Training in Cardiac CT: a Continuously Evolving Modality
Abstract Purpose of Review Over the past decade, the field of cardiac computed tomography (CCT) has experienced rapid evolution from an obscure curiosity to a powerful prognostic imaging modality for the evaluation of cardiovascular disease in a wide variety of clinical settings. Coronary CT angiography (CCTA) and coronary artery calcium (CAC) scoring for the diagnosis of coronary artery disease (CAD) in symptomatic and asymptomatic patients, respectively, remains the cornerstone of CCT imaging. Recent Findings In recent years, significant advance...
Source: Current Cardiovascular Imaging Reports - May 12, 2016 Category: Radiology Source Type: research

Update on Computed Tomography Myocardial Perfusion Imaging
Abstract Purpose of Review Computed tomography (CT) coronary angiography is a well-validated non-invasive technique for accurate and expedient diagnosis of coronary artery disease (CAD). However, a limitation of coronary CT angiography (CCTA) is its limited capability to identify physiologically significant stenoses, which may eventuate the need for further functional testing. Stress CT myocardial perfusion imaging (CT-MPI) is an emerging technique that has the ability to identify flow-limiting stenoses. Recent Findings The combination of CCTA cor...
Source: Current Cardiovascular Imaging Reports - May 5, 2016 Category: Radiology Source Type: research

The Role of Cardiac Magnetic Resonance Imaging in Pulmonary Hypertension
Abstract Purpose of Review During recent years, cardiovascular magnetic imaging has emerged as the gold standard for evaluating functional and hemodynamic impairment of the RV. Recent Findings In patients with pulmonary hypertension where right ventricular function dominates outcome and long-term prognosis, CMR is proving to be a particularly useful tool. It not only allows for evaluating the complex geometry of the RV but also vascular abnormalities, tissue characterization, RV-PA synchrony and PA flow in a single setting. The aim of this review ...
Source: Current Cardiovascular Imaging Reports - April 28, 2016 Category: Radiology Source Type: research

Nuclear Imaging for Assessment of Myocardial Perfusion, Metabolism, and Innervation in Hypertrophic Cardiomyopathy
Abstract Purpose of Review Hypertrophic cardiomyopathy, the most common genetic disease of the heart, is characterized by diverse cardiac phenotypic expression, presentation, clinical course, response to therapy, and outcomes. Disease causing mutations, genetic modifiers, and environmental factors are responsible for the diversity of morphological and clinical manifestations of this disease. Recent Findings Over the last four decades, cardiac nuclear imaging has made crucial contributions to our current understanding of the pathophysiology of HCM ...
Source: Current Cardiovascular Imaging Reports - April 25, 2016 Category: Radiology Source Type: research

Update on Intracoronary Optical Coherence Tomography: a Review of Current Concepts
Abstract Purpose of review The advent of intracoronary optical coherence tomography (OCT) has been a significant leap forward in the ability to visualize coronary structures with unprecedented resolution. However, the clinical application of this imaging modality has lagged behind rapid technological advances. One of the main reasons for the lack of wider clinical uptake has been the paucity of appropriately designed prospective randomized studies to demonstrate the impact of OCT on outcome measures after percutaneous coronary intervention (PCI). Recent find...
Source: Current Cardiovascular Imaging Reports - April 18, 2016 Category: Radiology Source Type: research

Transcatheter Aortic Valve Replacement Planning with Cardiac CT: Protocols and Practical Tips
Abstract The advent of transcatheter aortic valve replacement (TAVR) has provided a feasible treatment option for high surgical risk patients with severe aortic stenosis and increasingly is also being implemented in intermediate- and low-risk patients. As such, pre-procedure planning with multidetector computed tomography (MDCT) is now widespread and represents an integral component in the success of this treatment with contributions to transcatheter valve selection, sizing and identification of adverse annular root features. This review provides insight into the CT protocols utilised to acquire meaningful data f...
Source: Current Cardiovascular Imaging Reports - March 29, 2016 Category: Radiology Source Type: research

The Role of Cardiac CT in the Evaluation of Endocarditis
Abstract Endocarditis is an increasingly common yet complex disorder characterized by multiorgan system involvement, significant morbidity, and even mortality. In recent years, cardiac computed tomography (CT) has emerged as a leading imaging modality in the assessment of this disease. With ever more rapid and low-dose acquisitions, modern cardiac CT allows for confident diagnosis despite often protean and insidious clinical manifestations. At the same time, CT accurately depicts the many cardiac manifestations and complications of endocarditis while providing a comprehensive roadmap for preprocedural planning. T...
Source: Current Cardiovascular Imaging Reports - March 22, 2016 Category: Radiology Source Type: research

Intravascular NIRF Molecular Imaging Approaches in Coronary Artery Disease
Abstract Progression of vulnerable coronary atherosclerotic plaques underlies most episodes of acute myocardial infarction and sudden cardiac death. Recent advances in biological/molecular imaging technology are now enabling the accurate identification of high-risk plaques and coronary stents in living subjects. Due to their smaller caliber and susceptibility to cardiorespiratory motion, noninvasive molecular imaging of human coronary arteries remains challenging. Therefore, intravascular high-resolution molecular imaging approaches appear necessary to resolve molecular features of human coronary arteries and ste...
Source: Current Cardiovascular Imaging Reports - March 7, 2016 Category: Radiology Source Type: research

Low Radiation Dose Calcium Scoring: Evidence and Techniques
Abstract Coronary computed tomography (CT) allows for the acquisition of thin slices of the heart and coronary arteries, which can be used to detect and quantify coronary artery calcium (CAC), a marker of atherosclerotic cardiovascular disease. Despite the proven clinical value in cardiac risk prognostication, there remain concerns regarding radiation exposure from CAC CT scans. There have been several recent technical advancements that allow for significant radiation dose reduction in CAC scoring. This paper reviews the clinical utility and recent literature in low radiation dose CAC scoring. (Source: Current Ca...
Source: Current Cardiovascular Imaging Reports - March 2, 2016 Category: Radiology Source Type: research

Coronary Artery Calcium Analysis and Reporting on Noncontrast Chest CT Scans: a Paradigm Shift in Prevention
Abstract The quantification of coronary artery calcium (CAC) on gated noncontrast cardiac CT, as a screening test for subclinical coronary artery disease, has been consistently proven to be superior to risk factors and biomarkers for the prediction of long-term cardiovascular risk. Coronary artery calcium is also readily evaluable in every noncontrast (nongated) chest CT scan, yet there are no recommendations for reporting CAC in scans done for noncardiac indications. Lung CT scanning has been approved for lung cancer screening, and almost all the candidates are intermediate to high risk for coronary artery disea...
Source: Current Cardiovascular Imaging Reports - February 19, 2016 Category: Radiology Source Type: research

Erratum to: Nuclear Cardiology in the Management of Patients with Heart Failure
(Source: Current Cardiovascular Imaging Reports)
Source: Current Cardiovascular Imaging Reports - February 18, 2016 Category: Radiology Source Type: research

Cardiac Positron Emission Tomography: a Clinical Perspective
Abstract Cardiac positron emission tomography is a powerful, quantitative, non-invasive imaging modality, which adds valuable diagnostic and prognostic information to the clinical work-up. Myocardial perfusion and viability imaging are, as a result of continuously growing evidence, established clinical indications that may be cost-effective, due to the high diagnostic accuracy of cardiac positron emission tomography, despite high single-test costs. In the field of inflammation imaging, new indications are entering the clinical arena, which may contribute to a better diagnosis and overall patient care, as for inst...
Source: Current Cardiovascular Imaging Reports - February 6, 2016 Category: Radiology Source Type: research

Cardiac CT Scanner Technology: What Is New and What Is Next?
This article provides an overview of technologies available on state-of-the-art CT systems and the clinical needs they seek to address. (Source: Current Cardiovascular Imaging Reports)
Source: Current Cardiovascular Imaging Reports - February 3, 2016 Category: Radiology Source Type: research

Experience with the Multimodality Near-Infrared Spectroscopy/Intravascular Ultrasound Coronary Imaging System: Principles, Clinical Experience, and Ongoing Studies
Abstract Coronary near-infrared spectroscopy (NIRS) is a catheter-based imaging technique that can reliably detect lipid core plaques in the coronary artery wall. NIRS has now been combined with intravascular ultrasound (IVUS) in a single catheter. The combined NIRS/IVUS instrument provides all the information obtained by IVUS and adds lipid detection by NIRS. The instrument can detect large lipid core plaques that are at increased risk of causing periprocedural myocardial infarction during stenting. Preliminary data indicate that NIRS/IVUS imaging can identify vulnerable patients and vulnerable plaques associate...
Source: Current Cardiovascular Imaging Reports - January 21, 2016 Category: Radiology Source Type: research

Cardiac Innervation Imaging: Implications for Risk Stratification and Therapeutic Decision-Making
This article reviews the current status on the subject and evaluates the literature published over recent years. (Source: Current Cardiovascular Imaging Reports)
Source: Current Cardiovascular Imaging Reports - January 18, 2016 Category: Radiology Source Type: research

Angioscopy in 2015: the Role of Macroscopic Pathology in Living Patients
Abstract Angioscopy can detect lipid-rich yellow plaques that are regarded as vulnerable plaques. The patients who have multiple yellow plaques are regarded as vulnerable patients. The disrupted plaques can also be visualized directly by angioscopy, but they can be detected more sensitively as the presence of thrombus. On the other hand, angioscopy can also evaluate the neointima formed over stents. The follow-up angioscopic examinations after the implantation of coronary stents visualized atherosclerosis progression as the formation of yellow plaque in the stent-implanted segments. Recently, the presence of yell...
Source: Current Cardiovascular Imaging Reports - January 16, 2016 Category: Radiology Source Type: research

Radiation Dose Reduction from Radionuclide Myocardial Perfusion Imaging
Abstract Due to a tremendous increase in imaging usage in the last decades, in particular of myocardial perfusion imaging with radionuclide tracers, significant concerns have been recently raised on the possible harmful effect of the exposure of patients and health care operators to ionizing radiation. Recent estimates indicate that cardiac imaging procedures account for almost 40 % of the cumulative dose for imaging procedures. Thus, pertinent scientific associations published recommendations directed to limit patients’ exposure. The key points in the dose optimization process, including appropriate p...
Source: Current Cardiovascular Imaging Reports - January 11, 2016 Category: Radiology Source Type: research

Prediction Models for Cardiac Risk Classification with Nuclear Cardiology Techniques
Abstract Regression modeling strategies are increasingly used for the management of subjects with cardiovascular diseases as well as for decision-making of subjects without known disease but who are at risk of disease in the short- or long-term or during life span. Accurate individual risk assessment, taking in account clinical, laboratory, and imaging data is useful for choosing among prevention strategies and/or treatments. The value of nuclear cardiology techniques for risk stratification has been well documented. Many models have been proposed and are available for diagnostic and prognostic purposes and sever...
Source: Current Cardiovascular Imaging Reports - January 6, 2016 Category: Radiology Source Type: research

Coronary Computed Tomography Angiography Derived Fractional Flow Reserve and Plaque Stress
Abstract Fractional flow reserve (FFR) measured during invasive coronary angiography is an independent prognosticator in patients with coronary artery disease and the gold standard for decision making in coronary revascularization. The integration of computational fluid dynamics and quantitative anatomic and physiologic modeling now enables simulation of patient-specific hemodynamic parameters including blood velocity, pressure, pressure gradients, and FFR from standard acquired coronary computed tomography (CT) datasets. In this review article, we describe the potential impact on clinical practice and the scienc...
Source: Current Cardiovascular Imaging Reports - January 5, 2016 Category: Radiology Source Type: research

Nuclear Cardiology in the Management of Patients with Heart Failure
Abstract Heart failure is increasing worldwide, resulting in considerable disability, mortality, and high healthcare costs. Gated-SPECT or PET imaging is the most prominent imaging modality useful both for diagnosis and prognosis, capable of providing information about ventricular function, presence of intraventricular synchronism, and myocardial perfusion in the same test. In addition, PET can also offer quantification of coronary blood flow and metabolism. On the other hand, 123I- metaiodobenzylguanidine (MIBG) scintigraphy is the only imaging technique which provides information regarding the adrenergic functi...
Source: Current Cardiovascular Imaging Reports - December 29, 2015 Category: Radiology Source Type: research

Multiparametric Magnetic Resonance Imaging in Pulmonary Hypertension
This article reviews the current literature on MRI in pulmonary hypertension and also describes new and exciting developments in imaging of the heart, pulmonary vasculature and lungs, including assessment of myocardial changes with late gadolinium-enhanced imaging and T1 mapping, evaluating changes in the proximal pulmonary vasculature using image-based computational modelling and quantitative assessment of the capillary bed using MRI perfusion analysis. (Source: Current Cardiovascular Imaging Reports)
Source: Current Cardiovascular Imaging Reports - October 26, 2015 Category: Radiology Source Type: research

T1 Mapping for the Study of Cardiac Hypertrophy
Abstract Cardiovascular magnetic resonance has a fundamental role for diagnostic and prognostic assessment of cardiac hypertrophy. T1 mapping is a rapidly evolving field, and in the last years, many studies have applied this technique to study cardiac hypertrophy. In the current review, we discuss the results of the main studies on this topic, and we provide some insight on potential applications of this technique and unsolved questions that warrant further investigation. (Source: Current Cardiovascular Imaging Reports)
Source: Current Cardiovascular Imaging Reports - October 26, 2015 Category: Radiology Source Type: research

Automation with Anatomical Intelligence as a Novel Pathway in Echocardiography for the Advancement of Measurements and Analysis
Abstract Clinical environments are rapidly changing to demand higher throughputs, lower cost, and more successful clinical outcomes. Echocardiography has, in turn, been forced to evolve. In addition to providing real-time imaging at a relatively low cost and risk to the patient, it now also provides rapid and robust measurements that aid in monitoring, diagnosis, and intervention. These advancements of measurements and analysis are achieved through automation afforded by Anatomical Intelligence, which is an automatic recognition and segmentation of anatomic structures within an echo image by a trained algorithm. ...
Source: Current Cardiovascular Imaging Reports - October 14, 2015 Category: Radiology Source Type: research

Imaging During Percutaneous Valvular Heart DiseaseInterventions: Is More Better or Less?
Abstract Percutaneous valvular interventions have become a valid option in the treatment of valvular heart disease (VHD) for patients with prohibited surgical risk and multiple comorbidities. Multimodality imaging plays an increasingly central role in the evaluation of these interventions in which precise guidance for appropriate and accurate positioning of the device is mandatory. This review will discuss the role of these imaging modalities in patient selection and the pre-procedural assessment of the valve, intra-procedural guidance and, ultimately, result evaluation. (Source: Current Cardiovascular Imaging Reports)
Source: Current Cardiovascular Imaging Reports - October 1, 2015 Category: Radiology Source Type: research

Virtual Histology-Intravascular Ultrasound
Abstract Although gray-scale intravascular ultrasound (IVUS) has been an established method for assessing coronary lesion morphology and quantifying the atheroma, its role in plaque characterization is limited. Based on the spectral analysis of the primary raw backscattered radiofrequency signal, virtual histology (VH)-IVUS provides detailed tissue maps. Despite some methodological pitfalls, VH-IVUS has been used in recent clinical trials that suggested thin-cap fibroatheroma and large plaque burden as the predictors of future cardiovascular events related to non-culprit lesions. In addition, VH-IVUS helps us to ...
Source: Current Cardiovascular Imaging Reports - September 30, 2015 Category: Radiology Source Type: research

Vector Flow Mapping in Mitral Valve Disease: a Novel Method for the Assessment of Flow Mechanics and Their Potential Implications for Mitral Valve Repair
Abstract In the last few years, the development of new techniques enabling visualization and quantification of flow behavior inside cardiac chambers has increased the interest in flow mechanics, blood-tissue interaction, and the potential application of these new data to diagnosis and guidance of treatment. Several studies have focused on flow dynamics inside the left ventricle and a differential aspect in it: the vortex ring. In this article, we briefly describe the key role of the mitral valve on the generation of physiologic flow dynamics. We also review how mitral valve disease and its treatment can influence...
Source: Current Cardiovascular Imaging Reports - September 14, 2015 Category: Radiology Source Type: research

Imaging in Deciphering Histological Substrates in Hypertrophic Cardiomyopathy
This article aims to review the recent developments in advanced imaging and their potential clinical implications in HCM. The majority of these developments have occurred in the field of cardiac magnetic resonance (CMR) imaging, which is reflected in CMR forming a large proportion of the article, with other non-CMR techniques discussed in relation to these findings. Realizing the histological progression of HCM through advanced imaging has the potential to revolutionize diagnosis, management and future treatment. (Source: Current Cardiovascular Imaging Reports)
Source: Current Cardiovascular Imaging Reports - September 11, 2015 Category: Radiology Source Type: research

Cardiac CT for Quantification of Epicardial Fat: Where to Measure and Why?
This article reviews the available literature concerning imaging and quantification of epicardial adipose tissue and its potential clinical significance. (Source: Current Cardiovascular Imaging Reports)
Source: Current Cardiovascular Imaging Reports - September 11, 2015 Category: Radiology Source Type: research

Real-Time Three-Dimensional Echocardiographic Assessment of Severity of Mitral Regurgitation Using Proximal Isovelocity Surface Area and Vena Contracta Area Method. Lessons We Learned and Clinical Implications
Abstract Mitral regurgitation (MR) is considered the most common valve disease with a prevalence of 2–3 % of significant regurgitation (moderate to severe and severe) in the general population. Accurate assessment of the severity of regurgitation was demonstrated to be of significant importance for patient management and prognosis and consequently has been widely recognized in recent guidelines. However, evaluation of severity of valvular regurgitation can be potentially difficult with the largest challenges presenting in cases of mitral regurgitation. Real-time three-dimensional echocardiography (RT3D...
Source: Current Cardiovascular Imaging Reports - August 25, 2015 Category: Radiology Source Type: research

The Burden of Australian Indigenous Cardiac Disease and the Emerging Role of Cardiac Imaging
Abstract Cardiac imaging frequently serves as a gatekeeper to triage management decisions. Utilization trends differ not only globally but also within individual countries and may be directed by the presence of an indigenous population with unique needs. We reviewed the current state of Australian indigenous cardiovascular health, and contributing factors to outcome disparity with mainstream Australia are discussed. We also considered the utility of contemporary cardiac imaging modalities and their established and potential roles in the assessment of cardiovascular disease in both the indigenous and wider Austral...
Source: Current Cardiovascular Imaging Reports - August 20, 2015 Category: Radiology Source Type: research

Cardiovascular Imaging for the Primary Prevention of Atherosclerotic Cardiovascular Disease Events
Abstract Traditional cardiovascular risk factors have well-known limitations for the accurate assessment of individual cardiovascular risk. Unlike risk factor-based scores which rely on probabilistic calculations derived from population-based studies, coronary artery calcium (CAC) scoring, and carotid ultrasound allow for the direct visualization and quantification of subclinical atherosclerosis with the potential for a more accurate, personalized risk assessment and treatment approach. Among strategies used to guide preventive management, CAC scoring has consistently and convincingly outperformed traditional ris...
Source: Current Cardiovascular Imaging Reports - August 14, 2015 Category: Radiology Source Type: research

Transcaval TAVR—What the Radiologist Needs to Know
Abstract Transcaval transcatheter aortic valve replacement is a new approach in performing percutaneous aortic valve replacement in which aortic access is obtained by way of the femoral vein and inferior vena cava. Computed tomographic angiography is used to determine patient suitability and in preprocedural planning. CTA is also part of routine follow-up care to assess for potential caval-aortic access site complications. Postprocedural imaging findings at the caval-aortic site include aortocaval fistula, aortic dissection, retroperitoneal hemorrhage, and pseudoaneurysm. The purpose of this manuscript is to fami...
Source: Current Cardiovascular Imaging Reports - July 25, 2015 Category: Radiology Source Type: research

Cardiac CT in 2015: Clinical Role According to Current Multi-Societal Guidelines
This article aims to review the use of CT in cardiovascular risk stratification, the diagnosis of coronary artery disease in various clinical settings including acute presentations, and the expanding role of CT in non-coronary indications with a focus on the guidelines and the data that impacts the clinical application of CT in these varied scenarios. (Source: Current Cardiovascular Imaging Reports)
Source: Current Cardiovascular Imaging Reports - July 24, 2015 Category: Radiology Source Type: research

Hybrid Imaging During Transcatheter Structural Heart Interventions
Abstract Fusion of different imaging modalities has gained increasing popularity over the last decade. However, most fusions are done between static rather than dynamic images. In order to adequately visualize the complex three-dimensional structures of the beating heart, high-temporal and spatial image resolutions are mandatory. Currently, only the combination of transesophageal echocardiography with fluoroscopy allows real-time image fusion of high quality during structural heart disease (SHD) interventions. The use of markers as well as real-time image overlay greatly facilitates communication between SHD team...
Source: Current Cardiovascular Imaging Reports - July 16, 2015 Category: Radiology Source Type: research

An Increasing Mexican Population with Metabolic Syndrome-Emerging Role of Hybrid SPECT/CT and PET/CT in Cardiovascular Disease Detection
Abstract Metabolic syndrome represents a growing burden in the Mexican population with an increasing presence as evidenced by the most recent epidemiological data, showing a prevalence of 49.8 % in 2006. The cardiovascular hazard of metabolic syndrome has been proven in numerous occasions; these patients present an increased risk of cardiovascular disease not only because of epicardial coronary occlusion but also from microvascular disease secondary to endothelial dysfunction. Myocardial perfusion imaging using both single-photon emission computed tomography and positron emission tomography can be effectivel...
Source: Current Cardiovascular Imaging Reports - July 7, 2015 Category: Radiology Source Type: research

Cardiac CT vs. Stress Testing in Patients with Suspected Coronary Artery Disease: Review and Expert Recommendations
Abstract Diagnosis and management of coronary artery disease represent a major challenge to our health care systems affecting millions of patients each year. Until recently, the diagnosis of coronary artery disease could be conclusively determined only by invasive coronary angiography. To avoid risks from cardiac catheterization, many health care systems rely on stress testing as gatekeeper for coronary angiography. Advancements in cardiac computed tomography angiography technology now allows for the accurate noninvasive visualization of coronary artery disease, challenging the role of stress testing as the defau...
Source: Current Cardiovascular Imaging Reports - June 17, 2015 Category: Radiology Source Type: research

Translating Intravascular Optical Coherence Tomography from a Research to a Clinical Tool
Abstract Intravascular optical coherence tomography (IVOCT) continues to be a hot topic as a method for studying vulnerable plaque in research laboratories across the globe. It is also growing in popularity as a tool for interventional cardiologists to guide percutaneous coronary intervention (PCI). The power of IVOCT for diagnosis of thin-capped fibroatheromas (TCFAs) has yet to receive mainstream clinical attention due to the fact that clinicians still do not have a protocol to follow if TCFA are identified and that TCFA identification requires extensive training in IVOCT image analysis—it is not yet an a...
Source: Current Cardiovascular Imaging Reports - June 17, 2015 Category: Radiology Source Type: research

Is Attenuation Correction for Myocardial Perfusion Imaging Underutilized?
Abstract Myocardial SPECT remains an important diagnostic technique in patients suspected of significant coronary artery disease. However, the diagnostic accuracy is hampered by several clinical and technical difficulties. Among these, soft tissue attenuation is one of the most frequent causes. Attenuation correction has the power to correct for these artifacts, increasing the diagnostic accuracy of myocardial SPECT. The current review summarizes the available clinical evidence for attenuation correction and raises the question if this technique is not underutilized in current clinical practice. (Source: Current ...
Source: Current Cardiovascular Imaging Reports - June 17, 2015 Category: Radiology Source Type: research

The Role of Cardiac MRI in Patients with Troponin-Positive Chest Pain and Unobstructed Coronary Arteries
Abstract Acute coronary syndrome (ACS) still remains one of the leading causes of mortality and morbidity worldwide. Seven to fifteen percent of patients presenting with ACS have unobstructed coronary artery disease (CAD) on urgent angiography. Patients with ACS and unobstructed coronary arteries represent a clinical dilemma and their diagnosis and management is quite variable in current practice. Cardiovascular magnetic resonance imaging with its unique non-invasive myocardial tissue characterization property has the potential to identify underlying etiologies and reach a final diagnosis. These include acute and...
Source: Current Cardiovascular Imaging Reports - June 12, 2015 Category: Radiology Source Type: research

Noncalcified Plaque in Cardiac CT: Quantification and Clinical Implications
Abstract Coronary computed tomography angiography (CTA) is being increasingly used for direct, noninvasive evaluation of the coronary arteries. Beyond stenosis, coronary CTA also permits assessment of atherosclerotic plaque (including total and noncalcified plaque burden) and coronary artery remodeling, previously only measurable through invasive techniques. It has been shown that coronary plaque volume for noncalcified and mixed plaques and the arterial remodeling index correlate closely with corresponding measures from invasive intravascular ultrasound. Several studies have also shown a strong relationship betw...
Source: Current Cardiovascular Imaging Reports - May 29, 2015 Category: Radiology Source Type: research

Present Status and Future Direction of NIRS-IVUS Multimodality Direct Coronary Imaging
Abstract Intracoronary near-infrared spectroscopy (NIRS)-IVUS is a direct coronary imaging catheter for the identification and quantification of lipid core plaque (LCP). NIRS is combined with traditional grayscale IVUS in a hybrid catheter that provides co-registered architectural and compositional plaque characterization data. The novel capability of the NIRS catheter component is its ability to directly identify LCP, which underlies the majority of vulnerable and unstable plaques. NIRS-IVUS has potential to optimize percutaneous coronary intervention (PCI) by delineating precise lesion length, assuring adequate...
Source: Current Cardiovascular Imaging Reports - May 26, 2015 Category: Radiology Source Type: research

Value of Hybrid Imaging with PET/CT to Guide Percutaneous Revascularization of Chronic Total Coronary Occlusion
Abstract Chronic total coronary occlusions (CTO) are documented in approximately one fifth of diagnostic invasive coronary angiographies (ICA). Percutaneous coronary interventions (PCI) of CTO are challenging and are accompanied by higher complication and lower success rates in comparison with non-CTO PCI. Scrutinous evaluation of ischemia and viability to justify percutaneous revascularization is therefore of importance to select eligible patients for such a procedure. Furthermore, knowledge of the anatomical features of the occlusion may predict the chances of success of PCI CTO and could even guide the procedu...
Source: Current Cardiovascular Imaging Reports - May 26, 2015 Category: Radiology Source Type: research

Coronary Artery Disease Progression: Insights from Cardiac CT
Abstract Coronary plaque progression is a multi-faceted process influenced by cardiovascular risk factors, as well as the presence, extent, stenosis, morphology, and vulnerability of plaque, which may ultimately result in myocardial infarction or death. Traditionally, intravascular ultrasound (IVUS) has been the primary modality to study atherosclerosis progression. However, it is invasive and impractical for screening or monitoring. While coronary artery calcium (CAC) scoring has been widely studied as a non-invasive method to measure plaque progression, it is limited to visualization of stenosis and non-calcifi...
Source: Current Cardiovascular Imaging Reports - May 16, 2015 Category: Radiology Source Type: research

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 tissue charac...
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 guidelines, deve...
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 the mecha...
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: Current Cardio...
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 consideratio...
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 completed ...
Source: Current Cardiovascular Imaging Reports - March 22, 2015 Category: Radiology Source Type: research