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Coronary Sinus Diameter as a Potential Marker of Right Ventricle Impairment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042217. [PMID: 35206403 PMCID: PMC8871674 DOI: 10.3390/ijerph19042217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/10/2022] [Accepted: 02/14/2022] [Indexed: 11/28/2022]
Abstract
The aim of this study was to assess the influence of the parameters of the coronary sinus (CS) on the parameters that describe the function of the right ventricle (RV), which were calculated using cardiac computed tomography. Methods: A CT scan of the heart was performed on 150 patients due to suspicion of coronary artery disease using a Siemens Somatom Force (2 × 192 × 0.6) and a syngo.via workstation. The “CT coronary” and in some cases the generic presets were used to measure the CS ostium in millimeters (mm). The functional measurements of right heart ventricles were examined using the “CT cardiac function” automatic function on a 256 × 256 matrix. Results: The average diameter of the CS ostium was 16.29 ± 4.37 mm. In the group with RV impairment, it was 16.56 ± 4.76, whereas in the group with normal values of the RV, it was 15.98 ± 3.88 mm, p = 0.4199. The average angle of the entrance of the CS into the right atrium was 107.25° ± 9.68°. In the group with an RV impairment, it was 105.91° ± 9.22°, while in the patients with normal values of the RV, it was 108.82° ± 10.04°; p = 0.0682. A multiple regression showed that end systolic volume (p = 0.0017) and stroke volume (p = 0.0144) are important predictors of the CS ostium. Conclusions: Some relationships were found between the CS and the selected parameters that describe the function of the RV. This may suggest a role for the CS as a right ventricular buffer, which could potentially be treated as a marker of an RV impairment.
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Kim JY, Suh YJ, Han K, Kim YJ, Choi BW. Cardiac CT for Measurement of Right Ventricular Volume and Function in Comparison with Cardiac MRI: A Meta-Analysis. Korean J Radiol 2020; 21:450-461. [PMID: 32193893 PMCID: PMC7082652 DOI: 10.3348/kjr.2019.0499] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 12/16/2019] [Indexed: 11/18/2022] Open
Affiliation(s)
- Jin Young Kim
- Department of Radiology, Dongsan Hospital, Keimyung University College of Medicine, Daegu, Korea
| | - Young Joo Suh
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
| | - Kyunghwa Han
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Young Jin Kim
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Byoung Wook Choi
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Fluoroscopic Anatomy of Right-Sided Heart Structures for Transcatheter Interventions. JACC Cardiovasc Interv 2019; 11:1614-1625. [PMID: 30139469 DOI: 10.1016/j.jcin.2018.03.050] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 03/15/2018] [Accepted: 03/15/2018] [Indexed: 02/05/2023]
Abstract
Performing transcatheter tricuspid valve interventions requires a thorough knowledge of right-heart imaging. Integration of chamber views across the spectrum of imaging modalities (i.e., multislice computed tomography, fluoroscopy, and echocardiography) can facilitate transcatheter interventions on the right heart. Optimal fluoroscopic viewing angles for guiding interventional procedures can be obtained using pre-procedural multislice computed tomography scans. The present paper describes fluoroscopic viewing angles necessary to appreciate right-heart chamber anatomy and their relationship to echocardiography using multislice computed tomography.
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4
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Secondary tricuspid regurgitation: Do we understand what we would like to treat? Arch Cardiovasc Dis 2019; 112:642-651. [DOI: 10.1016/j.acvd.2019.04.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/28/2019] [Accepted: 04/30/2019] [Indexed: 11/19/2022]
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Nuffer Z, Baran TM, Krishnamoorthy V, Kaproth-Joslin K, Chaturvedi A. Accuracy of Non-Electrocardiographically Gated Thoracic CT Angiography for Right Atrial and Right Ventricular Enlargement. Radiol Cardiothorac Imaging 2019; 1:e190008. [PMID: 33778516 PMCID: PMC7977741 DOI: 10.1148/ryct.2019190008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 06/30/2019] [Accepted: 07/11/2019] [Indexed: 06/12/2023]
Abstract
PURPOSE To assess the role of long-axis (LA) and short-axis (SA) measurements of the right atrium (RA) and right ventricle (RV) at non-electrocardiographically (ECG) gated thoracic CT angiography for identification of RA enlargement and RV enlargement. MATERIALS AND METHODS This study was a retrospective case review of 138 patients who underwent both non-ECG-gated CT angiography and ECG-gated CT angiography concurrently from November 2016 through November 2018. The SA and LA of the RA and RV were measured by two observers blinded to the ECG-gated CT angiography data. ECG-gated CT angiography-derived RA end-systolic and RV end-diastolic volumes were used as standard of reference to derive cutoff values for diagnosis of RA and RV enlargement. RESULTS In this study, 138 patients were evaluated (70 men, 68 women; mean age, 70.0 years ± 18.4 [standard deviation]; mean body mass index, 29.3 kg/m2 ± 8.1). Of these patients, ECG-gated CT angiography revealed 36.2% had RA enhancement and 19.0% had RV enhancement. The best predictor of RA enhancement was the product of atrial LA and SA measurements, for which a threshold value of 3210 mm2 yielded a 94% sensitivity and 81.8% specificity (area under the curve [AUC], 0.92). A threshold of 55.5 mm for LA diameter had 86% sensitivity and 78.4% specificity in identifying RA enlargement. RV enlargement could be predicted if the SA diameter was greater than 48.5 mm (76.9% sensitivity and 64.9% specificity) and with a body surface area indexed value of 27.0 mm/m2 (92.3% sensitivity and 74.8% specificity [AUC, 0.87]). CONCLUSION RA and RV enlargement can be accurately diagnosed by using non-ECG-gated CT angiography.© RSNA, 2019Supplemental material is available for this article.
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Taron J, Foldyna B, Eslami P, Hoffmann U, Nikolaou K, Bamberg F. Cardiac Computed Tomography - More Than Coronary Arteries? A Clinical Update. ROFO-FORTSCHR RONTG 2019; 191:817-826. [PMID: 31250415 PMCID: PMC6839890 DOI: 10.1055/a-0924-5883] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Rapid improvement of scanner and postprocessing technology as well as the introduction of minimally invasive procedures requiring preoperative imaging have led to the broad utilization of cardiac computed tomography (CT) beyond coronary CT angiography (CTA). METHOD This review article presents an overview of recent literature on cardiac CT. The goal is to summarize the current guidelines on performing cardiac CT and to list established as well as emerging techniques with a special focus on extracoronary applications. RESULTS AND CONCLUSION Most recent guidelines for the appropriate use of cardiac CT include the evaluation of coronary artery disease, cardiac morphology, intra- and extracardiac structures, and functional and structural assessment of the myocardium under certain conditions. Besides coronary CTA, novel applications such as the calculation of a CT-derived fractional flow reserve (CT-FFR), assessment of myocardial function and perfusion imaging, as well as pre-interventional planning in valvular heart disease or prior pulmonary vein ablation in atrial fibrillation are becoming increasingly important. Especially these extracoronary applications are of growing interest in the field of cardiac CT and are expected to be gradually implemented in the daily clinical routine. KEY POINTS · Coronary artery imaging remains the main indication for cardiac CT. · Novel computational fluid dynamics allow the calculation of a CT-derived fractional flow reserve in patients with known or suspected coronary artery disease. · Cardiac CT delivers information on left ventricular volume as well as myocardial function and perfusion. · CT is the cardinal element for pre-interventional planning in transcatheter valve implantation and pulmonary vein isolation. CITATION FORMAT · Taron J, Foldyna B, Eslami P et al. Cardiac Computed Tomography - More Than Coronary Arteries? A Clinical Update. Fortschr Röntgenstr 2019; 191: 817 - 826.
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Affiliation(s)
- Jana Taron
- Cardiac MR PET CT Program, Massachusetts General-Hospital – Harvard Medical School, Boston, United States
- Department of Diagnostic and Interventional Radiology, University-Hospital Tübingen, Germany
| | - Borek Foldyna
- Cardiac MR PET CT Program, Massachusetts General-Hospital – Harvard Medical School, Boston, United States
| | - Parastou Eslami
- Cardiac MR PET CT Program, Massachusetts General-Hospital – Harvard Medical School, Boston, United States
| | - Udo Hoffmann
- Cardiac MR PET CT Program, Massachusetts General-Hospital – Harvard Medical School, Boston, United States
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, University-Hospital Tübingen, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
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7
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Cardiac CT Assessment of Right and Left Ventricular and Valvular Function. CURRENT CARDIOVASCULAR IMAGING REPORTS 2019. [DOI: 10.1007/s12410-019-9495-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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8
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Lee CH, Laurence DW, Ross CJ, Kramer KE, Babu AR, Johnson EL, Hsu MC, Aggarwal A, Mir A, Burkhart HM, Towner RA, Baumwart R, Wu Y. Mechanics of the Tricuspid Valve-From Clinical Diagnosis/Treatment, In-Vivo and In-Vitro Investigations, to Patient-Specific Biomechanical Modeling. Bioengineering (Basel) 2019; 6:E47. [PMID: 31121881 PMCID: PMC6630695 DOI: 10.3390/bioengineering6020047] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 05/16/2019] [Accepted: 05/17/2019] [Indexed: 12/29/2022] Open
Abstract
Proper tricuspid valve (TV) function is essential to unidirectional blood flow through the right side of the heart. Alterations to the tricuspid valvular components, such as the TV annulus, may lead to functional tricuspid regurgitation (FTR), where the valve is unable to prevent undesired backflow of blood from the right ventricle into the right atrium during systole. Various treatment options are currently available for FTR; however, research for the tricuspid heart valve, functional tricuspid regurgitation, and the relevant treatment methodologies are limited due to the pervasive expectation among cardiac surgeons and cardiologists that FTR will naturally regress after repair of left-sided heart valve lesions. Recent studies have focused on (i) understanding the function of the TV and the initiation or progression of FTR using both in-vivo and in-vitro methods, (ii) quantifying the biomechanical properties of the tricuspid valve apparatus as well as its surrounding heart tissue, and (iii) performing computational modeling of the TV to provide new insight into its biomechanical and physiological function. This review paper focuses on these advances and summarizes recent research relevant to the TV within the scope of FTR. Moreover, this review also provides future perspectives and extensions critical to enhancing the current understanding of the functioning and remodeling tricuspid valve in both the healthy and pathophysiological states.
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Affiliation(s)
- Chung-Hao Lee
- Biomechanics and Biomaterials Design Laboratory, School of Aerospace and Mechanical Engineering, The University of Oklahoma, Norman, OK 73019, USA.
- Institute for Biomedical Engineering, Science and Technology (IBEST), The University of Oklahoma, Norman, OK 73019, USA.
| | - Devin W Laurence
- Biomechanics and Biomaterials Design Laboratory, School of Aerospace and Mechanical Engineering, The University of Oklahoma, Norman, OK 73019, USA.
| | - Colton J Ross
- Biomechanics and Biomaterials Design Laboratory, School of Aerospace and Mechanical Engineering, The University of Oklahoma, Norman, OK 73019, USA.
| | - Katherine E Kramer
- Biomechanics and Biomaterials Design Laboratory, School of Aerospace and Mechanical Engineering, The University of Oklahoma, Norman, OK 73019, USA.
| | - Anju R Babu
- Biomechanics and Biomaterials Design Laboratory, School of Aerospace and Mechanical Engineering, The University of Oklahoma, Norman, OK 73019, USA.
- Department of Biotechnology and Medical Engineering, National Institute of Technology Rourkela, Rourkela, Odisha 769008, India.
| | - Emily L Johnson
- Department of Mechanical Engineering, Iowa State University, Ames, IA 50011, USA.
| | - Ming-Chen Hsu
- Department of Mechanical Engineering, Iowa State University, Ames, IA 50011, USA.
| | - Ankush Aggarwal
- Glasgow Computational Engineering Centre, School of Engineering, University of Glasgow, Scotland G12 8LT, UK.
| | - Arshid Mir
- Division of Pediatric Cardiology, Department of Pediatrics, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
| | - Harold M Burkhart
- Division of Cardiothoracic Surgery, Department of Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
| | - Rheal A Towner
- Advance Magnetic Resonance Center, MS 60, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA.
| | - Ryan Baumwart
- Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK 74078, USA.
| | - Yi Wu
- Biomechanics and Biomaterials Design Laboratory, School of Aerospace and Mechanical Engineering, The University of Oklahoma, Norman, OK 73019, USA.
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Lee J, Villablanca P, Ramakrishna H. Three-Dimensional Echocardiographic Evaluation of Right Ventricular Function in Chronic Thromboembolic Pulmonary Hypertension: Finding Meaning in the "Forgotten". J Cardiothorac Vasc Anesth 2018; 33:1504-1506. [PMID: 30538062 DOI: 10.1053/j.jvca.2018.10.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Indexed: 11/11/2022]
Affiliation(s)
- James Lee
- Division of Cardiology, Center for Structural Heart Disease, Henry Ford Heart and Vascular Institute, Detroit, MI
| | - Pedro Villablanca
- Division of Cardiology, Center for Structural Heart Disease, Henry Ford Heart and Vascular Institute, Detroit, MI
| | - Harish Ramakrishna
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, AZ
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Abstract
Valvular heart disease is a common clinical problem. Although echocardiography is the standard technique for the noninvasive evaluation of the valves, cardiac CT has evolved to become a useful tool in the evaluation of the cardiac structures as well. Importantly, CT allows for improved quantification of valvular calcification due to its superior spatial resolution. It may improve the detection of small valvular or perivalvular pathology or the characterization of valvular masses and vegetations. This review describes the assessment of normal and diseased heart valves by cardiac CT and discusses its strengths and weaknesses.
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Diagnostic Accuracy of Sex-Specific Chest CT Measurements Compared With Cardiac MRI Findings in the Assessment of Cardiac Chamber Enlargement. AJR Am J Roentgenol 2018; 211:993-999. [DOI: 10.2214/ajr.18.19805] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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12
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Konstam MA, Kiernan MS, Bernstein D, Bozkurt B, Jacob M, Kapur NK, Kociol RD, Lewis EF, Mehra MR, Pagani FD, Raval AN, Ward C. Evaluation and Management of Right-Sided Heart Failure: A Scientific Statement From the American Heart Association. Circulation 2018; 137:e578-e622. [DOI: 10.1161/cir.0000000000000560] [Citation(s) in RCA: 335] [Impact Index Per Article: 55.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background and Purpose:
The diverse causes of right-sided heart failure (RHF) include, among others, primary cardiomyopathies with right ventricular (RV) involvement, RV ischemia and infarction, volume loading caused by cardiac lesions associated with congenital heart disease and valvular pathologies, and pressure loading resulting from pulmonic stenosis or pulmonary hypertension from a variety of causes, including left-sided heart disease. Progressive RV dysfunction in these disease states is associated with increased morbidity and mortality. The purpose of this scientific statement is to provide guidance on the assessment and management of RHF.
Methods:
The writing group used systematic literature reviews, published translational and clinical studies, clinical practice guidelines, and expert opinion/statements to summarize existing evidence and to identify areas of inadequacy requiring future research. The panel reviewed the most relevant adult medical literature excluding routine laboratory tests using MEDLINE, EMBASE, and Web of Science through September 2017. The document is organized and classified according to the American Heart Association to provide specific suggestions, considerations, or reference to contemporary clinical practice recommendations.
Results:
Chronic RHF is associated with decreased exercise tolerance, poor functional capacity, decreased cardiac output and progressive end-organ damage (caused by a combination of end-organ venous congestion and underperfusion), and cachexia resulting from poor absorption of nutrients, as well as a systemic proinflammatory state. It is the principal cause of death in patients with pulmonary arterial hypertension. Similarly, acute RHF is associated with hemodynamic instability and is the primary cause of death in patients presenting with massive pulmonary embolism, RV myocardial infarction, and postcardiotomy shock associated with cardiac surgery. Functional assessment of the right side of the heart can be hindered by its complex geometry. Multiple hemodynamic and biochemical markers are associated with worsening RHF and can serve to guide clinical assessment and therapeutic decision making. Pharmacological and mechanical interventions targeting isolated acute and chronic RHF have not been well investigated. Specific therapies promoting stabilization and recovery of RV function are lacking.
Conclusions:
RHF is a complex syndrome including diverse causes, pathways, and pathological processes. In this scientific statement, we review the causes and epidemiology of RV dysfunction and the pathophysiology of acute and chronic RHF and provide guidance for the management of the associated conditions leading to and caused by RHF.
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Van Praet KM, Stamm C, Starck CT, Sündermann S, Meyer A, Montagner M, Nazari Shafti TZ, Unbehaun A, Jacobs S, Falk V, Kempfert J. An overview of surgical treatment modalities and emerging transcatheter interventions in the management of tricuspid valve regurgitation. Expert Rev Cardiovasc Ther 2018; 16:75-89. [DOI: 10.1080/14779072.2018.1421068] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Karel M. Van Praet
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
| | - Christof Stamm
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
- Department of Cardiothoracic Surgery, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Christoph T. Starck
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
| | - Simon Sündermann
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Alexander Meyer
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Matteo Montagner
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
| | - Timo Z. Nazari Shafti
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Axel Unbehaun
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
| | - Stephan Jacobs
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
| | - Volkmar Falk
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Department of Cardiothoracic Surgery, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Jörg Kempfert
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
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Muslem R, Ouhlous M, Akin S, Fares AA, Soliman OI. Tricuspid Valve Disease: A Computed Tomographic Assessment. PRACTICAL MANUAL OF TRICUSPID VALVE DISEASES 2018:179-203. [DOI: 10.1007/978-3-319-58229-0_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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15
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Abstract
Cardiac computed tomography (CT) is increasingly used in the evaluation of cardiomyopathies, particularly in patients who are not able to undergo other non-invasive imaging tests such as magnetic resonance imaging (MRI) due to the presence of MRI-incompatible pacemakers/defibrillators or other contraindications or due to extensive artifacts from indwelling metallic devices. Advances in scanner technology enable acquisition of CT images with high spatial resolution, good temporal resolution, wide field of view and multi-planar reconstruction capabilities. CT is useful in cardiomyopathies in several ways, particularly in the evaluation of coronary arteries, characterization of cardiomyopathy phenotype, quantification of cardiac volumes and function, treatment-planning, and post-treatment evaluation. In this article, we review the imaging techniques and specific applications of CT in the evaluation of cardiomyopathies.
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Affiliation(s)
- Kevin Kalisz
- University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Prabhakar Rajiah
- Cardiothoracic Imaging, Radiology Department, UT Southwestern Medical Center, Dallas, Texas, USA
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Estimation of right ventricular dysfunction by computed tomography pulmonary angiography: a valuable adjunct for evaluating the severity of acute pulmonary embolism. J Thromb Thrombolysis 2016; 43:271-278. [DOI: 10.1007/s11239-016-1438-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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17
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Multidetector computed tomography shows reverse cardiac remodeling after double lung transplantation for pulmonary hypertension. RADIOLOGIA 2016. [DOI: 10.1016/j.rxeng.2016.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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18
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Mandich Crovetto D, Alonso Charterina S, Jiménez López-Guarch C, Pont Vilalta M, Pérez Núñez M, de Pablo Gafas A, Escribano Subías P. Multidetector computed tomography shows reverse cardiac remodeling after double lung transplantation for pulmonary hypertension. RADIOLOGIA 2016; 58:277-82. [PMID: 27198195 DOI: 10.1016/j.rx.2016.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 04/02/2016] [Accepted: 04/04/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To use multidetector computed tomography (MDCT) to evaluate the structural changes in the right heart and pulmonary arteries that occur in patients with severe pulmonary hypertension treated by double lung transplantation. MATERIAL AND METHODS This was a retrospective study of 21 consecutive patients diagnosed with severe pulmonary hypertension who underwent double lung transplantation at our center between 2010 and 2014. We analyzed the last MDCT study done before lung transplantation and the first MDCT study done after lung transplantation. We recorded the following variables: diameter of the pulmonary artery trunk, ratio of the diameter of the pulmonary artery trunk to the diameter of the ascending aorta, diameter of the right ventricle, ratio of the diameter of the left ventricle to the diameter of the right ventricle, and eccentricity index. Statistical analysis consisted of the comparison of the means of the variables recorded. RESULTS In all cases analyzed, the MDCT study done a mean of 24±14 days after double lung transplantation showed a significant reduction in the size of the right heart chambers, with improved indices of ventricular interdependency index, and reduction in the size of the pulmonary artery trunk (p<0.001 for all the variables analyzed). CONCLUSION Patients with pulmonary hypertension treated by double lung transplantation present early reverse remodeling of the changes in the structures of the right heart and pulmonary arterial tree. MDCT is useful for detecting these changes.
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Affiliation(s)
- D Mandich Crovetto
- Servicio de Radiodiagnóstico, Hospital Universitario 12 de Octubre, Madrid, España.
| | - S Alonso Charterina
- Servicio de Radiodiagnóstico, Hospital Universitario 12 de Octubre, Madrid, España
| | | | - M Pont Vilalta
- Servicio de Radiodiagnóstico, Hospital Universitario 12 de Octubre, Madrid, España
| | - M Pérez Núñez
- Servicio de Radiodiagnóstico, Hospital Universitario 12 de Octubre, Madrid, España
| | - A de Pablo Gafas
- Servicio de Neumología, Hospital Universitario 12 de Octubre, Madrid, España
| | - P Escribano Subías
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, España
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19
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The Role of Cardiac CT in the Evaluation of Endocarditis. CURRENT CARDIOVASCULAR IMAGING REPORTS 2016. [DOI: 10.1007/s12410-016-9377-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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20
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Abstract
There is a growing appreciation for the adverse long-term impact of right-sided valvular dysfunction in patients with congenital heart disease. Although right-sided valvular stenosis and/or regurgitation is often better tolerated than left-sided valvular dysfunction in the short and intermediate term, the long-term consequences are numerous and include, but are not limited to, arrhythmias, heart failure, and multi-organ dysfunction. Surgical right-sided valve interventions have been performed for many decades, but the comorbidities associated with multiple surgeries are a concern. Transcatheter right-sided valve replacement is safe and effective and is being performed at an increasing number of centers around the world. It offers an alternative to traditional surgical techniques and may potentially alter the decision making process whereby valvular replacement is performed prior to the development of long-term sequelae of right-sided valvular dysfunction.
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Andreini D, Martuscelli E, Guaricci AI, Carrabba N, Magnoni M, Tedeschi C, Pelliccia A, Pontone G. Clinical recommendations on Cardiac-CT in 2015. J Cardiovasc Med (Hagerstown) 2016; 17:73-84. [DOI: 10.2459/jcm.0000000000000318] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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22
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Huttin O, Voilliot D, Mandry D, Venner C, Juillière Y, Selton-Suty C. All you need to know about the tricuspid valve: Tricuspid valve imaging and tricuspid regurgitation analysis. Arch Cardiovasc Dis 2016; 109:67-80. [DOI: 10.1016/j.acvd.2015.08.007] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 08/24/2015] [Accepted: 08/27/2015] [Indexed: 11/17/2022]
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Baxi AJ, Tavakoli S, Vargas D, Restrepo CS. Bands, Chords, Tendons, and Membranes in the Heart: An Imaging Overview. Curr Probl Diagn Radiol 2015; 45:380-391. [PMID: 26433812 DOI: 10.1067/j.cpradiol.2015.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 08/24/2015] [Indexed: 11/22/2022]
Abstract
Crests, bands, chords, and membranes can be seen within the different cardiac chambers, with variable clinical significance. They can be incidental or can have clinical implications by causing hemodynamic disturbance. It is crucial to know the morphology and orientation of normal structures, aberrant or accessory muscles, and abnormal membranes to diagnose the hemodynamic disturbance associated with them. Newer generation computed tomographic scanners and faster magnetic resonance imaging sequences offer high spatial and temporal resolution allowing for acquisition of high resolution images of the cardiac chambers improving identification of small internal structures, such as papillary muscles, muscular bands, chords, and membranes. They also help in identification of other associated complications, malformations, and provide a road map for treatment. In this article, we review cross-sectional cardiac imaging findings of normal anatomical variants and distinctive imaging features of pathologic bands, chords, or membranes, which may produce significant hemodynamic changes and clinical symptomatology.
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Affiliation(s)
- Ameya Jagdish Baxi
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX.
| | - Sina Tavakoli
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Daniel Vargas
- Department of Radiology, University of Colorado Hospital, Denver, CO
| | - Carlos S Restrepo
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX
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Pathogenic structural heart changes in early tricuspid regurgitation. J Thorac Cardiovasc Surg 2015; 150:323-30. [DOI: 10.1016/j.jtcvs.2015.05.009] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Revised: 04/19/2015] [Accepted: 05/02/2015] [Indexed: 02/06/2023]
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25
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Rizvi A, Deaño RC, Bachman DP, Xiong G, Min JK, Truong QA. Analysis of ventricular function by CT. J Cardiovasc Comput Tomogr 2015; 9:1-12. [PMID: 25576407 PMCID: PMC4329068 DOI: 10.1016/j.jcct.2014.11.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 11/14/2014] [Indexed: 11/22/2022]
Abstract
The assessment of ventricular function, cardiac chamber dimensions, and ventricular mass is fundamental for clinical diagnosis, risk assessment, therapeutic decisions, and prognosis in patients with cardiac disease. Although cardiac CT is a noninvasive imaging technique often used for the assessment of coronary artery disease, it can also be used to obtain important data about left and right ventricular function and morphology. In this review, we will discuss the clinical indications for the use of cardiac CT for ventricular analysis, review the evidence on the assessment of ventricular function compared with existing imaging modalities such cardiac magnetic resonance imaging and echocardiography, provide a typical cardiac CT protocol for image acquisition and postprocessing for ventricular analysis, and provide step-by-step instructions to acquire multiplanar cardiac views for ventricular assessment from the standard axial, coronal, and sagittal planes. Furthermore, both qualitative and quantitative assessments of ventricular function as well as sample reporting are detailed.
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Affiliation(s)
- Asim Rizvi
- Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and Weill Cornell Medical College, Suite 108, 413 East 69th Street, New York, NY 10021, USA
| | - Roderick C Deaño
- Division of Cardiovascular Disease, New York-Presbyterian Hospital and Weill Cornell Medical College, New York, NY, USA
| | - Daniel P Bachman
- Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and Weill Cornell Medical College, Suite 108, 413 East 69th Street, New York, NY 10021, USA
| | - Guanglei Xiong
- Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and Weill Cornell Medical College, Suite 108, 413 East 69th Street, New York, NY 10021, USA
| | - James K Min
- Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and Weill Cornell Medical College, Suite 108, 413 East 69th Street, New York, NY 10021, USA; Division of Cardiovascular Disease, New York-Presbyterian Hospital and Weill Cornell Medical College, New York, NY, USA
| | - Quynh A Truong
- Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and Weill Cornell Medical College, Suite 108, 413 East 69th Street, New York, NY 10021, USA; Division of Cardiovascular Disease, New York-Presbyterian Hospital and Weill Cornell Medical College, New York, NY, USA.
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Sommer A, Kronborg MB, Norgaard BL, Gerdes C, Mortensen PT, Nielsen JC. Left and right ventricular lead positions are imprecisely determined by fluoroscopy in cardiac resynchronization therapy: a comparison with cardiac computed tomography. Europace 2014; 16:1334-41. [DOI: 10.1093/europace/euu056] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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27
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Pawade T, Holloway B, Bradlow W, Steeds RP. Noninvasive imaging for the diagnosis and prognosis of pulmonary hypertension. Expert Rev Cardiovasc Ther 2013; 12:71-86. [DOI: 10.1586/14779072.2014.867806] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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28
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Li J, Lee A, Cheng Y. A GPS Map for Pulmonary Hypertension: A Review of Imaging Modalities. Curr Hypertens Rep 2013; 15:650-8. [DOI: 10.1007/s11906-013-0392-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tadic M, Ivanovic B, Cuspidi C. Metabolic syndrome and right ventricle: an updated review. Eur J Intern Med 2013; 24:608-16. [PMID: 24001437 DOI: 10.1016/j.ejim.2013.08.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 08/06/2013] [Accepted: 08/07/2013] [Indexed: 12/19/2022]
Abstract
The cluster of metabolic and hemodynamic abnormalities which characterize the metabolic syndrome (MS) is responsible for subclinical cardiac and extra-cardiac damage such as left ventricular hypertrophy, diastolic dysfunction, carotid atherosclerosis and microalbuminuria. The development of different non-invasive imaging methods enabled a detail investigation of right ventricular structure and function, and revealed that right ventricular remodeling followed changes in the left ventricular structure and function in patients with arterial hypertension, diabetes or obesity. Previous investigations also reported that the coexistence of two components of the MS induced more significant cardiac remodeling than the presence of only one MS risk-factor. The relationship between different components of the MS (increased blood pressure, abdominal obesity, increased fasting glucose level and dyslipidemia) and right ventricular remodeling could be explained by several hemodynamic and non-hemodynamic mechanisms. However, the association between right ventricular remodeling and the MS has not been sufficiently investigated so far. The aim of this article was to review recent articles focusing on the association between metabolic syndrome components and the metabolic syndrome itself with impairments in right ventricular structure and function assessed by different imaging techniques.
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Affiliation(s)
- Marijana Tadic
- University Clinical Hospital Centre "Dr Dragisa Misovic", Heroja Milana Tepica 1, 11000 Belgrade, Serbia.
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