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Coronary Computed Tomography Angiography as a Gatekeeper to Coronary Revascularization: Emphasizing Atherosclerosis Findings Beyond Stenosis
AbstractPurpose of ReviewCoronary computed tomography angiography (CCTA) is the optimal non-invasive test to rule out coronary artery disease (CAD). Decisions to perform coronary revascularization have traditionally been based upon ischemia testing. This review summarizes the latest observations and trials evaluating the suitability of CCTA to select patients for invasive coronary angiography (ICA) and subsequent revascularization.Recent FindingsRecent data shows that beyond stenosis, whole-heart quantification and characterization of coronary atherosclerotic plaque improves the estimation of myocardial ischemia. This comp...
Source: Current Cardiovascular Imaging Reports - May 13, 2019 Category: Radiology Source Type: research

Contemporary View of Magnetic Resonance Imaging in Fabry Disease
AbstractPurposeFabry disease is a rare lysosomal storage disorder, whose main cause of death is cardiac. CMR provides relevant information that contributes to diagnosis, enabling staging of the disease and an appropriate start of therapy. This review intends to highlight the main strengths of this technique, where a relatively robust scientific evidence supports its use.Recent FindingsCMR is useful in Fabry disease in a number of aspects. On the one hand, it helps characterize myocardial involvement, enabling accurate chamber size quantification and tissue characterization, by means of LGE, and more recently T1 mapping. Ea...
Source: Current Cardiovascular Imaging Reports - April 30, 2019 Category: Radiology Source Type: research

Cardiac CT Assessment of Right and Left Ventricular and Valvular Function
AbstractPurpose of ReviewThe purpose of this review is to summarize the recent technical and scientific advancements in cardiac computed tomography (CT) assessment of ventricular function and valvular heart disease.Recent FindingsWith improvement in scanner technology and protocols, cardiac CT can be used to assess cardiac function and chamber volumes with excellent accuracy and interobserver reproducibility. CT is a reliable adjunct modality to assess most valvular heart diseases when other modalities are not adequate or provide discrepant data. CT is now the standard of care in planning transcatheter valve interventions....
Source: Current Cardiovascular Imaging Reports - April 30, 2019 Category: Radiology Source Type: research

Coronary CT in Patients with a History of PCI or CABG: Helpful or Harmful?
AbstractPurpose of ReviewThe purpose of this review is to evaluate the role of coronary computed tomography angiography (CCTA) in the assessment of patients after coronary artery bypass graft surgery (CABG) or percutaneous coronary intervention (PCI).Recent FindingsAdvances in CT technology have resulted in tremendous improvements in diagnostic performance, safety, and ease of performance. CCTA accurately detects graft stenosis or occlusion. However, assessment of native coronary arteries in patients after CABG is challenging due to commonly present severe coronary calcifications. CCTA evaluation of coronary stents using c...
Source: Current Cardiovascular Imaging Reports - April 25, 2019 Category: Radiology Source Type: research

Common Incidental Findings on Cardiac CT: a Systematic Review
AbstractPurpose of ReviewCardiac computed tomography (CT) is an established tool for evaluating cardiovascular disease, which may incidentally depict extracardiac findings (ECF). The aim of this study is to identify the spectrum and the prevalence of incidental findings detected on cardiac CT.Recent FindingsThis systematic review found a median ECF occurrence of 45% in cardiac CT (range, 7 –100%) among papers published between 2006 and 2018. The median clinically significant ECF occurrence was 17% (1–67%) among studies. Respectively, the five most commonly reported ECF were lung nodules or masses, lung parenchymal chan...
Source: Current Cardiovascular Imaging Reports - April 25, 2019 Category: Radiology Source Type: research

New Molecular Imaging Strategies to Detect Inflammation in the Vulnerable Plaque
AbstractPurpose of reviewInflammation is an essential component of atherosclerosis and is intimately linked with plaque destabilization. Recent trials showed that therapies directed at inhibiting the systemic inflammatory cascade reduce atherosclerotic cardiovascular events. Hence, accurate molecular imaging of inflammation may help us identify patients for whom targeted therapies could be maximally effective.Recent findingsNumerous probes have been developed to detect different inflammatory components of atherosclerosis. Although18F-deoxyglucose has been in use for a long time, new tracers such as18F-sodium and67Ga-dotata...
Source: Current Cardiovascular Imaging Reports - April 25, 2019 Category: Radiology Source Type: research

Cardiac MRI: a Promising Diagnostic Tool to Detect Cancer Therapeutics –Related Cardiac Dysfunction
AbstractPurpose of ReviewRecent advances in oncological research have led to a major improvement of mortality amongst cancer patients. However, survivors are at an increased risk to develop cancer therapeutics –related cardiac dysfunction (CTRCD). The management of CTRCD may pose a challenge due to its heterogeneous clinical presentation. This warrants the need for a multi-modality diagnostic tool to objectively acquire prognostic information for timely commencement of cardio-protective treatment. Cardi ac magnetic resonance (CMR) imaging offers considerable potential due to its non-invasive, reproducible protocol. Moreo...
Source: Current Cardiovascular Imaging Reports - April 2, 2019 Category: Radiology Source Type: research

Radionuclide Imaging of Atherothrombotic Diseases
AbstractPurpose of ReviewA variety of approaches and molecular targets have emerged in recent years for radionuclide-based imaging of atherosclerosis and vulnerable plaque using single photon emission computed tomography (SPECT) and positron emission tomography (PET), with numerous methods focused on characterizing the mechanisms underlying plaque progression and rupture. This review highlights the ongoing developments in both the pre-clinical and clinical environment for radionuclide imaging of atherosclerosis and atherothrombosis.Recent FindingsNumerous physiological processes responsible for the evolution of high-risk a...
Source: Current Cardiovascular Imaging Reports - March 26, 2019 Category: Radiology Source Type: research

Coronary Vessel Wall Imaging: State of the Art and Future Directions
AbstractPurpose of ReviewThe purpose of this paper is to review the latest advancements and developments in non-invasive coronary magnetic resonance (MR) and hybrid positron emission tomography (PET)/MR imaging.Recent FindingsCoronary MRI has advanced in recent years in different aspects, especially regarding technical developments, scan protocols, and molecular probes. Recently introduced hybrid PET/MR scanners have already demonstrated great potential in improving cardiovascular imaging.SummaryCoronary atherosclerosis and acute myocardial infarction remain major threats to physical health worldwide. Several techniques, f...
Source: Current Cardiovascular Imaging Reports - March 25, 2019 Category: Radiology Source Type: research

Coronary Computed Tomography Angiography Improving Outcomes in Patients with Chest Pain
AbstractPurpose of ReviewTo provide an overview of recent studies of coronary computed tomography angiography (CCTA) and how it has helped to improve clinical outcomes for patients presenting with chest pain.Recent FindingsRandomised controlled trials have uniformly demonstrated that the use of CCTA is associated with improvements in patient diagnosis, management and treatments as well as the avoidance of unnecessary invasive coronary angiography. These changes have been associated with consistent reductions in long-term rates of fatal or non-fatal myocardial infarction.SummaryMajor beneficial effects in clinical managemen...
Source: Current Cardiovascular Imaging Reports - March 21, 2019 Category: Radiology Source Type: research

Artificial Intelligence in Nuclear Cardiology: Adding Value to Prognostication
AbstractPurpose of the ReviewRadionuclide myocardial perfusion imaging (MPI) continues to be an accurate and reproducible method of diagnosing obstructive coronary artery disease (CAD) with predictive, prognostic, and economic value. We review the evolutionary potential of machine learning (ML), a subset of artificial intelligence, as an adjunct to MPI.Recent FindingsApplying the broad scope of ML, including the integration of deep learning, can leverage the knowledge representation and automated reasoning to detect and extrapolate patterns from high-dimensional features of MPI. There is growing evidence to suggest superio...
Source: Current Cardiovascular Imaging Reports - March 18, 2019 Category: Radiology Source Type: research

CMR in Transcatheter Valve Interventions: State of the Art and Future Directions
AbstractPurpose of ReviewTranscatheter valve interventions require careful planning and rely heavily on multimodality imaging. In contrast to echocardiography and computed tomography cardiovascular magnetic resonance (CMR) remains underused in clinical practice.Recent FindingsCMR techniques such as multiplanar cine imaging unlimited by echo windows or ionizing radiation exposure, quantification of flow, and advanced tissue characterization have the potential to add valuable complimentary information to the evaluation of patients with valvular heart disease.SummaryIn this paper, we review the evidence for CMR to guide trans...
Source: Current Cardiovascular Imaging Reports - March 1, 2019 Category: Radiology Source Type: research

Choosing the Appropriate Stress Test for Myocardial Perfusion Imaging
AbstractPurpose of ReviewChoosing the most appropriate test or protocol to ensure patient safety along with accurate and informative results can be challenging. The aim of this article is to review important considerations when choosing a nuclear stress perfusion study.Recent FindingsSingle-photon emission computed tomography (SPECT) has a sensitivity of 70% and a specificity of 78% for the diagnosis of coronary artery disease (CAD), and positron emission tomography (PET) has a sensitivity of 90% and specificity of 88%. The addition of either SPECT or PET to cardiac-gated computed tomography (CCTA) confers an increase in s...
Source: Current Cardiovascular Imaging Reports - February 28, 2019 Category: Radiology Source Type: research

Molecular Imaging to Monitor Left Ventricular Remodeling in Heart Failure
AbstractPurpose of ReviewCardiovascular diseases are the leading cause of deaths worldwide. Many complex cellular and molecular pathways lead to myocardial remodeling after ischemic insults. Anatomy, function, and viability of the myocardium can be assessed by modern medical imaging techniques by both visualizing and quantifying damages. Novel imaging techniques aim for a precise and accurate visualization of the myocardium and for the detection of alternations at the molecular level.Recent FindingsMagnetic resonance imaging assesses anatomy, function, and tissue characterization of the myocardium non-invasively with high ...
Source: Current Cardiovascular Imaging Reports - February 26, 2019 Category: Radiology Source Type: research

Plaque Assessment on Serial Coronary CTA
AbstractPurpose of ReviewThis review addresses the role of serial coronary computed tomography angiography (CTA) on the evaluation of atherosclerosis progression, risk stratification, and targeting individual pharmacotherapy.Recent FindingsThe presence, extent, and severity of coronary artery disease (CAD) detected by coronary CTA are associated with an adverse prognosis. Similarly, the presence of high-risk plaque features such as positive remodeling, low-attenuation plaque, spotty calcifications, and napkin-ring sign are associated with major adverse cardiac events. More recently, examinations using serial coronary CTA h...
Source: Current Cardiovascular Imaging Reports - February 14, 2019 Category: Radiology Source Type: research