Mechanisms of Stent Failure: Lessons from IVUS and OCT
AbstractPurpose of ReviewDespite significant advances in stent design and procedural technique, stent failure remains the “Achilles’ heel” of percutaneous coronary intervention (PCI). It is important to understand the mechanism of stent failure to prevent major adverse events and improve clinical outcomes.Recent FindingsTwo-dimensional angiography alone is insufficient for elucidating the etiology of stent failure. Intracoronary imaging modalities, including intravascular ultrasound (IVUS) and optical coherence tomography (OCT) have evolved to guide optimal stent placement during PCI, and have enabled ide...
Source: Current Cardiovascular Imaging Reports - July 18, 2019 Category: Radiology Source Type: research

Role of Near-Infrared Spectroscopy (NIRS) in Intracoronary Imaging
AbstractPurpose of ReviewThe purpose of this article is to review the basic principles of near-infrared spectroscopy (NIRS) and its contemporary role in intracoronary imaging.Recent FindingsNIRS has been demonstrated to effectively detect culprit lesions in acute coronary syndromes (ACS) and to potentially identify vulnerable plaque. Lipid-rich plaques detected by NIRS are also associated with higher incidence of future adverse cardiac events. Plaques with high lipid content detected by NIRS have been shown to predict periprocedural myocardial infarction during percutaneous coronary intervention (PCI). The beneficial effec...
Source: Current Cardiovascular Imaging Reports - June 24, 2019 Category: Radiology Source Type: research

Laser Imaging: Unraveling Laser Atherectomy Mechanisms of Action with Optical Coherence Tomography
AbstractPurpose of ReviewThe goal is to review the current data regarding excimer laser coronary atherectomy (ELCA) through optical coherence tomography (OCT) imaging. We aim to reveal the mechanisms of action and principles of use for laser, and to analyze the current supportive data.Recent FindingsELCA is an adjuvant procedure to percutaneous coronary intervention, aimed at properly preparing coronary lesions to optimize stenting. It is an effective atherectomy device that requires a short period of training and works on a standard 0.014 ″ guidewire. Laser modifies coronary vessels by three distinct mechanisms: pho...
Source: Current Cardiovascular Imaging Reports - June 21, 2019 Category: Radiology Source Type: research

OCT-Guided Treatment of Calcified Coronary Artery Disease: Breaking the Barrier to Stent Expansion
AbstractPurpose of ReviewOur objective is to review the current status of OCT-guided treatment of calcified coronary artery disease.Recent FindingsNew treatment modalities provide multiple options for approaching interventions involving calcified lesions.SummaryCoronary artery calcification is associated with stent underexpansion and worse procedural outcomes. Optimizing stent expansion is essential to reduce restenosis and the need for revascularization. Optical coherence tomography (OCT) allows for accurate diagnosis and detailed characterization of calcified lesions. The features of coronary artery calcification are det...
Source: Current Cardiovascular Imaging Reports - June 17, 2019 Category: Radiology Source Type: research

Molecular Imaging in Ischemic Heart Disease
AbstractPurpose of ReviewThe purpose of this paper is to review current and new modalities to image key biological processes in ischemic heart disease and after myocardial infarction non-invasively.Recent FindingsNew imaging targets have been developed to detect and quantify myocardial damage after ischemia. Although positron emission tomography (PET) has been leading the development of new probes in the past, continuous improvements of magnetic resonance imaging (MRI) together with the development of new novel MRI contrast agents opens new research avenues including the combination of both PET and MRI to obtain anatomic, ...
Source: Current Cardiovascular Imaging Reports - June 11, 2019 Category: Radiology Source Type: research

Cardiovascular CT in Cyanotic Congenital Heart Disease
AbstractPurpose of ReviewTo discuss the role of cardiovascular computed tomography (CT) in diagnosing and managing a spectrum of cyanotic congenital heart defects before and after repair and to review practical imaging considerations in patients with specific cyanotic lesions.Recent FindingsAs CT technology has rapidly advanced and radiation doses have dramatically decreased, cardiovascular CT has provided a lower-risk, high-quality alternative to diagnostic cardiac catheterization or cardiac magnetic resonance imaging (MRI) and has been increasingly utilized in nearly every type of cyanotic congenital heart defect.Summary...
Source: Current Cardiovascular Imaging Reports - June 7, 2019 Category: Radiology Source Type: research

IVUS and OCT: Current State-of-the-Art in Intravascular Coronary Imaging
AbstractPurpose of ReviewTo summarize the current state-of-the-art of intracoronary imaging with a focus on clinical outcomes, novel approaches, and anticipated future developments.Recent FindingsMultiple randomized trials have demonstrated that intravascular ultrasound (IVUS) guidance of percutaneous coronary intervention (PCI) significantly reduces major cardiac adverse events (MACE), and in particular, rates of target lesion failure or clinical restenosis. High-definition IVUS enhances the ability to visualize stent struts and plaque components. Optical coherence tomography (OCT) offers a greater resolution and can imag...
Source: Current Cardiovascular Imaging Reports - May 31, 2019 Category: Radiology Source Type: research

Nanoparticle Imaging of Vascular Inflammation and Remodeling in Atherosclerotic Disease
AbstractPurpose of ReviewThe purpose of this review is to highlight some of the recent developments (within the last 5  years) in imaging atherosclerotic plaques using nanoparticles, with a focus on technologies that have been applied to in vivo models of disease.Recent FindingsStructural and cellular components of atherosclerotic plaques are being imaged with greater definition and improved sensitivity. This is a result of both molecular targeting of nanoparticles to disease-relevant biomarkers through the use of nanoparticles of different shapes and sizes and tailoring pharmacokinetic parameters that allow for enhan...
Source: Current Cardiovascular Imaging Reports - May 29, 2019 Category: Radiology Source Type: research

MRI of Patients with Cardiac Implantable Electronic Devices
AbstractPurpose of ReviewThe purpose of this review is to clarify the risks associated with MRI exams for patients with cardiac implantable electronic devices (CIEDs) and to provide information regarding the MRI examination protocol for patients with CIEDs.Recent FindingsSeveral prospective studies evaluated the feasibility of MRI exams for patients with CIEDs and reported no adverse events. These studies suggest that by following a specific MRI examination protocol and monitoring both CIED parameters and the patient ’s symptoms, an MRI exam can be performed by appropriately trained personnel with an acceptable benef...
Source: Current Cardiovascular Imaging Reports - May 27, 2019 Category: Radiology Source Type: research

Optimization of Coronary Bifurcation Intervention Using Intravascular Imaging
AbstractPurpose of ReviewCoronary bifurcation lesions require complex interventions and are associated with higher complication rates. Compared to angiography alone, intravascular imaging with intravascular ultrasound (IVUS) and optical coherence tomography (OCT) allows better planning and optimization of bifurcation lesion interventions leading to improved results and long-term success. In this review, we aim to analyze the current data on utilization of intravascular imaging for optimization of interventions in complex bifurcation lesions and its impact on clinical outcomes.Recent FindingsEvidence from meta-analyses and ...
Source: Current Cardiovascular Imaging Reports - May 27, 2019 Category: Radiology Source Type: research

Intravascular Ultrasound and Optical Coherence Tomography in the Procedural Planning and Execution of Left Main Coronary Artery Percutaneous Coronary Intervention
AbstractPurpose of ReviewLeft main coronary artery disease (LMCAD) is a frequently encountered, high-risk presentation of atherosclerosis, traditionally managed with surgical bypass grafting. Percutaneous coronary intervention (PCI) for LMCAD is an increasingly attractive option for patients with low to intermediate complexity disease or patients at extremely high or prohibitive surgical risk. The goal of this review is to outline the current indications and guideline recommendations regarding PCI for LMCAD and the role of intracoronary imaging in optimizing these cases.Recent FindingsSeveral recent randomized controlled t...
Source: Current Cardiovascular Imaging Reports - May 22, 2019 Category: Radiology Source Type: research

Coronary Computed Tomography Angiography as a Gatekeeper to Coronary Revascularization: Emphasizing Atherosclerosis Findings Beyond Stenosis
AbstractPurpose of ReviewCoronary computed tomography angiography (CCTA) is the optimal non-invasive test to rule out coronary artery disease (CAD). Decisions to perform coronary revascularization have traditionally been based upon ischemia testing. This review summarizes the latest observations and trials evaluating the suitability of CCTA to select patients for invasive coronary angiography (ICA) and subsequent revascularization.Recent FindingsRecent data shows that beyond stenosis, whole-heart quantification and characterization of coronary atherosclerotic plaque improves the estimation of myocardial ischemia. This comp...
Source: Current Cardiovascular Imaging Reports - May 14, 2019 Category: Radiology Source Type: research

Contemporary View of Magnetic Resonance Imaging in Fabry Disease
AbstractPurposeFabry disease is a rare lysosomal storage disorder, whose main cause of death is cardiac. CMR provides relevant information that contributes to diagnosis, enabling staging of the disease and an appropriate start of therapy. This review intends to highlight the main strengths of this technique, where a relatively robust scientific evidence supports its use.Recent FindingsCMR is useful in Fabry disease in a number of aspects. On the one hand, it helps characterize myocardial involvement, enabling accurate chamber size quantification and tissue characterization, by means of LGE, and more recently T1 mapping. Ea...
Source: Current Cardiovascular Imaging Reports - May 1, 2019 Category: Radiology Source Type: research

Cardiac CT Assessment of Right and Left Ventricular and Valvular Function
AbstractPurpose of ReviewThe purpose of this review is to summarize the recent technical and scientific advancements in cardiac computed tomography (CT) assessment of ventricular function and valvular heart disease.Recent FindingsWith improvement in scanner technology and protocols, cardiac CT can be used to assess cardiac function and chamber volumes with excellent accuracy and interobserver reproducibility. CT is a reliable adjunct modality to assess most valvular heart diseases when other modalities are not adequate or provide discrepant data. CT is now the standard of care in planning transcatheter valve interventions....
Source: Current Cardiovascular Imaging Reports - May 1, 2019 Category: Radiology Source Type: research

Coronary CT in Patients with a History of PCI or CABG: Helpful or Harmful?
AbstractPurpose of ReviewThe purpose of this review is to evaluate the role of coronary computed tomography angiography (CCTA) in the assessment of patients after coronary artery bypass graft surgery (CABG) or percutaneous coronary intervention (PCI).Recent FindingsAdvances in CT technology have resulted in tremendous improvements in diagnostic performance, safety, and ease of performance. CCTA accurately detects graft stenosis or occlusion. However, assessment of native coronary arteries in patients after CABG is challenging due to commonly present severe coronary calcifications. CCTA evaluation of coronary stents using c...
Source: Current Cardiovascular Imaging Reports - April 26, 2019 Category: Radiology Source Type: research

Common Incidental Findings on Cardiac CT: a Systematic Review
AbstractPurpose of ReviewCardiac computed tomography (CT) is an established tool for evaluating cardiovascular disease, which may incidentally depict extracardiac findings (ECF). The aim of this study is to identify the spectrum and the prevalence of incidental findings detected on cardiac CT.Recent FindingsThis systematic review found a median ECF occurrence of 45% in cardiac CT (range, 7 –100%) among papers published between 2006 and 2018. The median clinically significant ECF occurrence was 17% (1–67%) among studies. Respectively, the five most commonly reported ECF were lung nodules or masses, lung parenchy...
Source: Current Cardiovascular Imaging Reports - April 26, 2019 Category: Radiology Source Type: research

New Molecular Imaging Strategies to Detect Inflammation in the Vulnerable Plaque
AbstractPurpose of reviewInflammation is an essential component of atherosclerosis and is intimately linked with plaque destabilization. Recent trials showed that therapies directed at inhibiting the systemic inflammatory cascade reduce atherosclerotic cardiovascular events. Hence, accurate molecular imaging of inflammation may help us identify patients for whom targeted therapies could be maximally effective.Recent findingsNumerous probes have been developed to detect different inflammatory components of atherosclerosis. Although18F-deoxyglucose has been in use for a long time, new tracers such as18F-sodium and67Ga-dotata...
Source: Current Cardiovascular Imaging Reports - April 26, 2019 Category: Radiology Source Type: research

Cardiac MRI: a Promising Diagnostic Tool to Detect Cancer Therapeutics –Related Cardiac Dysfunction
AbstractPurpose of ReviewRecent advances in oncological research have led to a major improvement of mortality amongst cancer patients. However, survivors are at an increased risk to develop cancer therapeutics –related cardiac dysfunction (CTRCD). The management of CTRCD may pose a challenge due to its heterogeneous clinical presentation. This warrants the need for a multi-modality diagnostic tool to objectively acquire prognostic information for timely commencement of cardio-protective treatment. Cardi ac magnetic resonance (CMR) imaging offers considerable potential due to its non-invasive, reproducible protocol. M...
Source: Current Cardiovascular Imaging Reports - April 3, 2019 Category: Radiology Source Type: research

Radionuclide Imaging of Atherothrombotic Diseases
AbstractPurpose of ReviewA variety of approaches and molecular targets have emerged in recent years for radionuclide-based imaging of atherosclerosis and vulnerable plaque using single photon emission computed tomography (SPECT) and positron emission tomography (PET), with numerous methods focused on characterizing the mechanisms underlying plaque progression and rupture. This review highlights the ongoing developments in both the pre-clinical and clinical environment for radionuclide imaging of atherosclerosis and atherothrombosis.Recent FindingsNumerous physiological processes responsible for the evolution of high-risk a...
Source: Current Cardiovascular Imaging Reports - March 27, 2019 Category: Radiology Source Type: research

Coronary Vessel Wall Imaging: State of the Art and Future Directions
AbstractPurpose of ReviewThe purpose of this paper is to review the latest advancements and developments in non-invasive coronary magnetic resonance (MR) and hybrid positron emission tomography (PET)/MR imaging.Recent FindingsCoronary MRI has advanced in recent years in different aspects, especially regarding technical developments, scan protocols, and molecular probes. Recently introduced hybrid PET/MR scanners have already demonstrated great potential in improving cardiovascular imaging.SummaryCoronary atherosclerosis and acute myocardial infarction remain major threats to physical health worldwide. Several techniques, f...
Source: Current Cardiovascular Imaging Reports - March 26, 2019 Category: Radiology Source Type: research

Coronary Computed Tomography Angiography Improving Outcomes in Patients with Chest Pain
AbstractPurpose of ReviewTo provide an overview of recent studies of coronary computed tomography angiography (CCTA) and how it has helped to improve clinical outcomes for patients presenting with chest pain.Recent FindingsRandomised controlled trials have uniformly demonstrated that the use of CCTA is associated with improvements in patient diagnosis, management and treatments as well as the avoidance of unnecessary invasive coronary angiography. These changes have been associated with consistent reductions in long-term rates of fatal or non-fatal myocardial infarction.SummaryMajor beneficial effects in clinical managemen...
Source: Current Cardiovascular Imaging Reports - March 22, 2019 Category: Radiology Source Type: research

Artificial Intelligence in Nuclear Cardiology: Adding Value to Prognostication
AbstractPurpose of the ReviewRadionuclide myocardial perfusion imaging (MPI) continues to be an accurate and reproducible method of diagnosing obstructive coronary artery disease (CAD) with predictive, prognostic, and economic value. We review the evolutionary potential of machine learning (ML), a subset of artificial intelligence, as an adjunct to MPI.Recent FindingsApplying the broad scope of ML, including the integration of deep learning, can leverage the knowledge representation and automated reasoning to detect and extrapolate patterns from high-dimensional features of MPI. There is growing evidence to suggest superio...
Source: Current Cardiovascular Imaging Reports - March 19, 2019 Category: Radiology Source Type: research

CMR in Transcatheter Valve Interventions: State of the Art and Future Directions
AbstractPurpose of ReviewTranscatheter valve interventions require careful planning and rely heavily on multimodality imaging. In contrast to echocardiography and computed tomography cardiovascular magnetic resonance (CMR) remains underused in clinical practice.Recent FindingsCMR techniques such as multiplanar cine imaging unlimited by echo windows or ionizing radiation exposure, quantification of flow, and advanced tissue characterization have the potential to add valuable complimentary information to the evaluation of patients with valvular heart disease.SummaryIn this paper, we review the evidence for CMR to guide trans...
Source: Current Cardiovascular Imaging Reports - March 1, 2019 Category: Radiology Source Type: research

Choosing the Appropriate Stress Test for Myocardial Perfusion Imaging
AbstractPurpose of ReviewChoosing the most appropriate test or protocol to ensure patient safety along with accurate and informative results can be challenging. The aim of this article is to review important considerations when choosing a nuclear stress perfusion study.Recent FindingsSingle-photon emission computed tomography (SPECT) has a sensitivity of 70% and a specificity of 78% for the diagnosis of coronary artery disease (CAD), and positron emission tomography (PET) has a sensitivity of 90% and specificity of 88%. The addition of either SPECT or PET to cardiac-gated computed tomography (CCTA) confers an increase in s...
Source: Current Cardiovascular Imaging Reports - February 28, 2019 Category: Radiology Source Type: research

Molecular Imaging to Monitor Left Ventricular Remodeling in Heart Failure
AbstractPurpose of ReviewCardiovascular diseases are the leading cause of deaths worldwide. Many complex cellular and molecular pathways lead to myocardial remodeling after ischemic insults. Anatomy, function, and viability of the myocardium can be assessed by modern medical imaging techniques by both visualizing and quantifying damages. Novel imaging techniques aim for a precise and accurate visualization of the myocardium and for the detection of alternations at the molecular level.Recent FindingsMagnetic resonance imaging assesses anatomy, function, and tissue characterization of the myocardium non-invasively with high ...
Source: Current Cardiovascular Imaging Reports - February 26, 2019 Category: Radiology Source Type: research

Plaque Assessment on Serial Coronary CTA
AbstractPurpose of ReviewThis review addresses the role of serial coronary computed tomography angiography (CTA) on the evaluation of atherosclerosis progression, risk stratification, and targeting individual pharmacotherapy.Recent FindingsThe presence, extent, and severity of coronary artery disease (CAD) detected by coronary CTA are associated with an adverse prognosis. Similarly, the presence of high-risk plaque features such as positive remodeling, low-attenuation plaque, spotty calcifications, and napkin-ring sign are associated with major adverse cardiac events. More recently, examinations using serial coronary CTA h...
Source: Current Cardiovascular Imaging Reports - February 14, 2019 Category: Radiology Source Type: research

Contemporary Issues in Quantitative Myocardial Perfusion CMR Imaging
AbstractPurpose of ReviewThis review highlights the development and application of quantitative myocardial perfusion by cardiac magnetic resonance (CMR) and discusses recent innovations in this area.Recent FindingsFirst pass, contrast-enhanced CMR can accurately quantify myocardial perfusion in order to diagnose obstructive coronary artery disease and microvascular dysfunction. Quantitative analysis conveys additional prognostic information beyond other CMR findings. New, fully automated techniques may aid standardization of methods across centers.SummaryCMR quantitative perfusion has robust performance for the diagnosis o...
Source: Current Cardiovascular Imaging Reports - February 14, 2019 Category: Radiology Source Type: research

Advances in PET Imaging of Sarcoidosis
AbstractPurpose of ReviewThe purpose of this paper is to provide an updated review of recent advances in protocols for positron emission tomography (PET) or PET/computed tomography (PET/CT) imaging in patients with sarcoidosis.Recent FindingsThere has been more research focused on developing newer and improved PET imaging modalities to diagnose and follow-up cardiac sarcoidosis (CS). Fluorine-18-fluorodeoxyglucose (18F- FDG)-PET are widely used to diagnose CS, with or without concurrent rest nuclear myocardial perfusion study. There have been various patient preparation strategies for FDG PET/CT in CS. Interpretation crite...
Source: Current Cardiovascular Imaging Reports - February 14, 2019 Category: Radiology Source Type: research

Advances in Real-Time MRI –Guided Electrophysiology
AbstractPurpose of ReviewTheoretical benefits of real-time MRI guidance over conventional electrophysiology include contemporaneous 3D substrate assessment and accurate intra-procedural guidance and evaluation of ablation lesions. We review the unique challenges inherent to MRI-guided electrophysiology and how to translate the potential benefits in the treatment of cardiac arrhythmias.Recent FindingsOver the last 5  years, there has been substantial progress, initially in animal models and more recently in clinical studies, to establish methods and develop workflows within the MR environment that resemble those of con...
Source: Current Cardiovascular Imaging Reports - February 12, 2019 Category: Radiology Source Type: research

Radionuclide Imaging in Chagas Cardiomyopathy
AbstractPurpose of ReviewTo review the contributions of radionuclide imaging to understanding the manifestations and pathophysiology of chronic Chagas cardiomyopathy (CCC).Recent FindingsExperimental studies using high-resolution SPECT myocardial perfusion imaging (MPI) show that myocardial perfusion derangement that corresponds to dysfunctional, viable myocardium is closely linked to inflammation and precedes LV regional systolic dysfunction. Clinical studies show that microvascular ischemia is strictly related to the areas of cardiac sympathetic denervation, assessed by123I-MIBG imaging, which correlates with severe vent...
Source: Current Cardiovascular Imaging Reports - February 12, 2019 Category: Radiology Source Type: research

Machine Learning in the Evaluation of Myocardial Ischemia Through Nuclear Cardiology
AbstractPurpose of ReviewTo summarize the advances achieved in the detection and characterization of myocardial ischemia and prediction of related outcomes through machine learning (ML)-based artificial intelligence (AI) workflows in both single-photon emission computed tomography (SPECT) and positron emission tomography (PET).Recent FindingsIn the field of cardiology, the implementation of ML algorithms has recently gravitated around image processing for characterization, diagnostic, and prognostic purposes. Nuclear cardiology represents a particular niche for AI as it deals with complex images of semi-quantitative and qu...
Source: Current Cardiovascular Imaging Reports - February 9, 2019 Category: Radiology Source Type: research

Myocardial Perfusion Imaging for the Evaluation of Ischemic Heart Disease in Women
AbstractPurpose of the ReviewTo review the value of myocardial blood flow and coronary flow reserve (CFR) measurements, as assessed by positron emission tomography (PET), in women with suspected ischemic heart disease.Recent FindingsCFR is a noninvasive measure of coronary vasomotor function that integrates the hemodynamic effects of epicardial coronary stenosis, diffuse atherosclerosis, and microvascular dysfunction on myocardial tissue perfusion and has emerged as an imaging marker of cardiovascular risk, independently of the degree of obstructive coronary artery disease (CAD).SummaryNormal coronary arteries or nonobstru...
Source: Current Cardiovascular Imaging Reports - January 25, 2019 Category: Radiology Source Type: research

Microvascular Dysfunction in Hypertrophic Cardiomyopathy
AbstractPurpose of ReviewIn hypertrophic cardiomyopathy (HCM), the presence of vessel abnormalities with microvascular dysfunction is a well-known feature. The aim of this review is to present the evidences that support this notion and to describe the physiopathologic and clinical consequences of microvascular dysfunction.Recent FindingsAfter having demonstrated the presence and significance of microvascular dysfunction in HCM, the myocardial blood flow (MBF) measurement by positron emission tomography (PET) is ready to develop into a clinical tool for disease evaluation, in particular for patient prognostication. Alternat...
Source: Current Cardiovascular Imaging Reports - January 16, 2019 Category: Radiology Source Type: research

Stress Protocol and Myocardial Perfusion Imaging Accuracy
AbstractPurpose of ReviewTo evaluate the most recent evolutions in the field of single photon emission computed tomography (SPECT) nuclear cardiac imaging (NCI), particularly regarding the influence of stress protocol specifics on test accuracy.Recent FindingsThe substantial improvement in both software and hardware SPECT settings may allow a drastic redefinition of the acquisition parameters, with a radical reduction of scanning time. Moreover, recent evidence has identified novel (contra)-indications to the different cardiac stressors, defining the categories of patients in which a specific stressor is most appropriate.S...
Source: Current Cardiovascular Imaging Reports - January 16, 2019 Category: Radiology Source Type: research

Correction to: Coronary CTA for Surveillance of Cardiac Allograft Vasculopathy
The articleCoronary CTA for Surveillance of Cardiac Allograft Vasculopathy, written by Nishant R. Shah, Ron Blankstein, Todd Villines, Hafiz Imran, Alan R. Morrison and Michael K. Cheezum, was originally published electronically on the publisher ’s internet portal. (Source: Current Cardiovascular Imaging Reports)
Source: Current Cardiovascular Imaging Reports - November 8, 2018 Category: Radiology Source Type: research

IVUS- Versus OCT-Guided Coronary Stent Implantation: a Comparison of Intravascular Imaging for Stent Optimization
AbstractPurpose of ReviewIntravascular imaging provides improved diagnostic accuracy and optimization of percutaneous coronary interventions (PCI) compared with angiography alone. We review the latest literature on the predominant intravascular imaging modalities, intravascular ultrasound (IVUS), and optical coherence tomography (OCT).Recent FindingsA number of recently published clinical studies evaluating OCT and IVUS use have demonstrated improved procedural and clinical outcomes over angiography. Recent literature also reports on novel potential applications of these technologies.SummaryIntravascular imaging is an impo...
Source: Current Cardiovascular Imaging Reports - October 31, 2018 Category: Radiology Source Type: research

Diastolic Assessment: Application of the New ASE Guidelines
AbstractPurpose of ReviewThe purpose of this review is to summarize the new guidelines from the American Society of Echocardiography (ASE) and the European Association of Cardiovascular Imaging (EACVI) for the diagnosis and grading of diastolic dysfunction (DD), with commentary on the rationale behind the use of the recommended individual parameters.Recent FindingsPrevious guidelines for assessment of diastolic function have been criticized for being too complex with modest diagnostic performance and inter-observer variability.SummaryThe new ASE/EACVI diastology guidelines aim to simplify the diagnosis and gradation of DD ...
Source: Current Cardiovascular Imaging Reports - October 31, 2018 Category: Radiology Source Type: research

Stress Echocardiography: the Role in Assessing Valvular Heart Diseases
AbstractPurpose of ReviewStress echocardiography (SE) has clinical utility beyond its conventional use for the evaluation of myocardial ischemia. More specifically, SE has been shown to have significant clinical value in patients with valvular heart disease (VHD), hypertrophic cardiomyopathy (HCM), and congenital heart disease (CHD). Echocardiography laboratories providing services to such patient should be familiar with the principals of SE beyond coronary artery disease to ensure its optimum application and performance.Recent FindingsThe increased demand for SE standardization specifically in patients with VHD instigated...
Source: Current Cardiovascular Imaging Reports - October 23, 2018 Category: Radiology Source Type: research

Diagnosis of Cardiac Amyloidosis: Clinical and Echocardiographic Features
AbstractPurpose of ReviewThis review is geared to address the various forms of amyloidosis which have cardiac involvement and discuss the echocardiographic findings that may be present in patients with cardiac amyloidosis.Recent FindingsThe use of echocardiography has revolutionized the diagnosis of cardiac amyloidosis. The diagnosis is often first suspected due to characteristic echocardiographic findings. Although no single finding is pathognomonic, there are a constellation of features that point to the diagnosis including increased left and right ventricular wall thickness, thickened cardiac valves and atrial walls, an...
Source: Current Cardiovascular Imaging Reports - October 23, 2018 Category: Radiology Source Type: research

Intravascular Imaging for Chronic Total Occlusion Intervention
AbstractPurpose of ReviewWe sought to summarize the current evidence on use of intravascular imaging (with intravascular ultrasound [IVUS] or optical coherence tomography [OCT]) in chronic total occlusion (CTO) percutaneous coronary intervention (PCI).Recent FindingsUtilization of intravascular imaging in CTO PCI is increasing over time, both to facilitate CTO crossing and for optimization of the final result. OCT is used less often than IVUS due to its lower depth of penetration and need for contrast injection.SummaryIntravascular imaging has multiple uses in CTO PCI: (a) it can facilitate CTO crossing by resolving proxim...
Source: Current Cardiovascular Imaging Reports - October 17, 2018 Category: Radiology Source Type: research

Utility of Cardiac Computed Tomography in Patients with Left Ventricular Assist Devices
AbstractPurpose of ReviewThe number of left ventricular assist device implants has increased significantly in the last decade. Left ventricular assist device (LVAD) optimization, trouble-shooting complications, and surgical planning require a multi-modality imaging approach. Echocardiography remains the imaging modality of choice, particularly for physiological evaluation but accurate anatomical evaluation of the entirety of the LVAD is often challenging if not impossible. Cardiac computed tomography (CCT) offers additional information that is valuable in taking care of these complex patients. The purpose of this review is...
Source: Current Cardiovascular Imaging Reports - October 5, 2018 Category: Radiology Source Type: research

Utility of Cardiac Compute Tomography in Patients with Left Ventricular Assist Devices
AbstractPurpose of ReviewThe number of left ventricular assist device implants has increased significantly in the last decade. Left ventricular assist device (LVAD) optimization, trouble-shooting complications, and surgical planning require a multi-modality imaging approach. Echocardiography remains the imaging modality of choice, particularly for physiological evaluation but accurate anatomical evaluation of the entirety of the LVAD is often challenging if not impossible. Cardiac computed tomography (CCT) offers additional information that is valuable in taking care of these complex patients. The purpose of this review is...
Source: Current Cardiovascular Imaging Reports - October 5, 2018 Category: Radiology Source Type: research

A Review of Echocardiography Training for Internal Medicine Residents: Proposed Goals, Methods, and Metrics
AbstractPurpose of the reviewFocused cardiac ultrasound (FCU) is a useful bedside tool that is often utilized by internal medicine residents. Multiple studies have shown that FCU adds valuable information beyond the history and physical. No formal recommendations exist regarding which physiologic parameters should be included in FCU, how those parameters should be assessed, or how to adequately train residents in its use. This review highlights the available literature on FCU training for medicine residents and provides in-depth analysis of the existing programs.Recent findingsThere is significant variability among FCU tra...
Source: Current Cardiovascular Imaging Reports - October 2, 2018 Category: Radiology Source Type: research

Comprehensive Assessment of Aortic Stenosis in the TAVR Era
AbstractPurpose of ReviewTranscatheter aortic valve replacement (TAVR) has been approved for the treatment of severe aortic stenosis in patients who are prohibitive surgical risk, high surgical risk, and now intermediate surgical risk. This review aims to raise awareness of the role echocardiography in evaluating patients with aortic stenosis for TAVR, in assisting during the procedure for device placement and to identify procedural complications and in assessing follow-up valvular and cardiac function to guide ongoing therapy.Recent FindingsA comprehensive echocardiogram is an essential part of the evaluation of patients ...
Source: Current Cardiovascular Imaging Reports - September 27, 2018 Category: Radiology Source Type: research

The Comprehensive Assessment of Left Ventricular Assist Devices by Echocardiography
AbstractPurpose of ReviewEchocardiography is the imaging modality of choice for patient selection prior to left ventricular assist device (LVAD) implantation, assessment of device placement, optimization of device settings, diagnosis of device-related complications, and assessment of LV recovery. The key echocardiographic features of these devices will be highlighted in the following review.Recent FindingsWith increased utilization of LVADs as well as the development of centrifugal continuous-flow pumps, familiarity with echocardiographic imaging of LVADs is essential to optimal care of these complex patients.SummaryAll ec...
Source: Current Cardiovascular Imaging Reports - September 24, 2018 Category: Radiology Source Type: research

Coronary CTA for Surveillance of Cardiac Allograft Vasculopathy
AbstractPurpose of ReviewThe purpose of this review is to highlight recent hardware and software advances in coronary computed tomography angiography (CTA) that make it a potentially viable alternative to invasive coronary angiography for surveillance of cardiac allograft vasculopathy (CAV) in heart transplant recipients.Recent FindingsDual-source CT, multisegment reconstruction, and intracycle motion correction algorithms are all technologies applied during or after image acquisition that can improve image quality and diagnostic accuracy in patients with elevated heart rates, such as heart transplant recipients. CT fracti...
Source: Current Cardiovascular Imaging Reports - September 24, 2018 Category: Radiology Source Type: research

The Comprehensive Assessment of Left Ventricular Assist Devices by Echocardiography
AbstractPurpose of ReviewEchocardiography is the imaging modality of choice for patient selection prior to left ventricular assist device (LVAD) implantation, assessment of device placement, optimization of device settings, diagnosis of device-related complications, and assessment of LV recovery. The key echocardiographic features of these devices will be highlighted in the following review.Recent FindingsWith increased utilization of LVADs as well as the development of centrifugal continuous-flow pumps, familiarity with echocardiographic imaging of LVADs is essential to optimal care of these complex patients.SummaryAll ec...
Source: Current Cardiovascular Imaging Reports - September 24, 2018 Category: Radiology Source Type: research

Coronary CTA for Surveillance of Cardiac Allograft Vasculopathy
AbstractPurpose of ReviewThe purpose of this review is to highlight recent hardware and software advances in coronary computed tomography angiography (CTA) that make it a potentially viable alternative to invasive coronary angiography for surveillance of cardiac allograft vasculopathy (CAV) in heart transplant recipients.Recent FindingsDual-source CT, multisegment reconstruction, and intracycle motion correction algorithms are all technologies applied during or after image acquisition that can improve image quality and diagnostic accuracy in patients with elevated heart rates, such as heart transplant recipients. CT fracti...
Source: Current Cardiovascular Imaging Reports - September 24, 2018 Category: Radiology Source Type: research