Measure Twice, Cut Once: Adjunctive Physiology and Imaging in Left Main PCI
AbstractPurpose of ReviewWhile left main coronary artery (LMCA) disease is often evaluated based on angiographic findings, technical limitations of angiography or the presence of intermediate disease can make accurate lesion assessment difficult.Recent FindingsThe rise of intravascular imaging and functional assessment of coronary artery disease lesions over the past 20  years has greatly improved PCI outcomes, making it an acceptal alternative to CABG in selected patients and lesions (Class IIa recommendation, after multidisciplinary Heart-Team discussion). We reviewed the advances of intravascular imaging (IVUS and ...
Source: Current Cardiovascular Imaging Reports - December 11, 2021 Category: Radiology Source Type: research

Coronary Artery Calcium Measurement to Assist in Primary Prevention Decisions for Aspirin and Lipid-Lowering Therapies
AbstractPurpose of ReviewWe evaluated the role of CAC in guiding primary prevention with lipid-lowering medications and aspirin.Recent FindingsZero CAC is associated with low risk of future CVD events. Statin use does not weaken the prognostic utility of CAC. CAC scoring has clinical utility in patients with severe primary hypercholesteremia, hypertension, diabetes/metabolic syndrome, and in the young and older adults. The timing for repeat CAC measurement depends on baseline ASCVD risk and generally varies from 3 to 7  years.SummaryCAC is a cost-effective risk stratification approach useful in guiding shared clinical...
Source: Current Cardiovascular Imaging Reports - December 6, 2021 Category: Radiology Source Type: research

Cardiac Computed Tomography for Amyloidosis
AbstractPurpose of ReviewDetecting cardiac amyloid (CA) is challenging. Traditional approaches have not always succeeded in achieving a timely diagnosis. Cardiac magnetic resonance imaging (CMR) has begun to change this, but access to CMR may be limited due to availability or contraindications and may not be considered if clinical suspicion is not high. In contrast, cardiac CT (CCT) is widely available, fast, and has few contraindications. In this review, we will consider the role of CCT to identify CA using anatomy, function, and tissue characteristics.Recent FindingsWe discuss the different CT protocols that have been em...
Source: Current Cardiovascular Imaging Reports - November 18, 2021 Category: Radiology Source Type: research

Intracoronary Imaging for Bypass Graft Assessment and Intervention
AbstractPurpose of ReveiwTo compile knowledge of expected intravascular imaging findings in coronary venous and arterial bypass grafts, both at baseline and in diseased states in order to improve understanding of the pathology demonstrated in failing grafts. Also, to learn how intravascular imaging could be used to guide necessary graft interventions and to consider whether imaging practices in grafts could become formalized or potentially influence outcomes of graft interventions, which are notoriously poor.Recent FindingsDisease in saphenous vein grafts has features overlapping with pathology in native vessels, but can a...
Source: Current Cardiovascular Imaging Reports - October 8, 2021 Category: Radiology Source Type: research

Intravascular Ultrasound Use for Iliac Vein Interventions
AbstractPurpose of ReviewTo summarize the most clinically pertinent data supporting IVUS in deep venous procedures, the basics of IVUS interpretation, technical steps of iliac vein stenting, and typical interventional case examples of acute iliofemoral deep vein thrombosis (DVT) and non-thrombotic iliac vein lesion (NIVL).Recent FindingsIntravascular ultrasound (IVUS) has a fundamental role in deep venous diagnostic and interventional procedures. Venography, although essential and complimentary to IVUS, has many limitations which render it insufficient as a stand-alone imaging modality in deep venous interventions. The dia...
Source: Current Cardiovascular Imaging Reports - September 29, 2021 Category: Radiology Source Type: research

Sex Differences in Intracoronary Imaging and Functional Evaluation of Coronary Arteries
AbstractPurposeCoronary artery disease encompasses broad pathologies beyond atherosclerosis such as spontaneous coronary artery dissection, myocardial infarction with non-obstructive coronary artery disease, and microvascular dysfunction. These diagnoses often warrant more detailed evaluations with intracoronary imaging or functional testing. In this review, we highlight the reported sex differences in intracoronary imaging and functional evaluation of the coronary arteries.Recent FindingsThe diagnosis and treatment of women presenting with acute or chronic coronary syndromes have been fraught with disparities given the po...
Source: Current Cardiovascular Imaging Reports - September 17, 2021 Category: Radiology Source Type: research

Integrating Intracoronary Imaging into PCI Workflow and Catheterization Laboratory Culture
This article aims to explore barriers to the use of intracoronary imaging during PCI and potential strategies to improve the uptake of intracoronary imaging in the catheterization laboratory.Recent FindingsOver the past decade, several randomized trials have supported the use of intracoronary imaging in PCI to improve outcome. However, registry data has suggested that the uptake of intracoronary imaging has been particularly slow in the USA. Important barriers to the use of intracoronary imaging include procedural time, cost, perceived risk, and lack of familiarity with imaging use and interpretation. Potential strategies ...
Source: Current Cardiovascular Imaging Reports - September 8, 2021 Category: Radiology Source Type: research

40 Years Anniversary of Cardiac 123I-mIBG Imaging: State of the Heart
AbstractPurpose of ReviewThis narrative review reflects on the body of evidence on cardiac123I-mIBG imaging that has accumulated since the introduction in the late 1970s and focusses on to what extent cardiac123I-mIBG imaging has fulfilled its potential in cardiology especially.Recent FindingsIn contrast to the linear relationship between123I-mIBG-derived parameters and overall prognosis in heart failure, there seems a “bell-shape” curve for123I-mIBG-derived parameters and arrhythmic events. In addition, there is a potential clinical role for cardiac123I-mIBG in optimizing patient selection for expensive device...
Source: Current Cardiovascular Imaging Reports - September 3, 2021 Category: Radiology Source Type: research

The Evolution of Virtual Physiologic Assessments and Virtual Coronary Intervention to Optimize Revascularization
AbstractPurpose of ReviewIn this review, we summarize the use of virtual physiologic functional assessments of coronary artery disease and their utility to guide virtual coronary intervention (VCI).Recent FindingsVirtual fractional flow reserve (vFFR), coronary angiography –derived fractional flow reserve (FFRangio), virtual contrast FFR (cFFR), and quantitative flow reserve (QFR) are four technologies that generate computer-based FFR measurements comparable to the gold standard of pressure-wire-based FFR. VCI capitalizes on this technology by utilizing pre- and post-vFFR assessments to predict the physiologic respon...
Source: Current Cardiovascular Imaging Reports - July 15, 2021 Category: Radiology Source Type: research

Computational Simulation, Bench Testing, and Modeling: Novel Tools to Strategize and Optimize Interventional Procedures
AbstractPurpose of ReviewAlthough simulation was adopted many years ago to complement training programs, more recently it has become an integral part of planning individual invasive procedures as well as understanding and developing new devices and techniques. Here, we review the different types of simulation and modeling and their impact on the field of interventional cardiology.Recent FindingsThree-dimensional model printing has been employed to strategize complex structural procedures for various congenital heart defects and valvular heart diseases. Ex vivo bench testing permitted understanding the relationship of new t...
Source: Current Cardiovascular Imaging Reports - July 7, 2021 Category: Radiology Source Type: research

USPIOs as Targeted Contrast Agents in Cardiovascular Magnetic Resonance Imaging
AbstractPurpose of ReviewWe aim to discuss the diagnostic use of ultrasmall superparamagnetic iron oxide (USPIO) including ferumoxytol in targeted cardiovascular magnetic resonance imaging (MRI).Recent FindingsFerumoxytol is the only USPIO clinically available in the USA and is a negatively charged USPIO that has potential use for tracking and characterization of macrophage-infiltrated cardiovascular structures. As an iron supplement that is approved for treatment of iron deficiency anemia, the iron core of ferumoxytol is incorporated into the body once it is phagocytosed by macrophages. In organs or tissues with high-infl...
Source: Current Cardiovascular Imaging Reports - February 26, 2021 Category: Radiology Source Type: research

From Inception to 2020: a Review of Dynamic Myocardial CT Perfusion Imaging
AbstractPurpose of ReviewDynamic myocardial CT perfusion imaging (CTP) is an emerging new approach to establish the hemodynamic severity of coronary artery obstructions. Literature and consensus documents on its practical applicability are limited.Recent FindingsDespite significant amount of literature supporting the diagnostic accuracy of dynamic CTP and its incremental value over CTA in the last decade, its use has been relatively limited.SummaryObstacles to its broader clinical use may include knowledge gaps associated with dynamic CTP imaging. We review patient preparation, scanning protocols, scanner requirements, opt...
Source: Current Cardiovascular Imaging Reports - January 5, 2021 Category: Radiology Source Type: research

Cardiac Magnetic Resonance in Pulmonary Hypertension —an Update
This article reviews advances over the past 3  years in cardiac magnetic resonance (CMR) imaging in pulmonary hypertension (PH). We aim to bring the reader up-to-date with CMR applications in diagnosis, prognosis, 4D flow, strain analysis, T1 mapping, machine learning and ongoing research.Recent FindingsCMR volumetric and functional metrics are now established as valuable prognostic markers in PH. This imaging modality is increasingly used to assess treatment response and improves risk stratification when incorporated into PH risk scores. Emerging techniques such as myocardial T1 mapping may play a role in the follow-...
Source: Current Cardiovascular Imaging Reports - November 7, 2020 Category: Radiology Source Type: research

Artificial Intelligence in Cardiac CT: Automated Calcium Scoring and Plaque Analysis
AbstractPurpose of ReviewTo review the current applications of artificial intelligence (AI) for coronary artery calcium scoring (CACS) and plaque analysis with their achievements and potential clinical impacts.Recent FindingsRecent advances of AI-based technologies especially deep learning (DL) approaches in medical imaging have achieved substantial progress in automated detection and characterization of coronary atherosclerotic plaques, providing promising results for AI application in diagnosis and management of coronary artery disease.SummaryTo date, many studies investigated the potential role of DL in CACS and showed ...
Source: Current Cardiovascular Imaging Reports - October 1, 2020 Category: Radiology Source Type: research

Review: FFRCT Changing the Face of Cardiac CT
AbstractPurpose of ReviewNon-invasive fractional flow reserve derived from CT coronary angiography (FFRCT) offers an amalgamation of both coronary anatomy and physiology. This review aims to provide a contemporary evaluation of the evidence for clinical use of FFRCT. The review article pays particular attention to the importance of patient preparation, anatomical features, scan quality and the overall interpretation of results that can lead to the best use of FFRCT analysis. Previous cost evaluations of the technology are compared and reviewed.Recent FindingsDiagnostic accuracy of FFRCT in comparison with CTA has been esta...
Source: Current Cardiovascular Imaging Reports - September 11, 2020 Category: Radiology Source Type: research

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 10, 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 - June 30, 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 26, 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 21, 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 7, 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 29, 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 20, 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 12, 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 8, 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 7, 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 28, 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 27, 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 21, 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 2, 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 2, 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 2, 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 18, 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 18, 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 11, 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 29, 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 29, 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 20, 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 20, 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 15, 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 13, 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 12, 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 9, 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 19, 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 19, 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 15, 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 30, 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 18, 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 3, 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 1, 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 24, 2019 Category: Radiology Source Type: research