiology, Marmara University Faculty of Medicine, Pendik, Istanbul, Turkey
| | - Sena Sert
- Department of Cardiology, Marmara University Faculty of Medicine, Pendik, Istanbul, Turkey
| | - Anil Sahin
- Department of Cardiology, Marmara University Faculty of Medicine, Pendik, Istanbul, Turkey
| | - Beste Ozben
- Department of Cardiology, Marmara University Faculty of Medicine, Pendik, Istanbul, Turkey
| | - Kursat Tigen
- Department of Cardiology, Marmara University Faculty of Medicine, Pendik, Istanbul, Turkey
| | - Yelda Basaran
- Department of Cardiology, Marmara University Faculty of Medicine, Pendik, Istanbul, Turkey
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Terpenning S, White CS. Imaging pitfalls, normal anatomy, and anatomical variants that can simulate disease on cardiac imaging as demonstrated on multidetector computed tomography. Acta Radiol Short Rep 2015; 4:2047981614562443. [PMID: 25610617 PMCID: PMC4299369 DOI: 10.1177/2047981614562443] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 11/10/2014] [Indexed: 12/02/2022] Open
Abstract
Advances in computed tomography have led to continuous improvement in cardiac imaging. Dedicated postprocessing capabilities, faster scan times, and cardiac gating methods reveal details of normal cardiac anatomy and anatomic variants that can mimic pathologic conditions. This article will review normal cardiac anatomy and variants that can mimic disease. Radiologists should be familiar with normal cardiac anatomy and anatomic variants to avoid misinterpretation of normal findings for pathologic processes.
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Affiliation(s)
| | - Charles S White
- Department of Radiology, University of Maryland, Baltimore, MD, USA
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Wu VCC, Takeuchi M, Kuwaki H, Iwataki M, Nagata Y, Otani K, Haruki N, Yoshitani H, Tamura M, Abe H, Negishi K, Lin FC, Otsuji Y. Prognostic value of LA volumes assessed by transthoracic 3D echocardiography: comparison with 2D echocardiography. JACC Cardiovasc Imaging 2013; 6:1025-1035. [PMID: 24011776 DOI: 10.1016/j.jcmg.2013.08.002] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 08/02/2013] [Accepted: 08/09/2013] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The hypothesis of this study was that minimal left atrial volume index (LAVImin) by 3-dimensional echocardiography (3DE) is the best predictor of future cardiovascular events. BACKGROUND Although maximal left atrial volume index (LAVImax) by 2-dimensional echocardiography (2DE) is a robust index for predicting prognosis, the prognostic value of LAVImin and the superiority of measurements by 3DE over 2DE have not been determined in a large group of patients. METHODS In protocol 1, we assessed age and sex dependency of LAVIs using 2DE and 3DE in 124 normal subjects and determined their cutoff values (mean + 2 SD). In protocol 2, 2-dimensional (2D) and 3-dimensional (3D) LAVImax/LAVImin were measured in 556 patients with high prevalence of cardiovascular disease. After excluding patients with atrial fibrillation, mitral valve disease, and age <18 years, 439 subjects were followed to record major adverse cardiovascular events (MACE). Patients were divided into 2 groups by the cutoff criteria of LAVI in each method. RESULTS In protocol 1, there was no significant age and sex dependency for each 2D and 3D LAVI. In protocol 2, during a mean of 2.5 years of follow-up, MACE developed in 88 patients, including 32 cardiac deaths. Kaplan-Meier survival analyses showed that all 4 LAVI cutoff criteria had significant predictive power of MACE. After variables were adjusted for clinical variables and left ventricular ejection fraction, all 4 methods were still independently and significantly associated with MACE, but 3D-derived LAVImin had the highest risk ratio. 3D LAVImin also had an incremental prognostic value over 3D LAVImax. CONCLUSIONS LAVIs by both 2DE and 3DE are powerful predictors of future cardiac events. 3D LAVImin tended to have a stronger and additive prognostic value than 3D LAVImax.
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Affiliation(s)
- Victor Chien-Chia Wu
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
| | - Masaaki Takeuchi
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
| | - Hiroshi Kuwaki
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
| | - Mai Iwataki
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
| | - Yasufumi Nagata
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
| | - Kyoko Otani
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
| | - Nobuhiko Haruki
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
| | - Hidetoshi Yoshitani
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
| | - Masahito Tamura
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
| | - Haruhiko Abe
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
| | - Kazuaki Negishi
- Menzies Research Institute Tasmania, Hobart, Tasmania, Australia
| | - Fen-Chiung Lin
- Department of Second Section of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan
| | - Yutaka Otsuji
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
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Bonardi M, Valentini A, Camporotondo R. Unroofed coronary sinus and persistent left superior vena cava: A case report. J Ultrasound 2013; 15:179-82. [PMID: 23450671 DOI: 10.1016/j.jus.2012.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
The unroofed coronary sinus is a spectrum of cardiac anomalies in which part or all of the common wall between the coronary sinus and the left atrium is absent. Most cases are associated with anomalous systemic venous return, such as persistent left superior vena cava.The diagnosis of this lesion is important to the prognosis of the patient, but it is often difficult because of nonspecific clinical features.Here we report a case of a complete unroofed coronary sinus and persistent left superior vena cava discovered during a computed tomographic investigation for pulmonary hypertension.
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Affiliation(s)
- M Bonardi
- IRCCS Foundation, San Matteo Medical Center, Radiology, Pavia, Italy
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Coronary sinus ostium: the key structure in the heart's anatomy from the electrophysiologist's point of view. Heart Vessels 2011; 26:449-56. [PMID: 21240507 DOI: 10.1007/s00380-010-0075-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Accepted: 07/16/2010] [Indexed: 10/18/2022]
Abstract
There are no research studies that comprehensively analyze, with computed tomography, the coronary sinus (CS) ostium with respect to its importance for some electrophysiological procedures paying special attention to the Thebesian valve (ThebV). Our aim was to evaluate the characteristic features of the CS anatomy, which can be useful for electrophysiologists using multislice computed tomography (MSCT). An additional aim was to create a tomographic classification of ThebV types. Included into the study were 150 patients (aged 59.7 ± 11.4; 105M) (43 with heart failure). Due to the suspicion of coronary artery disease, 64-slice MSCT (Toshiba, Aquilion 64) was performed in all patients. All measurements and the search for the ThebV were performed on multiplanar reconstructions in axial projection at 0.5-mm slice thickness. The average diameter of CS ostium was 14.2 ± 3.5 mm and the angle of entrance of the CS to the right atrium was 112° ± 11°. Seven variants of the ThebV were introduced and six of them were confirmed in this group. The following frequency of variants of ThebV was confirmed: E, 11.3%; D, 10.6%; A1, 8.7%; A2, 7.4%; C, 6.0%; B2, 2.0%. A statistically significant correlation between age and the size of CS ostium was found (r = 0.25; p < 0.05). It is possible to visualize and evaluate the CS including measurements and ThebV evaluation in MSCT. Six anatomical variants of the valve were found. MSCT can potentially provide valuable knowledge before the CS cannulation.
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Multidetector CT of left atrium. Eur J Radiol 2010; 81:e37-46. [PMID: 21123014 DOI: 10.1016/j.ejrad.2010.11.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Revised: 10/23/2010] [Accepted: 11/09/2010] [Indexed: 11/20/2022]
Abstract
MDCT angiography has enabled visualization of left atrium in addition to coronary arteries. CT images can be utilized to demonstrate normal anatomy and pathologies. Left atrium variations and pathologies include atrial septal pouch, patent foramen ovale, atrial septal defect, atrial band, lipomatous hypertrophy, cor triatriatum, diverticulum, accessory appendages, atrial thrombus and masses. Left atrium should be carefully evaluated in patients undergoing coronary CT angiography. MDCT is becoming an alternative modality for the evaluation of left atrium.
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Boltz T, Pavlicek W, Paden R, Renno M, Jensen A, Akay M. An anthropomorphic beating heart phantom for cardiac x-ray CT imaging evaluation. J Appl Clin Med Phys 2010; 11:3129. [PMID: 20160697 PMCID: PMC5719788 DOI: 10.1120/jacmp.v11i1.3129] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2009] [Revised: 09/11/2009] [Accepted: 09/09/2009] [Indexed: 11/30/2022] Open
Abstract
The current work describes an anthropomorphic beating heart phantom constructed as a tool for the assessment of technological advances in cardiac X‐ray computed tomography (CT). The phantom is comprised of a thorax, a compressor system, an ECG system, a beating heart with tortuous coronary arteries, and the option to add or remove pathologies such as aberrant beats, stents, and plaques. Initial trials with the phantom have shown its utility to assess temporal resolution, spatial resolution, radiation dose, iodine contrast, stents, and plaques. PACS numbers: 87.59.Fm, 87.57.Ce
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Affiliation(s)
- Thomas Boltz
- Diagnostic Imaging Physics, Mayo Clinic Scottsdale, Scottsdale, AZ 85259, USA.
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Noce T, Gupta N, Posteraro A, Kim C. Dual-Source Cardiac Computed Tomographic Technique, Anatomy, and Normal Variants. Curr Probl Diagn Radiol 2010; 39:37-50. [DOI: 10.1067/j.cpradiol.2009.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Hoey ETD, Gopalan D, Agrawal SKB, Screaton NJ. Cardiac causes of pulmonary arterial hypertension: assessment with multidetector CT. Eur Radiol 2009; 19:2557-68. [DOI: 10.1007/s00330-009-1460-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2008] [Revised: 03/19/2009] [Accepted: 04/27/2009] [Indexed: 11/29/2022]
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Moussa F, Kumar P, Pen V. Cardiac CT Scan for Preoperative Planning in a Patient with Bilateral Subclavian Stenosis Needing Coronary Artery Bypass. J Card Surg 2009; 24:196-7. [DOI: 10.1111/j.1540-8191.2008.00673.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lu TLC, Huber CH, Rizzo E, Dehmeshki J, von Segesser LK, Qanadli SD. Ascending aorta measurements as assessed by ECG-gated multi-detector computed tomography: a pilot study to establish normative values for transcatheter therapies. Eur Radiol 2008; 19:664-9. [DOI: 10.1007/s00330-008-1182-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2008] [Revised: 07/15/2008] [Accepted: 07/31/2008] [Indexed: 10/21/2022]
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Zimmermann E, Schnapauff D, Dewey M. Cardiac and Coronary Anatomy in Computed Tomography. Semin Ultrasound CT MR 2008; 29:176-81. [DOI: 10.1053/j.sult.2008.02.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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