Postsystolic shortening on echocardiography as a gateway to cardiac computed tomography in patients with suspected stable angina pectoris

AbstractPostsystolic shortening (PSS) by speckle-tracking echocardiography (STE) is a marker of myocardial ischemia and may improve diagnostic strategy. We sought to evaluate if PSS is associated with the coronary artery calcium score (CACS) and stenosis by computed tomography angiography (CTA) in patients with suspected stable angina pectoris (SAP). We retrospectively studied 437 SAP patients (age 58  ± 11 years, 41% male) who underwent STE, evaluation of CACS and assessment of significant stenosis (≥ 50%) by CTA. The postsystolic index (PSI) was defined as follows: 100x([peak negative strain cardiac cycle − peak negative strain systole])/peak negative strain cardiac cycle. A wal l had PSS if any segment within the wall had a PSI ≥ 20%. We defined categories for walls with PSS: 0, 1, 2 and ≥ 3, and CACS: 0, 1–100, 101–400 and >  400. Each additional wall with PSS was associated with a 43% relative increase in CACS (95%CI +9% to +87%, P = 0.010), while each 1% absolute increase in the PSI was associated with a 9% relative increase in CACS (95%CI +1% to +18%, P = 0.031). Walls with PSS (OR 1.81 per 1 wall increase, 95%CI 1.27–2.59, P = 0.001) and the PSI (OR 1.12 per 1% increase, 95%CI 1.04–1.21, P = 0.004) were associated with the occurrence of CACS >  400. Additionally,...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research

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AbstractBackground and purposeClinical outcome after endovascular thrombectomy in patients with acute ischemic stroke still varies significantly. Higher blood glucose levels (BGL) have been associated with worse clinical outcome, but the pathophysiological causes are not yet understood. We hypothesized that higher levels of BGL are associated with more pronounced ischemic brain edema and worse clinical outcome mediated by cerebral collateral circulation.Methods178 acute ischemic stroke patients who underwent mechanical thrombectomy were included. Early ischemic brain edema was determined using quantitative lesion water upt...
Source: Journal of Neurology - Category: Neurology Source Type: research
Publication date: 2020Source: European Journal of Radiology Open, Volume 7Author(s): Hiroki Kamada, Hideki Ota, Yosuke Terui, Koichiro Sugimura, Shigefumi Fukui, Hiroaki Shimokawa, Kei TakaseAbstractPulmonary tumor thrombotic microangiopathy (PTTM) is a specific type of tumor embolism in the small and medium pulmonary arteries, leading to rapid progressive pulmonary hypertension. Antemortem diagnosis of PTTM is extremely difficult. We encountered three patients who were histopathologically or clinically diagnosed with PTTM. In all cases, lung perfused blood volume (PBV) images on dual-energy computed tomography (CT) demons...
Source: European Journal of Radiology Open - Category: Radiology Source Type: research
ConclusionIt is preferable to perform CCTA in young patients with cardiac symptoms, especially in Asian and Middle Eastern countries even of the CAC score is zero.
Source: European Journal of Radiology Open - Category: Radiology Source Type: research
We aimed to evaluate the burden of coronary artery disease (CAD) using the computed tomography (CT) Leaman score in low-risk transcatheter aortic valve implantation (TAVI) patients. The extent of CAD in low-risk patients with aortic stenosis (AS) who are candidates for TAVI has not been accurately quantified. The CT Leaman score was developed to quantify coronary CT angiography (CCTA) atherosclerotic burden and has been validated to evaluate the extent of CAD. CT Leaman score>5 has been associated with an increase in major adverse cardiac events over long-term follow-up.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
J Knee Surg DOI: 10.1055/s-0040-1701210Knee dislocations (KDs) are frequently found in high-energy impact injuries, ranging from automobile accidents to contact sports. KDs require careful examination due to the limb-threatening nature of these injuries. A key examination in any KD comprises a proper assessment of the vascular status. The risk of popliteal artery injury with a KD has varied from 7 to 40%, with more contemporary studies reporting injury in the range of 7 to 15%. The notion of mandatory emergent arteriography was challenged in the trauma literature as several small retrospective studies suggested that select...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Special Focus Section Source Type: research
ConclusionsTo date, this is the first reported case where a patient underwent oblique lateral interbody fusion surgery in a left lateral decubitus position due to a left-sided inferior vena cava. This case demonstrates that carefully reading radiological results is important for operation planning and avoiding anatomical complications.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
We describe a case of aggressive progression of TA in an infant. This child was the youngest to be affected with the disease as reported in the literature. A 3.5-month-old boy presented with cyanosis of both legs, tachycardia and antithrombin III deficiency. Computed tomography angiography (CTA) revealed thrombosis of distal aorta and both iliac arteries. Thrombectomy was performed at the level of both common femoral arteries. In addition, thigh amputation of the left leg had to be performed. TA was diagnosed postmortem with thrombosis of the distal aorta, its branches and upper mesenteric artery which was not occluded on ...
Source: Acta Clinica Croatica - Category: General Medicine Tags: Acta Clin Croat Source Type: research
CONCLUSION: Aortopexy offers an effective method of treating severe tracheomalacia due to vascular compression. PMID: 31971119 [PubMed - as supplied by publisher]
Source: Journal of Laryngology and Otology - Category: ENT & OMF Tags: J Laryngol Otol Source Type: research
Conclusion: This case report and literature review focused on the rarity of acute idiopathic/spontaneous subdural hematomas. PMID: 31966928 [PubMed]
Source: Surgical Neurology International - Category: Neurosurgery Tags: Surg Neurol Int Source Type: research
The objective of this work was to perform image-based classification of abdominal aortic aneurysms (AAA) based on their demographic, geometric, and biomechanical attributes. We retrospectively reviewed existing demographics and abdominal computed tomography angiography images of 100 asymptomatic and 50 symptomatic AAA patients who received an elective or emergent repair, respectively, within 1-6 months of their last follow up. An in-house script developed within the MATLAB computational platform was used to segment the clinical images, calculate 53 descriptors of AAA geometry, and generate volume meshes suitable for finite...
Source: Annals of Biomedical Engineering - Category: Biomedical Engineering Authors: Tags: Ann Biomed Eng Source Type: research
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