Role of Intravascular Imaging in the Diagnosis and Treatment of Spontaneous Coronary Artery Dissection
The objective of this article is to review the role of intracoronary imaging in the management of patients with spontaneous coronary artery dissection (SCAD). In this review article, we discuss the types of intracoronary imaging including intravascular ultrasound (IVUS) and optical coherence tomography (OCT) and their relative strengths and weaknesses. Additionally, we discuss in detail the findings on IVUS and OCT and how these modalities can be used for optimization of percutaneous coronary intervention (PCI) in SCAD cases.Recent FindingsWhile coronary angiography is the first-line investigation for diagnosis of SCAD, it...
Source: Current Cardiovascular Imaging Reports - July 11, 2020 Category: Radiology Source Type: research

CT Imaging of Left Ventricular Assist Devices and Associated Complications
AbstractPurpose of ReviewThe purpose of this paper is to review the current role of computed tomography (CT) in the imaging of left ventricular assist devices (LVAD).Recent FindingsRecent studies have highlighted the prognostic role of measuring skeletal muscle CT attenuation in predicting adverse LVAD outcomes. CT is also useful for evaluation of inflow cannula malposition, and outflow graft complications such as obstruction and kinking. In addition,18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) has been shown to be of value in evaluation of suspected LVAD infection. Newer CT techniqu...
Source: Current Cardiovascular Imaging Reports - July 1, 2020 Category: Radiology Source Type: research

Correction to: Role of Coronary Computed Tomography Angiography in Percutaneous Coronary Intervention of Chronic Total Occlusions
The original version of this image was of lower quality. The corrected image provides a better definition of the structures. (Source: Current Cardiovascular Imaging Reports)
Source: Current Cardiovascular Imaging Reports - June 27, 2020 Category: Radiology Source Type: research

Better Is the Evolution of Good: How IVUS and OCT Have Transformed PCI
AbstractPurpose of ReviewWe seek to provide a focused appraisal of the most recent outcomes data for intravascular ultrasound (IVUS) and optical coherence tomography (OCT).Recent FindingsThere are multiple randomized control trials and meta-analyses investigating the effects of these two intravascular imaging (IVI) modalities on clinical decision-making and long-term clinical outcomes in percutaneous coronary intervention (PCI). While the effects of IVUS have been studied for decades, OCT is a newer form of IVI with less experience and data on its use in clinical practice.SummaryIVUS-guided PCI has beneficial effects on mo...
Source: Current Cardiovascular Imaging Reports - June 22, 2020 Category: Radiology Source Type: research

Contrast Fractional Flow Reserve (cFFR) and Computed Tomography Fractional Flow Reserve (CT-FFR) Guidance for Percutaneous Coronary Intervention (PCI)
AbstractPurpose of ReviewIn this review, we summarize both contrast fractional flow reserve (cFFR) and computed tomography fractional flow reserve (CT-FFR) as novel modalities to evaluate the hemodynamic significance of coronary artery stenoses and to guide percutaneous coronary intervention (PCI).Recent FindingsImplementation of cFFR can reduce the time, cost, effort, and patient discomfort associated with traditional adenosine FFR. Clinical outcomes following cFFR-guided revascularization are currently under investigation. Emerging data on the use of CT-FFR in patients with acute coronary syndromes may increase the use o...
Source: Current Cardiovascular Imaging Reports - June 8, 2020 Category: Radiology Source Type: research

Single Tracer Combined Imaging: the Role of PET/MRI from Research Domain to Clinical Arena
AbstractPurpose of ReviewGoal of this review article was to summarize and evaluate the current developments in nuclear medicine cardiovascular imaging with focus on PET/MR imaging. Furthermore, it should highlight recent topics of interest, such as sarcoidosis, inflammation, and cardiac amyloidosis for instance, which have not properly characterized with PET/MRI yet.Recent FindingsIn the last years there have been advances in experimental tracers and clinical research especially for inflammatory cardiac diseases. Most articles still focus PET/CT rather than PET/MRI, which is mostly due to a limited number of PET/MRI center...
Source: Current Cardiovascular Imaging Reports - May 30, 2020 Category: Radiology Source Type: research

The Role of Imaging for MINOCA (Myocardial Infarction with No Obstructive Coronary Artery Disease): a Review of Literature and Current Perspectives
The objective of this review is to summarize scientific statements on the diagnosis and management of myocardial infarction with no obstructive coronary artery disease (MINOCA); define the diagnostic role of optical coherence tomography (OCT), intravascular ultrasound (IVUS), and cardiac magnetic resonance imaging (CMR); and provide representative case examples.Recent FindingsThe majority of patients with MINOCA are evaluated by conventional coronary angiography. However, intracoronary imaging using OCT or IVUS permits more accurate understanding of the underlying pathology. These and other imaging modalities provide signi...
Source: Current Cardiovascular Imaging Reports - May 21, 2020 Category: Radiology Source Type: research

Role of Coronary Computed Tomography Angiography in Percutaneous Coronary Intervention of Chronic Total Occlusions
AbstractPurpose of ReviewDespite significant advances in procedural techniques for revascularization of chronic total occlusions (CTO), comprehensive procedural planning and accurate prediction of procedural success remain the Achilles ’ heels of CTO percutaneous coronary intervention (PCI). Understanding the unique anatomic characteristics of CTOs that may predict relative success and complication rates of revascularization is imperative. Coronary computed tomography angiography (CCTA) has evolved as an adjunct to invasive angi ography to better characterize CTO lesions to improve success rates of CTO PCI.Recent Fin...
Source: Current Cardiovascular Imaging Reports - May 13, 2020 Category: Radiology Source Type: research

Intravascular Imaging for Venous Interventions
AbstractPurpose of ReviewThis review surveys the clinical landscape of intravascular imaging for endovenous interventions.Recent FindingsEndovascular imaging has become increasingly important for diagnosing venous pathology and guiding venous interventions. In particular, intravascular ultrasound (IVUS) provides 3D high-resolution cross-sectional imaging of vessel and surrounding tissues, often in anatomic locations inaccessible to surface ultrasound, namely the superior vena cava, inferior vena cava, and caval-iliac veins.SummaryCurrent well-established indications for venous IVUS include diagnostic studies, venoplasty, t...
Source: Current Cardiovascular Imaging Reports - May 9, 2020 Category: Radiology Source Type: research

A Brief History of Intracoronary Imaging
AbstractPurpose of ReviewThe purpose of this paper is to review the history of intracoronary imaging as it pertains to the development of intravascular ultrasound (IVUS) and optical coherence tomography (OCT) devices.Recent FindingsCoronary angiography continues to maintain its stronghold as the diagnostic modality of choice in the diagnosis of coronary artery disease. Limitations in scope, however, have necessitated the development of adjunctive forms of imaging through IVUS and OCT in order to augment the comprehensive assessment and therapeutic management of angiographic findings.SummaryIVUS and OCT have significantly e...
Source: Current Cardiovascular Imaging Reports - May 8, 2020 Category: Radiology Source Type: research

An Update on Cardiac Magnetic Resonance Imaging in Takotsubo Cardiomyopathy
AbstractPurpose of ReviewTo provide an update on the use of cardiac magnetic resonance imaging in the diagnosis of Takotsubo cardiomyopathy.Recent FindingsLong-term prognosis of Takotsubo cardiomyopathy may not be as clear-cut as previously thought. Cardiac magnetic resonance imaging not only allows differentiation between reversible and nonreversible changes but has an emerging role in identifying cellular level changes associated with prognostic indicators such as myocardial energetics using31P-CMR spectroscopy and detection of myocardial inflammation overlying myocardial oedema, using ultrasmall paramagnetic iron oxide ...
Source: Current Cardiovascular Imaging Reports - April 29, 2020 Category: Radiology Source Type: research

The Evolution of Ischemia Detection with Echocardiography
AbstractPurpose of ReviewThis review is aimed at understanding the clinical connect betweenischemia and tissue changes by firstly, describing the historical and clinicopathophysiologicalperspective of deformation imaging and secondly clinical advances of tissue imaging; nextthe body of evidence currently available for this methodology; and finally, the feasibility andbarriers to clinical translation. There will also be a brief review of the feasibility and currentuse of contrast for perfusion with flash imaging Myocardial contrast echocardiography (MCE) for the detection of ischemia.Recent FindingsMyocardial ischemia detec...
Source: Current Cardiovascular Imaging Reports - April 28, 2020 Category: Radiology Source Type: research

Aortic Stiffness and Heart Failure in Chronic Kidney Disease
AbstractPurpose of ReviewTo provide an update on the recent findings in the field of aortic stiffness and heart failure in patients with chronic kidney disease (CKD).Recent FindingsStratification of cardiovascular risk in CKD remains an open question. Recent reports suggest that aortic stiffness, an independent predictor of cardiovascular events in many patient populations, is also an important prognostic factor in CKD. Also, novel measures of myocardial tissue characterization, native T1 and T2 mapping techniques, have potential as diagnostic and prognostic factors in CKD.SummaryCardiovascular magnetic resonance has the a...
Source: Current Cardiovascular Imaging Reports - April 22, 2020 Category: Radiology Source Type: research

Cardiac Magnetic Resonance in Chagas Disease —an Update
AbstractPurpose of ReviewThe purpose of this paper is to review the current role of cardiac magnetic resonance (CMR) in Chagas disease.Recent FindingsCMR is crucial to detect the cardiac involvement in patients with Chagas disease given its ability to assess ventricular function and allow non-invasive tissue characterization.SummaryChagas disease is an emerging health problem in non-endemic areas because of growing population movements. Among other imaging modalities, CMR aids in the early detection of cardiac involvement in Chagas disease, allows stage patients in the course of the cardiomyopathy, stratify patients &rsquo...
Source: Current Cardiovascular Imaging Reports - March 3, 2020 Category: Radiology Source Type: research

CMR in Hypertrophic Cardiac Conditions —an Update
AbstractPurpose of ReviewMyocardial left ventricular (LV) hypertrophy (LVH) is a common phenotype associated to increased morbidity and mortality. Beyond an accurate LV mass quantification, cardiovascular magnetic resonance (CMR) can also provide tissue characterization, perfusion, and deformation assessments. Aim of the present review is to discuss recent advances in CMR imaging of LVH.Recent FindingsT1 and T2 mapping techniques expanded the ability of CMR in phenotyping LVH, underscoring the pathogenic significance of interstitial fibrosis and edema in hypertrophic conditions. Perfusion and deformation assessments reveal...
Source: Current Cardiovascular Imaging Reports - March 3, 2020 Category: Radiology Source Type: research

CMR in Pericardial Diseases - an Update
AbstractPurpose of ReviewTo review the latest developments and the current role of the cardiac magnetic resonance (CMR) in pericardial diseases and their complications.Recent FindingsCardiac Magnetic Resonance (CMR) has the ability to incorporate anatomy, physiology, and “virtual histology” strategies to achieve the most accurate diagnosis for even the most demanding, pericardial diseases.SummaryAcute, chronic, recurrent, and constrictive pericarditis as well as pericarditis related complications, pericardial masses and congenital pericardial defects are commonly encountered in clinical practice with relatively...
Source: Current Cardiovascular Imaging Reports - March 3, 2020 Category: Radiology Source Type: research

Cardiac Metabolic Implications of Fat Depot Imaging
AbstractPurpose of ReviewVisceral adipose tissues differentiate from subcutaneous fat by its local and systemic effects. As visceral adipose tissue within the thorax, the epicardial adipose tissue (EAT) surrounds the heart and the coronary arteries.Recent FindingsSeveral studies described the association of EAT and cardiovascular risk factors as well as prevalence and incidence of coronary artery disease. General measures of obesity like body mass index can easily be assessed. In contrast, visceral adipose tissue requires imaging modalities like computed tomography or ultrasonography for assessment. While computed tomograp...
Source: Current Cardiovascular Imaging Reports - February 19, 2020 Category: Radiology Source Type: research

Personalized Cardiac Imaging with New PET Radiotracers
This article reviews recent developments in the application of positron emission tomography (PET) for personalized cardiac imaging.Recent FindingsPET imaging has improved our understanding of various cardiovascular pathologies by probing the molecular pathways associated with specific cardiovascular diseases. The use of PET can improve disease detection and influence management strategies.SummaryPET has improved our understanding of the pathophysiology of atherosclerosis by imaging several key features including calcification, inflammation, apoptosis, and hypoxia. Molecular imaging of myocardial inflammation and cardiac sy...
Source: Current Cardiovascular Imaging Reports - February 19, 2020 Category: Radiology Source Type: research

Intravascular Imaging for Peripheral Vascular Disease and Endovascular Intervention
AbstractPurpose of ReviewIntravascular imaging has been increasingly incorporated into endovascular practice. The goal of this review is to explore the contemporary technologies used to perform intravascular imaging as well as the evidence supporting their use in the diagnostic assessment and treatment of peripheral vascular disease.Recent FindingsAlthough intravascular imaging has been more extensively studied in the coronary vasculature, there is a growing body of literature studying its use in other vascular territories. There are unique advantages and disadvantages for the two most commonly employed imaging modalities ...
Source: Current Cardiovascular Imaging Reports - February 12, 2020 Category: Radiology Source Type: research

Intravascular Imaging for Assessment of Cardiac Allograft Vasculopathy Following Heart Transplantation
AbstractPurpose of ReviewCardiac allograft vasculopathy (CAV) is a significant cause of morbidity and mortality in the post-cardiac transplant patient population. Current guidelines recommend annual angiographic surveillance for CAV; however, angiography alone has several limitations and can lead to systematic underestimation of disease burden and the inability to sensitively track disease progression. We provide an overview of intravascular imaging in the initial and longitudinal evaluation of CAV, with a focus on the use of intravascular ultrasound (IVUS).Recent FindingsMultiple studies have demonstrated that progression...
Source: Current Cardiovascular Imaging Reports - January 30, 2020 Category: Radiology Source Type: research

Intravascular Molecular Imaging to Detect High-Risk Vulnerable Plaques: Current Knowledge and Future Perspectives
AbstractPurpose of ReviewTo describe vulnerable plaque pathobiology and summarize potential targets for molecular imaging with a focus on intravascular near-infrared fluorescence (NIRF) and its translatable applications.Recent FindingsStructural imaging alone is unable to precisely identify high-risk plaques in patients with coronary artery disease (CAD). Intravascular near-infrared fluorescence (NIRF) imaging is an emerging translational approach that can image specific in vivo molecular processes and cells that characterize vulnerable plaques. High-priority NIRF targets imaged by intravascular NIRF imaging thus far inclu...
Source: Current Cardiovascular Imaging Reports - January 30, 2020 Category: Radiology Source Type: research

Current Challenges and Recent Updates in Artificial Intelligence and Echocardiography
AbstractPurpose of the ReviewThis review discusses the recent advances in automated echocardiography using artificial intelligence and machine learning (ML) techniques. Specific emphasis is placed on the potential for machine learning-based methods to improve accuracy and reproducibility of echocardiographic assessment as well as early cardiovascular disease detection and personalized risk assessment.Recent FindingsEchocardiography remains the first line imaging modality for evaluation of many cardiovascular diseases. The last few years have witnessed a rapid expansion and growth of ML-based automated analysis and interpre...
Source: Current Cardiovascular Imaging Reports - January 21, 2020 Category: Radiology Source Type: research

Stress Echocardiography in the Era of Fractional Flow Reserve
AbstractPurpose of ReviewIt is the aim of this review to demonstrate the relevance of stress echocardiography in the era of fractional flow reserve by establishing the current use of stress echocardiography and fractional flow reserve, underlining their physiological basis and through this demonstrating the clear differences in their application.Recent FindingsThe importance of the microcirculation is only now being understood, no more so than in the fact that abnormalities in the microcirculation, determined by abnormal coronary flow reserve, predict adverse mortality regardless of the normality of the epicardial coronary...
Source: Current Cardiovascular Imaging Reports - January 21, 2020 Category: Radiology Source Type: research

The Current and Future Role of Echocardiography for the Detection of Cardiotoxicity Related to Cancer Therapy
AbstractPurpose of the ReviewThe purpose of this review is to outline the role of echocardiography in identifying patients at increased cardiovascular risk for cancer treatment-associated cardiotoxicity.Recent FindingsWith a wide array of cancer therapeutics, a variety echocardiographic cardiotoxicity phenotypes have been identified. Recent consensus statements from several professional societies have provided a framework for risk assessment prior to cancer therapy that involves assessment and optimization of cardiac risk factors but also involves echocardiographic evaluation of left ventricular (LV) function at baseline, ...
Source: Current Cardiovascular Imaging Reports - January 16, 2020 Category: Radiology Source Type: research

Clinical and Advanced MRI Techniques for Detection of Checkpoint Inhibitor Associated Myocarditis
AbstractPurpose of ReviewWith the advent of immune checkpoint inhibitors (ICIs), cancer treatment has been revolutionized; however, these agents are associated with immune-related adverse events, including myocarditis, which ranges from mild to fulminant in severity. Currently, there are no established guidelines in diagnosing ICI-associated myocarditis, and the gold standard test for diagnosis of myocarditis in general is invasive endomyocardial biopsy (EMB). Cardiac magnetic resonance (CMR) imaging is a noninvasive test with the advantage of providing structural, functional and tissue characterization information. Additi...
Source: Current Cardiovascular Imaging Reports - January 14, 2020 Category: Radiology Source Type: research

Cardiovascular Magnetic Resonance Relaxometry in Early Detection of Anthracycline Cardiotoxicity
AbstractPurpose of the ReviewTo provide an overview of the published data on the value of cardiovascular magnetic resonance (CMR) based T1 and T2 and extracellular volume (ECV) fraction quantification to identify myocardial abnormalities related to anthracycline treatment in patients with cancer.Recent FindingsIn animal models of anthracycline cardiotoxicity, elevations in myocardial T1 and T2 values appear to occur early during treatment followed by ventricular remodeling, persistent elevation in T1, and increase in ECV. These findings suggest early myocardial inflammation/edema followed by myocardial fibrosis and ventric...
Source: Current Cardiovascular Imaging Reports - January 13, 2020 Category: Radiology Source Type: research

Differentiation of Cardiac Masses by Cardiac Magnetic Resonance Imaging
AbstractPurpose of the ReviewThe purpose of this study is to review the utility of cardiac magnetic resonance (CMR) imaging in diagnosing and differentiating among different cardiac masses.Recent FindingsRecent advances in tissue characterization have made CMR the noninvasive modality of choice in differentiating cardiac masses. Greater spatial resolution, sophisticated tissue characterization, and multiple imaging planes to assess intra-cavitary masses enable CMR to perform a “virtual biopsy” of the mass.SummaryCardiac tumors are rare but reporting of cardiac masses on noninvasive testing as computed tomograph...
Source: Current Cardiovascular Imaging Reports - January 10, 2020 Category: Radiology Source Type: research

Novel Echocardiographic Biomarkers in the Management of Atrial Fibrillation
AbstractPurpose of ReviewAtrial fibrillation (AF) is the most common arrhythmia in adults. The number of patients with AF is anticipated to increase annually, mainly due to the aging population alongside improved arrhythmia detection. AF is associated with a significantly elevated risk of hospitalization, stroke, thromboembolism, heart failure, and all-cause mortality. Echocardiography is one of the key components of routine assessment and management of AF. Therefore, the aim of this review is to briefly summarize current knowledge on “novel” echocardiographic parameters that may be of value in the management o...
Source: Current Cardiovascular Imaging Reports - November 20, 2019 Category: Radiology Source Type: research

The Role of Echocardiography in Cardio-oncology Patients: Contemporary Indications and Future Directions
AbstractPurpose of ReviewThis review discusses the latest advances, guideline recommendations, and limitations of the use of echocardiography in evaluation of cancer therapeutics –related cardiac dysfunction (CTRCD) and highlights advances in cardio-oncology that have the potential to augment the echocardiographic assessment of CTRCD.Recent FindingsCardio-oncology is a rapidly evolving field aimed at improving the quality of life of cancer patients by preventing and treating the adverse cardiovascular complications of cancer therapy. Cardiac imaging tools, in particular transthoracic echocardiography, play a pivotal ...
Source: Current Cardiovascular Imaging Reports - November 20, 2019 Category: Radiology Source Type: research

FDG-PET Imaging of Doxorubicin-Induced Cardiotoxicity: a New Window on an Old Problem
AbstractPurpose of ReviewThe present review focus on the published literature about the use of 18F-fluorodeoxyglucose (FDG) PET/CT imaging in the early recognition of anthracyclines-related cardiotoxicity.Recent FindingsThe application of PET/CT may represent an early predictor of subsequent cardiotoxicity in cancer patients treated with doxorubicin (DXR). However, the application of PET/CT may also extend beyond mere cardiotoxicity identification and monitoring to provide mechanistic delineation of the cardiotoxic pathophysiology. Indeed, this tool further enriched the current knowledge on energy metabolism impairment in ...
Source: Current Cardiovascular Imaging Reports - November 16, 2019 Category: Radiology Source Type: research

Low Gradient Aortic Stenosis: Role of Echocardiography
AbstractPurpose of ReviewThe purpose of this paper is to review the current role of echocardiography in the evaluation of patients with low gradient severe aortic stenosis (LG severe AS).Recent FindingsDiscordant grading of AS severity, in which a small aortic valve area coexists with a small gradient, can result in diagnostic and therapeutic dilemmas. Transthoracic, transesophageal, and stress echocardiography play pivotal roles in reconciling the discordance and clarifying AS severity. Three physiologic categories of LG severe AS can be identified (classical low flow (LF) LG AS, paradoxical LF-LG AS, and normal flow LG A...
Source: Current Cardiovascular Imaging Reports - October 31, 2019 Category: Radiology Source Type: research

Cardiac CT and Structural Heart Disease Interventions (Non-TAVI)
AbstractPurpose of reviewThe use of cardiac CT is well established in the TAVR sphere and gaining traction as an integral part of pre-procedural planning for left 13 atrial appendage closure (LAAC) and transcatheter mitral valve replacement (TMVR. We aim to review the recent evidence regarding the accuracy of cardiac CT for left atrial sizing and device selection and discuss the contribution of cardiac CT to decreasing complication rates in real-world experience as compared with clinical trials.Recent findingsPre-procedural CT imaging has evolved to become an integral part of LAA closure and TMVR. For LAA closure, CT imagi...
Source: Current Cardiovascular Imaging Reports - October 19, 2019 Category: Radiology Source Type: research

Recent Advances in Imaging Inflammation Post-Myocardial Infarction Using Positron Emission Tomography
AbstractPurpose of ReviewDespite advances in medical and surgical therapy, some patients after a myocardial infarction still develop heart failure, a devastating disease that has a high rate of morbidity and mortality. Differences in the immune response to the myocardial damage may affect the healing process. Molecular imaging enables the interrogation of immune cell subsets that can aid or impair left ventricular recovery post-myocardial infarction. Visualization of patient-specific differences in the cellular and molecular process among patients post-myocardial infarction may lead to the development of personalized thera...
Source: Current Cardiovascular Imaging Reports - September 4, 2019 Category: Radiology Source Type: research

Coronary Artery Calcium Scoring in 2019: Past, Present, and Future
AbstractPurpose of ReviewIn this review, we sought to present a clinically relevant history of coronary artery calcium (CAC) scoring from its initial introduction, to its more recent widespread adoption and guideline endorsement, to future directions of cutting-edge CAC research.Recent FindingsSince prior exhaustive reviews on CAC scoring, the introduction of the Pooled Cohort Equations (PCEs) for the assessment of atherosclerotic cardiovascular disease (ASCVD) risk has been formative in reframing how clinicians discuss risk and prevention with their patients. However, given weaknesses in the performance of the PCEs, addit...
Source: Current Cardiovascular Imaging Reports - August 2, 2019 Category: Radiology Source Type: research

Computed Tomography in Heart Failure
AbstractPurpose of ReviewThe purpose of this paper was to review the role of cardiac computed tomography (CCT) in both the diagnostic and management pathways of heart failure.Recent FindingsCT has an essential role in non-invasively excluding coronary artery disease but also can provide additional information that can aid the investigation of the patient presenting with heart failure. CT images provide high-quality information about cardiac structure and pericardium. Cardiac anatomical information, such as the location and size of coronary sinuses, can assist in lead placement in cardiac resynchronisation therapy. Cardiac ...
Source: Current Cardiovascular Imaging Reports - July 25, 2019 Category: Radiology Source Type: research

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