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Coronary Artery Calcium Scoring: a Valuable Aid in Shared Decision Making Among Non-traditional Risk Markers
AbstractPurpose of the ReviewThe purpose of this study was to evaluate the utility of coronary artery calcium (CAC) scoring and compare it with other non-traditional cardiovascular risk markers for improvement in cardiovascular risk assessment.Recent FindingsCAC scoring refines risk assessment among asymptomatic patients eligible for primary prevention across the spectrum of cardiovascular risk. Its use has been well-validated in several multi-ethnic population-based cohorts. With the recent ACC/AHA cholesterol treatment guidelines expanding the eligibility for statin therapy for primary prevention, the absence of CAC can ...
Source: Current Cardiovascular Imaging Reports - August 12, 2017 Category: Radiology Source Type: research

Detection of the Vulnerable Coronary Atherosclerotic Plaque —Promises and Limitations
AbstractPurpose of ReviewThe merit of imaging “vulnerable atherosclerotic plaques” remains highly controversial. This review aims at providing current evidence for both its benefit and limitations.Recent FindingsResults from optical coherence tomography and intravascular ultrasound imaging in patients with coronary heart disease suggest that certain individual coronary atherosclerotic plaque characteristics, e.g., large lipid core in a fibroatheroma, are associated with greater risk of adverse patient outcome. However, a closer look at these studies reveals that these associations are confounded by the relationship of ...
Source: Current Cardiovascular Imaging Reports - July 20, 2017 Category: Radiology Source Type: research

Cardiac CT for Guiding Mitral Valve Interventions
AbstractPurpose of ReviewThe purpose of this paper is to review the current role of contrast-enhanced cardiac computed tomography (CT) in the peri-procedural planning of mitral valve (MV) repair.Recent FindingsCardiac CT is increasingly implemented in the peri-interventional management of patients undergoing MV repair or MV replacement due to its widespread availability and its ability to provide detailed information on the complex cardiac and valvular anatomy.SummaryThe complex anatomy of the MV challenges the management of minimally invasive MV repair with respect to device sizing and procedural planning. Advances in CT ...
Source: Current Cardiovascular Imaging Reports - July 19, 2017 Category: Radiology Source Type: research

Assessment of Longitudinal Shortening in Cardiomyopathies with Cardiac Magnetic Resonance
AbstractPurpose of ReviewLongitudinal shortening (LS) allows additive information in the diagnosis and prognosis of cardiomyopathies. This review provides an overview of different LS assessment techniques using CMR and their supplemental value in various cardiomyopathies.Recent FindingsAssessment of LS using CMR-derived mitral and tricuspid annular plane systolic excursion (MAPSE and TAPSE) as well as feature tracking imaging (FTI) has been proven useful in the diagnosis of dilated cardiomyopathies (DCM), hypertrophic cardiomyopathies (HCM), ischemic heart disease, pulmonary artery hypertension, Brugada syndrome, arrhythmo...
Source: Current Cardiovascular Imaging Reports - July 11, 2017 Category: Radiology Source Type: research

Clinical Utility of Virtual Histology Intravascular Ultrasound
AbstractPurpose of ReviewTissue characterization using imaging is important to understand the pathophysiology of atherosclerosis and subsequent outcomes. In this review, the clinical utility of virtual histology intravascular ultrasound (VH-IVUS), which provides a quantitative and more objective evaluation of tissue characterization compared with grayscale IVUS, will be summarized.Recent FindingsPatient clinical characteristics, including coronary risk factors and medications, are associated with lesion morphology, especially plaque vulnerability. Different levels of vulnerability cause different clinical presentations and...
Source: Current Cardiovascular Imaging Reports - July 10, 2017 Category: Radiology Source Type: research

Current Clinical Applications of Intravascular Ultrasound in Coronary Artery Disease
AbstractPurpose of ReviewDuring the 20  years since the introduction of intravascular ultrasound (IVUS) to catheterization laboratory, there has been growing evidence supporting the role of IVUS. In this article, we review clinical application of routine use of IVUS with recent evidences, a dominant strategy even in the era of drug-elut ing stents.Recent FindingsIVUS provides pre-procedural information to evaluate stenosis severity and plaque characteristics. In addition, IVUS helps optimal stent deployment, minimizing underexpansion and geographic miss, which are major mechanisms of stent failure. Large-scale clinical tr...
Source: Current Cardiovascular Imaging Reports - July 7, 2017 Category: Radiology Source Type: research

Myocardial CT Perfusion: A Review of Current Modalities, Technology, and Clinical Performance
AbstractPurpose of ReviewThis review describes the current techniques for CT myocardial perfusion, reviews the current literature, and discusses future directions for CT perfusion.Recent FindingsMyocardial CT perfusion (CTP) is an emerging technology for evaluation of myocardial ischemia and infarction, and has the benefit of having both morphologic (coronary CT angiography) and physiologic (CTP) measures in the same setting. CTP has primarily been developed as an adjunct to coronary CT angiography in an effort to improve diagnostic performance, specifically in patients with luminal coronary artery disease. The principle o...
Source: Current Cardiovascular Imaging Reports - June 27, 2017 Category: Radiology Source Type: research

Radionuclide Imaging of Infective Endocarditis: State of Art and Future Perspective
AbstractPurpose of ReviewInfectious endocarditis is a serious disease requiring rapid diagnosis and accurate risk stratification to offer the best therapeutic strategy. Infection of prosthetic valve (PV) and cardiovascular implantable electronic device (CIED) is increasing due to the ageing of the population and the growing number of implants. Foreign material infection remains clinically challenging given the limitation of ultrasound techniques in this context whereas the diagnosis must be precocious.Recent Findings18F-fluorodeoxyglucose positron emission tomography/computed tomography ([18F]FDG PET/CT) and radiolabelled ...
Source: Current Cardiovascular Imaging Reports - June 27, 2017 Category: Radiology Source Type: research

Molecular Imaging of the Transplanted Heart: A Mechanistic Approach to Graft Survival
AbstractPurpose of ReviewIn this review, we will discuss recent developments in noninvasive molecular imaging of immune-mediated changes seen in cardiac allograft rejection.Recent FindingsThe significant developments of molecular imaging agents across various modalities, including MRI, PET/SPECT, optical imaging, and echocardiography, provide us with opportunities to image specific immunological pathways of cardiac allograft rejection that were previously not possible. Recent studies using novel molecular imaging modalities have shown us new understanding of immune-mediated mechanisms involved in allograft rejection. Thoug...
Source: Current Cardiovascular Imaging Reports - June 27, 2017 Category: Radiology Source Type: research

Imaging the Coronary Artery Plaque: Approaches, Advances, and Challenges
AbstractPurpose of ReviewAtherosclerosis is a major cause of morbidity and mortality in the world, largely due to the disruption of high-risk plaques (HRP). Understanding how best to identify HRP, using imaging, has the potential to improve assessment of cardiovascular disease (CVD) risk and facilitate better targeting of care to patients.Recent FindingsTechnological advances have been made across several imaging modalities, which provide opportunities to image HRP. Advances in computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), intravascular ultrasound (IVUS), optical coherence ...
Source: Current Cardiovascular Imaging Reports - June 19, 2017 Category: Radiology Source Type: research

Recent Advances in the Field of Optical Coherence Tomography
AbstractPurpose of ReviewThe scope of this text is to critically review the most important recent advances in the field of optical coherence tomography, both from a clinical, scientific, and technical point of view.Recent FindingsIn recent years, important steps forward have been put in the field of optimization of PCI (with a focus on optimal sizing of stents and optimization of stent expansion after implantation) and the differentiation and its possible applications of various underlying morphologic characteristics of acute coronary syndrome lesions. Several efforts have been made to elucidate underlying mechanical cause...
Source: Current Cardiovascular Imaging Reports - June 2, 2017 Category: Radiology Source Type: research

The Role of Nuclear Cardiac Imaging in Infective Endocarditis
AbstractPurpose of ReviewInfective endocarditis (IE) remains a deadly disease despite improvements in its management. Echocardiography is crucial for the diagnosis of IE; however, its value is operator-dependent and its sensitivity can decrease in the presence of valvular prosthesis. This review aims to provide an overview on the role of nuclear cardiac imaging in the diagnosis of IE.Recent FindingsAmong all nuclear cardiac imaging modalities, both radiolabeled leukocyte scintigraphy and 2-deoxy-2-[fluorine-18]fluoro-D-glucose positron emission tomography/computed tomography ([18F]FDG-PET/CT) have been recently introduced ...
Source: Current Cardiovascular Imaging Reports - May 20, 2017 Category: Radiology Source Type: research

3D Printing from Cardiac Computed Tomography for Procedural Planning
This article summarizes the uses of 3D-printed models in preoperative cardiac procedure planning and intraprocedural navigation during surgeries organized on a case-by-case basis.Recent FindingsThe 3D models have recently been shown to aid in a variety of procedures. Some of these include valvular replacement or repair, management of paravalvular leaks, left atrial appendage closure, myectomy in hypertrophic cardiomyopathy, cardiac aneurysm repair, tumor resection, and surgical planning in congenital heart lesions.SummaryWe anticipate that 3D models will become more accessible, and their utilization will increase in the ne...
Source: Current Cardiovascular Imaging Reports - May 18, 2017 Category: Radiology Source Type: research

Improving Quality and Communication in Cardiac Imaging: The Coronary Artery Disease Reporting and Data System (CAD-RADS ™)
AbstractPurpose of ReviewTo critically examine the Coronary Artery Disease Reporting and Data System (CAD-RADS ™) lexicon and its nuances, with representative case examples provided for each of the major CAD-RADS classification categories and modifiers.Recent FindingsCAD-RADS is a recently developed multi-disciplinary, multi-society standardized reporting system for coronary CTA based on scientific data and expert consensus from leaders in cardiac imaging.SummaryCAD-RADS was developed to improve quality and communication in cardiac imaging, and to provide management recommendations based on actionable information from th...
Source: Current Cardiovascular Imaging Reports - May 2, 2017 Category: Radiology Source Type: research

CMR in Phenotyping the Arrhythmic Substrate
AbstractPurpose of ReviewThe purpose of this review is to explore the role of cardiac magnetic resonance imaging (CMR) in the evaluation of myocardial disorders that can present with significant cardiac arrhythmias. In addition, we explore recent developments in the field of CMR in the evaluation of such conditions, such as T1 and T2 mapping techniques. The importance of CMR as a diagnostic tool in the evaluation of such conditions lies in the fact that in routine clinical practice these conditions are encountered relatively frequently, and often important clinical decisions are made based on the findings of cardiac invest...
Source: Current Cardiovascular Imaging Reports - April 26, 2017 Category: Radiology Source Type: research