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van der Stouwe JG, Rossi VA, Ghidoni C, Würzburger L, Wiech P, Schweiger V, Petrasch G, Moser G, Schmied CM, Vontobel J, Caselli S, Niederseer D. Effect of a hypertensive response during exercise on growth rates of aortic diameters. Am J Hypertens 2024:hpae050. [PMID: 38693860 DOI: 10.1093/ajh/hpae050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND Aortic diameters are related to age, sex, and body size. There are a scarcity of data on the long-term sequelae of a hypertensive response to exercise (HRE) on aortic diameters. In this retrospective cohort study, we aimed to evaluate the relationship between the growth rates of the aorta in individuals with a HRE. METHODS Our analysis included follow-up data of 649 patients recruited between January 2009 and December 2014 with a HRE. Participants with known connective tissue disease or a history of acute aortic syndrome were excluded. Sinus of Valsalva (SoV) and ascending aorta (AscAo) diameters were measured by transthoracic echocardiography using leading edge to leading edge convention at end-diastole. RESULTS At baseline, median age, maximum systolic blood pressure (BP), body mass index (BMI), diameter of the SoV, and AscAo were 62 years, 208 mmHg, 26.9 kg/m2, 35 mm, and 35 mm respectively. 32% of patients were female and 67% had hypertension. After a median follow-up of 7.1 years, mean yearly growth rates (±SD) of the SoV and AscAo were 0.09 (0.41) mm and 0.13 (0.56) mm respectively. No significant associations were observed between growth rates of aortic diameters and maximum systolic and diastolic BP or when considering only individuals with a baseline diameter > 40mm. CONCLUSION In this large cohort study, maximum systolic and diastolic BP during exercise showed no association with growth rates of aortic diameters. Furthermore, the mean growth rates of aortic diameters in this population were in line with growth rates in a normal population.
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Affiliation(s)
- Jan Gerrit van der Stouwe
- University Hospital Basel, Cardiology, Cardiovascular Research Institute Basel, Basel, Switzerland
- University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Valentina A Rossi
- University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Céline Ghidoni
- University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Laura Würzburger
- University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Patrick Wiech
- University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Victor Schweiger
- University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Gloria Petrasch
- Hochgebirgsklinik, Medicine Campus Davos, Davos, Switzerland
| | - Georg Moser
- University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | | | - Jan Vontobel
- Hochgebirgsklinik, Medicine Campus Davos, Davos, Switzerland
| | - Stefano Caselli
- University Heart Center, University Hospital Zurich, Zurich, Switzerland
- Herzgefaesszentrum im Park, Hirslanden Klinik im Park, Zurich, Switzerland
| | - David Niederseer
- University Heart Center, University Hospital Zurich, Zurich, Switzerland
- Hochgebirgsklinik, Medicine Campus Davos, Davos, Switzerland
- Christine Kühne Center for Allergy Research and Education (CK-CARE), Medicine Campus Davos, Davos, Switzerland
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Degtiarova G, Mikulicic F, Vontobel J, Garefa C, Keller LS, Boehm R, Ciancone D, Gebhard C, Pazhenkottil AP, Kaufmann PA, Buechel RR. Post-hoc motion correction for coronary computed tomography angiography without additional radiation dose - Improved image quality and interpretability for “free”. Imaging 2022. [DOI: 10.1556/1647.2022.00060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
AbstractObjectiveTo evaluate the impact of a motion-correction (MC) algorithm, applicable post-hoc and not dependent on extended padding, on the image quality and interpretability of coronary computed tomography angiography (CCTA).MethodsNinety consecutive patients undergoing CCTA on a latest-generation 256-slice CT device were prospectively included. CCTA was performed with prospective electrocardiogram-triggering and the shortest possible acquisition window (without padding) at 75% of the R-R-interval. All datasets were reconstructed without and with MC of the coronaries. The latter exploits the minimal padding inherent in cardiac CT scans with this device due to data acquisition also during the short time interval needed for the tube to reach target currents and voltage (“free” multiphase). Two blinded readers independently assessed image quality on a 4-point Likert scale for all segments.ResultsA total of 1,030 coronary segments were evaluated. Application of MC both with automatic and manual coronary centerline tracking resulted in a significant improvement in image quality as compared to the standard reconstruction without MC (mean Likert score 3.67 [3.50;3.81] vs 3.58 [3.40;3.73], P = 0.005, and 3.7 [3.55;3.82] vs 3.58 [3.40;3.73], P < 0.001, respectively). Furthermore, MC significantly reduced the proportion of non-evaluable segments and patients with at least one non-evaluable coronary segment from 2% to as low as 0.3%, and from 14% to as low as 3%. Reduction of motion artifacts was predominantly observed in the right coronary artery.ConclusionsA post-hoc device-specific MC algorithm improves image quality and interpretability of prospectively electrocardiogram-triggered CCTA and reduces the proportion of non-evaluable scans without any additional radiation dose exposure.
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Affiliation(s)
- Ganna Degtiarova
- Department of Nuclear Medicine, Cardiac Imaging, University and University Hospital Zurich, Zurich, Switzerland
| | - Fran Mikulicic
- Department of Nuclear Medicine, Cardiac Imaging, University and University Hospital Zurich, Zurich, Switzerland
| | - Jan Vontobel
- Department of Nuclear Medicine, Cardiac Imaging, University and University Hospital Zurich, Zurich, Switzerland
| | - Chrysoula Garefa
- Department of Nuclear Medicine, Cardiac Imaging, University and University Hospital Zurich, Zurich, Switzerland
| | - Lukas S. Keller
- Department of Nuclear Medicine, Cardiac Imaging, University and University Hospital Zurich, Zurich, Switzerland
| | - Reto Boehm
- Department of Nuclear Medicine, Cardiac Imaging, University and University Hospital Zurich, Zurich, Switzerland
| | - Domenico Ciancone
- Department of Nuclear Medicine, Cardiac Imaging, University and University Hospital Zurich, Zurich, Switzerland
| | - Catherine Gebhard
- Department of Nuclear Medicine, Cardiac Imaging, University and University Hospital Zurich, Zurich, Switzerland
| | - Aju P. Pazhenkottil
- Department of Nuclear Medicine, Cardiac Imaging, University and University Hospital Zurich, Zurich, Switzerland
| | - Philipp A. Kaufmann
- Department of Nuclear Medicine, Cardiac Imaging, University and University Hospital Zurich, Zurich, Switzerland
| | - Ronny R. Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University and University Hospital Zurich, Zurich, Switzerland
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KÖhn S, Schlumbohm A, Marquardt M, Scheel-Sailer A, Tobler S, Vontobel J, Menzi L. Predicting non-response in patient-reported outcome measures: results from the Swiss quality assurance programme in cardiac inpatient rehabilitation. Int J Qual Health Care 2022; 34:6833162. [PMID: 36399024 PMCID: PMC9729760 DOI: 10.1093/intqhc/mzac093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/30/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Quality assurance programmes measure and compare certain health outcomes to ensure high-quality care in the health-care sector. The outcome of health-related quality of life is typically measured by patient-reported outcome measures (PROMs). However, certain patient groups are less likely to respond to PROMs than others. This non-response bias can potentially distort results in quality assurance programmes. OBJECTIVE Our study aims to identify relevant predictors of non-response during assessment using the PROM MacNew Heart Disease questionnaire in cardiac rehabilitation. METHODS This is a cross-sectional study based on data from the Swiss external quality assurance programme. All patients aged 18 years or older who underwent inpatient cardiac rehabilitation in 16 Swiss rehabilitation clinics between 2016 and 2019 were included. Patients' socio-demographic and basic medical data were analysed descriptively by comparing two groups: non-responders and responders. We used a random intercept logistic regression model to estimate the associations of patient characteristics and clinic differences with non-response. RESULTS Of 24 572 patients, there were 33.3% non-responders and 66.7% responders. The mean age was 70 years, and 31.0% were women. The regression model showed that being female was associated with non-response [odds ratio (OR) 1.22; 95% confidence interval (CI) 1.14-1.30], as well as having no supplementary health insurance (OR 1.49; 95% CI 1.39-1.59). Each additional year of age increased the chance of non-response by an OR of 1.02 (95% CI 1.02-1.02). Not being a first language speaker of German, French or Italian increased the chance of non-response by an OR of 6.94 (95% CI 6.03-7.99). Patients admitted directly from acute care had a higher chance of non-response (OR 1.23; 95% CI 1.10-1.38), as well as patients being discharged back into acute care after rehabilitation (OR 3.89; 95% CI 3.00-5.04). Each point on the cumulative illness rating scale total score increased the chance of non-response by an OR of 1.05 (95% CI 1.04-1.05). Certain diagnoses also influenced the chance of non-response. Even after adjustment for known confounders, response rates differed substantially between the 16 clinics. CONCLUSION We have found significant non-response bias among certain patient groups, as well as across different treatment facilities. Measures to improve response rates among patients with known barriers to participation, as well as among different treatment facilities, need to be considered, particularly when PROMs are being used for comparison of providers in quality assurance programmes or outcome evaluation.
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Affiliation(s)
- Stefanie KÖhn
- Address reprint requests to: Stefanie Köhn, Institut für Medizinische Soziologie und Rehabilitationswissenschaften, Abteilung Rehabilitationsforschung, Charité—Universitätsmedizin Berlin, Charitéplatz 1, Berlin 10117, Germany. Tel: +49 30 450 517 156; Fax: +49 30 450 517 932; E-mail:
| | - Anna Schlumbohm
- Abteilung Rehabilitationsforschung, Institute of Medical Sociology and Rehabilitation Science, Charité—Universitätsmedizin Berlin, Charitéplatz 1, Berlin 10117, Germany
| | - Manuela Marquardt
- Abteilung Rehabilitationsforschung, Institute of Medical Sociology and Rehabilitation Science, Charité—Universitätsmedizin Berlin, Charitéplatz 1, Berlin 10117, Germany
| | - Anke Scheel-Sailer
- Swiss Paraplegic Centre, Guido-A.-Zäch-Strasse 1, Nottwil CH-6207, Switzerland
| | - Stephan Tobler
- Kliniken Valens, Taminaplatz 1, Valens CH-7317, Switzerland
| | - Jan Vontobel
- Hochgebirgsklinik Davos AG, Herman-Burchard-Strasse 1, Davos CH-7265, Switzerland
| | - Luise Menzi
- Swiss National Association for Quality Development in Hospitals and Clinics - ANQ, Weltpoststrasse 5, Bern CH-3015, Switzerland
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Vontobel J. [Heart Patients and Exposure to Altitude]. Praxis (Bern 1994) 2021; 110:303-311. [PMID: 33906438 DOI: 10.1024/1661-8157/a003649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Overall, heart patients should be advised individually with respect to their tolerance of altitudes. However, the historical reflex that altitude 'per se' is bad for heart patients should become a thing of the past. Adequately treated and stable patients can usually go up to an altitude of 2500 m without any restrictions. Higher altitudes are also possible for a large number of patients, but may require an adaptation of the medication and further clarification. This is especially the case when physical work is to be performed at great heights.
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Possner M, Buechel RR, Vontobel J, Mikulicic F, Gräni C, Benz DC, Clerc OF, Fuchs TA, Tobler D, Stambach D, Greutmann M, Kaufmann PA. Myocardial blood flow and cardiac sympathetic innervation in young adults late after arterial switch operation for transposition of the great arteries. Int J Cardiol 2020; 299:110-115. [DOI: 10.1016/j.ijcard.2019.07.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/03/2019] [Accepted: 07/11/2019] [Indexed: 11/24/2022]
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Gräni C, Vontobel J, Benz DC, Bacanovic S, Giannopoulos AA, Messerli M, Grossmann M, Gebhard C, Pazhenkottil AP, Gaemperli O, Kaufmann PA, Buechel RR. Ultra-low-dose coronary artery calcium scoring using novel scoring thresholds for low tube voltage protocols-a pilot study. Eur Heart J Cardiovasc Imaging 2019; 19:1362-1371. [PMID: 29432592 DOI: 10.1093/ehjci/jey019] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 01/18/2018] [Indexed: 11/13/2022] Open
Abstract
Aims To determine if tube-adapted thresholds for coronary artery calcium (CAC) scoring by computed tomography at 80 kilovolt-peak (kVp) tube voltage and 70-kVp yield comparable results to the standard 120-kVp protocol. Methods and results We prospectively included 103 patients who underwent standard scanning with 120-kVp tube voltage and additional scans with 80 kVp and 70 kVp. Mean body mass index (BMI) was 27.9 ± 5.1 kg/m2. For the lowered tube voltages, we applied novel kVp-adapted thresholds for calculation of CAC scores and compared them with standard 120-kVp scans using intraclass correlation and Bland-Altman (BA) analysis. Furthermore, risk-class (CAC score 0/1-10/11-100/101-400/>400) changes were assessed. Median CAC score from 120-kVp scans was 212 (interquartile range 25-901). Thirteen (12.6%) patients had zero CAC. Using the novel kVp-adapted thresholds, CAC scores derived from 80-kVp scans showed excellent correlation (r = 0.994, P < 0.001) with standard 120-kVp scans with BA limits of agreement of -235 (-39.5%) to 172 (28.9%). Similarly, for 70-kVp scans, correlation was excellent (r = 0.972, P < 0.001) but with broader limits of agreement of -476 (-85.0%) to 270 (48.2%). Only 2 (2.8%) reclassifications were observed for the 80-kVp scans in patients with a BMI <30 kg/m2 (n = 71), and 2 (6.1%) for the 70-kVp scans in patients with a BMI <25 kg/m2 (n = 33). Mean effective radiation dose was 0.60 ± 0.07 millisieverts (mSv), 0.19 ± 0.02 mSv, and 0.12 ± 0.01 mSv for the 120-kVp, 80-kVp, and 70-kVp scans, respectively. Conclusion The present study suggests that CAC scoring with reduced peak tube voltage is accurate if kVp-adapted thresholds for calculation of CAC scores are applied while offering a substantial further radiation dose reduction.
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Affiliation(s)
- Christoph Gräni
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich, Switzerland
| | - Jan Vontobel
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich, Switzerland
| | - Dominik C Benz
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich, Switzerland
| | - Sara Bacanovic
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich, Switzerland
| | - Andreas A Giannopoulos
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich, Switzerland
| | - Michael Messerli
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich, Switzerland
| | - Marvin Grossmann
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich, Switzerland
| | - Cathérine Gebhard
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich, Switzerland
| | - Aju P Pazhenkottil
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich, Switzerland
| | - Oliver Gaemperli
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich, Switzerland
| | - Philipp A Kaufmann
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich, Switzerland
| | - Ronny R Buechel
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich, Switzerland
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7
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Benz DC, Gräni C, Hirt Moch B, Mikulicic F, Vontobel J, Fuchs TA, Stehli J, Clerc OF, Possner M, Pazhenkottil AP, Gaemperli O, Buechel RR, Kaufmann PA. A low-dose and an ultra-low-dose contrast agent protocol for coronary CT angiography in a clinical setting: quantitative and qualitative comparison to a standard dose protocol. Br J Radiol 2017; 90:20160933. [PMID: 28406318 DOI: 10.1259/bjr.20160933] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate the impact of a low-dose (LD) and an ultra-LD (ULD) contrast protocol for coronary CT angiography on qualitative and quantitative image parameters in a clinical setting. METHODS We scanned 120 consecutive patients with a 256-slice CT scanner applying a LD (60 patients, 35-55 ml) or ULD (60 patients, 25-45 ml) contrast protocol adapted to the body mass index. Visually assessed image quality and attenuation measured in each coronary segment were retrospectively compared in 20 consecutive patients scanned with a normal-dose (ND, 40-105 ml) contrast protocol. RESULTS Visually assessed image quality did not differ significantly among protocols. By contrast, attenuation obtained from the ULD protocol (median contrast volume 35 ml) differed significantly from the LD (median 45 ml) and ND (median 70 ml) protocols in the coronary segments (316 ± 52 vs 363 ± 60 and 359 ± 52 HU, p < 0.001). Attenuation did not differ significantly between the LD and ND protocol. The proportion of patients with inadequate coronary vessel attenuation was significantly higher (p < 0.001) in the ULD protocol (37%) than in the ND (5%) and LD (10%) protocols but did not differ significantly between the ND and LD protocols. CONCLUSION In a clinical setting, a LD contrast protocol with a median volume of 45 ml is feasible for the latest generation 256-slice coronary CT angiography as it yields attenuation comparable to a ND protocol. By contrast, the implementation of an ULD protocol remains challenging. Advances in knowledge: Although not perceived by the naked eye, an ULD contrast protocol in a clinical setting yields attenuation below a threshold for diagnostic image quality.
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Affiliation(s)
- Dominik C Benz
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Christoph Gräni
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Beatrice Hirt Moch
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Fran Mikulicic
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Jan Vontobel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Tobias A Fuchs
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Julia Stehli
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Olivier F Clerc
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Mathias Possner
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Aju P Pazhenkottil
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Oliver Gaemperli
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Philipp A Kaufmann
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
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Gräni C, Benz DC, Steffen DA, Clerc OF, Schmied C, Possner M, Vontobel J, Mikulicic F, Gebhard C, Pazhenkottil AP, Gaemperli O, Hurwitz S, Kaufmann PA, Buechel RR. Outcome in middle-aged individuals with anomalous origin of the coronary artery from the opposite sinus: a matched cohort study. Eur Heart J 2017; 38:2009-2016. [DOI: 10.1093/eurheartj/ehx046] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 01/24/2017] [Indexed: 01/09/2023] Open
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9
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Gräni C, Vontobel J, Benz D, Bacanovic S, Moch BH, Messerli M, Grossmann M, Gebhard C, Pazhenkottil AP, Gaemperli O, Kaufmann P, Buechel R. PROSPECTIVE EVALUATION OF LOW-DOSE CORONARY CALCIUM SCORING WITH REDUCED TUBE VOLTAGE. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)34949-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Gräni C, Benz DC, Schmied C, Vontobel J, Mikulicic F, Possner M, Clerc OF, Stehli J, Fuchs TA, Pazhenkottil AP, Gaemperli O, Buechel RR, Kaufmann PA. Hybrid CCTA/SPECT myocardial perfusion imaging findings in patients with anomalous origin of coronary arteries from the opposite sinus and suspected concomitant coronary artery disease. J Nucl Cardiol 2017; 24:226-234. [PMID: 26711099 DOI: 10.1007/s12350-015-0342-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 11/05/2015] [Indexed: 02/05/2023]
Abstract
BACKGROUND Anomalous coronary arteries originating from the opposite sinus of Valsalva (ACAOS) are associated with adverse cardiac events. Discrimination between ACAOS and coronary artery disease (CAD)-related perfusion defects may be difficult. The aim of the present study was to investigate the value of hybrid coronary computed tomography angiography (CCTA)/SPECT-MPI in patients with ACAOS and possible concomitant CAD. METHODS We retrospectively identified 46 patients (mean age 56 ± 12 years) with ACAOS revealed by CCTA who underwent additional SPECT-MPI. ACAOS with an interarterial course were classified as malignant, whereas all other variants were considered benign. CCTA/SPECT-MPI hybrid imaging findings (ischemia or scar) were analyzed according to the territory subtended by an anomalous vessel or a stenotic coronary artery. RESULTS Twenty-six (57%) patients presented with malignant ACAOS. Myocardial ischemia or scar was found only in patients who had concomitant obstructive CAD in the vessel matching the perfusion defect as evidenced by hybrid CCTA/SPECT imaging. CONCLUSION Hybrid CCTA/SPECT-MPI represents a valuable non-invasive tool to discriminate the impact of ACAOS from concomitant CAD on myocardial ischemia. Our results suggest that in a middle-aged population myocardial ischemia due to ACAOS per se may be exceedingly rare and is more likely attributable to concomitant CAD.
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Affiliation(s)
- Christoph Gräni
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Dominik C Benz
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Christian Schmied
- Department of Cardiology, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Jan Vontobel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Fran Mikulicic
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Mathias Possner
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Olivier F Clerc
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Julia Stehli
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Tobias A Fuchs
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Aju P Pazhenkottil
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Oliver Gaemperli
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
- Department of Cardiology, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Philipp A Kaufmann
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland.
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Possner M, Vontobel J, Nguyen-Kim TDL, Zindel C, Holy EW, Stämpfli SF, Zuber M, Kaufmann PA, Nietlispach F, Maisano F, Niemann M, Tanner FC. Prognostic value of aortic regurgitation after TAVI in patients with chronic kidney disease. Int J Cardiol 2016; 221:180-7. [DOI: 10.1016/j.ijcard.2016.06.145] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 06/11/2016] [Accepted: 06/24/2016] [Indexed: 11/15/2022]
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Gräni C, Benz DC, Possner M, Clerc OF, Mikulicic F, Vontobel J, Stehli J, Fuchs TA, Pazhenkottil AP, Gaemperli O, Kaufmann PA, Buechel RR. Fused cardiac hybrid imaging with coronary computed tomography angiography and positron emission tomography in patients with complex coronary artery anomalies. CONGENIT HEART DIS 2016; 12:49-57. [PMID: 27539240 DOI: 10.1111/chd.12402] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 07/01/2016] [Accepted: 07/15/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To provide data on the value of fused cardiac hybrid imaging with coronary computed tomography angiography (CCTA) and positron emission tomography myocardial perfusion imaging (PET-MPI) in patients with complex coronary artery anomalies (CCAA). DESIGN/SETTING This is a retrospective, single-center study. PATIENTS Seven consecutive patients with CCAA (mean 57 ± 7 y, 86% were male) who underwent clinically indicated hybrid CCTA/PET-MPI between 2005 and 2015 in our clinic were included. The findings from both modalities and fused cardiac hybrid imaging were evaluated in these patients. RESULTS Out of the seven patients with CCAA, two patients had Bland-White-Garland anomaly, two patients showed a coronary artery fistula, two patients showed a "single right," and one patient showed a "single left" coronary artery. Semiquantitative fused hybrid CCTA/PET-MPI depicted inferolateral scar matching the territory of a nonanomalous vessel with significant concomitant coronary artery disease (CAD) in one patient only. In contrast, analysis of quantitative myocardial blood flow (MBF) as assessed by fused hybrid CCTA/PET-MPI revealed abnormally reduced flow capacities in the territories subtended by the anomalous vessels in 4 patients. CONCLUSIONS In this case series of middle-aged patients with CCAA, perfusion defects as assessed by semiquantitative PET-MPI were rare and attributable to concomitant CAD rather than to the anomalous vessel itself. By contrast, impaired MBF as assessed by quantitative hybrid CCTA/PET-MPI was revealed in the majority of patients in the vessel territories subtended by the anomalous coronary artery itself. Fused hybrid CCTA/PET-MPI incorporating information on morphology and on semiquantitative and quantitative myocardial perfusions may provide added value for the management of patients with CCAA.
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Affiliation(s)
- Christoph Gräni
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Dominik C Benz
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Mathias Possner
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Olivier F Clerc
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Fran Mikulicic
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Jan Vontobel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Julia Stehli
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Tobias A Fuchs
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Aju P Pazhenkottil
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Oliver Gaemperli
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Philipp A Kaufmann
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
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Benz DC, Gräni C, Hirt Moch B, Mikulicic F, Vontobel J, Fuchs TA, Stehli J, Clerc OF, Possner M, Pazhenkottil AP, Gaemperli O, Buechel RR, Kaufmann PA. Minimized Radiation and Contrast Agent Exposure for Coronary Computed Tomography Angiography: First Clinical Experience on a Latest Generation 256-slice Scanner. Acad Radiol 2016; 23:1008-14. [PMID: 27174030 DOI: 10.1016/j.acra.2016.03.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 03/03/2016] [Accepted: 03/05/2016] [Indexed: 12/29/2022]
Abstract
RATIONALE AND OBJECTIVES The aim of the study was to evaluate the impact of the latest coronary computed tomography angiography (CCTA) techniques allowing a radiation- and contrast-sparing protocol on image quality in unselected patients referred for exclusion of suspected coronary artery disease (CAD). MATERIALS AND METHODS This prospective study was approved by the local ethics committee, and all patients provided written informed consent. Between March and June 2015, 89 consecutive patients (61% male; mean age 55 ± 11 years) referred for exclusion of CAD by 256-slice CCTA using prospective electrocardiogram triggering were included. Tube voltage (80-120 kVp), tube current (180-310 mA) as well contrast agent volume (25-45 mL) and flow rate (3.5-5 mL/s) were adapted to body mass index. Signal intensity was measured by placing a region of interest in the aortic root, the left main artery, and the proximal right coronary artery. Image noise was measured in the aortic root. Two independent blinded readers semi-quantitatively assessed the image quality regarding motion, noise, and contrast on a 4-point scale. RESULTS Median contrast agent volume and median effective radiation dose were 35 mL (interquartile range, 30-40 mL) and 0.5 mSv (interquartile range, 0.4-0.6 mSv), respectively. Mean attenuation in the aortic root was 412 ± 89 Hounsfield units. Diagnostic image quality was obtained in 1050 of 1067 (98.4%) coronary segments and, on an intention-to-diagnosis basis, in 85 of 89 (95.5%) patients. Below a cut-off heart rate of 67 beats/min, only 1 of 974 (0.1%) coronary segments was nondiagnostic. CONCLUSION A radiation- and contrast-sparing protocol for CCTA on a latest generation 256-slice computed tomography scanner yields diagnostic image quality in patients referred for CAD exclusion in daily clinical routine.
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Gräni C, Benz DC, Schmied C, Vontobel J, Possner M, Clerc OF, Mikulicic F, Stehli J, Fuchs TA, Pazhenkottil AP, Gaemperli O, Kaufmann PA, Buechel RR. Prevalence and characteristics of coronary artery anomalies detected by coronary computed tomography angiography in 5 634 consecutive patients in a single centre in Switzerland. Swiss Med Wkly 2016; 146:w14294. [PMID: 27124568 DOI: 10.4414/smw.2016.14294] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
STUDY PRINCIPLES Coronary computed tomography angiography (CCTA) allows three-dimensional visualisation of the origin, course and ending of the coronary vessels with high spatial resolution, yielding an accurate depiction of coronary artery anomalies (CAAs). This study sought to determine the prevalence, incidence and characteristics of CAAs detected with CCTA in a single centre in Switzerland. METHODS CAAs were retrospectively identified in 5 634 consecutive patients referred for CCTA between March 2007 and July 2015. Single coronary arteries, Bland-White-Garland syndrome, anomalous coronary arteries originating from the opposite site of the sinus of Valsalva (ACAOS) with an interarterial course and coronary artery fistulas were classified as potentially malignant CAAs. RESULTS We identified 145 patients with CAAs, resulting in an overall prevalence of 2.6% and cumulative incidence of 2.1% in all patients referred for CCTA in the observation period. Forty-nine (33.8%) patients showed malignant CAAs including 1 (0.7%) patient with Bland-White-Garland syndrome, 7 (4.8%) with single coronary arteries, 36 (24.8%) with ACAOS and an interarterial course, and 5 (3.5%) with coronary artery fistulas. The remaining 96 (66.2%) patients were classified as having benign variants. CONCLUSIONS The prevalence of CAA detected by CCTA is not negligible. Because of its noninvasive nature, relatively low cost and low radiation exposure, a further increase in the utilisation of CCTA may be expected, which may consequently be paralleled by an increasing absolute number of incidentally detected CAAs. Hence, awareness of the main issues and possible management strategies regarding CAAs is of importance for every treating physician.
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Affiliation(s)
- Christoph Gräni
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland
| | - Dominik C Benz
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland
| | | | - Jan Vontobel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland
| | - Mathias Possner
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland
| | - Olivier F Clerc
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland
| | - Fran Mikulicic
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland
| | - Julia Stehli
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland
| | - Tobias A Fuchs
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland
| | - Aju P Pazhenkottil
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland
| | - Oliver Gaemperli
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland; Department of Cardiology, University Hospital Zurich, Switzerland
| | - Philipp A Kaufmann
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland
| | - Ronny Ralf Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland
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Gräni C, Benz D, Clerc O, Schmied C, Steffen D, Mikulicic F, Vontobel J, Possner M, Pazhenkottil A, Gaemperli O, Kaufmann P, Buechel R. OUTCOME IN MIDDLE-AGED INDIVIDUALS WITH ANOMALOUS CORONARY ARTERIES ORIGINATING FROM THE OPPOSITE SINUS: A CASE CONTROL STUDY. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)30982-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Pazhenkottil A, Benz D, Gräni C, Mikulicic F, Hirt Moch B, Madsen M, Vontobel J, Gaemperli O, Buechel R, Lüscher TF, Kaufmann PA, Imaging C. LONG-TERM PROGNOSTIC VALUE OF CARDIAC HYBRID IMAGING INTEGRATING SINGLE-PHOTON-EMISSION COMPUTED TOMOGRAPHY WITH CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)31751-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Benz DC, Gräni C, Hirt-Moch B, Mikulicic F, Vontobel J, Fuchs T, Stehli J, Clerc O, Possner M, Pazhenkottil A, Gaemperli O, Buechel R, Kaufmann P. A RADIATION- AND CONTRAST-SPARING PROTOCOL FOR CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY: FIRST CLINICAL EXPERIENCE ON A LATEST-GENERATION 256-SLICE SCANNER. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)31740-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Liga R, Vontobel J, Rovai D, Marinelli M, Caselli C, Pietila M, Teresinska A, Aguadé-Bruix S, Pizzi MN, Todiere G, Gimelli A, Chiappino D, Marraccini P, Schroeder S, Drosch T, Poddighe R, Casolo G, Anagnostopoulos C, Pugliese F, Rouzet F, Le Guludec D, Cappelli F, Valente S, Gensini GF, Zawaideh C, Capitanio S, Sambuceti G, Marsico F, Filardi PP, Fernández-Golfín C, Rincón LM, Graner FP, de Graaf MA, Stehli J, Reyes E, Nkomo S, Mäki M, Lorenzoni V, Turchetti G, Carpeggiani C, Puzzuoli S, Mangione M, Marcheschi P, Giannessi D, Nekolla S, Lombardi M, Sicari R, Scholte AJHA, Zamorano JL, Underwood SR, Knuuti J, Kaufmann PA, Neglia D, Gaemperli O. Multicentre multi-device hybrid imaging study of coronary artery disease: results from the EValuation of INtegrated Cardiac Imaging for the Detection and Characterization of Ischaemic Heart Disease (EVINCI) hybrid imaging population. Eur Heart J Cardiovasc Imaging 2016; 17:951-60. [PMID: 26992419 DOI: 10.1093/ehjci/jew038] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 02/14/2016] [Indexed: 12/18/2022] Open
Abstract
AIMS Hybrid imaging provides a non-invasive assessment of coronary anatomy and myocardial perfusion. We sought to evaluate the added clinical value of hybrid imaging in a multi-centre multi-vendor setting. METHODS AND RESULTS Fourteen centres enrolled 252 patients with stable angina and intermediate (20-90%) pre-test likelihood of coronary artery disease (CAD) who underwent myocardial perfusion scintigraphy (MPS), CT coronary angiography (CTCA), and quantitative coronary angiography (QCA) with fractional flow reserve (FFR). Hybrid MPS/CTCA images were obtained by 3D image fusion. Blinded core-lab analyses were performed for CTCA, MPS, QCA and hybrid datasets. Hemodynamically significant CAD was ruled-in non-invasively in the presence of a matched finding (myocardial perfusion defect co-localized with stenosed coronary artery) and ruled-out with normal findings (both CTCA and MPS normal). Overall prevalence of significant CAD on QCA (>70% stenosis or 30-70% with FFR≤0.80) was 37%. Of 1004 pathological myocardial segments on MPS, 246 (25%) were reclassified from their standard coronary distribution to another territory by hybrid imaging. In this respect, in 45/252 (18%) patients, hybrid imaging reassigned an entire perfusion defect to another coronary territory, changing the final diagnosis in 42% of the cases. Hybrid imaging allowed non-invasive CAD rule-out in 41%, and rule-in in 24% of patients, with a negative and positive predictive value of 88% and 87%, respectively. CONCLUSION In patients at intermediate risk of CAD, hybrid imaging allows non-invasive co-localization of myocardial perfusion defects and subtending coronary arteries, impacting clinical decision-making in almost one every five subjects.
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Affiliation(s)
- Riccardo Liga
- Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, CH-8091 Zurich, Switzerland
| | - Jan Vontobel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, CH-8091 Zurich, Switzerland
| | | | | | | | - Mikko Pietila
- Heart Center and Turku PET Center, University of Turku, Turku University Hospital, Turku, Finland
| | - Anna Teresinska
- Department of Nuclear Medicine, Institute of Cardiology, Warsaw, Poland
| | - Santiago Aguadé-Bruix
- Department of Nuclear Medicine, University Hospital Val d'Hebron, Institut Catala de la Salut, Barcelona, Spain
| | - Maria Nazarena Pizzi
- Department of Nuclear Medicine, University Hospital Val d'Hebron, Institut Catala de la Salut, Barcelona, Spain
| | - Giancarlo Todiere
- Cardiothoracic Department, Fondazione Toscana G. Monasterio, Pisa, Italy
| | - Alessia Gimelli
- Imaging Department, Fondazione Toscana G. Monasterio, Pisa, Italy
| | - Dante Chiappino
- Imaging Department, Fondazione Toscana G. Monasterio, Pisa, Italy
| | | | | | - Tanja Drosch
- Department of Cardiology, Alb-Fils-Kliniken, Göppingen, Germany
| | - Rosa Poddighe
- Emergency Department, Cardiology, Ospedale della Versilia, Lido di Camaiore, Italy
| | - Giancarlo Casolo
- Emergency Department, Cardiology, Ospedale della Versilia, Lido di Camaiore, Italy
| | - Constantinos Anagnostopoulos
- Center for Experimental Surgery, Clinical and Translational Research, Biomedical Research Foundation, Academy of Athens, Athens, Greece Centre for Advanced Cardiovascular Imaging, National Institute for Health Research Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Barts and The London School of Medicine, Queen Mary University of London, London, UK
| | - Francesca Pugliese
- Centre for Advanced Cardiovascular Imaging, National Institute for Health Research Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Barts and The London School of Medicine, Queen Mary University of London, London, UK
| | - Francois Rouzet
- Department of Nuclear Medicine, Bichat University Hospital, Département Hospitalo-Universitaire FIRE, Assistance Publique-Hôpitaux de Paris, University Paris Diderot, Paris, France
| | - Dominique Le Guludec
- Department of Nuclear Medicine, Bichat University Hospital, Département Hospitalo-Universitaire FIRE, Assistance Publique-Hôpitaux de Paris, University Paris Diderot, Paris, France
| | - Francesco Cappelli
- Cardiothoracic and Vascular Department, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | - Serafina Valente
- Cardiothoracic and Vascular Department, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | - Gian Franco Gensini
- Cardiothoracic and Vascular Department, Azienda Ospedaliera Universitaria Careggi, Florence, Italy Don Carlo Gnocchi Foundation, IRCCS, Florence, Italy
| | - Camilla Zawaideh
- Department of Health Science and Internal Medicine, IRCCS Hospital San Martino, National Institute for Cancer Research and University of Genoa, Genoa, Italy
| | - Selene Capitanio
- Department of Health Science and Internal Medicine, IRCCS Hospital San Martino, National Institute for Cancer Research and University of Genoa, Genoa, Italy
| | - Gianmario Sambuceti
- Department of Health Science and Internal Medicine, IRCCS Hospital San Martino, National Institute for Cancer Research and University of Genoa, Genoa, Italy
| | - Fabio Marsico
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | | | | | - Luis M Rincón
- Department of Cardiology, University Hospital Ramón y Cajal, Madrid, Spain
| | - Frank P Graner
- Department of Nuclear Medicine, Klinikum Rechts der Isar der Technischen Universität München, Muenchen, Germany
| | - Michiel A de Graaf
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Julia Stehli
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, CH-8091 Zurich, Switzerland
| | - Eliana Reyes
- Biomedical Research Unit, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London, London, UK
| | - Sandy Nkomo
- Biomedical Research Unit, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London, London, UK
| | - Maija Mäki
- Heart Center and Turku PET Center, University of Turku, Turku University Hospital, Turku, Finland
| | | | | | | | - Stefano Puzzuoli
- Technology Department, Fondazione Toscana G. Monasterio, Pisa, Italy
| | - Maurizio Mangione
- Technology Department, Fondazione Toscana G. Monasterio, Pisa, Italy
| | - Paolo Marcheschi
- Technology Department, Fondazione Toscana G. Monasterio, Pisa, Italy
| | | | - Stephan Nekolla
- Department of Nuclear Medicine, Klinikum Rechts der Isar der Technischen Universität München, Muenchen, Germany
| | - Massimo Lombardi
- Imaging Department, Fondazione Toscana G. Monasterio, Pisa, Italy
| | - Rosa Sicari
- Institute of Clinical Physiology, CNR, Pisa, Italy
| | - Arthur J H A Scholte
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - José L Zamorano
- Department of Cardiology, University Hospital Ramón y Cajal, Madrid, Spain
| | - S Richard Underwood
- Biomedical Research Unit, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London, London, UK
| | - Juhani Knuuti
- Heart Center and Turku PET Center, University of Turku, Turku University Hospital, Turku, Finland
| | - Philipp A Kaufmann
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, CH-8091 Zurich, Switzerland
| | - Danilo Neglia
- Institute of Clinical Physiology, CNR, Pisa, Italy Cardiothoracic Department, Fondazione Toscana G. Monasterio, Pisa, Italy
| | - Oliver Gaemperli
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, CH-8091 Zurich, Switzerland
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Clerc OF, Fuchs TA, Possner M, Vontobel J, Mikulicic F, Stehli J, Liga R, Benz DC, Gräni C, Pazhenkottil AP, Gaemperli O, Buechel RR, Kaufmann PA. Real-time respiratory triggered SPECT myocardial perfusion imaging using CZT technology: impact of respiratory phase matching between SPECT and low-dose CT for attenuation correction. Eur Heart J Cardiovasc Imaging 2016; 18:31-38. [DOI: 10.1093/ehjci/jew031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 02/04/2016] [Indexed: 01/10/2023] Open
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Vontobel J, Possner M, Schütz P, Müller B, Taramasso M, Binder RK, Haueis S, Attinger-Toller A, Maisano F, Nietlispach F. Early safety outcome following transcatheter aortic valve implantation: is the amount of contrast media used a matter of concern? Swiss Med Wkly 2015; 145:w14238. [PMID: 26709491 DOI: 10.4414/smw.2015.14238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
QUESTIONS UNDER STUDY The study objective was to evaluate the impact of the amount of contrast medium used for transcatheter aortic valve implantation (TAVI) on short-term outcome. Patients undergoing TAVI are exposed to repeat contrast medium application both for preprocedural screening and during the TAVI procedure itself. Whether the amount of contrast media is associated with worse outcome is unclear. METHODS A total of 257 patients were included (median age 82.7 years) and divided into two groups with preserved and reduced kidney function (glomerular filtration rate <60 ml/min/1.73 m2), respectively. Total volume of contrast media administered during and within 5 days prior to TAVI was analysed. A combined early safety endpoint at 30 days was evaluated. RESULTS The early safety endpoint was reached by 31 patients and acute kidney injury occurred in 22 patients. The median total volume of contrast media administered was 144 ml (interquartile range 81-225 ml). The amount of contrast did not independently predict the early safety endpoint in the overall population (odds ratio [OR] 0.93, 95% confidence interval [CI] 0.56 to 1.53, p = 0.774) and in subgroups with preserved and reduced kidney function. Change in creatinine was an independent strong predictor of the early safety endpoint in the overall population (OR 18.13, 95% CI 4.70 to 69.99, p <0.001), as well as in subgroups with preserved and reduced kidney function. The amount of contrast did not predict a change in creatinine within 72 hours following TAVI (r = 0.02, 95% CI -0.02 to 0.07, p = 0.368). CONCLUSION Decreased kidney function after TAVI influences outcome. When rather small amounts of contrast media are used for screening and the TAVI procedure itself, the amount of contrast media seems not to be an independent predictor of outcome, further suggesting that decreased kidney function after TAVI is multifactorial.
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Affiliation(s)
- Jan Vontobel
- Department of Cardiology, University Heart Centre, Zurich, Switzerland
| | - Mathias Possner
- Department of Cardiology, University Heart Centre, Zurich, Switzerland
| | - Philipp Schütz
- Department of Endocrinology, Diabetology and Metabolism, Medical University Hospital Aarau, Switzerland
| | - Beat Müller
- Department of Endocrinology, Diabetology and Metabolism, Medical University Hospital Aarau, Switzerland
| | | | - Roland K Binder
- Department of Cardiology, University Heart Centre, Zurich, Switzerland
| | - Sabine Haueis
- Department of Cardiology, University Heart Centre, Zurich, Switzerland
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Lagan J, Rio P, Barone-Rochette G, Limeres Freire J, Abreu A, Clerc OF, Iriart X, Van Den Hoven AT, Meah M, Hasleton J, Mcshane J, Trent R, Abreu A, Santos V, Santa-Clara H, Oliveira L, Martins Oliveira M, Silva Cunha P, Moura Branco L, Mota Carmo M, Cruz Ferreira R, Zoreka FZ, Calizzano A, Vautrin E, Quesada JL, Broisat A, Riou L, Baguet JP, Fagret D, Ghezzi C, Rodriguez J, Oristrell G, Quiroga X, Pizzi N, Perez-Rodon J, Galve E, Aguade S, Santa Clara H, Santos V, Oliveira L, Oliveira M, Rio P, Cunha P, Portugal G, Ferreira R, Mota Carmo M, Kaufmann BP, Possner M, Liga R, Vontobel J, Mikulicic F, Graeni C, Benz DC, Kaufmann PA, Buechel RR, Selmi W, Jalal Z, Thambo JB, Saru-Chelu RG, Duijnhouwer AL, Van Hagen IM, Roos-Hesselink JW. Rapid Fire Abstract session: usefulness of CT and radionuclide imaging in different clinical scenarios378Improving the cost-effectiveness of chest pain investigations using single photon emission computed tomography379Is autonomic nervous dysfunction severity associated to less benefit from cardiac resynchronization therapy?380Validation of stress Thallium-201/Rest Technetium-99m sequential dual isotope high-speed myocardial perfusion imaging against fractional flow reserve for the detection of the extent of ischemia.381Nuclear imaging to predict adverse events in heart failure patients382Autonomic nervous system modulation in patients with heart failure and resynchronization after high intensity interval training383Long-term prediction of cardiac events using low-dose coronary ct angiography with prospective triggering384Left atrial appendage sizing for percutaneous occlusion with Amplatzer cardiac plug: a multimodality imaging approach385Evaluation of PAPVR using cardiac CT or MR imaging in patients with Turner syndrome. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Clerc OF, Lima Da Silva G, Jobbe Duval A, Santoro C, Possner M, Liga R, Fuchs TA, Dougoud S, Stehli J, Vontobel J, Mikulicic F, Kaufmann PA, Gaemperli O, Almeida AMG, David C, Francisco AR, Guimaraes T, Placido R, Menezes M, Pinto FJ, Rimbert A, Cueff C, Lecointe S, Hagege AA, Levine R, Merot J, Le Marec H, Schott JJ, Le Tourneau T, Lembo M, Esposito R, Cocozza S, Ilardi F, Arpino G, De Placido S, De Simone G, Trimarco B, Galderisi M. Young Investigator Award session – Clinical Science442Left bundle branch block and coronary artery disease in coronary ct angiography443Focal myocardial fibrosis and abnormal left ventricular strain in patients with sarcoidosis without clinical evidence of cardiac disease444Arhgap24, a first gene for fibro elastic deficiency mitral valve prolapse? A phenotypic study445Advantage of using ASE/EACVI criteria for detection of subclinical cardiotoxicity in breast cancer patients undergoing anthracycline and trastuzumab therapy. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Possner M, Liga R, Gaisl T, Vontobel J, Clerc OF, Mikulicic F, Benz DC, Gräni C, Stehli J, Fuchs TA, Dey D, Pazhenkottil AP, Herzog BA, Gaemperli O, Buechel RR, Kaufmann PA. Quantification of epicardial and intrathoracic fat volume does not provide an added prognostic value as an adjunct to coronary artery calcium score and myocardial perfusion single-photon emission computed tomography. Eur Heart J Cardiovasc Imaging 2015; 17:885-91. [PMID: 26341295 DOI: 10.1093/ehjci/jev209] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 08/02/2015] [Indexed: 11/14/2022] Open
Abstract
AIMS To compare the predictive value of epicardial and intrathoracic fat volume (EFV, IFV), coronary artery calcium (CAC) score, and single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) for major adverse cardiac events (MACE). METHODS AND RESULTS Follow-up was obtained in 275 patients with known or suspected coronary artery disease (CAD), who underwent SPECT-MPI including non-contrast cardiac computed tomography (CT) for attenuation correction to evaluate ischaemic heart disease and in whom EFV, IFV, and CAC score were calculated from non-contrast CT. Associations between fat volume, traditional cardiovascular risk factors, CAC score, and SPECT-MPI results were assessed and MACE predictors identified by Cox proportional hazard regression and global χ(2) statistics. After a median follow-up of 2.9 years, MACE were recorded in 38 patients. In univariate Cox regression analysis, EFV and IFV were predictors of MACE (P = 0.013 and P = 0.004, respectively). In multivariate analysis, EFV and IFV provided incremental predictive value beyond traditional cardiovascular risk factors (P < 0.05 and P < 0.01). However, after adjustment for CAC score and SPECT-MPI results, EFV and IFV fell short of statistical significance as independent outcome predictors. CONCLUSION Quantification of EFV and IFV is associated with MACE and may improve risk stratification beyond traditional cardiovascular risk factors. However, once CAC score and/or SPECT-MPI results are known, EFV and IFV do not provide any added clinically relevant prognostic value. Further studies may identify the subpopulation with the largest relative merit of EFV and IFV as an adjunct to SPECT-MPI and CAC score.
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Affiliation(s)
- Mathias Possner
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland
| | - Riccardo Liga
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland
| | - Thomas Gaisl
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Jan Vontobel
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland
| | - Olivier F Clerc
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland
| | - Fran Mikulicic
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland
| | - Dominik C Benz
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland
| | - Christoph Gräni
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland
| | - Julia Stehli
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland
| | - Tobias A Fuchs
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland
| | - Damini Dey
- Department of Biomedical Sciences, Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Aju P Pazhenkottil
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland
| | - Bernhard A Herzog
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland
| | - Oliver Gaemperli
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland
| | - Ronny R Buechel
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland
| | - Philipp A Kaufmann
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland
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Clerc OF, Possner M, Maire R, Liga R, Fuchs TA, Stehli J, Vontobel J, Mikulicic F, Gräni C, Benz DC, Lüscher TF, Herzog BA, Buechel RR, Kaufmann PA, Gaemperli O. Association of left bundle branch block with obstructive coronary artery disease on coronary CT angiography: a case-control study. Eur Heart J Cardiovasc Imaging 2015; 17:765-71. [PMID: 26320169 DOI: 10.1093/ehjci/jev202] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 07/27/2015] [Indexed: 11/14/2022] Open
Abstract
AIMS Left bundle branch block (LBBB) is considered an unfavourable prognostic marker in patients with underlying heart disease. Testing for coronary artery disease (CAD) is often prompted by incidental LBBB finding, but published studies disagree about a significant association between LBBB and CAD. We therefore assessed the association of LBBB with previously unknown CAD in patients undergoing coronary computed tomography angiography (CCTA). METHODS AND RESULTS We enrolled 818 patients (mean age 57.2 ± 11.1 years, 106 patients with presumably new LBBB and 712 controls) without known CAD who underwent 64-slice CCTA. Image quality was assessed for each coronary segment. Comparison of obstructive CAD prevalence (defined as ≥50% stenosis) was performed using triple case-matching for pre-test probability (based on age, gender, and symptom typicality) in 101 LBBB patients and 303 matched controls with diagnostic quality in all segments. We found no difference in obstructive CAD prevalence between LBBB patients and matched controls (15 vs. 16%, P = 0.88). Similarly, there were no significant differences in cardiovascular risk factors (CVRF), stenosis severity, CAD extent, non-obstructive CAD, and vessel-based analysis between patient groups. Image quality was very high in LBBB patients and comparable to controls. On multivariate analysis, age, gender, typical angina, and CVRF, but not LBBB (P = 0.94), emerged as significant and independent predictors of obstructive CAD. CONCLUSION CAD prevalence is similar in LBBB patients at low-to-moderate pre-test probability compared with controls with similar CVRF matched for age, gender, and symptom typicality. CCTA is a useful imaging modality in LBBB patients, providing comparable image quality to non-LBBB controls.
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Affiliation(s)
- Olivier F Clerc
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich CH-8091, Switzerland Department of Cardiology, University Hospital Zurich, Ramistrasse 100, Zurich CH-8091, Switzerland
| | - Mathias Possner
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich CH-8091, Switzerland
| | - René Maire
- Cardiological and Aviation Medicine Practice, Männedorf CH-8708, Switzerland
| | - Riccardo Liga
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich CH-8091, Switzerland
| | - Tobias A Fuchs
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich CH-8091, Switzerland
| | - Julia Stehli
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich CH-8091, Switzerland Department of Cardiology, University Hospital Zurich, Ramistrasse 100, Zurich CH-8091, Switzerland
| | - Jan Vontobel
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich CH-8091, Switzerland
| | - Fran Mikulicic
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich CH-8091, Switzerland
| | - Christoph Gräni
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich CH-8091, Switzerland
| | - Dominik C Benz
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich CH-8091, Switzerland
| | - Thomas F Lüscher
- Department of Cardiology, University Hospital Zurich, Ramistrasse 100, Zurich CH-8091, Switzerland
| | - Bernhard A Herzog
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich CH-8091, Switzerland
| | - Ronny R Buechel
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich CH-8091, Switzerland
| | - Philipp A Kaufmann
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich CH-8091, Switzerland
| | - Oliver Gaemperli
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich CH-8091, Switzerland Department of Cardiology, University Hospital Zurich, Ramistrasse 100, Zurich CH-8091, Switzerland
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Vontobel J, Liga R, Possner M, Clerc OF, Mikulicic F, Veit-Haibach P, Ter Voert EEGW, Fuchs TA, Stehli J, Pazhenkottil AP, Benz DC, Gräni C, Gaemperli O, Herzog B, Buechel RR, Kaufmann PA. MR-based attenuation correction for cardiac FDG PET on a hybrid PET/MRI scanner: comparison with standard CT attenuation correction. Eur J Nucl Med Mol Imaging 2015; 42:1574-80. [PMID: 26091704 DOI: 10.1007/s00259-015-3089-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 05/15/2015] [Indexed: 12/20/2022]
Abstract
PURPOSE The aim of this study was to evaluate the feasibility of attenuation correction (AC) for cardiac (18)F-labelled fluorodeoxyglucose (FDG) positron emission tomography (PET) using MR-based attenuation maps. METHODS We included 23 patients with no known cardiac history undergoing whole-body FDG PET/CT imaging for oncological indications on a PET/CT scanner using time-of-flight (TOF) and subsequent whole-body PET/MR imaging on an investigational hybrid PET/MRI scanner. Data sets from PET/MRI (with and without TOF) were reconstructed using MR AC and semi-quantitative segmental (20-segment model) myocardial tracer uptake (per cent of maximum) and compared to PET/CT which was reconstructed using CT AC and served as standard of reference. RESULTS Excellent correlations were found for regional uptake values between PET/CT and PET/MRI with TOF (n = 460 segments in 23 patients; r = 0.913; p < 0.0001) with narrow Bland-Altman limits of agreement (-8.5 to +12.6 %). Correlation coefficients were slightly lower between PET/CT and PET/MRI without TOF (n = 460 segments in 23 patients; r = 0.851; p < 0.0001) with broader Bland-Altman limits of agreement (-12.5 to +15.0 %). PET/MRI with and without TOF showed minimal underestimation of tracer uptake (-2.08 and -1.29 %, respectively), compared to PET/CT. CONCLUSION Relative myocardial FDG uptake obtained from MR-based attenuation corrected FDG PET is highly comparable to standard CT-based attenuation corrected FDG PET, suggesting interchangeability of both AC techniques.
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Affiliation(s)
- Jan Vontobel
- Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
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Taniguchi Y, Takahashi Y, Toba T, Yamada S, Yokoi K, Kobayashi S, Okajima S, Shimane A, Kawai H, Yasaka Y, Smanio P, Oliveira MA, Machado L, Cestari P, Medeiros E, Fukuzawa S, Okino S, Ikeda A, Maekawa J, Ichikawa S, Kuroiwa N, Yamanaka K, Igarashi A, Inagaki M, Patel K, Mahan M, Ananthasubramaniam K, Mouden M, Yokota S, Ottervanger J, Knollema S, Timmer J, Jager P, Padron K, Peix A, Cabrera L, Pena Bofill V, Valera D, Rodriguez Nande L, Carrillo Hernandez R, Mena Esnard E, Fernandez Columbie Y, Bertella E, Baggiano A, Mushtaq S, Segurini C, Loguercio M, Conte E, Beltrama V, Petulla' M, Andreini D, Pontone G, Guzic Salobir B, Dolenc Novak M, Jug B, Kacjan B, Novak Z, Vrtovec M, Mushtaq S, Pontone G, Bertella E, Conte E, Segurini C, Volpato V, Baggiano A, Formenti A, Pepi M, Andreini D, Ajanovic R, Husic-Selimovic A, Zujovic-Ajanovic A, Mlynarski R, Mlynarska A, Golba K, Sosnowski M, Ameta D, Goyal M, Kumar D, Chandra S, Sethi R, Puri A, Dwivedi SK, Narain VS, Saran RK, Nekolla S, Rischpler C, Nicolosi S, Langwieser N, Dirschinger R, Laugwitz K, Schwaiger M, Goral JL, Napoli J, Forcada P, Zucchiatti N, Damico A, Damico A, Olivieri D, Lavorato M, Dubesarsky E, Montana O, Salgado C, Jimenez-Heffernan A, Ramos-Font C, Lopez-Martin J, Sanchez De Mora E, Lopez-Aguilar R, Manovel A, Martinez A, Rivera F, Soriano E, Maroz-Vadalazhskaya N, Trisvetova E, Vrublevskaya O, Abazid R, Kattea M, Saqqah H, Sayed S, Smettei O, Winther S, Svensson M, Birn H, Jorgensen H, Botker H, Ivarsen P, Bottcher M, Maaniitty T, Stenstrom I, Saraste A, Pikkarainen E, Uusitalo V, Ukkonen H, Kajander S, Bax J, Knuuti J, Choi T, Park H, Lee C, Lee J, Seo Y, Cho Y, Hwang E, Cho D, Sanchez Enrique C, Ferrera C, Olmos C, Jimenez - Ballve A, Perez - Castejon MJ, Fernandez C, Vivas D, Vilacosta I, Nagamachi S, Onizuka H, Nishii R, Mizutani Y, Kitamura K, Lo Presti M, Polizzi V, Pino P, Luzi G, Bellavia D, Fiorilli R, Madeo A, Malouf J, Buffa V, Musumeci F, Rosales S, Puente A, Zafrir N, Shochat T, Mats A, Solodky A, Kornowski R, Lorber A, Boemio A, Pellegrino T, Paolillo S, Piscopo V, Carotenuto R, Russo B, Pellegrino S, De Matteis G, Perrone-Filardi P, Cuocolo A, Piscopo V, Pellegrino T, Boemio A, Carotenuto R, Russo B, Pellegrino S, De Matteis G, Petretta M, Cuocolo A, Amirov N, Ibatullin M, Sadykov A A, Saifullina G, Ruano R, Diego Dominguez M, Rodriguez Gabella T, Diego Nieto A, Diaz Gonzalez L, Garcia-Talavera J, Sanchez Fernandez P, Leen A, Al Younis I, Zandbergen-Harlaar S, Verberne H, Gimelli A, Veltman C, Wolterbeek R, Bax J, Scholte A, Mooney D, Rosenblatt J, Dunn T, Vasaiwala S, Okuda K, Nakajima K, Nystrom K, Edenbrandt L, Matsuo S, Wakabayashi H, Hashimoto M, Kinuya S, Iric-Cupic V, Milanov S, Davidovic G, Zdravkovic V, Ashikaga K, Yoneyama K, Akashi Y, Shugushev Z, Maximkin D, Chepurnoy A, Volkova O, Baranovich V, Faibushevich A, El Tahlawi M, Elmurr A, Alzubaidi S, Sakrana A, Gouda M, El Tahlawi R, Sellem A, Melki S, Elajmi W, Hammami H, Okano M, Kato T, Kimura M, Funasako M, Nakane E, Miyamoto S, Izumi T, Haruna T, Inoko M, Massardo T, Swett E, Fernandez R, Vera V, Zhindon J, Fernandez R, Swett E, Vera V, Zhindon J, Alay R, Massardo T, Ohshima S, Nishio M, Kojima A, Tamai S, Kobayashi T, Murohara T, Burrell S, Van Rosendael A, Van Den Hoogen I, De Graaf M, Roelofs J, Kroft L, Bax J, Scholte A, Rjabceva I, Krumina G, Kalvelis A, Chanakhchyan F, Vakhromeeva M, Kankiya E, Koppes J, Knol R, Wondergem M, Van Der Ploeg T, Van Der Zant F, Lazarenko SV, Bruin VS, Pan XB, Declerck JM, Van Der Zant FM, Knol RJJ, Juarez-Orozco LE, Alexanderson E, Slart R, Tio R, Dierckx R, Zeebregts C, Boersma H, Hillege H, Martinez-Aguilar M, Jordan-Rios A, Christensen TE, Ahtarovski KA, Bang LE, Holmvang L, Soeholm H, Ghotbi AA, Andersson H, Ihlemann N, Kjaer A, Hasbak P, Gulya M, Lishmanov YB, Zavadovskii K, Lebedev D, Stahle M, Hellberg S, Liljenback H, Virta J, Metsala O, Yla-Herttuala S, Saukko P, Knuuti J, Saraste A, Roivainen A, Thackeray J, Wang Y, Bankstahl J, Wollert K, Bengel F, Saushkina Y, Evtushenko V, Minin S, Efimova I, Evtushenko A, Smishlyaev K, Lishmanov Y, Maslov L, Okuda K, Nakajima K, Kirihara Y, Sugino S, Matsuo S, Taki J, Hashimoto M, Kinuya S, Ahmadian A, Berman J, Govender P, Ruberg F, Miller E, Piriou N, Pallardy A, Valette F, Cahouch Z, Mathieu C, Warin-Fresse K, Gueffet J, Serfaty J, Trochu J, Kraeber-Bodere F, Van Dijk J, Mouden M, Ottervanger J, Van Dalen J, Jager P, Zafrir N, Ofrk H, Vaturi M, Shochat T, Hassid Y, Belzer D, Sagie A, Kornowski R, Kaminek M, Metelkova I, Budikova M, Koranda P, Henzlova L, Sovova E, Kincl V, Drozdova A, Jordan M, Shahid F, Teoh Y, Thamen R, Hara N, Onoguchi M, Hojyo O, Kawaguchi Y, Murai M, Udaka F, Matsuzawa Y, Bulugahapitiya DS, Avison M, Martin J, Liu YH, Wu J, Liu C, Sinusas A, Daou D, Sabbah R, Bouladhour H, Coaguila C, Aguade-Bruix S, Pizzi M, Romero-Farina G, Candell-Riera J, Castell-Conesa J, Patchett N, Sverdlov A, Miller E, Daou D, Sabbah R, Bouladhour H, Coaguila C, Smettei O, Abazid R, Boulaamayl El Fatemi S, Sallam L, Snipelisky D, Park J, Ray J, Shapiro B, Kostkiewicz M, Szot W, Holcman K, Lesniak-Sobelga A, Podolec P, Clerc O, Possner M, Liga R, Vontobel J, Mikulicic F, Graeni C, Benz D, Herzog B, Gaemperli O, Kaufmann P. Poster Session 1: Sunday 3 May 2015, 08:30-18:00 * Room: Poster Area. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Bouyoucef SE, Uusitalo V, Kamperidis V, De Graaf M, Maaniitty T, Stenstrom I, Broersen A, Scholte A, Saraste A, Bax J, Knuuti J, Furuhashi T, Moroi M, Awaya T, Masai H, Minakawa M, Kunimasa T, Fukuda H, Sugi K, Berezin A, Kremzer A, Clerc O, Kaufmann B, Possner M, Liga R, Vontobel J, Mikulicic F, Graeni C, Benz D, Kaufmann P, Buechel R, Ferreira M, Cunha M, Albuquerque A, Ramos D, Costa G, Lima J, Pego M, Peix A, Cisneros L, Cabrera L, Padron K, Rodriguez L, Heres F, Carrillo R, Mena E, Fernandez Y, Huizing E, Van Dijk J, Van Dalen J, Timmer J, Ottervanger J, Slump C, Jager P, Venuraju S, Jeevarethinam A, Yerramasu A, Atwal S, Mehta V, Lahiri A, Arjonilla Lopez A, Calero Rueda MJ, Gallardo G, Fernandez-Cuadrado J, Hernandez Aceituno D, Sanchez Hernandez J, Yoshida H, Mizukami A, Matsumura A, Smettei O, Abazid R, Sayed S, Mlynarska A, Mlynarski R, Golba K, Sosnowski M, Winther S, Svensson M, Jorgensen H, Bouchelouche K, Gormsen L, Holm N, Botker H, Ivarsen P, Bottcher M, Cortes CM, Aramayo G E, Daicz M, Casuscelli J, Alaguibe E, Neira Sepulveda A, Cerda M, Ganum G, Embon M, Vigne J, Enilorac B, Lebasnier A, Valancogne L, Peyronnet D, Manrique A, Agostini D, Menendez D, Rajpal S, Kocherla C, Acharya M, Reddy P, Sazonova I, Ilushenkova Y, Batalov R, Rogovskaya Y, Lishmanov Y, Popov S, Varlamova N, Prado Diaz S, Jimenez Rubio C, Gemma D, Refoyo Salicio E, Valbuena Lopez S, Moreno Yanguela M, Torres M, Fernandez-Velilla M, Lopez-Sendon J, Guzman Martinez G, Puente A, Rosales S, Martinez C, Cabada M, Melendez G, Ferreira R, Gonzaga A, Santos J, Vijayan S, Smith S, Smith M, Muthusamy R, Takeishi Y, Oikawa M, Goral JL, Napoli J, Montana O, Damico A, Quiroz M, Damico A, Forcada P, Schmidberg J, Zucchiatti N, Olivieri D, Jeevarethinam A, Venuraju S, Dumo A, Ruano S, Rakhit R, Davar J, Nair D, Cohen M, Darko D, Lahiri A, Yokota S, Ottervanger J, Maas A, Mouden M, Timmer J, Knollema S, Jager P, Sanja Mazic S, Lazovic B, Marina Djelic M, Jelena Suzic Lazic J, Tijana Acimovic T, Milica Deleva M, Vesnina Z, Zafrir N, Bental T, Mats I, Solodky A, Gutstein A, Hasid Y, Belzer D, Kornowski R, Ben Said R, Ben Mansour N, Ibn Haj Amor H, Chourabi C, Hagui A, Fehri W, Hawala H, Shugushev Z, Patrikeev A, Maximkin D, Chepurnoy A, Kallianpur V, Mambetov A, Dokshokov G, Teresinska A, Wozniak O, Maciag A, Wnuk J, Dabrowski A, Czerwiec A, Jezierski J, Biernacka K, Robinson J, Prosser J, Cheung G, Allan S, Mcmaster G, Reid S, Tarbuck A, Martin W, Queiroz R, Falcao A, Giorgi M, Imada R, Nogueira S, Chalela W, Kalil Filho R, Meneghetti W, Matveev V, Bubyenov A, Podzolkov V, Shugushev Z, Maximkin D, Chepurnoy A, Baranovich V, Faibushevich A, Kolzhecova Y, Volkova O, Kallianpur V, Peix A, Cabrera L, Padron K, Rodriguez L, Fernandez J, Lopez G, Mena E, Fernandez Y, Dondi M, Paez D, Butcher C, Reyes E, Al-Housni M, Green R, Santiago H, Ghiotto F, Hinton-Taylor S, Pottle A, Mason M, Underwood S, Casans Tormo I, Diaz-Exposito R, Plancha-Burguera E, Elsaban K, Alsakhri H, Yoshinaga K, Ochi N, Tomiyama Y, Katoh C, Inoue M, Nishida M, Suzuki E, Manabe O, Ito Y, Tamaki N, Tahilyani A, Jafary F, Ho Hee Hwa H, Ozdemir S, Kirilmaz B, Barutcu A, Tan Y, Celik F, Sakgoz S, Cabada Gamboa M, Puente Barragan A, Morales Vitorino N, Medina Servin M, Hindorf C, Akil S, Hedeer F, Jogi J, Engblom H, Martire V, Pis Diez E, Martire M, Portillo D, Hoff C, Balche A, Majgaard J, Tolbod L, Harms H, Bouchelouche K, Soerensen J, Froekiaer J, Gormsen L, Nudi F, Neri G, Procaccini E, Pinto A, Vetere M, Biondi-Zoccai G, Falcao A, Chalela W, Giorgi M, Imada R, Soares J, Do Val R, Oliveira M, Kalil Filho R, Meneghetti J, Tekabe Y, Anthony T, Li Q, Schmidt A, Johnson L, Groenman M, Tarkia M, Kakela M, Halonen P, Kiviniemi T, Pietila M, Yla-Herttuala S, Knuuti J, Roivainen A, Saraste A, Nekolla S, Swirzek S, Higuchi T, Reder S, Schachoff S, Bschorner M, Laitinen I, Robinson S, Yousefi B, Schwaiger M, Kero T, Lindsjo L, Antoni G, Westermark P, Carlson K, Wikstrom G, Sorensen J, Lubberink M, Rouzet F, Cognet T, Guedj K, Morvan M, El Shoukr F, Louedec L, Choqueux C, Nicoletti A, Le Guludec D, Jimenez-Heffernan A, Munoz-Beamud F, Sanchez De Mora E, Borrachero C, Salgado C, Ramos-Font C, Lopez-Martin J, Hidalgo M, Lopez-Aguilar R, Soriano E, Okizaki A, Nakayama M, Ishitoya S, Sato J, Takahashi K, Burchert I, Caobelli F, Wollenweber T, Nierada M, Fulsche J, Dieckmann C, Bengel F, Shuaib S, Mahlum D, Port S, Gemma D, Refoyo E, Cuesta E, Guzman G, Lopez T, Valbuena S, Fernandez-Velilla M, Del Prado S, Moreno M, Lopez-Sendon J, Harbinson M, Donnelly L, Einstein AJ, Johnson LL, Deluca AJ, Kontak AC, Groves DW, Stant J, Pozniakoff T, Cheng B, Rabbani LE, Bokhari S, Caobelli F, Schuetze C, Nierada M, Fulsche J, Dieckmann C, Bengel F, Aguade-Bruix S, Pizzi M, Romero-Farina G, Terricabras M, Villasboas D, Castell-Conesa J, Candell-Riera J, Brunner S, Gross L, Todica A, Lehner S, Di Palo A, Niccoli Asabella A, Magarelli C, Notaristefano A, Ferrari C, Rubini G, Sellem A, Melki S, Elajmi W, Hammami H, Ziadi M, Montero J, Ameriso J, Villavicencio R, Benito Gonzalez TF, Mayorga Bajo A, Gutierrez Caro R, Rodriguez Santamarta M, Alvarez Roy L, Martinez Paz E, Barinaga Martin C, Martin Fernandez J, Alonso Rodriguez D, Iglesias Garriz I, Gemma D, Refoyo E, Cuesta E, Guzman G, Valbuena S, Rosillo S, Del Prado S, Torres M, Moreno M, Lopez-Sendon J, Taleb S, Cherkaoui Salhi G, Regbaoui Y, Ait Idir M, Guensi A, Puente A, Rosales S, Martinez C, Cabada M, Benito Gonzalez TF, Mayorga Bajo A, Gutierrez Caro R, Rodriguez Santamarta M, Alvarez Roy L, Martinez Paz E, Martin Lopez CE, Castano Ruiz M, Martin Fernandez J, Iglesias Garriz I. Poster Session 2: Monday 4 May 2015, 08:00-18:00 * Room: Poster Area. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Vontobel J, Saguner AM, Brunckhorst CB. [CME-EKG 43. Palpitations after physical exertion]. Praxis (Bern 1994) 2013; 103:54-57. [PMID: 24393827 DOI: 10.1024/1661-8157/a001523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Jan Vontobel
- Klinik für Kardiologie, Herz-Kreislauf Zentrum, Universitätsspital Zürich
| | - Ardan M Saguner
- Klinik für Kardiologie, Herz-Kreislauf Zentrum, Universitätsspital Zürich
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Vontobel J, Hufschmid U, Zellweger MJ, Friedli BC. Ventricular septal defect originating from an apical left ventricular pseudoaneurysm. Eur Heart J 2013; 35:1159. [PMID: 24371080 DOI: 10.1093/eurheartj/eht518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jan Vontobel
- Cardiology, Department of Internal Medicine, Cantonal Hospital Baden, CH-5404 Baden, Switzerland
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