1,721,036 research outputs found
Clinical applications of multimodality cardiac imaging
No full textRecent decades have brought marked advances in cardiac imaging. Although the single imaging techniques have seen their fields of application expanding, the definition of cardiac pathophysiology frequently demands a multimodality approach. In fact, multimodality imaging offers the chance to perform an integrated anatomo-functional cardiac evaluation in a completely non-invasive manner. This result is obtained by combining the information derived from mainly anatomical imaging modalities, such as multi-slice computed tomography and magnetic resonance, with the functional measures derived from nuclear imaging techniques, single photon emission computed tomography or positron emission tomography. This review will focus on the clinical applications of multimodality cardiac imaging, explaining the need for an integrated evaluation of myocardial structure and function that may enhance the clinician’s ability to characterize cardiac pathology
Cardiac Imaging on COVID-19 Pandemic Era: the Stand, The Lost, and Found
No full textPURPOSE OF REVIEW: The present review will outline the main effects of COVID-19 pandemic on cardiovascular pathologies, focusing on the role of modern non-invasive cardiac imaging techniques in this setting. RECENT FINDINGS: Multimodality cardiac imaging seems particularly suited for the in-depth characterization of patients with COVID-19, allowing the assessment of the variegated impact of the disease on the different aspects of myocardial perfusion, structure, and function. SUMMARY: The infection of SARS-CoV-2, leading to the coronavirus disease-19 (COVID-19), has represented a consistent challenge for the organization of the healthcare systems, associating to a significant increase of the fatality rate of different acute and chronic disease. Moreover, the reallocation of healthcare providers led to a significant reduction of the availability of tests and therapies, with the deferral of non-urgent tests and non-lifesaving procedures
Multi-Modality Imaging for the Identification of Arrhythmogenic Substrates Prior to Electrophysiology Studies
No full text: Noninvasive cardiac imaging is crucial for the characterization of patients who are candidates for cardiac ablations, for both procedure planning and long-term management. Multimodality cardiac imaging can provide not only anatomical parameters but even more importantly functional information that may allow a better risk stratification of cardiac patients. Moreover, fusion of anatomical and functional data derived from noninvasive cardiac imaging with the results of endocavitary mapping may possibly allow a better identification of the ablation substrate and also avoid peri-procedural complications. As a result, imaging-guided electrophysiological procedures are associated with an improved outcome than traditional ablation procedures, with a consistently lower recurrence rate
Management of patients with ischaemic cardiomyopathy: is there still a role for ischaemia-guided revascularization?
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The Evolving Role of Multimodality Imaging in Heart Failure
No full textIn patients with LV dysfunction, multimodality imaging offers the opportunity to obtain continued information on regional and global cardiac function, myocardial viability, coronary anatomy and regional relative or absolute myocardial perfusion.
The different modalities may be performed separately and integrated/fused afterwards (i.e. through hybrid imaging) or may be used in a single step approach to define HF etiology, the extent and severity of myocardial damage/ischemia, indicate and predict the response to targeted treatments (i.e. CRT, coronary revascularization) as well as to perform pre-interventional assessment (i.e. to program trans-catheter ablation of arrhythmias or valvular interventions
What Is New in Risk Assessment in Nuclear Cardiology?
No full text: Nuclear cardiology techniques allow in-depth evaluation of cardiac patients. A body of literature has established the use of nuclear cardiology. The results obtained with traditional cameras have been reinforced by those obtained with a series of innovations that have revolutionized the field of nuclear cardiology. This article highlights the role of nuclear cardiology in the risk assessment of patients with cardiac disease and sheds light on advancements of nuclear imaging techniques in the cardiovascular field. Patient risk stratification has a key role in modern precision medicine. Nuclear cardiac imaging techniques may quantitatively investigate major disease mechanisms of different cardiac pathologies
Stress-induced alteration of left ventricular eccentricity: An additional marker of multivessel CAD
No full textBackgroundAbnormal left ventricular (LV) eccentricity index (EI) is a marker of adverse cardiac remodeling. However, the interaction between stress-induced alterations of EI and major cardiac parameters has not been explored. We sought to evaluate the relationship between LV EI and coronary artery disease (CAD) burden in patients submitted to myocardial perfusion imaging (MPI).Methods and resultsThree-hundred and forty-three patients underwent MPI and coronary angiography. LV ejection fraction (EF) and EI were computed from gated stress images as measures of stress-induced functional impairment.One-hundred and thirty-six (40%), 122 (35%), and 85 (25%) patients had normal coronary arteries, single-vessel CAD, and multivessel CAD, respectively. Post-stress EI was lower in patients with multivessel CAD than in those with normal coronary arteries and single-vessel CAD (P=0.001). This relationship was confirmed only in patients undergoing exercise stress test, where a lower post-stress EI predicted the presence of multivessel CAD (P=0.039).ConclusionsPost-stress alterations of LV EI on MPI may unmask the presence of multivessel CAD
Coronary Revascularization in Patients With Stable Coronary Artery Disease: The Role of Imaging
Full text link: In the last decades, the effective management of some cardiovascular risk factors in the general population has led to a progressive decrease in the prevalence of coronary artery disease (CAD). Nevertheless, coronary heart disease remains the major cause of death in developed and developing countries and chronic coronary syndromes (CCS) are still a major target of utilization of non-invasive cardiac imaging and invasive procedures. Current guidelines recommend the use of non-invasive imaging in patients with CCS to identify subjects at higher risk to be referred for invasive coronary angiography and possible revascularization. These recommendations are challenged by two opposite lines of evidence. Recent trials have somewhat questioned the efficacy of coronary revascularization as compared with optimal medical therapy in CCS. As a consequence the role of imaging in these patients and in in patients with ischemic cardiomyopathy is under debate. On the other hand, real-life data indicate that a consistent proportion of patients undergo invasive procedure and are revascularized without any previous non-invasive imaging characterization. On top of this, the impact of COVID-19 pandemic on the sanitary systems caused a change in the current management of patients with CAD. In the present review we will discuss these conflicting data analyzing the evidence which has been recently accumulated as well as the gaps of knowledge which should still be filled
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