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Alfieri M, Guerra F, Lofiego C, Fogante M, Ciliberti G, Vagnarelli F, Barbarossa A, Principi S, Stronati G, Volpato G, Compagnucci P, Valeri Y, Tofoni P, Brugiatelli L, Capodaglio I, Esposto Pirani P, Argalia G, Schicchi N, Messano L, Centanni M, Giovagnoni A, Perna GP, Dello Russo A, Casella M. A Novel Approach to Cardiac Magnetic Resonance Scar Characterization in Patients Affected by Cardiac Amyloidosis: A Pilot Study. Medicina (Kaunas) 2024; 60:613. [PMID: 38674259 PMCID: PMC11051713 DOI: 10.3390/medicina60040613] [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] [Received: 02/20/2024] [Revised: 03/29/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: Cardiac magnetic resonance (CMR) imaging has become an essential instrument in the study of cardiomyopathies; it has recently been integrated into the diagnostic workflow for cardiac amyloidosis (CA) with remarkable results. An additional emerging role is the stratification of the arrhythmogenic risk by scar analysis and the possibility of merging these data with electro-anatomical maps. This is made possible by using a software (ADAS 3D, Galgo Medical, Barcelona, Spain) able to provide 3D heart models by detecting fibrosis along the whole thickness of the myocardial walls. Little is known regarding the applications of this software in the wide spectrum of cardiomyopathies and the potential benefits have yet to be discovered. In this study, we tried to apply the ADAS 3D in the context of CA. Materials and Methods: This study was a retrospectively analysis of consecutive CMR imaging of patients affected by CA that were treated in our center (Marche University Hospital). Wherever possible, the data were processed with the ADAS 3D software and analyzed for a correlation between the morphometric parameters and follow-up events. The outcome was a composite of all-cause mortality, unplanned cardiovascular hospitalizations, sustained ventricular arrhythmias (VAs), permanent reduction in left ventricular ejection fraction, and pacemaker implantation. The secondary outcomes were the need for a pacemaker implantation and sustained VAs. Results: A total of 14 patients were deemed eligible for the software analysis: 8 patients with wild type transthyretin CA, 5 with light chain CA, and 1 with transthyretin hereditary CA. The vast majority of imaging features was not related to the composite outcome, but atrial wall thickening displayed a significant association with both the primary (p = 0.003) and the secondary outcome of pacemaker implantation (p = 0.003). The software was able to differentiate between core zones and border zones of scars, with the latter being the most extensively represented in all patients. Interestingly, in a huge percentage of CMR images, the software identified the highest degree of core zone fibrosis among the epicardial layers and, in those patients, we found a higher incidence of the primary outcome, without reaching statistical significance (p = 0.18). Channels were found in the scar zones in a substantial percentage of patients without a clear correlation with follow-up events. Conclusions: CMR imaging plays a pivotal role in cardiovascular diagnostics. Our analysis shows the feasibility and applicability of such instrument for all types of CA. We could not only differentiate between different layers of scars, but we were also able to identify the presence of fibrosis channels among the different scar zones. None of the data derived from the ADAS 3D software seemed to be related to cardiac events in the follow-up, but this might be imputable to the restricted number of patients enrolled in the study.
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Affiliation(s)
- Michele Alfieri
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy (G.C.); (P.C.); (Y.V.); (P.T.); (L.B.)
| | - Federico Guerra
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy (G.C.); (P.C.); (Y.V.); (P.T.); (L.B.)
- Department of Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy
| | - Carla Lofiego
- Division of Cardiology, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy
| | - Marco Fogante
- Cardiovascular Radiological Diagnostics, Department of Radiological Sciences, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy; (M.F.)
| | - Giuseppe Ciliberti
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy (G.C.); (P.C.); (Y.V.); (P.T.); (L.B.)
| | - Fabio Vagnarelli
- Division of Cardiology, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy
| | - Alessandro Barbarossa
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy (G.C.); (P.C.); (Y.V.); (P.T.); (L.B.)
| | - Samuele Principi
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy (G.C.); (P.C.); (Y.V.); (P.T.); (L.B.)
| | - Giulia Stronati
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy (G.C.); (P.C.); (Y.V.); (P.T.); (L.B.)
| | - Giovanni Volpato
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy (G.C.); (P.C.); (Y.V.); (P.T.); (L.B.)
| | - Paolo Compagnucci
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy (G.C.); (P.C.); (Y.V.); (P.T.); (L.B.)
| | - Yari Valeri
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy (G.C.); (P.C.); (Y.V.); (P.T.); (L.B.)
| | - Paolo Tofoni
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy (G.C.); (P.C.); (Y.V.); (P.T.); (L.B.)
| | - Leonardo Brugiatelli
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy (G.C.); (P.C.); (Y.V.); (P.T.); (L.B.)
| | - Irene Capodaglio
- Division of Cardiology, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy
| | - Paolo Esposto Pirani
- Cardiovascular Radiological Diagnostics, Department of Radiological Sciences, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy; (M.F.)
| | - Giulio Argalia
- Cardiovascular Radiological Diagnostics, Department of Radiological Sciences, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy; (M.F.)
| | - Nicolò Schicchi
- Cardiovascular Radiological Diagnostics, Department of Radiological Sciences, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy; (M.F.)
| | - Loredana Messano
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy (G.C.); (P.C.); (Y.V.); (P.T.); (L.B.)
| | - Maurizio Centanni
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy (G.C.); (P.C.); (Y.V.); (P.T.); (L.B.)
| | - Andrea Giovagnoni
- Cardiovascular Radiological Diagnostics, Department of Radiological Sciences, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy; (M.F.)
- Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, 60121 Ancona, Italy
| | - Gian Piero Perna
- Division of Cardiology, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy
| | - Antonio Dello Russo
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy (G.C.); (P.C.); (Y.V.); (P.T.); (L.B.)
- Department of Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy
| | - Michela Casella
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, Via Conca 71, 60126 Ancona, Italy (G.C.); (P.C.); (Y.V.); (P.T.); (L.B.)
- Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, 60121 Ancona, Italy
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Fogante M, Volpato G, Esposto Pirani P, Cela F, Compagnucci P, Valeri Y, Selimi A, Alfieri M, Brugiatelli L, Belleggia S, Coraducci F, Argalia G, Casella M, Dello Russo A, Schicchi N. Cardiac Magnetic Resonance and Cardiac Implantable Electronic Devices: Are They Truly Still "Enemies"? Medicina (Kaunas) 2024; 60:522. [PMID: 38674168 PMCID: PMC11051994 DOI: 10.3390/medicina60040522] [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] [Received: 02/24/2024] [Revised: 03/15/2024] [Accepted: 03/20/2024] [Indexed: 04/28/2024]
Abstract
The application of cardiac magnetic resonance (CMR) imaging in clinical practice has grown due to technological advancements and expanded clinical indications, highlighting its superior capabilities when compared to echocardiography for the assessment of myocardial tissue. Similarly, the utilization of implantable cardiac electronic devices (CIEDs) has significantly increased in cardiac arrhythmia management, and the requirements of CMR examinations in patients with CIEDs has become more common. However, this type of exam often presents challenges due to safety concerns and image artifacts. Until a few years ago, the presence of CIED was considered an absolute contraindication to CMR. To address these challenges, various technical improvements in CIED technology, like the reduction of the ferromagnetic components, and in CMR examinations, such as the introduction of new sequences, have been developed. Moreover, a rigorous protocol involving multidisciplinary collaboration is recommended for safe CMR examinations in patients with CIEDs, emphasizing risk assessment, careful monitoring during CMR, and post-scan device evaluation. Alternative methods to CMR, such as computed tomography coronary angiography with tissue characterization techniques like dual-energy and photon-counting, offer alternative potential solutions, although their diagnostic accuracy and availability do limit their use. Despite technological advancements, close collaboration and specialized staff training remain crucial for obtaining safe diagnostic CMR images in patients with CIEDs, thus justifying the presence of specialized centers that are equipped to handle these type of exams.
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Affiliation(s)
- Marco Fogante
- Maternal-Child, Senological, Cardiological Radiology and Outpatient Ultrasound, Department of Radiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (P.E.P.); (F.C.); (G.A.)
| | - Giovanni Volpato
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, 60126 Ancona, Italy; (G.V.); (P.C.); (Y.V.); (A.S.); (M.A.); (L.B.); (S.B.); (F.C.); (M.C.); (A.D.R.)
| | - Paolo Esposto Pirani
- Maternal-Child, Senological, Cardiological Radiology and Outpatient Ultrasound, Department of Radiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (P.E.P.); (F.C.); (G.A.)
| | - Fatjon Cela
- Maternal-Child, Senological, Cardiological Radiology and Outpatient Ultrasound, Department of Radiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (P.E.P.); (F.C.); (G.A.)
| | - Paolo Compagnucci
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, 60126 Ancona, Italy; (G.V.); (P.C.); (Y.V.); (A.S.); (M.A.); (L.B.); (S.B.); (F.C.); (M.C.); (A.D.R.)
| | - Yari Valeri
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, 60126 Ancona, Italy; (G.V.); (P.C.); (Y.V.); (A.S.); (M.A.); (L.B.); (S.B.); (F.C.); (M.C.); (A.D.R.)
| | - Adelina Selimi
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, 60126 Ancona, Italy; (G.V.); (P.C.); (Y.V.); (A.S.); (M.A.); (L.B.); (S.B.); (F.C.); (M.C.); (A.D.R.)
| | - Michele Alfieri
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, 60126 Ancona, Italy; (G.V.); (P.C.); (Y.V.); (A.S.); (M.A.); (L.B.); (S.B.); (F.C.); (M.C.); (A.D.R.)
| | - Leonardo Brugiatelli
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, 60126 Ancona, Italy; (G.V.); (P.C.); (Y.V.); (A.S.); (M.A.); (L.B.); (S.B.); (F.C.); (M.C.); (A.D.R.)
| | - Sara Belleggia
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, 60126 Ancona, Italy; (G.V.); (P.C.); (Y.V.); (A.S.); (M.A.); (L.B.); (S.B.); (F.C.); (M.C.); (A.D.R.)
| | - Francesca Coraducci
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, 60126 Ancona, Italy; (G.V.); (P.C.); (Y.V.); (A.S.); (M.A.); (L.B.); (S.B.); (F.C.); (M.C.); (A.D.R.)
| | - Giulio Argalia
- Maternal-Child, Senological, Cardiological Radiology and Outpatient Ultrasound, Department of Radiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (P.E.P.); (F.C.); (G.A.)
| | - Michela Casella
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, 60126 Ancona, Italy; (G.V.); (P.C.); (Y.V.); (A.S.); (M.A.); (L.B.); (S.B.); (F.C.); (M.C.); (A.D.R.)
- Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, 60121 Ancona, Italy
| | - Antonio Dello Russo
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, 60126 Ancona, Italy; (G.V.); (P.C.); (Y.V.); (A.S.); (M.A.); (L.B.); (S.B.); (F.C.); (M.C.); (A.D.R.)
- Department of Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy
| | - Nicolò Schicchi
- Cardiovascular Radiological Diagnostics, Department of Radiological Sciences, University Hospital of Marche, 60126 Ancona, Italy;
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Tagliati C, Fogante M, Palmisano A, Catapano F, Lisi C, Monti L, Lanni G, Cerimele F, Bernardini A, Procaccini L, Argalia G, Esposto Pirani P, Marcucci M, Rebonato A, Cerimele C, Luciano A, Cesarotto M, Belgrano M, Pagnan L, Sarno A, Cova MA, Ventura F, Regnicolo L, Polonara G, Uguccioni L, Quaranta A, Balardi L, Barbarossa A, Stronati G, Guerra F, Chiocchi M, Francone M, Esposito A, Schicchi N. Cardiac Masses and Pseudomasses: An Overview about Diagnostic Imaging and Clinical Background. Medicina (Kaunas) 2023; 60:70. [PMID: 38256331 PMCID: PMC10818366 DOI: 10.3390/medicina60010070] [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] [Received: 11/14/2023] [Revised: 12/09/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024]
Abstract
A cardiac lesion detected at ultrasonography might turn out to be a normal structure, a benign tumor or rarely a malignancy, and lesion characterization is very important to appropriately manage the lesion itself. The exact relationship of the mass with coronary arteries and the knowledge of possible concomitant coronary artery disease are necessary preoperative information. Moreover, the increasingly performed coronary CT angiography to evaluate non-invasively coronary artery disease leads to a rising number of incidental findings. Therefore, CT and MRI are frequently performed imaging modalities when echocardiography is deemed insufficient to evaluate a lesion. A brief comprehensive overview about diagnostic radiological imaging and the clinical background of cardiac masses and pseudomasses is reported.
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Affiliation(s)
- Corrado Tagliati
- Radiologia, AST Pesaro Urbino, 61121 Pesaro, Italy; (C.T.); (A.R.)
| | - Marco Fogante
- Maternal-Child, Senological, Cardiological Radiology and Outpatient Ultrasound, Department of Radiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (G.A.); (P.E.P.)
| | - Anna Palmisano
- Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy; (A.P.); (A.E.)
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
| | - Federica Catapano
- Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20072 Milan, Italy; (F.C.); (C.L.); (L.M.); (M.F.)
- IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Costanza Lisi
- Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20072 Milan, Italy; (F.C.); (C.L.); (L.M.); (M.F.)
| | - Lorenzo Monti
- Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20072 Milan, Italy; (F.C.); (C.L.); (L.M.); (M.F.)
- IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Giuseppe Lanni
- Radiologia, ASL 4 Teramo, 64100 Teramo, Italy; (G.L.); (F.C.); (A.B.); (L.P.)
| | - Federico Cerimele
- Radiologia, ASL 4 Teramo, 64100 Teramo, Italy; (G.L.); (F.C.); (A.B.); (L.P.)
| | - Antonio Bernardini
- Radiologia, ASL 4 Teramo, 64100 Teramo, Italy; (G.L.); (F.C.); (A.B.); (L.P.)
| | - Luca Procaccini
- Radiologia, ASL 4 Teramo, 64100 Teramo, Italy; (G.L.); (F.C.); (A.B.); (L.P.)
| | - Giulio Argalia
- Maternal-Child, Senological, Cardiological Radiology and Outpatient Ultrasound, Department of Radiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (G.A.); (P.E.P.)
| | - Paolo Esposto Pirani
- Maternal-Child, Senological, Cardiological Radiology and Outpatient Ultrasound, Department of Radiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (G.A.); (P.E.P.)
| | - Matteo Marcucci
- U.O.C. di Radiodiagnostica, Ospedale Generale Provinciale di Macerata, 62100 Macerata, Italy;
| | - Alberto Rebonato
- Radiologia, AST Pesaro Urbino, 61121 Pesaro, Italy; (C.T.); (A.R.)
| | - Cecilia Cerimele
- Dipartimento di Biomedicina e Prevenzione, Universiy of Roma Tor Vergata, 00133 Roma, Italy; (C.C.); (A.L.); (M.C.)
| | - Alessandra Luciano
- Dipartimento di Biomedicina e Prevenzione, Universiy of Roma Tor Vergata, 00133 Roma, Italy; (C.C.); (A.L.); (M.C.)
| | - Matteo Cesarotto
- Department of Radiology, Azienda Sanitaria Universitaria Giuliano Isontina Ospedale di Cattinara, 34149 Trieste, Italy; (M.C.); (L.P.); (A.S.)
| | - Manuel Belgrano
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34151 Trieste, Italy; (M.B.); (M.A.C.)
| | - Lorenzo Pagnan
- Department of Radiology, Azienda Sanitaria Universitaria Giuliano Isontina Ospedale di Cattinara, 34149 Trieste, Italy; (M.C.); (L.P.); (A.S.)
| | - Alessandro Sarno
- Department of Radiology, Azienda Sanitaria Universitaria Giuliano Isontina Ospedale di Cattinara, 34149 Trieste, Italy; (M.C.); (L.P.); (A.S.)
| | - Maria Assunta Cova
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34151 Trieste, Italy; (M.B.); (M.A.C.)
| | | | - Luana Regnicolo
- Department of Neuroradiology, University Hospital of Marche, 60126 Ancona, Italy;
| | - Gabriele Polonara
- Department of Specialized Clinical Sciences and Odontostomatology, Polytechnic University of Marche, 60126 Ancona, Italy;
| | - Lucia Uguccioni
- Emodinamica e Cardiologia Interventistica, AST Pesaro Urbino, 61121 Pesaro, Italy;
| | - Alessia Quaranta
- Cardiologia, Distretto Sanitario di Civitanova Marche, AST 3, 62012 Civitanova Marche, Italy;
| | - Liliana Balardi
- Health Professions Area, Diagnostic Technical Area, University Hospital of Marche, 60126 Ancona, Italy;
| | - Alessandro Barbarossa
- Cardiology and Arrhythmology Clinic, Department of Cardiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (A.B.); (G.S.); (F.G.)
| | - Giulia Stronati
- Cardiology and Arrhythmology Clinic, Department of Cardiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (A.B.); (G.S.); (F.G.)
| | - Federico Guerra
- Cardiology and Arrhythmology Clinic, Department of Cardiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (A.B.); (G.S.); (F.G.)
| | - Marcello Chiocchi
- Dipartimento di Biomedicina e Prevenzione, Universiy of Roma Tor Vergata, 00133 Roma, Italy; (C.C.); (A.L.); (M.C.)
| | - Marco Francone
- Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20072 Milan, Italy; (F.C.); (C.L.); (L.M.); (M.F.)
- IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Antonio Esposito
- Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy; (A.P.); (A.E.)
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
| | - Nicolò Schicchi
- Cardiovascular Radiological Diagnostics, Department of Radiological Sciences, University Hospital of Marche, 60126 Ancona, Italy;
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Schicchi N, Fogante M, Paolini E, Cela F, Pirani PE, Perna GP. Stress-rest dynamic-CT myocardial perfusion imaging in the management of myocardial bridging: A "one-stop shop" exam. J Cardiol Cases 2023; 28:229-232. [PMID: 38126055 PMCID: PMC10730270 DOI: 10.1016/j.jccase.2023.08.002] [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: 04/06/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 12/23/2023] Open
Abstract
Myocardial bridging (MB) is a congenital anomaly characterized by the intramyocardial coronary course that can cause coronary compression during systole leading to myocardial ischemia, often with the concomitant presence of endothelial dysfunction.Improvements in computed tomography (CT) technology have increased the burden of MB detection during coronary-CT (cCT) but their anatomical and functional assessment is often challenging. A stress-rest myocardial perfusion imaging (MPI) by single-photon emission CT (SPECT) is usually required to decide the correct patient management. However, SPECT has long acquisition protocols, poor spatial resolution, and significant radiation doses for the patient. The recent advances in CT scan technology have allowed the evaluation of stress-rest MPI, representing a promising alternative to SPECT.In this paper, we report six cases of MBs assessed with cCT examination and further evaluated with a stress-rest dynamic-CT MPI and SPECT. A reversible perfusion defect in the left anterior descending (LAD) territory segments potentially due to MB was detected in two of six patients, and they were referred for heart team evaluation.In conclusion, cCT and stress-rest dynamic-CT MPI allowed to detect MBs, evaluate their functional significance, and decide the patients' management in a "one-stop shop" examination. Learning objective Improvements in computed tomography (CT) technology have increased the burden of myocardial bridging (MB) detection during coronary-CT but their anatomical and functional assessment is often challenging.A stress-rest myocardial perfusion imaging (MPI) by single-photon emission CT (SPECT) is then usually required to decide the correct patient management.Recent advances in CT scan technology have allowed the evaluation of stress-rest MPI, that represent a promising alternative to SPECT.
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Affiliation(s)
- Nicolò Schicchi
- S.O.S. Diagnostica Radiologica Cardiovascolare, Department of Radiology, Marche University Hospital, Ancona, Italy
| | - Marco Fogante
- S.O.D. Radiologia Materno Infantile, Senologica, Cardiologica ed Ecografia Ambulatoriale, Department of Radiology, Marche University Hospital, Ancona, Italy
| | - Enrico Paolini
- Cardiologia e UTIC, Cardiovascular Department, Marche University Hospital, Ancona, Italy
| | - Fatjon Cela
- S.O.D. Radiologia Materno Infantile, Senologica, Cardiologica ed Ecografia Ambulatoriale, Department of Radiology, Marche University Hospital, Ancona, Italy
| | - Paolo Esposto Pirani
- S.O.D. Radiologia Materno Infantile, Senologica, Cardiologica ed Ecografia Ambulatoriale, Department of Radiology, Marche University Hospital, Ancona, Italy
| | - Gian Piero Perna
- Cardiologia e UTIC, Cardiovascular Department, Marche University Hospital, Ancona, Italy
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Rizzetto G, Tagliati C, Fogante M, Marcucci M, Argalia G, Lanni G, Rebonato A, Giuseppetti GM, Esposito R, Molinelli E, De Simoni E, Offidani A, Simonetti O. CT Patterns of Interstitial Lung Disease in Patients with Plaque Psoriasis: A Retrospective Case Series Study. Medicina (Kaunas) 2023; 59:1650. [PMID: 37763769 PMCID: PMC10534496 DOI: 10.3390/medicina59091650] [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] [Received: 07/03/2023] [Revised: 08/25/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: Recently published articles reported an association between psoriasis and interstitial lung diseases (ILDs). The aim of this study is to evaluate the differences in ILD computed tomography (CT) patterns between smoker and never smoker plaque psoriasis (PP) patients under topical treatment without psoriatic arthritis (PA), inflammatory bowel disease (IBD) or connective tissue diseases (CTDs). Matherials and Methods: Two radiologists evaluated chest CT examinations of 65 patients (33 smokers, 32 never smokers) with PP. Results: Usual interstitial pneumonia (UIP) pattern was diagnosed in 36 patients, nonspecific interstitial pneumonia pattern in 19, hypersensitivity pneumonitis in 7 and pleuropulmonary fibroelastosis (PPFE) in 3 patients. UIP pattern showed a statistically significant higher frequency in smoker patients (p = 0.0351). Respiratory symptoms were reported in 80% of patients. Conclusions: ILDs seems to represent a new comorbidity associated with psoriasis. Moreover, a statistically significant association between smokers and UIP pattern in PP patients is found. Respiratory symptoms should be evaluated in PP patients, in collaboration with a radiologist and a pneumologist. However, further studies are required to better understand the epidemiology of ILDs in PP patients.
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Affiliation(s)
- Giulio Rizzetto
- Department of Clinical and Molecular Sciences, Dermatology Clinic, Polytechnic Marche University, 60121 Ancona, Italy; (G.R.); (E.D.S.)
| | - Corrado Tagliati
- Radiologia AST Pesaro Urbino, 611121 Pesaro, Italy; (C.T.); (A.R.); (R.E.)
| | - Marco Fogante
- Department of Radiological Sciences, Azienda Ospedaliero Universitaria Ospedali Riuniti, Università Politecnica delle Marche, 60121 Ancona, Italy (G.A.); (G.M.G.)
| | - Matteo Marcucci
- Department of Radiological Sciences, Azienda Ospedaliero Universitaria Ospedali Riuniti, Università Politecnica delle Marche, 60121 Ancona, Italy (G.A.); (G.M.G.)
| | - Giulio Argalia
- Department of Radiological Sciences, Azienda Ospedaliero Universitaria Ospedali Riuniti, Università Politecnica delle Marche, 60121 Ancona, Italy (G.A.); (G.M.G.)
| | - Giuseppe Lanni
- U.O.S.D. Radiologia Ospedale “San Liberatore” Atri-Dipartimento dei Servizi-ASL Teramo, 64032 Teramo, Italy
| | - Alberto Rebonato
- Radiologia AST Pesaro Urbino, 611121 Pesaro, Italy; (C.T.); (A.R.); (R.E.)
| | - Gian Marco Giuseppetti
- Department of Radiological Sciences, Azienda Ospedaliero Universitaria Ospedali Riuniti, Università Politecnica delle Marche, 60121 Ancona, Italy (G.A.); (G.M.G.)
| | - Roberto Esposito
- Radiologia AST Pesaro Urbino, 611121 Pesaro, Italy; (C.T.); (A.R.); (R.E.)
| | - Elisa Molinelli
- Department of Clinical and Molecular Sciences, Dermatology Clinic, Polytechnic Marche University, 60121 Ancona, Italy; (G.R.); (E.D.S.)
| | - Edoardo De Simoni
- Department of Clinical and Molecular Sciences, Dermatology Clinic, Polytechnic Marche University, 60121 Ancona, Italy; (G.R.); (E.D.S.)
| | - Annamaria Offidani
- Department of Clinical and Molecular Sciences, Dermatology Clinic, Polytechnic Marche University, 60121 Ancona, Italy; (G.R.); (E.D.S.)
| | - Oriana Simonetti
- Department of Clinical and Molecular Sciences, Dermatology Clinic, Polytechnic Marche University, 60121 Ancona, Italy; (G.R.); (E.D.S.)
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Fogante M, Ventura F, Schicchi N, Regnicolo L, Potente C, Argalia G, Polonara G. Cardiac rhabdomyomas and cerebral lesions in 4 pediatric patients with tuberous sclerosis. Radiol Case Rep 2023; 18:2645-2648. [PMID: 37287722 PMCID: PMC10241653 DOI: 10.1016/j.radcr.2023.04.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 02/10/2023] [Revised: 04/14/2023] [Accepted: 04/26/2023] [Indexed: 06/09/2023] Open
Abstract
Rhabdomyoma is the most common primary cardiac tumor in pediatric patients. A strong association exists between cardiac rhabdomyomas and tuberous sclerosis (TS), an autosomal dominant disease, characterized by diffuse lesions in the nervous system, such as cortical-subcortical tubers and subependymal nodules. In TS, cardiac rhabdomyomas typically are diagnosed in childhood, but they could be detected in the neonatal period with echocardiography and magnetic resonance imaging and may precede cerebral lesions. Therefore, the precocious detection of cardiac rhabdomyomas in pediatric patients can suggest the diagnosis of TS and the early detection of cerebral lesions, improving the management of the related symptoms. We reported the cases of 4 pediatric patients, in which the detection of cardiac rhabdomyomas lead to the early discovery of cerebral lesions and the diagnosis of the TS.
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Affiliation(s)
- Marco Fogante
- Department of Radiology, University Hospital of Marche, Via Conca 71, Ancona 60126, Italy
| | | | - Nicolò Schicchi
- SOS Diagnostica Radiologica Cardiovascolare – University Hospital of Marche, Ancona, Italy
| | - Luana Regnicolo
- Department of Neuroradiology, University Hospital of Marche, Ancona, Italy
| | - Chiara Potente
- Department of Neuroradiology, University Hospital of Marche, Ancona, Italy
| | - Giulio Argalia
- Department of Radiology, University Hospital of Marche, Via Conca 71, Ancona 60126, Italy
| | - Gabriele Polonara
- Department of Specialized Clinical Sciences and Odontostomatology, Polytechnic University of Marche, Ancona, Italy
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Fogante M, Esposto Pirani P, Cela F, Balardi L, Piva T, Argalia G, Schicchi N. Ultra-low radiation dose and contrast volume CT protocol and TAVI-CT score for TAVI planning and outcome. Br J Radiol 2023:20221026. [PMID: 37183830 PMCID: PMC10392642 DOI: 10.1259/bjr.20221026] [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: 05/16/2023] Open
Abstract
OBJECTIVE To investigate the feasibility of an ultra-low radiation dose and contrast volume protocol using third-generation dual-source (DS) CT for transcatheter aortic valve implantation (TAVI) planning with coronary artery disease (CAD) assessment, coronary artery calcium score (CACS) and aortic valve calcium score (AVCS) quantification and to evaluate their relationship with TAVI outcome. METHODS In this retrospective study were selected 203 patients (131 males, 79.4 ± 5.4 years) underwent to TAVI and at 30- and 90-day follow-up. All patients had performed a third-generation 2 × 192-slices DSCT. The CT protocol included a non-contrast and a contrast high-pitch aortic acquisition for TAVI planning and CAD assessment. Semi-qualitative and quantitative image analysis were performed; the performance in CAD assessment was compared with ICA; the relationship between AVCS and CACS and paravalvular aortic regurgitation (PAR) and major cardiovascular events (MACEs) were evaluated. Mean radiation dose were calculated. Non-parametric tests were used. RESULTS Semi-qualitative image analysis was good. Contrast enhancement >500 Hounsfield unit (HU) and contrast-to-noise ratio <20 were obtained in all segments. The diagnostic accuracy in CAD was 89.0%. AVCS was significantly higher in patients with 30-day severe PAR. AVCS and CACS were higher in patients with 90-day MACE complications, respectively, 1904.5 ± 621.3 HU (p < 0.0001) and 769.2 ± 365.5 HU (p < 0.0230). Mean radiation dose was 2.8 ± 0.3 mSv. CONCLUSION A TAVI planning ultra-low radiation dose and contrast volume protocol using third-generation DSCT provides highly diagnostic images with CAD assessment, AVCS and CACS quantification and these latter were related with TAVI outcomes. ADVANCES IN KNOWLEDGE The proposed protocol using third-generation 2 × 192-slices DSCT allows with an ultra-low radiation dose and contrast volume the TAVI planning and the coronary artery assessment.
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Affiliation(s)
- Marco Fogante
- SOD di Radiologia Materno-Infantile, Senologica, Cardiologica ed Ecografia Ambulatoriale, University Hospital of Marche, Ancona, Italy
| | - Paolo Esposto Pirani
- SOD di Radiologia Materno-Infantile, Senologica, Cardiologica ed Ecografia Ambulatoriale, University Hospital of Marche, Ancona, Italy
| | - Fatjon Cela
- SOD di Radiologia Materno-Infantile, Senologica, Cardiologica ed Ecografia Ambulatoriale, University Hospital of Marche, Ancona, Italy
| | - Liliana Balardi
- Direzione Aziendale, University Hospital of Marche, Ancona, Italy
| | - Tommaso Piva
- SOD Cardiologia Ospedaliera e UTIC, University Hospital of Marche, Ancona, Italy
| | - Giulio Argalia
- SOD di Radiologia Materno-Infantile, Senologica, Cardiologica ed Ecografia Ambulatoriale, University Hospital of Marche, Ancona, Italy
| | - Nicolò Schicchi
- SOS Diagnostica Radiologica Cardiovascolare - University Hospital of Marche, Ancona, Italy
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Marcucci M, Papiri G, Tagliati C, Fogante M. Diffusion-weighted imaging in the early diagnosis of intraventricular rupture of a brain abscess. Radiol Case Rep 2022; 17:3059-3063. [PMID: 35769116 PMCID: PMC9234537 DOI: 10.1016/j.radcr.2022.05.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 05/23/2022] [Indexed: 11/24/2022] Open
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Valeri Y, Bagliani G, Compagnucci P, Volpato G, Cipolletta L, Parisi Q, Misiani A, Fogante M, Molini S, Dello Russo A, Casella M. Pathophysiology of Typical Atrial Flutter. Card Electrophysiol Clin 2022; 14:401-409. [PMID: 36153122 DOI: 10.1016/j.ccep.2022.05.003] [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] [Indexed: 11/28/2022]
Abstract
Nowadays, the pathophysiology mechanism of initiation and maintenance of reentrant arrhythmias, including atrial flutter, is well characterized. However, the anatomic and functional elements of the macro reentrant arrhythmias are not always well defined. In this article, we illustrate the anatomic structures that delineate the typical atrial flutter circuit, both clockwise and counterclockwise, paying attention to the inferior vena cava-tricuspid isthmus (CTI) and crista terminalis crucial role. Finally, we describe the left atrial role during typical atrial flutter, electrophysiologically a by-stander but essential in the phenotypic electrocardiogram (ECG).
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Affiliation(s)
- Yari Valeri
- Cardiology and Arrhythmology Clinic, University Hospital "Ospedali Riuniti", Via Conca 71, Ancona 60126, Italy; Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy.
| | - Giuseppe Bagliani
- Cardiology and Arrhythmology Clinic, University Hospital "Ospedali Riuniti", Via Conca 71, Ancona 60126, Italy; Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Paolo Compagnucci
- Cardiology and Arrhythmology Clinic, University Hospital "Ospedali Riuniti", Via Conca 71, Ancona 60126, Italy; Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Giovanni Volpato
- Cardiology and Arrhythmology Clinic, University Hospital "Ospedali Riuniti", Via Conca 71, Ancona 60126, Italy; Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Laura Cipolletta
- Cardiology and Arrhythmology Clinic, University Hospital "Ospedali Riuniti", Via Conca 71, Ancona 60126, Italy
| | - Quintino Parisi
- Cardiology and Arrhythmology Clinic, University Hospital "Ospedali Riuniti", Via Conca 71, Ancona 60126, Italy
| | - Agostino Misiani
- Cardiology and Arrhythmology Clinic, University Hospital "Ospedali Riuniti", Via Conca 71, Ancona 60126, Italy
| | - Marco Fogante
- Cardiology and Arrhythmology Clinic, University Hospital "Ospedali Riuniti", Via Conca 71, Ancona 60126, Italy; Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - Silvano Molini
- Cardiology and Arrhythmology Clinic, University Hospital "Ospedali Riuniti", Via Conca 71, Ancona 60126, Italy
| | - Antonio Dello Russo
- Cardiology and Arrhythmology Clinic, University Hospital "Ospedali Riuniti", Via Conca 71, Ancona 60126, Italy; Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Michela Casella
- Cardiology and Arrhythmology Clinic, University Hospital "Ospedali Riuniti", Via Conca 71, Ancona 60126, Italy; Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona, Italy
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10
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Fogante M, Carboni N, Argalia G. Clinical application of ultra-high frequency ultrasound: Discovering a new imaging frontier. J Clin Ultrasound 2022; 50:817-825. [PMID: 35730639 DOI: 10.1002/jcu.23255] [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] [Received: 05/16/2022] [Revised: 06/02/2022] [Accepted: 06/05/2022] [Indexed: 06/15/2023]
Abstract
The ultra-high frequency ultrasound (UHFUS) is characterized by the use of probes between 30 and 100 MHz. This technology has recently been introduced in clinical practice and represents an opportunity for the diagnosis of numerous pathologies. The high spatial resolution of UHFUS, up to 30 μ in pixel size, allows to study the pathological modifications and to guide microsurgery treatments in anatomical body structures not evaluable by conventional HFUS. The aim of this work is to provide a review of the literature on the current clinical applications of UHFUS and to discuss its added role in different clinical settings.
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Affiliation(s)
- Marco Fogante
- Department of Radiological Sciences, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Ancona, Italy
| | - Nicola Carboni
- Department of Radiological Sciences, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Ancona, Italy
| | - Giulio Argalia
- Department of Radiological Sciences, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Ancona, Italy
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11
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Marcucci M, Fogante M, Tagliati C, Papiri G. Cut-off point of CT-assessed epicardial adipose tissue volume for predicting worse clinical burden of SARS-CoV-2 pneumonia. Emerg Radiol 2022; 29:645-653. [PMID: 35606630 PMCID: PMC9126108 DOI: 10.1007/s10140-022-02059-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 03/16/2022] [Accepted: 05/10/2022] [Indexed: 11/21/2022]
Abstract
Objective To identify a cut-off value of epicardial adipose tissue (EAT) volume quantified by CT associated with a worse clinical outcome in patients with SARS-CoV-2 pneumonia. Materials and methods In this retrospective study, sixty patients with a diagnosis of laboratory-confirmed COVID-19 pneumonia and a chest CT exam on admission were enrolled. Based on a total severity score (range 0–20), patients were divided into two groups: ordinary group (total severity score < 7) and severe/critical group (total severity score > 7). Clinical results and EAT volume were compared between the two groups. Results The severe/critical patients, compared to the ordinary ones, were older (66.83 ± 11.72 vs 58.57 ± 16.86 years; p = 0.031), had higher body mass index (27.77 ± 2.11 vs 25.07 ± 2.80 kg/m2; p < 0.001) and higher prevalence of comorbidities. EAT volume was higher in severe/critical group, compared with the ordinary group (151.40 ± 66.22 cm3 vs 92.35 ± 44.46 cm3, p < 0.001). In severe/critical group, 19 (73%) patients were admitted in intensive care unit (ICU), compared with 6 (20%) patients in the ordinary group (p < 0.001). The area under the ROC curve (AUC) is equal to 0.781 (p < 0.001) (95% CI: 0.662–0.900). The cut-off found, in correspondence with the highest value of the Youden Index, is 97 cm3: the sensitivity is equal to 83.3%, while the specificity is equal to 70% for predicting a worse outcome. The risk (odds ratio) of belonging to the severe/critical group in this population due to EAT ≥ 97 cm3 is 11.667 (95% CI: 3.384–40.220; p < 0.001). Conclusion An EAT volume of 97 cm3 has good sensitivity and specificity to predict a greater extent of pulmonary involvement and therefore a worse clinical outcome in patients with SARS-CoV-2 pneumonia.
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Affiliation(s)
- Matteo Marcucci
- U.O.C. Radiodiagnostica, Ospedale Generale Provinciale Di Macerata, Via Santa Lucia, 2, 62100, Macerata, Italy.
| | - Marco Fogante
- Radiology Department, Azienda Ospedaliero Universitaria "Ospedali Riuniti", Via Conca, 71, 60126, Ancona, Italy
| | - Corrado Tagliati
- U.O.S.D. Radiologia Ospedale "San Liberatore" Atri - Dipartimento Dei Servizi - ASL Teramo, Viale del Risorgimento, 1158, 64032, Atri, Teramo, Italy
| | - Giulio Papiri
- Neurology Unit, Ospedale Provinciale "Madonna del Soccorso", Via Luciano Manara, 8, 63074, San Benedetto del Tronto, Ascoli Piceno, Italy
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Casella M, Compagnucci P, Conti MA, Falanga U, Volpato G, Fogante M, Cipolletta L, Misiani A, Molini S, Giovagnoni A, Dello Russo A. Recurrence of atrial fibrillation post-ablation: which is the most effective approach for detection? Minerva Cardiol Angiol 2022; 70:628-638. [PMID: 35212506 DOI: 10.23736/s2724-5683.22.05859-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Over the last 20 years, catheter ablation of atrial fibrillation (AF) has evolved from a research tool into a fundamental therapeutic measure, with the potential to improve symptoms, quality of life, and even risk of major adverse cardiac events (among patients with heart failure and a reduced ejection fraction). Notwithstanding the tremendous evolution in techniques and tools, risk of AF recurrences post-ablation is not negligible, and a comprehensive structured follow-up is highly needed to deliver optimal patient care. In this follow-up process, monitoring of heart rhythm is quintessential to detect recurrences, and may be accomplished by means of symptoms-triggered, intermittent, or continuous monitors. In recent years, the development and widespread adoption of implantable cardiac monitors, by allowing continuous long-term rhythm assessment, has surged to become the gold-standard strategy, both in research settings and in clinical practice. In this review, we both summarize the present state-of-the art on the detection of post-ablation AF recurrences, and provide future perspectives on this emerging yet often neglected topic, aiming to give practical hints for evidence-based, personalized patient care.
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Affiliation(s)
- Michela Casella
- Cardiology and Arrhythmology Clinic, University Hospital Ospedali Riuniti, Ancona, Italy.,Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - Paolo Compagnucci
- Cardiology and Arrhythmology Clinic, University Hospital Ospedali Riuniti, Ancona, Italy - .,Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Manuel A Conti
- Cardiology and Arrhythmology Clinic, University Hospital Ospedali Riuniti, Ancona, Italy
| | - Umberto Falanga
- Cardiology and Arrhythmology Clinic, University Hospital Ospedali Riuniti, Ancona, Italy.,Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Giovanni Volpato
- Cardiology and Arrhythmology Clinic, University Hospital Ospedali Riuniti, Ancona, Italy.,Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Marco Fogante
- Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - Laura Cipolletta
- Cardiology and Arrhythmology Clinic, University Hospital Ospedali Riuniti, Ancona, Italy
| | - Agostino Misiani
- Cardiology and Arrhythmology Clinic, University Hospital Ospedali Riuniti, Ancona, Italy
| | - Silvano Molini
- Cardiology and Arrhythmology Clinic, University Hospital Ospedali Riuniti, Ancona, Italy
| | - Andrea Giovagnoni
- Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - Antonio Dello Russo
- Cardiology and Arrhythmology Clinic, University Hospital Ospedali Riuniti, Ancona, Italy.,Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
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Fogante M, Cavagna E, Rinaldi G. Coronary arteries and aortic valve calcifications in COVID-19. Emerg Radiol 2022; 29:623. [PMID: 35066659 PMCID: PMC8783786 DOI: 10.1007/s10140-021-02011-3] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 12/11/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Marco Fogante
- Department of Radiology, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Ancona, Italy.
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Fogante M, Cavagna E, Rinaldi G. REMOVED: Correlation between COVID-19 and cardiac calcification. J Med Imaging Radiat Sci 2022:S1939-8654(22)00003-0. [PMID: 35131217 PMCID: PMC8761559 DOI: 10.1016/j.jmir.2022.01.002] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/03/2021] [Accepted: 01/11/2022] [Indexed: 11/05/2022]
Abstract
The Publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
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Affiliation(s)
- Marco Fogante
- Azienda Ospedaliero Universitaria "Ospedali Riuniti" Ancona.
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Fogante M, Cavagna E, Rinaldi G. COVID-19 follow-up: Chest X-ray findings with clinical and radiological relationship three months after recovery. Radiography (Lond) 2021; 28:531-536. [PMID: 34728138 PMCID: PMC8531194 DOI: 10.1016/j.radi.2021.10.012] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 11/20/2022]
Abstract
Introduction To evaluate the radiological sequelae of coronavirus disease (COVID-19) in a mid-term follow-up and investigate their relationship with clinical-radiological findings. Methods This prospective study included COVID-19 patients who underwent a CXR three months after discharge. The relationship between CXR score at three months after discharge and clinical findings and previous CXR scores, at admission and before the discharge, were evaluated. Then, based on mid-term follow-up CXR score, patients were divided in Group A (score = 0) and Group B (score≥1), and clinical-radiological findings were compared between two Groups. Finally, we calculated the CXR scores at admission and before the discharge with the highest sensitivity and specificity to predict normal and abnormal CXR score at mid-term follow-up. Results The study included 119 patients, mean age 65.9 ± 14.6 years. The oxygen saturation (SaO2) (p = 0.0006), the days of hospitalization (p < 0.0001) and the CXR score before the discharge (p = 0.0091) were independent factors to predict the mid-term follow-up CXR score. The Group A, 59 (49.6%) patients, had CXR scores at admission and before the discharge lower than Group B. The CXR scores at admission and before the discharge with the highest sensitivity and specificity to predict normal and abnormal CXR score at mid-term follow-up were, respectively, 3 and 2 (p < 0.0001). Conclusions The radiological abnormalities were present in about half patients three months after discharge, which had higher age, previous CXR scores and longer hospitalization. The SO2, days of hospitalization and previous CXR scores were independent factors for predicting the CXR at three months. Implications for practice The radiologist with CXR could play a central role in mid to long-term follow-up of COVID-19, assessing the radiological sequelae of patients and identifying those who might require a closer follow-up.
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Affiliation(s)
- M Fogante
- Azienda Ospedaliera "Ospedali Riuniti", Ancona, Italy.
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Casella M, Bergonti M, Dello Russo A, Maragna R, Gasperetti A, Compagnucci P, Catto V, Trombara F, Frappampina A, Conte E, Fogante M, Sommariva E, Rizzo S, De Gaspari M, Giovagnoni A, Andreini D, Pompilio G, Di Biase L, Natale A, Basso C, Tondo C. Endomyocardial Biopsy: The Forgotten Piece in the Arrhythmogenic Cardiomyopathy Puzzle. J Am Heart Assoc 2021; 10:e021370. [PMID: 34569251 PMCID: PMC8649151 DOI: 10.1161/jaha.121.021370] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background Endomyocardial biopsy (EMB) is part of 2010 Task Force Criteria (TFC) for arrhythmogenic right ventricular cardiomyopathy (ARVC). However, its usage has been curtailed because of its low presumed diagnostic yield, and it is now a poorly used tool. This study aims to analyze the contribution of EMB to the final diagnosis of ARVC. Methods and Results We included 104 consecutive patients evaluated for a suspicion of ARVC, who were referred for EMB. Patients with suspected left dominant pattern were excluded from the primary analysis. Subjects were initially stratified according to TFC without considering EMB. After EMB, patients were reclassified accordingly, and the reclassification rate was calculated. EMB yielded a diagnostic finding in 92 patients (85.5%). After including EMB evaluation, 20 (43%) more patients "at risk" received a definite diagnosis of ARVC. Overall, 59 patients received a definite diagnosis of ARVC, 34% only after EMB. EMB appeared to be the better-performing exam with respect to the final diagnosis (β, 2.2; area uder the curve, 0.73; P<0.05). The reclassification improvement after EMB measured 28%. TFC score increased from 3.5±1.3 to 4.3±1.4 (P<0.001). Notably, active inflammation was present in 6 (10%) patients. Minor complications were reported in only 2% of the cohort. In patients with suspected left-dominant disease, conventional TFC performed poorly. Conclusions Electroanatomic voltage mapping-guided EMB was safe and yielded an optimal diagnostic yield. It allowed upgrading of the diagnosis of nearly one-third of the patients considered "at risk." Classical TFC without EMB performed poorly in patients with the left dominant form of ARVC.
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Affiliation(s)
- Michela Casella
- Cardiology and Arrhythmology Clinic University Hospital "Umberto I -Lancisi - Salesi"Marche Polytechnic University Ancona Italy.,Department of Clinical, Special and Dental Sciences University Hospital "Umberto I -Lancisi - Salesi"Marche Polytechnic University Ancona Italy
| | - Marco Bergonti
- Heart Rhythm Center Department of Clinical Electrophysiology and Cardiac Pacing Monzino Cardiology CenterIRCCS Milano Italy
| | - Antonio Dello Russo
- Cardiology and Arrhythmology Clinic University Hospital "Umberto I -Lancisi - Salesi"Marche Polytechnic University Ancona Italy.,Department of Biomedical Sciences and Public Health University Hospital "Umberto I -Lancisi - Salesi"Marche Polytechnic University Ancona Italy
| | - Riccardo Maragna
- Heart Rhythm Center Department of Clinical Electrophysiology and Cardiac Pacing Monzino Cardiology CenterIRCCS Milano Italy
| | - Alessio Gasperetti
- Department of Biomedical Sciences and Public Health University Hospital "Umberto I -Lancisi - Salesi"Marche Polytechnic University Ancona Italy
| | - Paolo Compagnucci
- Cardiology and Arrhythmology Clinic University Hospital "Umberto I -Lancisi - Salesi"Marche Polytechnic University Ancona Italy.,Department of Biomedical Sciences and Public Health University Hospital "Umberto I -Lancisi - Salesi"Marche Polytechnic University Ancona Italy
| | - Valentina Catto
- Heart Rhythm Center Department of Clinical Electrophysiology and Cardiac Pacing Monzino Cardiology CenterIRCCS Milano Italy
| | - Filippo Trombara
- Heart Rhythm Center Department of Clinical Electrophysiology and Cardiac Pacing Monzino Cardiology CenterIRCCS Milano Italy
| | - Antonio Frappampina
- Heart Rhythm Center Department of Clinical Electrophysiology and Cardiac Pacing Monzino Cardiology CenterIRCCS Milano Italy
| | - Edoardo Conte
- Cardiovascular Computed Tomography and Radiology Unit Monzino Cardiology CenterIRCCS Milano Italy
| | - Marco Fogante
- Department of Clinical, Special and Dental Sciences University Hospital "Umberto I -Lancisi - Salesi"Marche Polytechnic University Ancona Italy.,Department of Radiology University Hospital "Umberto I -Lancisi - Salesi" Ancona Italy
| | - Elena Sommariva
- Unit of Vascular Biology and Regenerative Medicine Monzino Cardiology CenterIRCCS Milano Italy
| | - Stefania Rizzo
- Cardiovascular Pathology Unit Department of Cardiac, Thoracic, Vascular Sciences and Public Health Azienda Ospedaliera-University of Padua Padova Italy
| | - Monica De Gaspari
- Cardiovascular Pathology Unit Department of Cardiac, Thoracic, Vascular Sciences and Public Health Azienda Ospedaliera-University of Padua Padova Italy
| | - Andrea Giovagnoni
- Department of Clinical, Special and Dental Sciences University Hospital "Umberto I -Lancisi - Salesi"Marche Polytechnic University Ancona Italy.,Department of Radiology University Hospital "Umberto I -Lancisi - Salesi" Ancona Italy
| | - Daniele Andreini
- Cardiovascular Computed Tomography and Radiology Unit Monzino Cardiology CenterIRCCS Milano Italy.,Department of Clinical Sciences and Community Health University of Milan Milano Italy
| | - Giulio Pompilio
- Unit of Vascular Biology and Regenerative Medicine Monzino Cardiology CenterIRCCS Milano Italy
| | - Luigi Di Biase
- Montefiore Medical Center Albert-Einstein College of Medicine Bronx NY
| | - Andrea Natale
- Texas Cardiac Arrhyhtmia Institute (TCAI)St. David's Hospital Austin TX
| | - Cristina Basso
- Cardiovascular Pathology Unit Department of Cardiac, Thoracic, Vascular Sciences and Public Health Azienda Ospedaliera-University of Padua Padova Italy
| | - Claudio Tondo
- Heart Rhythm Center Department of Clinical Electrophysiology and Cardiac Pacing Monzino Cardiology CenterIRCCS Milano Italy.,Department of Biochemical Surgical and Dentist Sciences University of Milan Milano Italy
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Marcucci M, Fogante M, Schicchi N, Agliata G, Giovagnoni A. Rare malignant anomalous right coronary artery incidentally detected by dual source computed tomography angiography in an adult referred for transcatheter aortic valve implantation. Radiol Case Rep 2021; 16:3481-3484. [PMID: 34527126 PMCID: PMC8433112 DOI: 10.1016/j.radcr.2021.08.032] [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: 07/25/2021] [Accepted: 08/11/2021] [Indexed: 11/19/2022] Open
Abstract
Transcatheter aortic valve implantation (TAVI) is a safe treatment option for elderly patients with aortic stenosis (AS) with high or intermediate surgical risk. The anomalous origin of coronaries from a single Valsalva sinus has a higher risk of coronary obstruction during the TAVI procedure, so prior knowledge of these anatomical variants is of paramount importance as it can change the surgical strategy. In this report, we present the case of an adult patient suffering from severe aortic stenosis and incidentally diagnosed with an anomalous malignant variant of right coronary artery (RCA) by pre-procedural Computed Tomography (CT) Angiography. In TAVI planning, the use of electrocardiography (ECG) gated Dual Source CT (DSCT) enables accurate coronary and aorto-iliac vascular study, useful for detecting congenital coronary anomalies.
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Affiliation(s)
- Matteo Marcucci
- Radiology Department, Azienda Ospedaliero Universitaria "Ospedali Riuniti", 60126, Ancona, Italy
| | - Marco Fogante
- Radiology Department, Azienda Ospedaliero Universitaria "Ospedali Riuniti", 60126, Ancona, Italy
| | - Nicolò Schicchi
- Radiology Department, Azienda Ospedaliero Universitaria "Ospedali Riuniti", 60126, Ancona, Italy
| | - Giacomo Agliata
- Radiology Department, Azienda Ospedaliero Universitaria "Ospedali Riuniti", 60126, Ancona, Italy
| | - Andrea Giovagnoni
- Radiology Department, Azienda Ospedaliero Universitaria "Ospedali Riuniti", 60126, Ancona, Italy
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18
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Volpato G, Falanga U, Cipolletta L, Conti MA, Grifoni G, Ciliberti G, Urbinati A, Barbarossa A, Stronati G, Fogante M, Bergonti M, Catto V, Guerra F, Giovagnoni A, Dello Russo A, Casella M, Compagnucci P. Sports Activity and Arrhythmic Risk in Cardiomyopathies and Channelopathies: A Critical Review of European Guidelines on Sports Cardiology in Patients with Cardiovascular Diseases. ACTA ACUST UNITED AC 2021; 57:medicina57040308. [PMID: 33805943 PMCID: PMC8064370 DOI: 10.3390/medicina57040308] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/10/2021] [Accepted: 03/16/2021] [Indexed: 12/27/2022]
Abstract
The prediction and prevention of sudden cardiac death is the philosopher’s stone of clinical cardiac electrophysiology. Sports can act as triggers of fatal arrhythmias and therefore it is essential to promptly frame the athlete at risk and to carefully evaluate the suitability for both competitive and recreational sports activity. A history of syncope or palpitations, the presence of premature ventricular complexes or more complex arrhythmias, a reduced left ventricular systolic function, or the presence of known or familiar heart disease should prompt a thorough evaluation with second level examinations. In this regard, cardiac magnetic resonance and electrophysiological study play important roles in the diagnostic work-up. The role of genetics is increasing both in cardiomyopathies and in channelopathies, and a careful evaluation must be focused on genotype positive/phenotype negative subjects. In addition to being a trigger for fatal arrhythmias in certain cardiomyopathies, sports also play a role in the progression of the disease itself, especially in the case arrhythmogenic right ventricular cardiomyopathy. In this paper, we review the latest European guidelines on sport cardiology in patients with cardiovascular diseases, focusing on arrhythmic risk stratification and the management of cardiomyopathies and channelopathies.
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Affiliation(s)
- Giovanni Volpato
- Department of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60100 Ancona, Italy; (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (A.U.); (A.B.); (G.S.); (F.G.); (A.D.R.); (P.C.)
- Correspondence:
| | - Umberto Falanga
- Department of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60100 Ancona, Italy; (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (A.U.); (A.B.); (G.S.); (F.G.); (A.D.R.); (P.C.)
| | - Laura Cipolletta
- Department of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60100 Ancona, Italy; (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (A.U.); (A.B.); (G.S.); (F.G.); (A.D.R.); (P.C.)
| | - Manuel Antonio Conti
- Department of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60100 Ancona, Italy; (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (A.U.); (A.B.); (G.S.); (F.G.); (A.D.R.); (P.C.)
| | - Gino Grifoni
- Department of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60100 Ancona, Italy; (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (A.U.); (A.B.); (G.S.); (F.G.); (A.D.R.); (P.C.)
| | - Giuseppe Ciliberti
- Department of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60100 Ancona, Italy; (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (A.U.); (A.B.); (G.S.); (F.G.); (A.D.R.); (P.C.)
| | - Alessia Urbinati
- Department of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60100 Ancona, Italy; (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (A.U.); (A.B.); (G.S.); (F.G.); (A.D.R.); (P.C.)
| | - Alessandro Barbarossa
- Department of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60100 Ancona, Italy; (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (A.U.); (A.B.); (G.S.); (F.G.); (A.D.R.); (P.C.)
| | - Giulia Stronati
- Department of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60100 Ancona, Italy; (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (A.U.); (A.B.); (G.S.); (F.G.); (A.D.R.); (P.C.)
| | - Marco Fogante
- Department of Radiology, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60100 Ancona, Italy; (M.F.); (A.G.)
| | - Marco Bergonti
- Department of Clinical Sciences and Community Health, University of Milan, 20100 Milan, Italy;
| | - Valentina Catto
- Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico, 20100 Milan, Italy;
| | - Federico Guerra
- Department of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60100 Ancona, Italy; (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (A.U.); (A.B.); (G.S.); (F.G.); (A.D.R.); (P.C.)
| | - Andrea Giovagnoni
- Department of Radiology, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60100 Ancona, Italy; (M.F.); (A.G.)
| | - Antonio Dello Russo
- Department of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60100 Ancona, Italy; (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (A.U.); (A.B.); (G.S.); (F.G.); (A.D.R.); (P.C.)
| | - Michela Casella
- Department of Clinical, Special and Dental Sciences, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60100 Ancona, Italy;
| | - Paolo Compagnucci
- Department of Biomedical Science and Public Health, Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60100 Ancona, Italy; (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (A.U.); (A.B.); (G.S.); (F.G.); (A.D.R.); (P.C.)
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19
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Compagnucci P, Volpato G, Falanga U, Cipolletta L, Conti MA, Grifoni G, Ciliberti G, Stronati G, Fogante M, Bergonti M, Sommariva E, Guerra F, Giovagnoni A, Dello Russo A, Casella M. Myocardial Inflammation, Sports Practice, and Sudden Cardiac Death: 2021 Update. ACTA ACUST UNITED AC 2021; 57:medicina57030277. [PMID: 33802881 PMCID: PMC8002711 DOI: 10.3390/medicina57030277] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/02/2021] [Accepted: 03/10/2021] [Indexed: 02/07/2023]
Abstract
Myocardial inflammation is an important cause of cardiovascular morbidity and sudden cardiac death in athletes. The relationship between sports practice and myocardial inflammation is complex, and recent data from studies concerning cardiac magnetic resonance imaging and endomyocardial biopsy have substantially added to our understanding of the challenges encountered in the comprehensive care of athletes with myocarditis or inflammatory cardiomyopathy (ICM). In this review, we provide an overview of the current knowledge on the epidemiology, pathophysiology, diagnosis, and treatment of myocarditis, ICM, and myopericarditis/perimyocarditis in athletes, with a special emphasis on arrhythmias, patient-tailored therapies, and sports eligibility issues.
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Affiliation(s)
- Paolo Compagnucci
- Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, 60126 Ancona, Italy; (G.V.); (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (G.S.); (F.G.); (A.D.R.); (M.C.)
- Department of Biomedical Science and Public Health, Marche Polytechnic University, 60121 Ancona, Italy
- Correspondence:
| | - Giovanni Volpato
- Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, 60126 Ancona, Italy; (G.V.); (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (G.S.); (F.G.); (A.D.R.); (M.C.)
- Department of Biomedical Science and Public Health, Marche Polytechnic University, 60121 Ancona, Italy
| | - Umberto Falanga
- Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, 60126 Ancona, Italy; (G.V.); (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (G.S.); (F.G.); (A.D.R.); (M.C.)
- Department of Biomedical Science and Public Health, Marche Polytechnic University, 60121 Ancona, Italy
| | - Laura Cipolletta
- Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, 60126 Ancona, Italy; (G.V.); (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (G.S.); (F.G.); (A.D.R.); (M.C.)
| | - Manuel Antonio Conti
- Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, 60126 Ancona, Italy; (G.V.); (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (G.S.); (F.G.); (A.D.R.); (M.C.)
| | - Gino Grifoni
- Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, 60126 Ancona, Italy; (G.V.); (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (G.S.); (F.G.); (A.D.R.); (M.C.)
| | - Giuseppe Ciliberti
- Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, 60126 Ancona, Italy; (G.V.); (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (G.S.); (F.G.); (A.D.R.); (M.C.)
| | - Giulia Stronati
- Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, 60126 Ancona, Italy; (G.V.); (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (G.S.); (F.G.); (A.D.R.); (M.C.)
- Department of Biomedical Science and Public Health, Marche Polytechnic University, 60121 Ancona, Italy
| | - Marco Fogante
- Department of Radiology, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, 60121 Ancona, Italy; (M.F.); (A.G.)
| | - Marco Bergonti
- Department of Clinical Sciences and Community Health, University of Milan, 20138 Milan, Italy;
| | - Elena Sommariva
- Vascular Biology and Regenerative Medicine Unit, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy;
| | - Federico Guerra
- Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, 60126 Ancona, Italy; (G.V.); (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (G.S.); (F.G.); (A.D.R.); (M.C.)
- Department of Biomedical Science and Public Health, Marche Polytechnic University, 60121 Ancona, Italy
| | - Andrea Giovagnoni
- Department of Radiology, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, 60121 Ancona, Italy; (M.F.); (A.G.)
| | - Antonio Dello Russo
- Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, 60126 Ancona, Italy; (G.V.); (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (G.S.); (F.G.); (A.D.R.); (M.C.)
- Department of Biomedical Science and Public Health, Marche Polytechnic University, 60121 Ancona, Italy
| | - Michela Casella
- Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti Umberto I-Lancisi-Salesi”, 60126 Ancona, Italy; (G.V.); (U.F.); (L.C.); (M.A.C.); (G.G.); (G.C.); (G.S.); (F.G.); (A.D.R.); (M.C.)
- Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, 60121 Ancona, Italy
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Schicchi N, Fogante M, Palumbo P, Agliata G, Esposto Pirani P, Di Cesare E, Giovagnoni A. The sub-millisievert era in CTCA: the technical basis of the new radiation dose approach. Radiol Med 2020; 125:1024-1039. [PMID: 32930945 DOI: 10.1007/s11547-020-01280-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [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: 08/10/2020] [Accepted: 09/03/2020] [Indexed: 12/12/2022]
Abstract
Computed tomography coronary angiography (CTCA) has become a cornerstone in the diagnostic process of the heart disease. Although the cardiac imaging with interventional procedures is responsible for approximately 40% of the cumulative effective dose in medical imaging, a relevant radiation dose reduction over the last decade was obtained, with the beginning of the sub-mSv era in CTCA. The main technical basis to obtain a radiation dose reduction in CTCA is the use of a low tube voltage, the adoption of a prospective electrocardiogram-triggering spiral protocol and the application of the tube current modulation with the iterative reconstruction technique. Nevertheless, CTCA examinations are characterized by a wide range of radiation doses between different radiology departments. Moreover, the dose exposure in CTCA is extremely important because the benefit-risk calculus in comparison with other modalities also depends on it. Finally, because anatomical evaluation not adequately predicts the hemodynamic relevance of coronary stenosis, a low radiation dose in routine CTCA would allow the greatest use of the myocardial CT perfusion, fractional flow reserve-CT, dual-energy CT and artificial intelligence, to shift focus from morphological assessment to a comprehensive morphological and functional evaluation of the stenosis. Therefore, the aim of this work is to summarize the correct use of the technical basis in order that CTCA becomes an established examination for assessment of the coronary artery disease with low radiation dose.
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Affiliation(s)
- Nicolò Schicchi
- Radiology Department, Azienda Ospedaliero Universitaria "Ospedali Riuniti", 60126, Ancona, Italy
| | - Marco Fogante
- Radiology Department, Azienda Ospedaliero Universitaria "Ospedali Riuniti", 60126, Ancona, Italy.
| | - Pierpaolo Palumbo
- Radiology Department, Azienda Ospedaliero Universitaria "San Salvatore", 60126, L'Aquila, Italy
| | - Giacomo Agliata
- Radiology Department, Azienda Ospedaliero Universitaria "Ospedali Riuniti", 60126, Ancona, Italy
| | - Paolo Esposto Pirani
- Radiology Department, Azienda Ospedaliero Universitaria "Ospedali Riuniti", 60126, Ancona, Italy
| | - Ernesto Di Cesare
- Radiology Department, Azienda Ospedaliero Universitaria "San Salvatore", 60126, L'Aquila, Italy
| | - Andrea Giovagnoni
- Radiology Department, Azienda Ospedaliero Universitaria "Ospedali Riuniti", 60126, Ancona, Italy
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Dobran M, Mancini F, Nasi D, Lattanzi S, Fogante M, Tagliati C, Gesuita R, Polonara G, Iacoangeli M. Relationship between Burr-Hole position and pneumocephalus in patients operated for chronic subdural hematoma. Interdisciplinary Neurosurgery 2020. [DOI: 10.1016/j.inat.2020.100759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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Scendoni R, Cingolani M, Giovagnoni A, Fogante M, Fedeli P, Pigolkin YI, Ferrante L, Cameriere R. Analysis of carpal bones on MR images for age estimation: First results of a new forensic approach. Forensic Sci Int 2020; 313:110341. [PMID: 32473482 DOI: 10.1016/j.forsciint.2020.110341] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 11/24/2019] [Revised: 03/26/2020] [Accepted: 05/13/2020] [Indexed: 11/29/2022]
Abstract
Current multifactorial age estimation methods are based on radiography, however, in the forensic field there is growing interest in using magnetic resonance imaging (MRI). With regard to the carpal region, MRI provides more information for defining the individual ossification nuclei and the cartilage surrounding single bones. During the phase of bone growth, the progressive reduction of the cartilage layer is accompanied by the development of a cartilage-bone interface. The aim of our study was to create a new model for age estimation, based on the ratio between the area occupied by the nucleus of ossification (NO) and the surface of growth (SG) of each carpal bone, the latter derived by adding NO to the area of cartilage-bone interface. We analyzed 57 MRI scans of Italian subjects aged between 12 and 20 years, without growth diseases, endocrine disorders or osteodystrophy. Measurements of NO and SG areas were extracted using ImageJ software, and the ratio between the NO and SG of each bone (NOSG) was calculated. A multiple linear regression model was used to estimate the individual's age as a function of the variables: gender and wrist bone measurements. The results showed that the best model was obtained with 6 predictors (nvmax=6): Gender, and the NOSG of the Trapezoid, Trapezium, Scaphoid, Pisiform, and Capitate. The median of the residuals (observed age minus predicted age) was -0.025 years, with an IQR of 0.19 years. Thus a new forensic approach to age assessment using MRI is introduced in this paper, which gives the preliminary results.
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Affiliation(s)
- Roberto Scendoni
- Institute of Legal Medicine (AgEstimation Project), University of Macerata, Macerata, Italy.
| | - Mariano Cingolani
- Institute of Legal Medicine (AgEstimation Project), University of Macerata, Macerata, Italy
| | - Andrea Giovagnoni
- Department of Radiological Sciences, Ospedali Riuniti, Marche Polytechnic University, Ancona, Italy
| | - Marco Fogante
- Department of Radiological Sciences, Ospedali Riuniti, Marche Polytechnic University, Ancona, Italy
| | | | - Yu I Pigolkin
- Department of Forensic Medicine, University of Sechenov, Moscow, Russia
| | - Luigi Ferrante
- Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Roberto Cameriere
- Institute of Legal Medicine (AgEstimation Project), University of Macerata, Macerata, Italy; Department of Forensic Medicine, University of Sechenov, Moscow, Russia
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23
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Floridi C, Fogante M, Agostini A, Borgheresi A, Cellina M, Natella R, Bruno F, Cozzi D, Maggialetti N, Palumbo P, Miele V, Carotti M, Giovagnoni A. Radiological diagnosis of Coronavirus Disease 2019 (COVID-19): a Practical Guide. Acta Biomed 2020; 91:51-59. [PMID: 32945279 PMCID: PMC7944677 DOI: 10.23750/abm.v91i8-s.9973] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/11/2020] [Indexed: 12/13/2022]
Abstract
Novel beta-coronavirus (2019-nCoV) is the cause of Coronavirus disease-19 (COVID-19), and on March 12th 2020, the World Health Organization defined COVID-19 as a controllable pandemic. Currently, the 2019 novel coronavirus (SARS-CoV-2) can be identified by virus isolation or viral nucleic acid detection; however, false negatives associated with the nucleic acid detection provide a clinical challenge. Imaging examination has become the indispensable means not only in the early detection and diagnosis but also in monitoring the clinical course, evaluating the disease severity, and may be presented as an important warning signal preceding the negative RT-PCR test results. Different radiological modalities can be used in different disease settings. Radiology Departments must be nimble in implementing operational changes to ensure continued radiology services and protect patients and staff health.
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Affiliation(s)
- Chiara Floridi
- University Politecnica delle Marche, Department of Clinical, Special and Dental Sciences and University Hospital "Umberto I - Lancisi - Salesi", Department of Radiology, Ancona, Italy.
| | - Marco Fogante
- University Hospital "Umberto I - Lancisi - Salesi", Department of Radiology, Ancona, Italy.
| | - Andrea Agostini
- University Politecnica delle Marche, Department of Clinical, Special and Dental Sciences and University Hospital "Umberto I - Lancisi - Salesi", Department of Radiology, Ancona, Italy.
| | - Alessandra Borgheresi
- University Hospital "Umberto I - Lancisi - Salesi", Department of Radiology, Ancona, Italy.
| | - Michaela Cellina
- Department of Radiology, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Raffaele Natella
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Federico Bruno
- Department of Biotecnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Diletta Cozzi
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
| | - Nicola Maggialetti
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy..
| | - Pierpaolo Palumbo
- Department of Biotecnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Vittorio Miele
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
| | - Marina Carotti
- University Hospital "Umberto I - Lancisi - Salesi", Department of Radiology, Ancona, Italy.
| | - Andrea Giovagnoni
- University Politecnica delle Marche, Department of Clinical, Special and Dental Sciences and University Hospital "Umberto I - Lancisi - Salesi", Department of Radiology, Ancona, Italy.
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24
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Stronati G, Manfredi L, Ferrarini A, Zuliani L, Fogante M, Schicchi N, Capucci A, Giovagnoni A, Russo AD, Gabrielli A, Guerra F. Subclinical progression of systemic sclerosis-related cardiomyopathy. Eur J Prev Cardiol 2020; 27:1876-1886. [PMID: 32306757 DOI: 10.1177/2047487320916591] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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] [Indexed: 11/15/2022]
Abstract
AIMS Cardiac involvement in patients with systemic sclerosis (SSc) is frequent and represents a negative prognostic factor. Recent studies have described subclinical heart involvement of both the right ventricle (RV) and left ventricle (LV) via speckle-tracking-derived global longitudinal strain (GLS). It is currently unknown if SSc-related cardiomyopathy progresses through time. Our aim was to assess the progression of subclinical cardiac involvement in patients with SSc via speckle-tracking-derived GLS. METHODS This was a prospective longitudinal study enrolling 72 consecutive patients with a diagnosis of SSc and no structural heart disease nor pulmonary hypertension. A standard echocardiographic exam and GLS calculations were performed at baseline and at follow-up. RESULTS Traditional echocardiographic parameters did not differ from baseline to 20-month follow-up. LV GLS, despite being already impaired at baseline, worsened significantly during follow-up (from -19.8 ± 3.5% to -18.7 ± 3.5%, p = .034). RV GLS impairment progressed through the follow-up period (from -20.9 ± 6.1% to -18.7 ± 5.4%, p = .013). The impairment was more pronounced for the endocardial layers of both LV (from -22.5 ± 3.9% to -21.4 ± 3.9%, p = .041) and RV (-24.2 ± 6.2% to -20.6 ± 5.9%, p = .001). A 1% worsening in RV GLS was associated with an 18% increased risk of all-cause death or major cardiovascular event (p = .03) and with a 55% increased risk of pulmonary hypertension (p = .043). CONCLUSION SSC-related cardiomyopathy progresses over time and can be detected by speckle-tracking GLS. The highest progression towards reduced deformation was registered for the endocardial layers, which supports the hypothesis that microvascular dysfunction is the main determinant of heart involvement in SSc patients and starts well before overt pulmonary hypertension.
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Affiliation(s)
- Giulia Stronati
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital 'Ospedali Riuniti', Italy
| | - Lucia Manfredi
- Clinica Medica, Marche Polytechnic University, University Hospital 'Ospedali Riuniti', Italy
| | - Alessia Ferrarini
- Clinica Medica, Marche Polytechnic University, University Hospital 'Ospedali Riuniti', Italy
| | - Lucia Zuliani
- Clinica Medica, Marche Polytechnic University, University Hospital 'Ospedali Riuniti', Italy
| | - Marco Fogante
- Radiology Clinic, Marche Polytechnic University, University Hospital 'Ospedali Riuniti', Italy
| | - Nicolò Schicchi
- Radiology Clinic, Marche Polytechnic University, University Hospital 'Ospedali Riuniti', Italy
| | - Alessandro Capucci
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital 'Ospedali Riuniti', Italy
| | - Andrea Giovagnoni
- Radiology Clinic, Marche Polytechnic University, University Hospital 'Ospedali Riuniti', Italy
| | - Antonio Dello Russo
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital 'Ospedali Riuniti', Italy
| | - Armando Gabrielli
- Clinica Medica, Marche Polytechnic University, University Hospital 'Ospedali Riuniti', Italy
| | - Federico Guerra
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital 'Ospedali Riuniti', Italy
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25
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Schicchi N, Tiberi M, Fogante M, Andolfi M, Giovagnoni A, Refai M. Chest wall lipoma mimicking intrathoracic mass: Imaging with surgical correlation. Radiol Case Rep 2019; 14:956-961. [PMID: 31193853 PMCID: PMC6543187 DOI: 10.1016/j.radcr.2019.05.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 04/09/2019] [Revised: 05/17/2019] [Accepted: 05/18/2019] [Indexed: 12/28/2022] Open
Abstract
Lipoma is the most frequent benign soft-tissue tumor. It originates from fat cells. According to position, it is distinguished in superficial, typically subcutaneous lipoma, or deep, such as intramuscular lipoma. This latter form is infrequently and may resemble well-differentiated liposarcoma. For this reason, early radiological detection and characterization are necessary to obtain a wide complete resection and histopathologic evaluation to differentiate benign from malign lesions. We report an extremely rare case of an intrathoracic intramuscular lipoma of the chest wall detect and characterize with chest X-ray and computed tomography examinations, resected with thoracoscopic intervention and confirmed with histopathologic analysis.
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Affiliation(s)
- Nicolò Schicchi
- Radiology Department, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Via Conca 71, Ancona 60126, Italy
| | - Michela Tiberi
- Thoracic Surgery Department, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Via Conca 71, Ancona 60126, Italy
| | - Marco Fogante
- Radiology Department, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Via Conca 71, Ancona 60126, Italy
| | - Marco Andolfi
- Thoracic Surgery Department, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Via Conca 71, Ancona 60126, Italy
| | - Andrea Giovagnoni
- Radiology Department, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Via Conca 71, Ancona 60126, Italy
| | - Majed Refai
- Thoracic Surgery Department, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Via Conca 71, Ancona 60126, Italy
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26
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Schicchi N, Fogante M, Oliva M, Schicchi F, Giovagnoni A. Bilateral coronary-to-pulmonary artery fistulas associated with giant aneurysm in an elderly woman: Case report and literature review. Radiol Case Rep 2019; 14:911-916. [PMID: 31193577 PMCID: PMC6536618 DOI: 10.1016/j.radcr.2019.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 04/20/2019] [Revised: 04/29/2019] [Accepted: 04/30/2019] [Indexed: 01/02/2023] Open
Abstract
Coronary artery fistula is an abnormal vascular communication of coronary artery with cardiac chambers or any segment of the systemic or pulmonary circulation. The prevalence is 0.9% of all coronary anomalies. Coronary artery fistula arises from the right coronary artery in approximately 50.0% of patients, from left coronary artery in approximately 42.0% of patients, and from both in approximately 5.0% of patients. Low-pressure structures are the most common sites of drainage of the coronary fistulas. If a large left-to-right shunt exists, it can be associated with potential complications, such as arterial aneurysm. Here we report an extremely rare case of a 76-year-old woman with bilateral coronary-to-pulmonary artery fistulas associated with giant aneurysms, detected by coronary angiography and confirmed with coronary computed tomography.
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Affiliation(s)
- Nicolò Schicchi
- Radiology Department, Azienda Ospedaliero-Universitaria “Ospedali Riuniti”, Ancona 60126, Italy
| | - Marco Fogante
- Radiology Department, Azienda Ospedaliero-Universitaria “Ospedali Riuniti”, Ancona 60126, Italy
| | - Matteo Oliva
- Radiology Department, Azienda Ospedaliero-Universitaria “Ospedali Riuniti”, Ancona 60126, Italy
| | | | - Andrea Giovagnoni
- Radiology Department, Azienda Ospedaliero-Universitaria “Ospedali Riuniti”, Ancona 60126, Italy
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27
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Schicchi N, Fogante M, Giuseppetti GM, Giovagnoni A. Diagnostic detection with cardiac tomography and resonance of extremely rare coronary anomaly: A case report and review of literature. World J Clin Cases 2019; 7:628-635. [PMID: 30863762 PMCID: PMC6406198 DOI: 10.12998/wjcc.v7.i5.628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 01/09/2019] [Accepted: 01/26/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The association of two congenital coronary artery anomalies (CAAs) is extremely rare but represents one of the main cause of sudden cardiac death in young athletes. Although coronary angiography (CX-A) is still widely used in childhood, cardiac magnetic resonance (C-MRI) and cardiac computed tomography (C-CT) have recently taken on an increasing diagnostic role in early detection of CAAs and concomitant congenital cardiac malformations.
CASE SUMMARY A healthy 10-year-old male patient was referred to the Radiological Department of our Institution due to no evidence of left coronary artery in echocardiographic examination. With C-MRI was detected marked myocardial trabeculation and was suspected anomalous origin and course of left circumflex (LCx) artery and of left anterior descending (LAD) artery. With third generation Dual Source C-CT 192x2-sections (SOMATOM Force, Siemens, Germany) was confirmed anomalous origin of LCx artery from right pulmonary artery associated with anomalous origin of LAD artery from right coronary artery with course in front of right ventricular outflow tract. The patient underwent surgical treatment with reimplantation of the anomalous LCX and LAD arteries into the wall of ascending aorta, with no postoperative complications. The patient remained asymptomatic and follow-up C-MRI scan four months after operation showed complete success of surgery treatment.
CONCLUSION This case highlights the diagnostic potential of C-CT and C-MRI in evaluation of CAAs and of cardiac morphology and functionality, with very low radiation dose and without the risks related to invasive procedure.
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Affiliation(s)
- Nicolò Schicchi
- Department of Radiology, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona 60126, Italy
| | - Marco Fogante
- Department of Radiology, Università Politecnica delle Marche, Ancona 60126, Italy
| | - Gian Marco Giuseppetti
- Department of Radiology, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona 60126, Italy
| | - Andrea Giovagnoni
- Department of Radiology, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona 60126, Italy
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28
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Prochowski Iamurri A, Ponziani M, Macchini M, Fogante M, Pistelli M, De Lisa M, Berardi R, Giuseppetti GM. Evaluation of Multifocality and Multicentricity With Breast Magnetic Resonance Imaging in Each Breast Cancer Subtype. Clin Breast Cancer 2018; 18:e231-e235. [DOI: 10.1016/j.clbc.2017.10.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 09/21/2017] [Accepted: 10/16/2017] [Indexed: 01/05/2023]
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