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Coronary imaging

Rudolf A Werner, Xinyu Chen, Steven P Rowe, Constantin Lapa, Mehrbod S Javadi, Takahiro Higuchi
The heart failure epidemic continues to rise with coronary artery disease as one of its main causes. Novel concepts for risk stratification to guide the referring cardiologist towards revascularization procedures are of significant value. Myocardial perfusion imaging using single-photon emission computed tomography (SPECT) agents has demonstrated high accuracy for the detection of clinically relevant stenoses. With positron emission tomography (PET) becoming more widely available, mainly due to its diagnostic performance in oncology, perfusion imaging with that modality is more practical than in the past and overcomes existing limitations of SPECT MPI...
October 17, 2018: International Journal of Cardiovascular Imaging
Nitin Sabharwal, Abhinav Saxena, Aleksandre Toreli, Vineet Meghrajani, Bilal Malik, Jacob Shani
Anomalous aortic origin of coronary arteries from the opposite sinus (AAOCA) is a rare finding which, when discovered, raises questions regarding its approach and management. Modern imaging techniques can help us to identify certain anatomical features of the anomalous coronary arteries to further classify them as benign or malignant anomalies. We present a case of a 64-year-old male who had an incidental finding of AAOCA with the left anterior descending artery arising from the right coronary cusp from an ostium anterior to the one that gave rise to both the left circumflex artery and right coronary artery (RCA)...
August 3, 2018: Curēus
C Hamm, C W Hamm
In recent years it has been observed with increasing interest that there is a group of patients with electrocardiographic and laboratory features of myocardial infarction (MI) but no obstructive coronary artery disease (<50% diameter stenosis). For this entity the term myocardial infarction with non-obstructive coronary arteries (MINOCA) has been coined. The prevalence of MINOCA is estimated to be 6-9% among patients diagnosed with MI and it is more common in women than men as well as in patients presenting with NSTEMI than in those presenting with STEMI...
October 17, 2018: Herz
Myong Hwa Yamamoto, Akiko Maehara, Sung Sik Kim, Kohei Koyama, Song-Yi Kim, Masaru Ishida, Akiko Fujino, Elizabeth S Haag, Dragos Alexandru, Allen Jeremias, Fernando A Sosa, Keyvan Karimi Galougahi, Ajay J Kirtane, Jeffrey W Moses, Ziad A Ali, Gary S Mintz, Richard A Shlofmitz
OBJECTIVES: We sought to assess plaque modification and stent expansion following orbital atherectomy (OA) for calcified lesions using optical coherence tomography (OCT). BACKGROUND: The efficacy of OA for treating calcified lesions is not well studied, especially using intravascular imaging in vivo. METHODS: OCT was performed preprocedure, post-OA, and post-stent (n = 58). Calcium modification after OA was defined as a round, concave, polished calcium surface...
October 17, 2018: Catheterization and Cardiovascular Interventions
Yoshiyuki Okuya, Yuichi Saito, Yoshiaki Sakai, Iwao Ishibashi, Yoshio Kobayashi
Clinical impact of tissue protrusion (TP) after coronary stenting is still controversial, especially in patients with ST-segment elevation myocardial infarction (STEMI). A total of 104 STEMI patients without previous MI who underwent primary percutaneous coronary intervention (PCI) under intravascular ultrasound (IVUS)-guidance were included. Post-stenting grayscale IVUS analysis was performed, and the patients were classified according to the presence or absence of post-stenting TP on IVUS. Coronary angiography and single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI) with 99m Tc tetrofosmin were analyzed...
October 16, 2018: International Journal of Cardiovascular Imaging
Peter Bak, Anders Kehlet Nørskov
Persistent left-sided superior vena cava (PLSVC) is a central venous anomaly in up to 0.5% of the population. It is usually asymptomatic due to drainage into the right atrium via the coronary sinus. This case report describes placement of a dialysis catheter in a 55-year-old patient with PLSVC and subsequent complications following the uncertainty of the placement. In 10%, PLSVC drains to the left atrium inducing risk of left-to-right shunt and fatal paradoxical emboli in case of catheterisation. Hence, clarification of the central venous haemodynamics by relevant imaging modalities is advised, if suspicion arises...
October 8, 2018: Ugeskrift for Laeger
Danielle M Moyé, Tarique Hussain, Rene M Botnar, Animesh Tandon, Gerald F Greil, Adrian K Dyer, Markus Henningsson
BACKGROUND: Dual-phase 3-dimensional whole-heart acquisition allows simultaneous imaging during systole and diastole. Respiratory navigator gating and tracking of the diaphragm is used with limited accuracy. Prolonged scan time is common, and navigation often fails in patients with erratic breathing. Image-navigation (iNAV) tracks movement of the heart itself and is feasible in single phase whole heart imaging. To evaluate its diagnostic ability in congenital heart disease, we sought to apply iNAV to dual-phase sequencing...
October 16, 2018: BMC Medical Imaging
Sarah Feger, Carsten Kendziorra, Steffen Lukas, Ahmed Shaban, Björn Bokelmann, Elke Zimmermann, Matthias Rief, Marc Dewey
PURPOSE: Myocardial computed tomography perfusion (CTP) allows the assessment of the functional relevance of coronary artery stenosis. This study investigates to what extent the contour sharpness of sequences acquired by dynamic myocardial CTP is influenced by the following noise reduction methods: temporal averaging and adaptive iterative dose reduction 3D (AIDR 3D). MATERIALS AND METHODS: Dynamic myocardial CT perfusion was conducted in 29 patients at a dose level of 9...
2018: PloS One
Mateen Moghbel, Abdullah Al-Zaghal, Thomas J Werner, Caius Mihail Constantinescu, Poul Flemming Høilund-Carlsen, Abass Alavi
Atherosclerosis is a common age-related disorder and is the major cause of morbidity and mortality in the developed countries. Structural imaging techniques, such as CT and MRI, have been of limited value in early detection of atherosclerotic plaques, and therefore, there is a dire need for techniques that are highly sensitive and specific for this purpose. Over the past decade, PET imaging with FDG and NaF has been tested for detection and characterization of atherosclerotic plaques in the major coronary arteries...
November 2018: Seminars in Nuclear Medicine
Camila Munoz, Radhouene Neji, Karl P Kunze, Stephan G Nekolla, Rene M Botnar, Claudia Prieto
PURPOSE: To develop a framework for efficient and simultaneous acquisition of motion-compensated whole-heart coronary MR angiography (CMRA) and left ventricular function by MR and myocardial integrity by PET on a 3T PET-MR system. METHODS: An acquisition scheme based on a dual-phase CMRA sequence acquired simultaneously with cardiac PET data has been developed. The framework is integrated with a motion-corrected image reconstruction approach, so that non-rigid respiratory and cardiac deformation fields estimated from MR images are used to correct both the CMRA (respiratory motion correction for each cardiac phase) and the PET data (respiratory and cardiac motion correction)...
October 15, 2018: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Atefeh Abdolmanafi, Luc Duong, Nagib Dahdah, Ibrahim Ragui Adib, Farida Cheriet
Coronary artery disease is the number one health hazard leading to the pathological formations in coronary artery tissues. In severe cases, they can lead to myocardial infarction and sudden death. Optical Coherence Tomography (OCT) is an interferometric imaging modality, which has been recently used in cardiology to characterize coronary artery tissues providing high resolution ranging from 10 to 20 µm . In this study, we investigate different deep learning models for robust tissue characterization to learn the various intracoronary pathological formations caused by Kawasaki disease (KD) from OCT imaging...
October 1, 2018: Biomedical Optics Express
Catherine T Gunther-Harrington, Kathryn L Phillips, Lance C Visser, Samantha L Fousse, Joshua A Stern
Coronary artery anomalies have been reported in Bulldogs and present an increased risk when performing balloon valvuloplasty. Identification of coronary anomalies has been reported using multidetector-row computed tomographic (MDCT) angiography with electrocardiographic gating. However, the utility of non-electrocardiographic-gated 16-row computed tomographic for MDCT for the identification of coronary artery anatomy or anomalies to the authors' knowledge has not been fully investigated. The purpose of this study was to evaluate the feasibility of non-electrocardiographic-gated computed tomographic (CT) angiography to identify coronary anomalies in Bulldogs with pulmonary valve stenosis...
October 14, 2018: Veterinary Radiology & Ultrasound
Arun Sharma, Niraj Nirmal Pandey, Sanjeev Kumar
Coronary artery fistulas are rare cardiac conditions which constitute a subgroup of anomalies of the coronary arteries. Though majority are asymptomatic, they may be associated with high prevalence of late symptoms and complications. Accurate identification of the fistulas, their hemodynamic significance and associated conditions generally influence management strategies. Dual source computed tomographic evaluation is valuable in delineating its precise morphology with identification and characterization of associated anomalies, thereby assisting in mapping the ideal treatment option...
October 8, 2018: Clinical Imaging
Khaled Al-Shaibi, Waqar Ahmed, Walid Abukhudair, Yousef Nosir, Abdulaziz Al-Shaibi, Rayan Kateb, Mirvat Alasnag
BACKGROUND: Partner 2 and SURTAVI trials (mean STS score of 5.8 and 4.5) support extending TAVR into the intermediate risk group. We present our results of TAVR in a group with mean STS score of 2.9 and 2 year follow up. METHODS: This is a prospective cohort study of 46 consecutive patients undergoing TAVR between 2011 and 2016. All patients had severe symptomatic AS. Age, functional status, coronary disease, co-morbidity and imaging parameters were assessed. Patients were followed up for 12-60 months...
October 4, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Constantina Aggeli, Kali Polytarchou, Dimitrios Varvarousis, Stellios Kastellanos, Dimitrios Tousoulis
Stress echocardiography (SE) is a very useful method in clinical practice, since it offers important information both for patient's functional status and hemodynamic changes during stress. Therefore, SE provides strong diagnostic and prognostic data in a wide spectrum of cardiovascular diseases. This review summarizes the clinical applications of SE in conditions beyond coronary artery disease and highlights practical recommendations and key issues for each condition that need further investigation. SE is an established method for the evaluation of symptomatic and asymptomatic patients with valvular heart disease and cardiomyopathies, and provides important information regarding prognosis and management of patients with congenital heart disease, pulmonary hypertension or diastolic dysfunction...
October 12, 2018: Clinical Cardiology
F Aboukhoudir, S Rekik, M Pansieri, P Obert
OBJECTIVE: The aim of this study is to assess the association between epicardial adipose tissue (EAT) and infraclinical myocardial dysfunction detected by strain imaging in diabetic patients (T2DM) with poor glycemic control. METHODS: 22 patients with T2DM and 22 healthy control subjects of similar age and sex were prospectively recruited. Echocardiographic parameters were investigated. RESULTS: In comparison to controls, diabetic patients had significantly higher body mass index (27...
October 9, 2018: Annales de Cardiologie et D'angéiologie
Tien C Nguyen, Yoshiaki Ohyama, Ayako Taketomi-Takahashi, Huong T Nguyen, Akio Sugimoto, Makito Sato, Hisako Sumiyoshi, Tetsuya Nakamura, Masahiko Kurabayashi, Yoshito Tsushima
PURPOSE: To evaluate the correlation between cardiac functional parameters and image quality in coronary computed tomography angiography (CCTA). MATERIAL AND METHODS: Sixty-six patients who underwent both CCTA and echocardiography were included. The coronary artery attenuation values and contrast-to-noise ratios (CNR) were measured in the proximal right coronary arteries (RCA) and left main (LM) trunk. Then, the averages of the mean values derived from RCA and LM were calculated...
October 6, 2018: Clinical Imaging
Hyunkyung Jang, Ji Young Rho, Young Ju Suh, Yeon Joo Jeong
PURPOSE: We presented details and incidence of systemic arterial embolism (SAE) following a CT-guided percutaneous transthoracic needle biopsy (PTNB) and evaluated risk factors for SAEs. METHODS: We retrospectively evaluated 1014 PTNBs performed in our hospital from 2005 to 2017. SAE was identified in the pulmonary vein, left heart, coronary artery, and aorta by reviewing post-biopsy CT images. Limited post-biopsy CT scans only covering the region biopsied were available until the first case of SAE was identified (n = 503)...
September 11, 2018: Clinical Imaging
Carlos Collet, Yoshinobu Onuma, Daniele Andreini, Jeroen Sonck, Giulio Pompilio, Saima Mushtaq, Mark La Meir, Yosuke Miyazaki, Johan de Mey, Oliver Gaemperli, Ahmed Ouda, Juan Pablo Maureira, Damien Mandry, Edoardo Camenzind, Laurent Macron, Torsten Doenst, Ulf Teichgräber, Holger Sigusch, Taku Asano, Yuki Katagiri, Marie-Angele Morel, Wietze Lindeboom, Gianluca Pontone, Thomas F Lüscher, Antonio L Bartorelli, Patrick W Serruys
Aims: Coronary computed tomography angiography (CTA) has emerged as a non-invasive diagnostic method for patients with suspected coronary artery disease, but its usefulness in patients with complex coronary artery disease remains to be investigated. The present study sought to determine the agreement between separate heart teams on treatment decision-making based on either coronary CTA or conventional angiography. Methods and results: Separate heart teams composed of an interventional cardiologist, a cardiac surgeon, and a radiologist were randomized to assess the coronary artery disease with either coronary CTA or conventional angiography in patients with de novo left main or three-vessel coronary artery disease...
October 11, 2018: European Heart Journal
Matthew W Sherwood, Amit N Vora
PURPOSE OF REVIEW: This review aims to describe the current evidence and consensus recommendations around antiplatelet and anticoagulant management in three common clinical scenarios in transcatheter aortic valve replacement (TAVR): (1) recent percutaneous coronary intervention (PCI) preceding TAVR, (2) atrial fibrillation (AF) management in patients undergoing TAVR, and (3) bioprosthetic valve thrombosis management in TAVR. RECENT FINDINGS: Several small clinical trials have evaluated the use of single vs...
October 11, 2018: Current Cardiology Reports
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