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Liga R, Korosoglou G. Editorial: Case reports in cardiovascular imaging 2023. Front Cardiovasc Med 2024; 11:1424893. [PMID: 38867849 PMCID: PMC11167077 DOI: 10.3389/fcvm.2024.1424893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Accepted: 05/20/2024] [Indexed: 06/14/2024] Open
Affiliation(s)
- Riccardo Liga
- Department of Surgical Pathology, University of Pisa, Pisa, Italy
- Cardiothoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
| | - Grigorios Korosoglou
- Department of Cardiology, Vascular Medicine and Pneumology, GRN Hospital Weinheim, Weinheim, Germany
- Cardiac Imaging Center Weinheim, Hector Foundation, Weinheim, Germany
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Aher P, Saad N, Aher A, Priya S, Albini A. Pulmonary Artery Stenosis After an Orthotopic Heart Transplantation: A Case Report With Cardiac Imaging Findings and a Literature Review. Cureus 2024; 16:e57416. [PMID: 38694640 PMCID: PMC11062755 DOI: 10.7759/cureus.57416] [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: 04/01/2024] [Indexed: 05/04/2024] Open
Abstract
Pulmonary artery stenosis is a rare complication of heart transplantation. It is typically a congenital condition or can be secondary to rheumatic fever, systemic vasculitis like Behcet's disease, or Takayasu's arteritis. It can also occur as a rarity of a delayed complication post-heart transplant. In this report, we describe the imaging findings of pulmonary artery stenosis in a patient who underwent an orthotopic heart transplant more than 10 years prior. Dynamic cardiac magnetic resonance imaging (MRI), phase contrast imaging, and MR angiography in the management of pulmonary artery stenosis helped in heart and pulmonary circulation. Functional evaluation can be achieved with current multichannel transmit-receive coils. Cardiac gated pre- and dynamic contrast-enhanced MR was performed with phase-contrast imaging for further evaluation confirming the diagnosis of pulmonary artery stenosis.
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Affiliation(s)
- Pritish Aher
- Radiology, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, USA
| | - Nini Saad
- Radiology, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, USA
| | - Aman Aher
- Nutrition and Exercise Physiology, University of Missouri, Columbia, USA
| | - Sarv Priya
- Radiology, University of Iowa Hospitals and Clinics, Iowa City, USA
| | - Alessandra Albini
- Radiology, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, USA
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3
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Steen H, Montenbruck M, Kallifatidis A, André F, Frey N, Kelle S, Korosoglou G. Multi-parametric non-contrast cardiac magnetic resonance for the differentiation between cardiac amyloidosis and hypertrophic cardiomyopathy. Clin Res Cardiol 2024; 113:469-480. [PMID: 38095711 DOI: 10.1007/s00392-023-02348-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 11/20/2023] [Indexed: 02/22/2024]
Abstract
AIM To evaluate the ability of fast strain-encoded (SENC) cardiac magnetic resonance (CMR) derived myocardial strain and native T1 mapping to discriminate between hypertrophic cardiomyopathy (HCM) and cardiac amyloidosis. METHODS Ninety nine patients (57 with hypertrophic cardiomyopathy and 42 with cardiac amyloidosis) were systematically analysed. LV-ejection fraction, LV-mass index, septal wall thickness and native T1 mapping values were assessed. In addition, global circumferential and longitudinal strain and segmental circumferential and longitudinal strain in basal, mid-ventricular, and apical segments were calculated. A ratio was built by dividing native T1 values by basal segmental strain (T1-to-basal segmental strain ratio). RESULTS Myocardial strain was equally distributed in apical and basal segments in HCM patients, whereas an apical sparing with less impaired apical strain was noticed in cardiac amyloidosis (apical-to-basal-ratio of 1.01 ± 0.23 versus 1.20 ± 0.28, p < 0.001). T1 values were significantly higher in amyloidosis compared to HCM patients (1170.7 ± 66.4 ms versus 1078.3 ± 57.4ms, p < 0.001). The T1-to-basal segmental strain ratio exhibited high accuracy for the differentiation between the two clinical entities (Sensitivity = 85%, Specificity = 77%, AUC = 0.90, 95% CI = 0.81-0.95, p < 0.001). Multivariable analysis showed that age and the T1-to-basal-strain-ratio were the most robust factors for the differentiation between HCM and cardiac amyloidosis. CONCLUSION The T1-to-basal-segmental strain ratio, combining information from segmental circumferential and longitudinal strain and native T1 mapping aids the differentiation between HCM and cardiac amyloidosis with high accuracy and within a fast CMR protocol, obviating the need for contrast agent administration.
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Affiliation(s)
- Henning Steen
- Department of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, Heidelberg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg, Heidelberg, Germany
| | | | | | - Florian André
- Department of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, Heidelberg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg, Heidelberg, Germany
| | - Norbert Frey
- Department of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, Heidelberg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg, Heidelberg, Germany
| | - Sebastian Kelle
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité Berlin, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Grigorios Korosoglou
- Departments of Cardiology, Vascular Medicine and Pneumology, GRN Hospital Weinheim, Roentgenstrasse 1, 69469, Weinheim, Germany.
- Weinheim Imaging Center, GRN Hospital Weinheim, Hector Foundation, Weinheim, Germany.
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Korosoglou G, Sagris M, André F, Steen H, Montenbruck M, Frey N, Kelle S. Systematic review and meta-analysis for the value of cardiac magnetic resonance strain to predict cardiac outcomes. Sci Rep 2024; 14:1094. [PMID: 38212323 PMCID: PMC10784294 DOI: 10.1038/s41598-023-50835-5] [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: 11/02/2023] [Accepted: 12/26/2023] [Indexed: 01/13/2024] Open
Abstract
Cardiac magnetic resonance (CMR) is the gold standard for the diagnostic classification and risk stratification in most patients with cardiac disorders. The aim of the present study was to investigate the ability of Strain-encoded MR (SENC) for the prediction of major adverse cardiovascular events (MACE). A systematic review and meta-analysis was performed according to the PRISMA Guidelines, including patients with or without cardiovascular disease and asymptomatic individuals. Myocardial strain by HARP were used as pulse sequences in 1.5 T scanners. Published literature in MEDLINE (PubMed) and Cochrane's databases were explored before February 2023 for studies assessing the clinical utility of myocardial strain by Harmonic Phase Magnetic Resonance Imaging (HARP), Strain-encoded MR (SENC) or fast-SENC. In total, 8 clinical trials (4 studies conducted in asymptomatic individuals and 4 in patients with suspected or known cardiac disease) were included in this systematic review, while 3 studies were used for our meta-analysis, based on individual patient level data. Kaplan-Meier analysis and Cox proportional hazard models were used, testing the ability of myocardial strain by HARP and SENC/fast-SENC for the prediction of MACE. Strain enabled risk stratification in asymptomatic individuals, predicting MACE and the development of incident heart failure. Of 1332 patients who underwent clinically indicated CMR, including SENC or fast-SENC acquisitions, 19 patients died, 28 experienced non-fatal infarctions, 52 underwent coronary revascularization and 86 were hospitalized due to heart failure during median 22.4 (17.2-28.5) months of follow-up. SENC/fast-SENC, predicted both all-cause mortality and MACE with high accuracy (HR = 3.0, 95% CI = 1.2-7.6, p = 0.02 and HR = 4.1, 95% CI = 3.0-5.5, respectively, p < 0.001). Using hierarchical Cox-proportional hazard regression models, SENC/fast-SENC exhibited incremental value to clinical data and conventional CMR parameters. Reduced myocardial strain predicts of all-cause mortality and cardiac outcomes in symptomatic patients with a wide range of ischemic or non-ischemic cardiac diseases, whereas in asymptomatic individuals, reduced strain was a precursor of incident heart failure.
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Affiliation(s)
- Grigorios Korosoglou
- Departments of Cardiology, Vascular Medicine and Pneumology, GRN Academic Teaching Hospital Weinheim, Roentgenstrasse 1, 69469, Weinheim, Germany.
- Cardiac Imaging Center Weinheim, Hector Foundations, Weinheim, Germany.
| | - Marios Sagris
- Hippokration General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Florian André
- Departments of Cardiology, Angiology and Pneumology, Heidelberg University, Heidelberg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Heidelberg, Germany
| | - Henning Steen
- Departments of Cardiology, Angiology and Pneumology, Heidelberg University, Heidelberg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Heidelberg, Germany
| | | | - Norbert Frey
- Departments of Cardiology, Angiology and Pneumology, Heidelberg University, Heidelberg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Heidelberg, Germany
| | - Sebastian Kelle
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
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5
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Karanasos A, Korosoglou G. Editorial: Novel Approaches in Cardiovascular Imaging: Case Reports. Front Cardiovasc Med 2022; 9:932990. [PMID: 35722111 PMCID: PMC9201958 DOI: 10.3389/fcvm.2022.932990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Antonios Karanasos
- First Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece
| | - Grigorios Korosoglou
- Department of Cardiology, Vascular Medicine and Pneumology, GRN Hospital Weinheim, Weinheim, Germany
- Cardiac Imaging Center Weinheim, Hector Foundation, Weinheim, Germany
- *Correspondence: Grigorios Korosoglou
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6
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Licordari R, Casale M, Correale M, Imbalzano E, Crea P, Santo Signorelli S, Pistelli L, Parisi F, Perna A, de Sarro R, de Gregorio C, Dattilo G. Prognostic value of two-dimensional strain in early ischemic heart disease: A 5-year follow-up study. Echocardiography 2022; 39:768-775. [PMID: 35524703 DOI: 10.1111/echo.15360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 04/12/2022] [Accepted: 04/23/2022] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION Two-dimensional strain echocardiography (2D-SE) is a reliable method for measuring deformation of the left ventricle. AIM OF THE STUDY Aim of the study was to determine changes in 2D-SE parameters over time collected during dipyridamole stress echo-cardiography (dipy-stress) and prognosis of patients with non-diagnostic dipy-stress results. METHODS In the first phase of the study, assessment of a prospective enrolled population with a non-diagnostic dipy-stress test result was conducted, checking through coronary CT angiography (CCTA) the presence of coronary artery disease (CAD). In the follow-up phase, an echocardiographic re-evaluation and outcome analysis during a mean follow-up of 78 months was carried out. RESULTS In the first phase, Global Circumferential Strain (GCS) values were similar in the CCTA positive and CCTA negative groups at rest and after stress. For Global Longitudinal Strain (GLS), there was a significant reduction (p < .0001) in the CCTA positive group compared to the CCTA negative group. After 78 ± 9 months none of the enrolled patients experimented cardiac events. Values of GCS, both at rest and after stress, did not differ statistically comparing follow-up values with baseline ones. No statistically significant changes were seen in the same analysis for GLS rest and stress values, between baseline and follow-up in the two groups. CONCLUSIONS Performing 2D-SE during dipy-stress can detect mild CAD that conventional stress-tests miss. Patients with mild coronary stenosis may have a favorable mid-term prognosis, but efforts should be made to investigate the decrease trend in GLS, at rest and after stress, reported in this patient group.
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Affiliation(s)
- Roberto Licordari
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Matteo Casale
- Coronary Intensive Care Unit and Cardiology, Urbino Hospital, Urbino, Italy
| | - Michele Correale
- Cardiology Unit, University Hospital Policlinico Riuniti, Foggia, Italy
| | - Egidio Imbalzano
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Pasquale Crea
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | | | - Lorenzo Pistelli
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Francesca Parisi
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Alessia Perna
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Rosalba de Sarro
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Cesare de Gregorio
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giuseppe Dattilo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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7
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Korosoglou G, Giusca S, André F, Aus dem Siepen F, Nunninger P, Kristen AV, Frey N. Diagnostic Work-Up of Cardiac Amyloidosis Using Cardiovascular Imaging: Current Standards and Practical Algorithms. Vasc Health Risk Manag 2021; 17:661-673. [PMID: 34720583 PMCID: PMC8550552 DOI: 10.2147/vhrm.s295376] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 10/07/2021] [Indexed: 01/15/2023] Open
Abstract
Among non-ischemic cardiomyopathies, cardiac amyloidosis is one of the most common, being caused by extracellular depositions of amyloid fibrils in the myocardium. Two main forms of cardiac amyloidosis are known so far, including 1) light-chain (AL) amyloidosis caused by monoclonal production of light-chains, and 2) transthyretin (ATTR) amyloidosis, caused by dissociation of the transthyretin tetramer into monomers. Both AL and ATTR amyloidosis are progressive diseases with median survival from diagnosis of less than 6 months and 3 to 5 years, respectively, if untreated. In this regard, death occurs in most patients due to cardiac causes, mainly congestive heart failure, which can be prevented due to the presence of effective, life-saving treatment regimens. Therefore, early diagnosis of cardiac amyloidosis is crucial more than ever. However, diagnosis of cardiac amyloidosis may be challenging due to variable clinical manifestations and the perceived rarity of the disease. In this regard, clinical and laboratory reg flags are available, which may help clinicians to raise suspicion of cardiac amyloidosis. In addition, advances in cardiovascular imaging have already revealed a higher prevalence of cardiac amyloidosis in specific populations, so that the diagnosis especially of ATTR amyloidosis has experienced a >30-fold increase during the past ten years. The goal of our review article is to summarize these findings and provide a practical approach for clinicians on how to use cardiovascular imaging techniques, such as echocardiography, cardiac magnetic resonance, bone scintigraphy and, if required, organ biopsy within predefined diagnostic algorithms for the diagnostic work-up of patients with suspected cardiac amyloidosis. In addition, two clinical cases and practical tips are provided in this context.
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Affiliation(s)
- Grigorios Korosoglou
- GRN Hospital Weinheim, Department of Cardiology, Vascular Medicine and Pneumology, Weinheim, Germany.,Cardiac Imaging Center Weinheim, Hector Foundation, Weinheim, Germany
| | - Sorin Giusca
- GRN Hospital Weinheim, Department of Cardiology, Vascular Medicine and Pneumology, Weinheim, Germany.,Cardiac Imaging Center Weinheim, Hector Foundation, Weinheim, Germany
| | - Florian André
- Department of Cardiology, Pneumology and Angiology, University Hospital Heidelberg, Heidelberg, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg, Heidelberg, Germany
| | - Fabian Aus dem Siepen
- Department of Cardiology, Pneumology and Angiology, University Hospital Heidelberg, Heidelberg, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg, Heidelberg, Germany
| | | | - Arnt V Kristen
- Department of Cardiology, Pneumology and Angiology, University Hospital Heidelberg, Heidelberg, Germany.,Cardiovascular Center Darmstadt, Darmstadt, Germany
| | - Norbert Frey
- Department of Cardiology, Pneumology and Angiology, University Hospital Heidelberg, Heidelberg, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg, Heidelberg, Germany
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8
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Butaish Z, Alajmi M, Elahi A, Bafaraj SM. Evaluation of Cardiac Scan in Diagnosing Coronary-artery Disease. Curr Med Imaging 2021; 16:1022-1028. [PMID: 32473003 DOI: 10.2174/1573405616666200530211415] [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: 02/08/2020] [Revised: 05/07/2020] [Accepted: 05/11/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND With the evaluation of focal epicardial coronary stenosis and non-obstructive atherosclerosis, the cardiac scans play a significant role in diagnosing coronary artery disease (CAD). Moreover, the advancements in the imaging techniques leading to improved risk assessment and timely therapies help in early diagnosis of CAD with greater accuracy. AIMS To evaluate the role of cardiac scan in diagnosing CAD. METHODS Recruited 100 individuals without any history of CAD that refers to the assessment of suspected angina, conducted the prospective study. Electrocardiogram (ECG) findings assisted in the evaluation of left bundle branch blockage, abnormalities of ST-segment, and pathological Q waves. RESULTS The results depicted negative N.M findings among 38 respondents; whereas, ischemia and myocardial infarctions were diagnosed in 26% and 19% of the respondents, respectively. The majority of the males (59) were positive in contrast to 37 females with positive results. Similarly, 24 respondents were presented with mild dilated left atria (LA), 37 respondents suffered from impaired relaxation pattern of left ventricular (LV) diastolic filling; while, 40 of the respondents had normal global LV systolic function. CONCLUSION The study results have concluded that non-invasive, low-risk, and cost-effective technique like ECG is an important beneficial advancement in the diagnosis of CAD.
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Affiliation(s)
- Zubaida Butaish
- Diagnostic Radiology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Masheal Alajmi
- Diagnostic Radiology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Arouba Elahi
- Diagnostic Radiology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Saeed M Bafaraj
- Diagnostic Radiology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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9
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Korosoglou G, Giusca S. Contrast agent volume in coronary computer tomography angiography-where are the limits? Quant Imaging Med Surg 2021; 11:4511-4513. [PMID: 34604006 DOI: 10.21037/qims-21-488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 05/14/2021] [Indexed: 12/20/2022]
Affiliation(s)
- Grigorios Korosoglou
- GRN Hospital Weinheim, Cardiology, Vascular Medicine & Pneumology, Weinheim, Germany.,Cardiac Imaging Center Weinheim, Hector Foundation, Weinheim, Germany
| | - Sorin Giusca
- GRN Hospital Weinheim, Cardiology, Vascular Medicine & Pneumology, Weinheim, Germany.,Cardiac Imaging Center Weinheim, Hector Foundation, Weinheim, Germany
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10
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Coronary Computer Tomography Angiography in 2021-Acquisition Protocols, Tips and Tricks and Heading beyond the Possible. Diagnostics (Basel) 2021; 11:diagnostics11061072. [PMID: 34200866 PMCID: PMC8230532 DOI: 10.3390/diagnostics11061072] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/06/2021] [Accepted: 06/09/2021] [Indexed: 01/09/2023] Open
Abstract
Recent technological advances, together with an increasing body of evidence from randomized trials, have placed coronary computer tomography angiography (CCTA) in the center of the diagnostic workup of patients with coronary artery disease. The method was proven reliable in the diagnosis of relevant coronary artery stenosis. Furthermore, it can identify different stages of the atherosclerotic process, including early atherosclerotic changes of the coronary vessel wall, a quality not met by other non-invasive tests. In addition, newer computational software can measure the hemodynamic relevance (fractional flow reserve) of a certain stenosis. In addition, if required, information related to cardiac and valvular function can be provided with specific protocols. Importantly, recent trials have highlighted the prognostic relevance of CCTA in patients with coronary artery disease, which helped establishing CCTA as the first-line method for the diagnostic work-up of such patients in current guidelines. All this can be gathered in one relatively fast examination with minimal discomfort for the patient and, with newer machines, with very low radiation exposure. Herein, we provide an overview of the current technical aspects, indications, pitfalls, and new horizons with CCTA, providing examples from our own clinical practice.
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11
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Korosoglou G, Haass M. Diagnosis of heart failure with preserved ejection fraction. Not seeing the forest for the trees or a step to precision medicine? Int J Cardiovasc Imaging 2021; 37:2497-2499. [PMID: 34050839 DOI: 10.1007/s10554-021-02301-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Grigorios Korosoglou
- GRN Hospital Weinheim, Department of Cardiology, Vascular Medicine & Pneumology, Weinheim, Germany. .,Cardiac Imaging Center Weinheim, Hector Foundation, Weinheim, Germany.
| | - Markus Haass
- Department of Cardiology, Theresienkrankenhaus, Mannheim, Germany
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12
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Craven TP, Tsao CW, La Gerche A, Simonetti OP, Greenwood JP. Exercise cardiovascular magnetic resonance: development, current utility and future applications. J Cardiovasc Magn Reson 2020; 22:65. [PMID: 32907587 PMCID: PMC7488086 DOI: 10.1186/s12968-020-00652-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 07/01/2020] [Indexed: 12/23/2022] Open
Abstract
Stress cardiac imaging is the current first line investigation for coronary artery disease diagnosis and decision making and an adjunctive tool in a range of non-ischaemic cardiovascular diseases. Exercise cardiovascular magnetic resonance (Ex-CMR) has developed over the past 25 years to combine the superior image qualities of CMR with the preferred method of exercise stress. Presently, numerous exercise methods exist, from performing stress on an adjacent CMR compatible treadmill to in-scanner exercise, most commonly on a supine cycle ergometer. Cardiac conditions studied by Ex-CMR are broad, commonly investigating ischaemic heart disease and congenital heart disease but extending to pulmonary hypertension and diabetic heart disease. This review presents an in-depth assessment of the various Ex-CMR stress methods and the varied pulse sequence approaches, including those specially designed for Ex-CMR. Current and future developments in image acquisition are highlighted, and will likely lead to a much greater clinical use of Ex-CMR across a range of cardiovascular conditions.
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Affiliation(s)
- Thomas P Craven
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
| | - Connie W Tsao
- Cardiovascular Division, Beth Israel Deaconess Medical Center, 330 Brookline Ave, RW-453, Boston, MA, 02215, USA
| | - Andre La Gerche
- Clinical Research Domain, Baker Heart and Diabetes Institute, Melbourne, Australia
- National Centre for Sports Cardiology, St Vincent's Hospital, Fitzroy, Australia
| | | | - John P Greenwood
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
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13
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Qian L, Xie F, Xu D, Porter TR. Prognostic value of resting myocardial contrast echocardiography: a meta-analysis. Echo Res Pract 2020; 7:19-28. [PMID: 32698153 PMCID: PMC7487191 DOI: 10.1530/erp-20-0023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 07/20/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Resting myocardial perfusion (MP) and wall motion (WM) imaging during real time myocardial contrast echocardiography (MCE) improves the detection of coronary artery disease (CAD). However, its prognostic role in different clinical settings (emergency department and outpatient setting) remains unclear. METHODS A systematic search in PubMed and Embase databases, and the Cochrane library, was conducted to evaluate the role of resting MP and WM in predicting major adverse cardiac events (MACE), including death, nonfatal myocardial infarction (NFMI) and urgent revascularization in patients presenting to either outpatient clinics or emergency departments with suspected symptomatic CAD. Summary receiver operating characteristic (SROC) curves, sensitivity and specificity plots were applied to assess diagnostic performance using RevMan 5.3. RESULTS Seven studies met criteria, including 3668 patients (six with follow up ranging from two days to 2.6 years). The relative risk (RR) for predicting MACE in patients with both abnormal resting MP and WM was 6.1 (95% CI, 5.1-7.2) and 14.3 (95% CI, 10.3-19.8) for death/NFMI, when compared to normal resting MP and WM patients. Having both abnormal resting MP and WM was also more predictive of MACE (RR 1.7; 95% CI 1.5-1.9) and death/NFMI (RR, 2.2; 95% CI, 1.8-2.7) when compared to abnormal WM with normal resting MP. CONCLUSION In this meta-analysis of both ED and outpatient clinic presentations for suspected CAD, having both a resting regional MP and WM abnormality identifies the highest risk patient for adverse events.
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Affiliation(s)
- Lijun Qian
- L Qian, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Feng Xie
- F Xie, Internal Medicine, Nebraska Medical Center, Omaha, United States
| | - Di Xu
- D Xu, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Thomas R Porter
- T Porter, Internal Medicine, Nebraska Medical Center, Omaha, 68198-2265, United States
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14
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Association of Helicobacter pylori and Coronary heart disease in Iran: A meta-analysis. Med J Islam Repub Iran 2018; 32:73. [PMID: 30643748 PMCID: PMC6325280 DOI: 10.14196/mjiri.32.73] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Indexed: 12/30/2022] Open
Abstract
Background: Several studies in the recent decade have supported a relationship between different types of infections and CHD (Coronary Heart Disease); however, such a relationship is not definitely proven. Helicobacter pylori is one of the most common infections in human. The role of inflammation in the pathogens of CAD (Coronary Artery Disease) has been widely discussed; although, the mechanism is not clearly known yet.
Methods: In this systematic review and meta-analysis all case-control articles on the relationship between Helicobacter pylori and CHD published from 31st June 2000 to 31st June 2016 indexed in Scopus, PubMed, Google Scholar, Science Direct, and Iranian databases Magiran, Iran Medex, Irandoc, and SID were included. The articles were searched using the following keywords in Farsi and English. The extracted data was imported into Microsoft Excel and analyzed in Stata 12.
Results: Thirty case-control studies conducted in different regions of Iran (15 provinces) have been published from 2001 to 2015 included in this study. A general estimate of OR (Odds Ratio) for the association of Helicobacter pylori and heart diseases in Iran was 2.351 (95 CI: (1.715, 3.221)).
Conclusion: According to the observed association between Helicobacter pylori and heart diseases in the resent study, most of the hosts of the bacterium are afflicted with the infection in their childhood. Therefore, personal hygiene promotion and preventive programs for Iranian children may have a considerable role in reducing the risk of the infection and cardiovascular diseases, consequently.
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15
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Nakata T. A multifunctional CT technology: Reality or illusion for patient risk assessment? J Nucl Cardiol 2017; 24:1263-1266. [PMID: 27021384 DOI: 10.1007/s12350-016-0439-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 02/01/2016] [Indexed: 10/22/2022]
Abstract
A high-speed, multi-slice coronary computed tomography (CT) imaging has emerged as a promising or clinically available multifunctional technique for the assessment of myocardial ischemia, viability, ischemia-induced cardiac dysfunction, and coronary atherosclerotic alterations in patients with suspected or known coronary artery disease. Despite several technical issues remain to be resolved, cardiac CT imaging will have a reality as a multifunctional modality for guiding physicians in better decision-making for favorable clinical outcomes in patients with suspected coronary artery disease, provided that this imaging technology can contribute to characterization and localization of high-risk coronary atherosclerosis in combination with the quantitative evaluation of functional myocardial ischemia.
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Affiliation(s)
- Tomoaki Nakata
- Department of Cardiology, Hakodate Goryoukaku Hospital, Hakodate, 040-8611, Japan.
- Sapporo Medical University School of Medicine, Sapporo, 060-8543, Japan.
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16
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Gleissner CA, Erbel C, Linden F, Domschke G, Akhavanpoor M, Doesch AO, Buss SJ, Giannitsis E, Katus HA, Korosoglou G. Galectin-3 binding protein plasma levels are associated with long-term mortality in coronary artery disease independent of plaque morphology. Atherosclerosis 2016; 251:94-100. [DOI: 10.1016/j.atherosclerosis.2016.06.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/12/2016] [Accepted: 06/01/2016] [Indexed: 01/12/2023]
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17
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Gleissner CA. Translational atherosclerosis research: From experimental models to coronary artery disease in humans. Atherosclerosis 2016; 248:110-6. [DOI: 10.1016/j.atherosclerosis.2016.03.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 02/09/2016] [Accepted: 03/08/2016] [Indexed: 01/23/2023]
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18
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Di Marco L, Rosset M, Zhang-Yin J, Ohana M. [Multimodal imaging of ischemic heart diseases: A 2015 update]. Rev Med Interne 2016; 37:350-62. [PMID: 26775644 DOI: 10.1016/j.revmed.2015.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 10/08/2015] [Accepted: 12/08/2015] [Indexed: 11/26/2022]
Abstract
Current realities and future possibilities of imaging in the ischemic heart diseases are very broad and constantly evolving, with the improvement of existing technologies and the introduction of new features such as dual-energy CT, strain ultrasound, multimodality fusion or perfusion MRI. Regular collaboration between prescribing clinicians, cardiologists, radiologists and nuclear radiologists is therefore essential to tailor the examination to the specific clinical question. The indications for each modality will therefore depend on its diagnostic performance, cost, acquisition and post-processing times and eventual radiation exposure. This review will detail principles and applications of current cardiac imaging examinations: echocardiography, nuclear medicine, MRI, CT and coronary angiography, emphasizing their current strengths and weaknesses in the ischemic heart diseases management.
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Affiliation(s)
- L Di Marco
- Imagerie, Bocage Central, 14, rue Paul-Gaffarel, 21000 Dijon, France.
| | - M Rosset
- Cardiologie, hôpital Louis-Pradel, 28, avenue du Doyen-Jean-Lépine, 69500 Bron, France
| | - J Zhang-Yin
- Médecine nucléaire, hôpital d'instruction des armées du Val-de-Grâce, 74, boulevard de Port-Royal, 75005 Paris, France
| | - M Ohana
- Imagerie, Nouvel Hôpital Civil, 1, place de l'Hôpital, 67000 Strasbourg, France
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19
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Karayiannis S, McCrossan BA, Sands A. Diagnosing Left Coronary Ostial Atresia: Sometimes the Old Ways Are Best. Int J Angiol 2015; 25:e147-e148. [PMID: 28031682 DOI: 10.1055/s-0035-1560037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
A 12-year-old boy with intermittent syncope associated with exercise. Exercise stress testing suggested myocardial ischemia and 2D echocardiography failed to confirm antegrade flow in the left main stem. Advanced imaging techniques including cardiac-gated computed tomography angiography and stress cardiac magnetic resonance imaging were falsely reassuring. Cardiac catheterization demonstrated left coronary artery ostial atresia with a good caliber left coronary system supplied by generous collaterals from the right coronary artery. The patient underwent successful coronary artery bypass grafting.
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Affiliation(s)
- Steven Karayiannis
- Department of Paediatric Cardiology, Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland
| | - Brian Anthony McCrossan
- Department of Paediatric Cardiology, Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland
| | - Andrew Sands
- Department of Paediatric Cardiology, Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland
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20
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Linden F, Domschke G, Erbel C, Akhavanpoor M, Katus HA, Gleissner CA. Inflammatory therapeutic targets in coronary atherosclerosis-from molecular biology to clinical application. Front Physiol 2014; 5:455. [PMID: 25484870 PMCID: PMC4240064 DOI: 10.3389/fphys.2014.00455] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 11/04/2014] [Indexed: 01/13/2023] Open
Abstract
Atherosclerosis is the leading cause of death worldwide. Over the past two decades, it has been clearly recognized that atherosclerosis is an inflammatory disease of the arterial wall. Accumulating data from animal experiments have supported this hypothesis, however, clinical applications making use of this knowledge remain scarce. In spite of optimal interventional and medical therapy, the risk for recurrent myocardial infarction remains by about 20% over 3 years after acute coronary syndromes, novel therapies to prevent atherogenesis or treat atherosclerosis are urgently needed. This review summarizes selected potential molecular inflammatory targets that may be of clinical relevance. We also review recent and ongoing clinical trails that target inflammatory processes aiming at preventing adverse cardiovascular events. Overall, it seems surprising that translation of basic science into clinical practice has not been a great success. In conclusion, we propose to focus on specific efforts that promote translational science in order to improve outcome and prognosis of patients suffering from atherosclerosis.
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Affiliation(s)
- Fabian Linden
- Department of Cardiology, University of Heidelberg Heidelberg, Germany
| | - Gabriele Domschke
- Department of Cardiology, University of Heidelberg Heidelberg, Germany
| | - Christian Erbel
- Department of Cardiology, University of Heidelberg Heidelberg, Germany
| | | | - Hugo A Katus
- Department of Cardiology, University of Heidelberg Heidelberg, Germany
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