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Coronary Artery Anomalies: a Pictorial Review
Abstract Coronary artery anomalies range in prevalence from 0.2 to 2.3 % of the population. They range from benign incidental findings to an important cause of sudden cardiac death (SCD). In fact, coronary anomalies are the second leading cause of SCD in athletes and are responsible for ∼30 % of SCD in the young. Clinically, anomalous coronary arteries arising from the opposite sinus and anomalous left coronary artery arising from the pulmonary artery are the most important as they are associated with the highest risk of mortality. Several high-risk features and their pathophysiology are reviewed. M...
Source: Current Cardiovascular Imaging Reports - May 15, 2015 Category: Radiology Source Type: research

Advances in CMR of Post-ablation Atrial Injury
Abstract Technical advancements in cardiac magnetic resonance (CMR) imaging over the past two decades have allowed clinically useful imaging of the thin atrial wall for the first time. During this period, there has been a parallel increase in the use of catheter ablation to treat atrial fibrillation (AF). These developments have led to new indications for and increasing use of CMR in the assessment of pre- and post-ablation atrial structure and function and their potential link to arrhythmia substrate. This review focuses on the role of CMR in the assessment of acute and chronic post-ablation atrial tis...
Source: Current Cardiovascular Imaging Reports - April 29, 2015 Category: Radiology Source Type: research

Strategy for Building a Successful Coronary CT Angiography Program in the Emergency Department
Abstract Coronary CT angiography (cCTA) is a rapid, accurate, safe, and efficient technique for evaluating acute chest pain in patients with low-intermediate pretest probability of coronary artery disease. In this review, we outline a strategy for building and maintaining a successful cCTA program in the emergency department. We define success as the ability for a program to improve patient outcomes and yield cost savings for a health care organization. Establishing a successful program can be achieved by organizing a multidisciplinary task force, developing a shared vision, utilizing established guidel...
Source: Current Cardiovascular Imaging Reports - April 24, 2015 Category: Radiology Source Type: research

Cardiac Magnetic Resonance Imaging in Ventricular Remodelling
Abstract Ventricular remodelling is characterised by changes in ventricular structure and/or function in response to haemodynamic load and/or cardiac injury. Several cardiovascular conditions, including ischaemic heart disease, inherited cardiomyopathies, systemic hypertension and valvular heart disease, may cause ventricular remodelling and, over time, progression to heart failure. Cardiac magnetic resonance (CMR) imaging is increasingly utilised to provide gold standard assessments of ventricular structure and function, and also non-invasively evaluate myocardial fibrosis. An enhanced understanding of...
Source: Current Cardiovascular Imaging Reports - April 23, 2015 Category: Radiology Source Type: research

Vulnerable Plaque: Molecular Imaging
Abstract Despite the remarkable advances in cardiovascular imaging over the last decade, it is still challenging to identify high-risk atherosclerotic plaques prior to onset of major cardiovascular complications. Accumulating knowledge regarding the pathophysiological properties of vulnerable plaque (VP) has driven the development of molecular imaging technologies that target biologic process to characterize vulnerable plaques. Given the importance of VP detection in vivo, molecular imaging has emerged as an attractive diagnostic tool to more accurately estimate the risk of plaque rupture. (Source: Curr...
Source: Current Cardiovascular Imaging Reports - April 22, 2015 Category: Radiology Source Type: research

Management of Coronary Artery Calcium and Coronary CTA Findings
Abstract Coronary artery calcium (CAC) testing and coronary computed tomography angiography (CTA) have significant data supporting their ability to identify coronary artery disease (CAD) and classify patient risk for atherosclerotic cardiovascular disease (ASCVD). Evidence regarding CAC use for screening has established an excellent prognosis in patients with no detectable CAC, and the ability to risk re-classify the majority of asymptomatic patients considered intermediate risk by traditional risk scores. While data regarding the ideal management of CAC findings are limited, evidence supports statin co...
Source: Current Cardiovascular Imaging Reports - April 15, 2015 Category: Radiology Source Type: research

State and Recent Progress of Nuclear Cardiology in China
Abstract In this review, we focus mainly on the clinical applications of myocardial perfusion imaging (MPI) with single-photon emission CT (SPECT) and metabolic imaging in clinical practice. Important advances have been made in the clinical applications of MPI, including its role in stratifying risk and guiding management decisions. The impact of incomplete and complete myocardial ischemia correction on long-term outcomes was analyzed and compared with complete and incomplete diseased vessel intervention. Importantly, a new pharmacologic stress testing agent—higenamine—was developed and has complete...
Source: Current Cardiovascular Imaging Reports - March 22, 2015 Category: Radiology Source Type: research

Cardiac Imaging of Infiltrative Cardiomyopathies
Abstract Infiltrative cardiomyopathies are characterized by deposition of abnormal material in the intra- or extracellular compartment of the myocardium resulting in impairment in cardiac filling and relaxation. Disorders of myocardial infiltration are distinct with differing abnormalities in cardiac histology, pathophysiology, morphology, and function. Cardiac imaging plays a critical role in management, facilitating diagnosis, risk stratification, disease monitoring, and treatment. Importantly, advances in imaging technology have enabled earlier detection, providing opportunity for intervention and im...
Source: Current Cardiovascular Imaging Reports - March 14, 2015 Category: Radiology Source Type: research

An Increasing Population with Metabolic Syndrome and/or Diabetes Mellitus in the Middle East—Is There an Added Value of Coronary Calcium Scoring to Myocardial Perfusion Imaging?
Abstract The population of the Middle East is a growing population characterized by increasing prevalence of metabolic syndrome, diabetes, and obesity. Both myocardial perfusion imaging (MPI) and coronary artery calcification (CAC) have a well-validated role in the diagnosis and prognosis of coronary artery disease (CAD). In the recent years, adding CAC score to myocardial perfusion imaging has been associated with incremental diagnostic and prognostic value. The aim of this paper is to review the diagnostic and prognostic value of adding CAC score to nuclear MPI in the Middle Eastern patients in the fa...
Source: Current Cardiovascular Imaging Reports - March 5, 2015 Category: Radiology Source Type: research

Lessons on Quality Control in Large Scale Imaging Trials: the Multi-Ethnic Study of Atherosclerosis (MESA)
This article reviews the influence of research management for quality control and work standardization processes in cardiac magnetic MRI results at the 10th year of follow-up in MESA. (Source: Current Cardiovascular Imaging Reports)
Source: Current Cardiovascular Imaging Reports - March 5, 2015 Category: Radiology Source Type: research

An Integrated Backscatter Ultrasound Technique for Coronary Plaque Imaging
Abstract The instability of atherosclerotic coronary plaques is related to their histological composition and the thickness of their fibrous caps. Therefore, recognition of the tissue characteristics of coronary plaques is important to understand and prevent coronary artery disease. Recently, an ultrasound integrated backscatter (IB) technique has been developed. Ultrasound signals have unique characteristics of reflection. That is, the ultrasound IB power ratio is a function of the difference in acoustic characteristic impedance between the medium and target tissue, and the acoustic characteristic impe...
Source: Current Cardiovascular Imaging Reports - March 5, 2015 Category: Radiology Source Type: research

Relatively High Prevalence of Takotsubo Cardiomyopathy (Stress-Induced Cardiomyopathy) in the Japanese Population—Contribution of Cardiac Imaging in the Identification of Takotsubo Cardiomyopathy and its Differentiation from Acute Coronary Syndrome
Abstract Apical ballooning syndrome, the so-called takotsubo cardiomyopathy (TTC), is characterized by wall-motion abnormality. The wall-motion abnormality includes hypokinesis in the mid and apical segments of the left ventricle (LV) with hyperkinesis in the mid LV segment. The LV dysfunction is reversible. TTC has been reportedly been found in 1 to 2 % of patients suspected of having acute coronary syndrome (ACS). Although the wall-motion abnormality of TTC is a significant feature, clinical presentation involving chest pain or ECG abnormalities is similar to that for ACS. Therefore, the diagnosis of...
Source: Current Cardiovascular Imaging Reports - March 4, 2015 Category: Radiology Source Type: research

State of Overall Cardiovascular Risk and Imaging Strategies in India
Abstract Noninvasive cardiac imaging has undergone a recent resurgence in India with the development of new approaches for imaging coronary atherosclerosis. Noncontrast computed tomography (CT) for imaging the extent of coronary artery calcification (CAC) and contrast CT for noninvasive coronary angiography (CTA) are developments with a growing evidence base regarding risk assessment and the diagnosis of obstructive coronary disease. Stress myocardial perfusion SPECT (MPS) is the most commonly used stress imaging technique for patients with suspected or known coronary disease, which is slowly gaining po...
Source: Current Cardiovascular Imaging Reports - March 4, 2015 Category: Radiology Source Type: research

Application of Cardiac Neurohormonal Imaging to Heart Failure, Transplantation, and Diabetes
Abstract The neurohormonal system adapts to body demands, but in cardiac disease it can become maladaptive. A key component, the sympathetic nervous system, can be imaged with radiotracers such as iodine-123-meta-iodobenzylguanidine (123I-mIBG), a norepinephrine analogue. Parameters assessed are the heart-to-mediastinal ratio (HMR), tracer washout, and regional single photon emission computed tomography (SPECT) defects. Much focus has been on heart failure that has a large neurohormonal pathophysiologic component. 123I-mIBG imaging has powerful risk stratification ability for this high morbidity/mortali...
Source: Current Cardiovascular Imaging Reports - February 26, 2015 Category: Radiology Source Type: research

Cardiac Imaging in Latin America: Chagas Heart Disease
Abstract Patients with Chagas heart disease can be evaluated for diagnostic and prognostic purposes using several imaging methods, including the plain chest radiography and various echocardiography techniques for biventricular systolic and diastolic function assessment, myocardial perfusion scintigraphy for uncovering microvascular disturbances, and 123iodine-MIBG labeling of sympathetic myocardial innervation, MRI for detection and quantitation of myocardial fibrosis, and coronary angiography during cardiac catheterization to characterize the mechanism of myocardial ischemia. Through the careful analys...
Source: Current Cardiovascular Imaging Reports - February 26, 2015 Category: Radiology Source Type: research