1
|
Reid A, Dweck MR. Let there be light! The meteoric rise of cardiac imaging. BRITISH HEART JOURNAL 2022; 108:780-786. [PMID: 35459728 DOI: 10.1136/heartjnl-2021-320147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/02/2022] [Indexed: 11/04/2022]
Abstract
Imaging plays a central role in modern cardiovascular practice. It is a field characterised by exciting technological advances that have shaped our understanding of pathology and led to major improvements in patient diagnosis and care. The UK has played a key international role in the development of this subspecialty and is the current home to many of the leading global centres in multimodality cardiovascular imaging. In this short review, we will outline some of the key contributions of the British Cardiovascular Society and its members to this rapidly evolving field and look at how this relationship may continue to shape future cardiovascular practice.
Collapse
Affiliation(s)
- Anna Reid
- Department of Cardiology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Marc Richard Dweck
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
2
|
Raftopoulos L, Aggeli C, Dimitroglou Y, Kakiouzi V, Tsartsalis D, Patsourakos D, Tsioufis C. The fundamental role of stress echo in evaluating coronary artery disease in specific patient populations. Curr Vasc Pharmacol 2021; 20:156-167. [PMID: 34931964 DOI: 10.2174/1570161120666211220104156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/06/2021] [Accepted: 11/19/2021] [Indexed: 11/22/2022]
Abstract
Stress echocardiography (SE) was initially used for assessing patients with known or suspected coronary heart disease by detecting and evaluating myocardial ischemia and viability. The implementation of SE has gradually been extended to several cardiovascular diseases beyond coronary artery disease, and SE protocols have been modified and adapted for the detection of coronary artery disease (CAD) or other cardiovascular diseases in specific patient populations. This review attempts to summarize current data concerning SE implementation and clinical value in these specific and diverse populations: patients with an intramural course of a coronary artery - known as a myocardial bridge, chronic severe or end-stage hepatic disease, chronic severe or end-stage kidney disease, cardiac allograft vasculopathy, patients scheduled for solid-organ transplantation and other intermediate and high-risk surgery and, finally, patients treated with anticancer drugs or radiotherapy.
Collapse
Affiliation(s)
- Leonidas Raftopoulos
- First Department of Cardiology, University of Athens Medical School, General Hospital of Athens Hippokration, Athens, Greece
| | - Constantina Aggeli
- First Department of Cardiology, University of Athens Medical School, General Hospital of Athens Hippokration, Athens, Greece
| | - Yannis Dimitroglou
- First Department of Cardiology, University of Athens Medical School, General Hospital of Athens Hippokration, Athens, Greece
| | - Vasiliki Kakiouzi
- First Department of Cardiology, University of Athens Medical School, General Hospital of Athens Hippokration, Athens, Greece
| | - Dimitrios Tsartsalis
- First Department of Cardiology, University of Athens Medical School, General Hospital of Athens Hippokration, Athens, Greece
| | - Dimitrios Patsourakos
- First Department of Cardiology, University of Athens Medical School, General Hospital of Athens Hippokration, Athens, Greece
| | - Costas Tsioufis
- First Department of Cardiology, University of Athens Medical School, General Hospital of Athens Hippokration, Athens, Greece
| |
Collapse
|
3
|
Naderi H, Robinson S, Swaans MJ, Bual N, Cheung WS, Reid L, Shun-Shin M, Asaria P, Pabari P, Cole G, Kanaganayagam GS, Sutaria N, Bellamy M, Fox K, Nihoyannopoulos P, Petraco R, Al-Lamee R, Nijjer SS, Sen S, Ruparelia N, Baker C, Mikhail G, Malik I, Khamis R, Varnava A, Francis D, Mayet J, Rana B. Adapting the role of handheld echocardiography during the COVID-19 pandemic: A practical guide. Perfusion 2021; 36:547-558. [PMID: 33427055 DOI: 10.1177/0267659120986532] [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] [Indexed: 01/09/2023]
Abstract
The COVID-19 pandemic has altered our approach to inpatient echocardiography delivery. There is now a greater focus to address key clinical questions likely to make an immediate impact in management, particularly during the period of widespread infection. Handheld echocardiography (HHE) can be used as a first-line assessment tool, limiting scanning time and exposure to high viral load. This article describes a potential role for HHE during a pandemic. We propose a protocol with a reporting template for a focused core dataset necessary in delivering an acute echocardiography service in the setting of a highly contagious disease, minimising risk to the operator. We cover the scenarios typically encountered in the acute cardiology setting and how an expert trained echocardiography team can identify such pathologies using a limited imaging format and include cardiac presentations encountered in those patients acutely unwell with COVID-19.
Collapse
Affiliation(s)
- Hafiz Naderi
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Shaun Robinson
- North West Anglia NHS Foundation Trust, Peterborough, Cambridgeshire, UK
| | - Martin J Swaans
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Nina Bual
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Wing-See Cheung
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Laura Reid
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Matthew Shun-Shin
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Perviz Asaria
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Punam Pabari
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Graham Cole
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Gajen S Kanaganayagam
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Nilesh Sutaria
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Michael Bellamy
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Kevin Fox
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | | | - Ricardo Petraco
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Rasha Al-Lamee
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Sukhjinder S Nijjer
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Sayan Sen
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Neil Ruparelia
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Christopher Baker
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Ghada Mikhail
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Iqbal Malik
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Ramzi Khamis
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Amanda Varnava
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Darrel Francis
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Jamil Mayet
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Bushra Rana
- Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK
| |
Collapse
|
4
|
Picano E, Zagatina A, Wierzbowska-Drabik K, Borguezan Daros C, D’Andrea A, Ciampi Q. Sustainability and Versatility of the ABCDE Protocol for Stress Echocardiography. J Clin Med 2020; 9:E3184. [PMID: 33008112 PMCID: PMC7601661 DOI: 10.3390/jcm9103184] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 09/23/2020] [Accepted: 09/28/2020] [Indexed: 12/19/2022] Open
Abstract
For the past 40 years, the methodology for stress echocardiography (SE) has remained basically unchanged. It is based on two-dimensional, black and white imaging, and is used to detect regional wall motion abnormalities (RWMA) in patients with known or suspected coronary artery disease (CAD). In the last five years much has changed and RWMA is not enough on its own to stratify patient risk and dictate therapy. Patients arriving at SE labs often have comorbidities and are undergoing full anti-ischemic therapy. The SE positivity rate based on RWMA fell from 70% in the eighties to 10% in the last decade. The understanding of CAD pathophysiology has shifted from a regional hydraulic disease to a systemic biologic disease. The conventional view of CAD encouraged the use of coronary anatomic imaging for diagnosis and the oculo-stenotic reflex for the deployment of therapy. This has led to a clinical oversimplification that ignores the lessons of pathophysiology and epidemiology, and in fact, CAD is not synonymous with ischemic heart disease. Patients with CAD may also have other vulnerabilities such as coronary plaque (step A of ABCDE-SE), alveolar-capillary membrane and pulmonary congestion (step B), preload and contractile reserve (step C), coronary microcirculation (step D) and cardiac autonomic balance (step E). The SE methodology based on two-dimensional echocardiography is now integrated with lung ultrasound (step B for B-lines), volumetric echocardiography (step C), color- and pulsed-wave Doppler (step D) and non-imaging electrocardiogram-based heart rate assessment (step E). In addition, qualitative assessment based on the naked eye has now become more quantitative, has been improved by contrast and based on cardiac strain and artificial intelligence. ABCDE-SE is now ready for large scale multicenter testing in the SE2030 study.
Collapse
Affiliation(s)
- Eugenio Picano
- Biomedicine Department, CNR Institute of Clinical Physiology, 56124 Pisa, Italy
| | - Angela Zagatina
- Cardiology Department, Saint Petersburg State University Clinic, Saint Petersburg State University, 199034 Saint Petersburg, Russia;
| | - Karina Wierzbowska-Drabik
- First Department and Chair of Cardiology, Bieganski Hospital, Medical University, 90926 Lodz, Poland;
| | | | | | - Quirino Ciampi
- Cardiolody Division, Fatebenefratelli Hospital, 82100 Benevento, Italy;
| |
Collapse
|