295 research outputs found
International standardization of diagnostic criteria for vasospastic angina
No full textThe Coronary Vasomotion Disorders International Study Group (COVADIS) was established to develop international standards for the diagnostic criteria of coronary vasomotor disorders. The first symposium held on the 4-5 September 2013 addressed the criteria for vasospastic angina, which included the following (i) nitrate-responsive angina, (ii) transient ischaemic electrocardiogram changes, and (iii) documented coronary artery spasm. Adoption of these diagnostic criteria will improve the clinical diagnosis of this condition and facilitate research in this field.John F. Beltrame, Filippo Crea, Juan Carlos Kaski, Hisao Ogawa, Peter Ong, Udo Sechtem, Hiroaki Shimokawa, C. Noel Bairey Merz on behalf of On Behalf of the Coronary Vasomotion Disorders International Study Group (COVADIS
Assessing suspected angina: requiem for coronary computed tomography angiography or exercise electrocardiogram?
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Remote magnetic targeting of iron oxide nanoparticles for cardiovascular diagnosis and therapeutic drug delivery: where are we now?
No full textMichael Bietenbeck,1 Anca Florian,1 Cornelius Faber,2 Udo Sechtem,3 Ali Yilmaz11Department of Cardiology and Angiology, 2Department of Clinical Radiology, University Hospital Münster, Münster, 3Division of Cardiology, Robert-Bosch-Krankenhaus, Stuttgart, Germany Abstract: Magnetic resonance imaging (MRI) allows for an accurate assessment of both functional and structural cardiac parameters, and thereby appropriate diagnosis and validation of cardiovascular diseases. The diagnostic yield of cardiovascular MRI examinations is often increased by the use of contrast agents that are almost exclusively based on gadolinium compounds. Another clinically approved contrast medium is composed of superparamagnetic iron oxide nanoparticles (IONs). These particles may expand the field of contrast-enhanced cardiovascular MRI as recently shown in clinical studies focusing on acute myocardial infarction (AMI) and atherosclerosis. Furthermore, IONs open up new research opportunities such as remote magnetic drug targeting (MDT). The approach of MDT relies on the coupling of bioactive molecules and magnetic nanoparticles to form an injectable complex. This complex, in turn, can be attracted to and retained at a desired target inside the body with the help of applied magnetic fields. In comparison to common systemic drug applications, MDT techniques promise both higher concentrations at the target site and lower concentrations elsewhere in the body. Moreover, concurrent or subsequent MRI can be used for noninvasive monitoring of drug distribution and successful delivery to the desired organ in vivo. This review does not only illustrate the basic conceptual and biophysical principles of IONs, but also focuses on new research activities and achievements in the cardiovascular field, mainly in the management of AMI. Based on the presentation of successful MDT applications in preclinical models of AMI, novel approaches and the translational potential of MDT are discussed.Keywords: MRI, CMR, magnetic targeting, SPION, myocardial infarctio
Aortic aneurysm: thoracic aortic aneurysm—diagnostic approach
No full textThe goals of the diagnostic approach to thoracic aortic aneurysms (TAAs) are to confirm the diagnosis, to measure diameter and define longitudinal extent, to determine involvement of the aortic valve and aortic branches, and to detect mural thrombus, dissection, and/or haematoma. A wide array of non-invasive and invasive imaging modalities is available to address all diagnostic challenges encountered in TAAs. Cross-sectional tomographic imaging methods are the preferred techniques for accurate measurement of TAA dimensions and extension, while echocardiography is crucial for assessing the aortic root and aortic valve function. The choice of technique should be based on patient factors and clinical scenario, but other factors such as operator skills, expertise and availability, costs, and potential safety issues of the techniques should be considered.</p
Multimodality imaging in coronary artery disease – “The more the better?”
No full textAbstractMultimodality imaging in coronary artery disease (CAD) comprises a combination of information from more than one imaging technique. These combinations, performed in a side-by-side or fusion mode, include computed tomography (CT) and single photon emission computed tomography (SPECT), positron emission tomography (PET) and CT, and PET with magnetic resonance imaging (MRI). Data thus obtained lead to either a summative or synergistic gain of information. For instance, morphology (coronary plaques/stenosis) can be depicted by coronary CT angiography, whereas functional aspects of CAD such as myocardial perfusion abnormalities or myocardial metabolism can be evaluated by the complementary technique in order to separate a hemodynamic significant coronary stenosis from a hemodynamic non-significant stenosis. Distinguishing these two entities has an important impact on patient management. Beyond the diagnostic yield, some of these combinations in multimodality imaging also have prognostic implications. In this article, we will describe different multimodality imaging approaches (CT/SPECT, PET/CT and PET/MRI) for evaluation of CAD in patients with suspected or known CAD and put them into the context of current knowledge
Can delayed enhancement and T2-weighted imaging distinguish acute from chronic myocardial infarction?
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