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    479 results match your criteria Circulation: Cardiovascular Imaging [Journal]

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    Virtual Coronary Intervention: A Treatment Planning Tool Based Upon the Angiogram.
    JACC Cardiovasc Imaging 2018 Mar 9. Epub 2018 Mar 9.
    Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom; Department of Cardiology, Sheffield Teaching Hospitals, National Health Service Foundation Trust, Northern General Hospital, Sheffield, United Kingdom; Insigneo Institute for In Silico Medicine, Sheffield, United Kingdom.
    Objectives: This study sought to assess the ability of a novel virtual coronary intervention (VCI) tool based on invasive angiography to predict the patient's physiological response to stenting.

    Background: Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) is associated with improved clinical and economic outcomes compared with angiographic guidance alone. Virtual (v)FFR can be calculated based upon a 3-dimensional (3D) reconstruction of the coronary anatomy from the angiogram, using computational fluid dynamics (CFD) modeling. Read More

    Assessment of mechanical dyssynchrony can improve the prognostic value of guideline-based patient selection for cardiac resynchronization therapy.
    Eur Heart J Cardiovasc Imaging 2018 Feb 22. Epub 2018 Feb 22.
    Department of Cardiovascular Diseases, University Hospitals Leuven, University of Leuven, Herestraat 49, 3000 Leuven, Belgium.
    Aim: To determine if incorporation of assessment of mechanical dyssynchrony could improve the prognostic value of patient selection based on current guidelines.

    Methods And Results: Echocardiography was performed in 1060 patients before and 12 ± 6 months after cardiac resynchronization therapy (CRT) implantation. Mechanical dyssynchrony, defined as the presence of apical rocking or septal flash was visually assessed at the baseline examination. Read More

    Timing of myocardial shortening determines left ventricular regional myocardial work and regional remodelling in hearts with conduction delays.
    Eur Heart J Cardiovasc Imaging 2017 Dec 19. Epub 2017 Dec 19.
    Department of Cardiovascular Diseases, University Hospital Leuven, Herestraat 49, 3000 Leuven, Belgium.
    Aims: The interaction between asynchronous regional myocardial activation and left ventricular (LV) wall remodelling has not been well established. We investigated the relationship between time of onset of longitudinal shortening (Tonset), regional myocardial work, and segmental LV wall thickness (SWT) in patients treated with cardiac resynchronization therapy (CRT).

    Methods And Results: We analysed 26 patients with sinus rhythm, non-ischaemic cardiomyopathy (63 ± 9 years, 69% male, QRS duration 174 ± 18 ms) and positive response to CRT (15% reduction in end-systolic volume). Read More

    Prognostic Stratification of Patients With ST-Segment-Elevation Myocardial Infarction (PROSPECT): A Cardiac Magnetic Resonance Study.
    Circ Cardiovasc Imaging 2017 Nov;10(11)
    From the Centro Cardiologico Monzino, IRCCS, Milan, Italy (G.P., D.A., M.G., A.B., L.F., S.M., E.C., A.A., A.F., M.E.M., M.V., N.C., G.M., P.A., A.L.B., M.P.); Yonsei University Health System, Seoul, South Korea (G.P.); Department of Emergency and Organ Transplantation, Institute of Cardiovascular Disease, University Hospital Policlinico Consorziale of Bari, Italy (A.I.G.); Department of Medical and Surgical Sciences, University of Foggia, Italy (A.I.G.); Dipartimento di Cardiologia, Policlinico Universitario Paolo Giaccone, Palermo, Italy (G.F., P.C., F.F.); Centro Medico Polispecialistico, Torre Annunziata (Naples), Italy (G.M.); Istituto di Management, Scuola Superiore Sant'Anna, Pisa, Italy (V.L.); Multimodality Cardiac Imaging Section, IRCCS, Policlinico San Donato, Milan, Italy (S.P.); Loyola University of Chicago, IL (M.G.R.); Edward Hines Jr. Veterans Administration Hospital, IL (M.G.R.); Luigi Sacco Department of Biomedical and Clinical Sciences (A.L.B.) and Department of Cardiovascular Sciences and Community Health (D.A., P.A.), University of Milan, Italy; and Division of Cardiology, Centre of Cardiac Magnetic Resonance, University Hospital Lausanne, Switzerland (P.G.M.).
    Background: Cardiac magnetic resonance (CMR) is a robust tool to evaluate left ventricular ejection fraction (LVEF), myocardial salvage index, microvascular obstruction, and myocardial hemorrhage in patients with ST-segment-elevation myocardial infarction. We evaluated the additional prognostic benefit of a CMR score over standard prognostic stratification with global registry of acute coronary events (GRACE) score and transthoracic echocardiography LVEF measurement.

    Methods And Results: Two hundred nine consecutive patients with ST-segment-elevation myocardial infarction (age, 61. Read More

    Cerebral Oxygenation Measurements by Magnetic Resonance Imaging in Fetuses With and Without Heart Defects.
    Circ Cardiovasc Imaging 2017 Nov;10(11):e006459
    From Pediatrics and Adolescent Medicine, Neonatal and Intensive Care Unit (M.H.L., T.B.H.), Department of Obstetrics and Gynecology (N.U., O.B.P.), Department of Pediatrics, Perinatal Epidemiology Research Unit (T.B.H., N.B.M.), Department of Radiology (B.S.-G.), and Department of Cardio-Thoracic and Vascular Surgery (V.E.H.), Aarhus University Hospital, Denmark; Institute for Clinical Medicine (M.H.L., N.U., S.R., V.E.H.) and the MR Research Centre (S.R.), Aarhus University, Denmark; and Department of Clinical Engineering, Central Denmark Region, Aarhus (D.A.P.).
    Background: Children with major congenital heart defects are risking impaired cerebral growth, delayed cerebral maturation, and neurodevelopmental disorders. We aimed to compare the cerebral tissue oxygenation of fetuses with major heart defects to that of fetuses without heart defects as estimated by the magnetic resonance imaging modality T2*. T2* is low in areas with high concentrations of deoxyhemoglobin. Read More

    Optimized Prognosis Assessment in ST-Segment-Elevation Myocardial Infarction Using a Cardiac Magnetic Resonance Imaging Risk Score.
    Circ Cardiovasc Imaging 2017 Nov;10(11)
    From the University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, Lübeck, Germany; and German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Germany.
    Background: Cardiac magnetic resonance (CMR) demonstrated great potential for the prediction of major adverse cardiac events (MACE) in ST-segment-elevation myocardial infarction. The aim of this study was to develop and validate a CMR-based risk score for ST-segment-elevation myocardial infarction patients.

    Methods And Results: The scoring model was developed and validated on ST-segment-elevation myocardial infarction cohorts from 2 independent randomized controlled trials (n=738 and n=458 patients, respectively) and included left ventricular (LV) ejection fraction, infarct size, and microvascular obstruction. Read More

    Prognostic value of pulmonary blood volume by first-pass contrast-enhanced CMR in heart failure outpatients: the PROVE-HF study.
    Eur Heart J Cardiovasc Imaging 2017 Oct 17. Epub 2017 Oct 17.
    G. Monasterio Foundation, MRI-laboratory, Via Giuseppe Moruzzi, 1 - 56124 Pisa, Italy.
    Aims: Pulmonary blood volume (PBV) is a novel clinical application of cardiovascular magnetic resonance (CMR) imaging for the quantitative grading of haemodynamic congestion. In this study, we aimed to assess the prognostic value of PBV in a cohort of outpatients with chronic heart failure (HF).

    Methods And Results: One hundred and twelve consecutive patients (91 men, 67 ± 12 years) and 53 age- and sex-matched healthy controls underwent echocardiography and contrast-enhanced CMR. Read More

    The association of volumetric response and long-term survival after cardiac resynchronization therapy.
    Eur Heart J Cardiovasc Imaging 2017 Oct;18(10):1109-1117
    Department of Cardiovascular Diseases, University Hospital Gasthuisberg, Catholic University Leuven, Herestraat 49, 3000 Leuven, Belgium.
    Aims: Clinical experience indicates that limited or no reverse left ventricular (LV) remodelling may not necessarily imply non-response to cardiac resynchronization therapy (CRT). We investigated the association of the extent of LV remodelling, mechanical dyssynchrony, and survival in patients undergoing CRT.

    Methods And Results: In 356 CRT candidates, three blinded readers visually assessed the presence of mechanical dyssynchrony (either apical rocking and/or septal flash) before device implantation and also its correction by CRT 12 ± 3 months post-implantation. Read More

    Increased arterial stiffness in childhood onset diabetes: a cardiovascular magnetic resonance study.
    Eur Heart J Cardiovasc Imaging 2017 Jul 25. Epub 2017 Jul 25.
    Pediatric Department, Oslo University Hospital, Ullevål, Postboks 4950 Nydalen, 0424 Oslo, Norway.
    Aims: Arterial stiffness is a strong predictor of cardiovascular events. We aimed to assess the impact of type 1 diabetes (T1D) on arterial stiffness and cardiac function in young adults.

    Methods And Results: Aortic pulse wave velocity (PWV), distensibility, left ventricular (LV) function and LV mass were measured by cardiovascular magnetic resonance imaging (CMR) in 47 T1D patients and 33 healthy controls. Read More

    Lowering Interleukin-12 Activity Improves Myocardial and Vascular Function Compared With Tumor Necrosis Factor-a Antagonism or Cyclosporine in Psoriasis.
    Circ Cardiovasc Imaging 2017 Sep;10(9)
    From the Second Department of Cardiology (I.I., G.M., M.V., G.P., H.T., J.P., E.I., J.L.), Second Department of Dermatology and Venereology (E.P., K.T., D.R.), Department of Biological Chemistry (P.M., C.P.), and Department of Clinical Biochemistry (P.M., C.P.), Attikon Hospital, National and Kapodistrian University of Athens Medical School, Greece; and Department of Pharmaceutical Chemistry, National and Kapodistrian University of Athens School of Pharmacy, Greece (I.A., K.G.).
    Background: Interleukin (IL)-12 activity is involved in the pathogenesis of psoriasis and acute coronary syndromes. We investigated the effects of IL-12 inhibition on vascular and left ventricular (LV) function in psoriasis.

    Methods And Results: One hundred fifty psoriasis patients were randomized to receive an anti-IL-12/23 (ustekinumab, n=50), anti-tumor necrosis factor-a (TNF-α; etanercept, n=50), or cyclosporine treatment (n=50). Read More

    Quantitative Assessment of Coronary Microvascular Function: Dynamic Single-Photon Emission Computed Tomography, Positron Emission Tomography, Ultrasound, Computed Tomography, and Magnetic Resonance Imaging.
    Circ Cardiovasc Imaging 2017 Aug;10(8)
    From the Section of Cardiovascular Medicine, Department of Internal Medicine (A.F., A.J.S.) and Department of Radiology and Biomedical Imaging (A.J.S.), Yale University School of Medicine, New Haven, CT.
    A healthy, functional microcirculation in combination with nonobstructed epicardial coronary arteries is the prerequisite of normal myocardial perfusion. Quantitative assessment in myocardial perfusion and determination of absolute myocardial blood flow can be achieved noninvasively using dynamic imaging with multiple imaging modalities. Extensive evidence supports the clinical value of noninvasively assessing indices of coronary flow for diagnosing coronary microvascular dysfunction; in certain diseases, the degree of coronary microvascular impairment carries important prognostic relevance. Read More

    Derivation and Evaluation of Age-Specific Multivariate Reference Regions to Aid in Identification of Abnormal Filling Patterns: The HUNT and VaMIS Studies.
    JACC Cardiovasc Imaging 2018 Mar 19;11(3):400-408. Epub 2017 Jul 19.
    Department of Clinical Physiology, Västmanland County Hospital, Västerås, Sweden; Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden.
    Objectives: This study aimed to derive age-specific multivariate reference regions (MVRs) able to classify subjects into those having normal or abnormal filling patterns and to evaluate the prognostic impact of this classification.

    Background: The integration of several parameters is necessary to diagnose disorders of left ventricular (LV) filling because no single measurement accurately describes the complexity of diastolic function. However, no generally accepted validated multiparametric algorithm currently exists. Read More

    Visual and Quantitative Assessment of Coronary Stenoses at Angiography Versus Fractional Flow Reserve: The Impact of Risk Factors.
    Circ Cardiovasc Imaging 2017 Jul;10(7)
    From the Cardiovascular Center Aalst, Belgium (J.A., P.X., A.F., M.P., G.C., V.F., E.B., B.D.B.); and Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (E.B.).
    Background: The correlation between angiographic assessment of coronary stenoses and fractional flow reserve (FFR) is weak. Whether and how risk factors impact the diagnostic accuracy of angiography is unknown. We sought to evaluate the diagnostic accuracy of angiography by visual estimate and by quantitative coronary angiography when compared with FFR and evaluate the influence of risk factors (RF) on this accuracy. Read More

    Temporal Trends of Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging in Patients With Coronary Artery Disease: A 22-Year Experience From a Tertiary Academic Medical Center.
    Circ Cardiovasc Imaging 2017 Jul;10(7)
    From the Department of Cardiovascular Diseases (H.J., J.W.A., T.D.M., R.J.G.) and Division of Biostatistics, Department of Health Sciences Research (D.J.C.), Mayo Clinic, Rochester, MN.
    Background: There has been a gradual decline in the prevalence of abnormal stress single-photon emission computed tomography (SPECT) myocardial perfusion imaging studies among patients without history of coronary artery disease (CAD). The trends of SPECT studies among patients with known CAD have not been evaluated previously.

    Methods And Results: We assessed the Mayo Clinic nuclear cardiology database for all stress SPECT tests performed between January 1991 and December 2012 in patients with history of CAD defined as having previous myocardial infarction, percutaneous coronary intervention, and coronary artery bypass grafting. Read More

    Recent Advances in Cardiovascular Magnetic Resonance: Techniques and Applications.
    Circ Cardiovasc Imaging 2017 Jun;10(6)
    From the Cardiovascular Division, Department of Medicine, Department of Radiology and Medical Imaging, and Department of Biomedical Engineering, University of Virginia Health System, Charlottesville (M.S.); Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA (B.S., D.L.); Department of Clinical Sciences, Clinical Physiology, Lund University, Skane University Hospital, Sweden (H.A.); Cardiology Division, Department of Medicine, Northern Ontario School of Medicine, Sudbury, Canada (A.K.); Department of Radiology and Department of Medicine, New York University, New York (L.A.); and Division of Cardiovascular Medicine, Oxford Center for Clinical Magnetic Resonance Research, University of Oxford, London, United Kingdom (S.N.).
    Cardiovascular magnetic resonance imaging has become the gold standard for evaluating myocardial function, volumes, and scarring. Additionally, cardiovascular magnetic resonance imaging is unique in its comprehensive tissue characterization, including assessment of myocardial edema, myocardial siderosis, myocardial perfusion, and diffuse myocardial fibrosis. Cardiovascular magnetic resonance imaging has become an indispensable tool in the evaluation of congenital heart disease, heart failure, cardiac masses, pericardial disease, and coronary artery disease. Read More

    Identification of High-Risk Patients After ST-Segment-Elevation Myocardial Infarction: Comparison Between Angiographic and Magnetic Resonance Parameters.
    Circ Cardiovasc Imaging 2017 Jun;10(6):e005841
    From the Vita-Salute University and San Raffaele Hospital, Milan, Italy (A.D., A.L., G.B., A.E., A.M., F.D., A.C., P.G.C.); CNR-IBFM, Segrate, Italy (O.R.).
    Background: The incidence of angiographic no reflow (NR) and microvascular obstruction (MVO) at cardiac magnetic resonance is significantly different. The aim of this study was to investigate the occurrence of NR and MVO in a cohort of consecutive patients with ST-segment-elevation myocardial infarction treated with primary percutaneous coronary interventions.

    Methods And Results: In this prospective study, 88 consecutive ST-segment-elevation myocardial infarction patients were enrolled within 12 hours from symptoms onset. Read More

    RV Contractile Function and its Coupling to Pulmonary Circulation in Heart Failure With Preserved Ejection Fraction: Stratification of Clinical Phenotypes and Outcomes.
    JACC Cardiovasc Imaging 2017 Oct 12;10(10 Pt B):1211-1221. Epub 2017 Apr 12.
    Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Feinberg Cardiovascular Research Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
    Objectives: This study sought to investigate how right ventricular (RV) contractile function and its coupling with pulmonary circulation (PC) stratify clinical phenotypes and outcome in heart failure preserved ejection fraction (HFpEF) patients.

    Background: Pulmonary hypertension and RV dysfunction are key hemodynamic abnormalities in HFpEF.

    Methods: Three hundred eighty seven HFpEF patients (mean age 64 ± 12 years, 59% females, left ventricular ejection fraction 59 ± 7%) underwent RV and pulmonary hemodynamic evaluation by echocardiography (entire population) and right heart catheterization (219 patients). Read More

    Stress Perfusion CMR in Patients With Known and Suspected CAD: Prognostic Value and Optimal Ischemic Threshold for Revascularization.
    JACC Cardiovasc Imaging 2017 May 12;10(5):526-537. Epub 2017 Apr 12.
    Division of Cardiology University Hospital of Lausanne (CHUV), Lausanne, Switzerland; Cardiac MR Center, University Hospital of Lausanne (CHUV), Lausanne, Switzerland. Electronic address:
    Objectives: This study sought to determine the ischemia threshold and additional prognostic factors that identify patients for safe deferral from revascularizations in a large cohort of all-comer patients with known or suspected coronary artery disease (CAD).

    Background: Stress-perfusion cardiac magnetic resonance (CMR) is increasingly used in daily practice for ischemia detection. However, there is insufficient evidence about the ischemia burden that identifies patients who benefit from revascularization versus those with a good prognosis who receive drugs only. Read More

    Dynamic Computed Tomography Myocardial Perfusion Imaging: Comparison of Clinical Analysis Methods for the Detection of Vessel-Specific Ischemia.
    Circ Cardiovasc Imaging 2017 Apr;10(4)
    From the Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom and Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (A.R., A.W., F. Pirro, F. Pugliese); Siemens Healthineers, Forchheim, Germany (E.K.); Institute of Cardiovascular Science, University College London, United Kingdom (J.C.M.); and Departments of Cardiology and Radiology, Erasmus MC University Medical Centre Rotterdam, The Netherlands (K.N.).
    Background: The clinical analysis of myocardial dynamic computed tomography myocardial perfusion imaging lacks standardization. The objective of this prospective study was to compare different analysis approaches to diagnose ischemia in patients with stable angina referred for invasive coronary angiography.

    Methods And Results: Patients referred for evaluation of stable angina symptoms underwent adenosine-stress dynamic computed tomography myocardial perfusion imaging with a second-generation dual-source scanner. Read More

    Prolonged central circulation transit time in patients with HFpEF and HFrEF by magnetic resonance imaging.
    Eur Heart J Cardiovasc Imaging 2018 Mar;19(3):339-346
    Department of Cardiac Imaging, St Francis Hospital, The Heart Center, 100 Port Washington Blvd, Roslyn, NY 11576, USA.
    Aims: Prolonged central circulation transit time (TT) has long been associated with heart failure (HF) and left ventricular (LV) dysfunction. In this study, we assessed the central circulation TT using cardiovascular magnetic resonance imaging (CMR) in patients with HF of preserved ejection fraction (HFpEF) and of reduced EF (HFrEF) and investigated its relation to haemodynamics.

    Methods And Results: Fifty eight prospectively recruited volunteers underwent CMR. Read More

    Optimal Adenosine Stress for Maximum Stress Perfusion, Coronary Flow Reserve, and Pixel Distribution of Coronary Flow Capacity by Kolmogorov-Smirnov Analysis.
    Circ Cardiovasc Imaging 2017 Feb;10(2)
    From the Weatherhead PET Center For Preventing and Reversing Atherosclerosis (A.E.R., D.D.S., K.L.G.), Division of Cardiology, Department of Medicine (D.K., N.P.J., M.B.P., R.K.), McGovern Medial Medical School, University of Texas, and Memorial Hermann Hospital, Houston; and Department of Biostatistics, School of Public Health, The University of Texas Health Science Center at Houston (D.L., H.Z.).
    Background: Different adenosine stress imaging protocols have not been systemically validated for absolute myocardial perfusion and coronary flow reserve (CFR) by positron emission tomography, where submaximal stress precludes assessing physiological severity of coronary artery disease.

    Methods And Results: In 127 volunteers, serial rest-stress positron emission tomography scans using rubidium-82 with various adenosine infusion protocols identified (1) the protocol with maximum stress perfusion and CFR, (2) test-retest precision in same subject, (3) stress perfusion and CFR after adenosine compared with dipyridamole, (4) heterogeneity of coronary flow capacity combining stress perfusion and CFR, and (5) potential relevance for patients with risk factors or coronary artery disease. The adenosine 6-minute infusion with rubidium-82 injection at 3 minutes caused CFR that was significantly 15. Read More

    Myocardial Blood Flow and Inflammatory Cardiac Sarcoidosis.
    JACC Cardiovasc Imaging 2017 Feb 18;10(2):157-167. Epub 2017 Jan 18.
    Division of Nuclear Medicine-Cardiovascular Section, Department of Radiology and Radiological Science, School of Medicine, Johns Hopkins University, Baltimore, Maryland; Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland. Electronic address:
    Objectives: This study sought to evaluate the effects of inflammatory sarcoid disease on coronary circulatory function and the response to immune-suppressive treatment.

    Background: Although positron emission tomography assessment of myocardial inflammation is increasingly applied to identify active cardiac sarcoidosis, its effect on coronary flow and immune-suppressive treatment remains to be characterized.

    Methods: Thirty-two individuals, who were referred for positron emission tomography/computed tomography, were evaluated for known or suspected cardiac sarcoidosis applyingF-fluorodeoxyglucose to determine inflammation andN-ammonia to assess for perfusion deficits following a high-fat/low-carbohydrate diet and fasting state >12 h to suppress myocardial glucose uptake. Read More

    Beyond Bernoulli: Improving the Accuracy and Precision of Noninvasive Estimation of Peak Pressure Drops.
    Circ Cardiovasc Imaging 2017 Jan;10(1)
    From the King's College London, Division of Biomedical Engineering and Imaging Sciences, St. Thomas' Hospital, The Rayne Institute, United Kingdom (F.D., N.P.S., D.A.N., P.L.); Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (S.M., M.M.B., S.N.); University of Auckland, New Zealand (N.P.S.); and Department of Non Invasive Cardiology, King's College Hospital, London, United Kingdom (M.J.M.).
    Background: Transvalvular peak pressure drops are routinely assessed noninvasively by echocardiography using the Bernoulli principle. However, the Bernoulli principle relies on several approximations that may not be appropriate, including that the majority of the pressure drop is because of the spatial acceleration of the blood flow, and the ejection jet is a single streamline (single peak velocity value).

    Methods And Results: We assessed the accuracy of the Bernoulli principle to estimate the peak pressure drop at the aortic valve using 3-dimensional cardiovascular magnetic resonance flow data in 32 subjects. Read More

    Left Atrial Function Dynamics During Exercise in Heart Failure: Pathophysiological Implications on the Right Heart and Exercise Ventilation Inefficiency.
    JACC Cardiovasc Imaging 2017 Oct 21;10(10 Pt B):1253-1264. Epub 2016 Dec 21.
    University Cardiology Department, University of Milano School of Medicine, I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan, Italy. Electronic address:
    Objectives: The hypothesis of this study was that left atrial (LA) dynamic impairment during exercise may trigger right ventricular (RV)-to-pulmonary circulation (PC) uncoupling and ventilation inefficiency.

    Background: LA function plays a key role in the hemodynamics of heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). Extensive investigation of LA dynamics, however, has been performed exclusively at rest. Read More

    Routine Clinical Quantitative Rest Stress Myocardial Perfusion for Managing Coronary Artery Disease: Clinical Relevance of Test-Retest Variability.
    JACC Cardiovasc Imaging 2017 May 21;10(5):565-577. Epub 2016 Dec 21.
    Weatherhead PET Center for Preventing and Reversing Atherosclerosis, McGovern Medical School, Houston, Texas. Electronic address:
    Objectives: Positron emission tomography (PET) quantifies stress myocardial perfusion (in cc/min/g) and coronary flow reserve to guide noninvasively the management of coronary artery disease. This study determined their test-retest precision within minutes and daily biological variability essential for bounding clinical decision-making or risk stratification based on low flow ischemic thresholds or follow-up changes.

    Background: Randomized trials of fractional flow reserve-guided percutaneous coronary interventions established an objective, quantitative, outcomes-driven standard of physiological stenosis severity. Read More

    Functional Assessment of Coronary Artery Disease Using Whole-Heart Dynamic Computed Tomographic Perfusion.
    Circ Cardiovasc Imaging 2016 Dec;9(12)
    From the Department of Radiological Sciences (L.H., B.Z., J.L., B.S., H.J., S. Malkasian, S. Molloi) and Division of Cardiology (E.M.G.), University of California, Irvine.
    Background: Computed tomographic (CT) angiography is an important tool for the evaluation of coronary artery disease but often correlates poorly with myocardial ischemia. Current dynamic CT perfusion techniques can assess ischemia but have limited accuracy and deliver high radiation dose. Therefore, an accurate, low-dose, dynamic CT perfusion technique is needed. Read More

    Microvascular Function Contributes to the Relation Between Aortic Stiffness and Cardiovascular Events: The Framingham Heart Study.
    Circ Cardiovasc Imaging 2016 Dec;9(12)
    From the Cardiovascular Engineering, Inc., Norwood, MA (L.L.C., G.F.M.); Cardiovascular Research Center, Lifespan Cardiovascular Institute, W. Alpert Medical School of Brown University, Providence, RI (L.L.C.); Data Coordinating Center (J.N.P.), Department of Epidemiology (E.J.B., R.S.V.), and Department of Biostatistics (M.G.L.), Boston University School of Public Health, MA; Boston University and the National Heart, Lung, and Blood Institute's Framingham Study, MA (E.J.B., M.G.L., R.S.V.); and Cardiology and Preventive Medicine Sections, Department of Medicine (E.J.B., R.S.V.), Evans Department of Medicine (E.J.B., R.S.V., N.M.H.), and Whitaker Cardiovascular Institute (E.J.B., R.S.V., N.M.H.), Boston University School of Medicine, MA.
    Background: Arterial dysfunction contributes to cardiovascular disease (CVD) progression and clinical events. Inter-relations of aortic stiffness and vasodilator function with incident CVD remain incompletely studied.

    Methods And Results: We used proportional hazards models to relate individual measures of vascular function to incident CVD in 4547 participants (mean age, 51±11 years; 54% women) in 2 generations of Framingham Heart Study participants. Read More

    Right Ventricular Dysfunction Impairs Effort Tolerance Independent of Left Ventricular Function Among Patients Undergoing Exercise Stress Myocardial Perfusion Imaging.
    Circ Cardiovasc Imaging 2016 Nov;9(11)
    From the Greenberg Cardiology Division, Department of Medicine (J.K., T.S., A.S., P.N.K., A.G., S.R.G., S.A.K., M.S., P.M., M.R., T.S., R.B.D., J.W.W.) and Department of Cardiothoracic Surgery (A.D.F.), Weill Cornell Medical College, New York, NY; Division of Cardiology, Department of Surgery (M.B.R., A.E.M.), and Department of Bioengineering (M.B.R., A.E.M.), University of California, San Francisco; Veterans Affairs Medical Center, San Francisco, CA (M.B.R., A.E.M.); and Massachusetts General Hospital, Harvard Medical School, Boston (R.A.L.).
    Background: Right ventricular (RV) and left ventricular (LV) function are closely linked due to a variety of factors, including common coronary blood supply. Altered LV perfusion holds the potential to affect the RV, but links between LV ischemia and RV performance, and independent impact of RV dysfunction on effort tolerance, are unknown.

    Methods And Results: The population comprised 2051 patients who underwent exercise stress myocardial perfusion imaging and echo (5. Read More

    Persistent Microvascular Obstruction After Myocardial Infarction Culminates in the Confluence of Ferric Iron Oxide Crystals, Proinflammatory Burden, and Adverse Remodeling.
    Circ Cardiovasc Imaging 2016 Nov;9(11)
    From the Cedars-Sinai Medical Center, Los Angeles, CA (A.K., I.C., R.T., H.-J.Y., A.K., D.U., E.M., R.D.); University of California, Los Angeles (A.K., H.-J.Y., D.U., E.M., R.D.); Pacific Northwest National Laboratory, Environmental Molecular Sciences Laboratory, Richland, WA (A.D., L.K.); Lawson Health Research Institute, University of Western Ontario, London, Canada (F.S.P.); and Children's Hospital Los Angeles, CA (J.C.W.).
    Background: Emerging evidence indicates that persistent microvascular obstruction (PMO) is more predictive of major adverse cardiovascular events than myocardial infarct (MI) size. But it remains unclear how PMO, a phenomenon limited to the acute/subacute period of MI, drives adverse remodeling in chronic MI setting. We hypothesized that PMO resolves into chronic iron crystals within MI territories, which in turn are proinflammatory and favor adverse remodeling post-MI. Read More

    High Structural Stress and Presence of Intraluminal Thrombus Predict Abdominal Aortic Aneurysm 18F-FDG Uptake: Insights From Biomechanics.
    Circ Cardiovasc Imaging 2016 Nov;9(11)
    From the Department of Radiology (Y.H., Z.T., Y.Z., J.H.G.), EPSRC Centre for Mathematical and Statistical Analysis of Multimodal Clinical Imaging (Y.H.), Department of Engineering (Z.T.), Division of Cardiovascular Medicine (M.E., J.M.T., I.B.W., J.H.F.R.), Wolfson Brain Imaging Centre (T.D.F.), and Statistical Laboratory (A.Y.P.), University of Cambridge, United Kingdom; British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (N.J., D.E.N.); Department of Vascular Surgery (J.R. Boyle) and Department of Nuclear Medicine (J.R. Buscombe), Addenbrooke's Hospital, Cambridge, United Kingdom; and Department of Vascular Surgery, Changhai Hospital, Shanghai, China (Y.Z.).
    Background: Abdominal aortic aneurysm (AAA) wall inflammation and mechanical structural stress may influence AAA expansion and lead to rupture. We hypothesized a positive correlation between structural stress and fluorine-18-labeled 2-deoxy-2-fluoro-d-glucose (F-FDG) positron emission tomography-defined inflammation. We also explored the influence of computed tomography-derived aneurysm morphology and composition, including intraluminal thrombus, on both variables. Read More

    Residual Myocardial Iron Following Intramyocardial Hemorrhage During the Convalescent Phase of Reperfused ST-Segment-Elevation Myocardial Infarction and Adverse Left Ventricular Remodeling.
    Circ Cardiovasc Imaging 2016 Oct;9(10)
    From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.).
    Background: The presence of intramyocardial hemorrhage (IMH) in ST-segment-elevation myocardial infarction patients reperfused by primary percutaneous coronary intervention has been associated with residual myocardial iron at follow-up, and its impact on adverse left ventricular (LV) remodeling is incompletely understood and is investigated here.

    Methods And Results: Forty-eight ST-segment-elevation myocardial infarction patients underwent cardiovascular magnetic resonance at 4±2 days post primary percutaneous coronary intervention, of whom 40 had a follow-up scan at 5±2 months. Native T1, T2, and T2* maps were acquired. Read More

    CMR First-Pass Perfusion for Suspected Inducible Myocardial Ischemia.
    JACC Cardiovasc Imaging 2016 11;9(11):1338-1348
    Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt/Main, DZHK Centre for Cardiovascular Imaging, Frankfurt, Germany. Electronic address:
    Cardiovascular magnetic resonance (CMR) has evolved from a pioneering research tool to an established noninvasive imaging method for detecting inducible myocardial perfusion deficits. In this consensus document, experts of different imaging techniques summarize the existing body of evidence regarding CMR perfusion as a viable complement to other established noninvasive tools for the assessment of perfusion and discuss the advantages and pitfalls of the technique. A rapid, standardized CMR perfusion protocol is described, which is safe, clinically feasible, and cost-effective for centers with contemporary magnetic resonance equipment. Read More

    Computed Tomographic Perfusion Improves Diagnostic Power of Coronary Computed Tomographic Angiography in Women: Analysis of the CORE320 Trial (Coronary Artery Evaluation Using 320-Row Multidetector Computed Tomography Angiography and Myocardial Perfusion) According to Gender.
    Circ Cardiovasc Imaging 2016 Nov;9(11)
    From the Johns Hopkins Hospital and School of Medicine (A.P., A.L.V., J.M.M., A.A.-Z, J.A.C.L.) and Johns Hopkins Bloomberg School of Public Health (A.B., C.C.), Baltimore, MD; National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (A.Y.H., M.Y.C.); Toshiba Medical Systems Corporation, Japan (C.S); Charité Medical School, Humboldt, Berlin, Germany (E.Z., M.D.); Heart Institute, InCor, University of São Paulo Medical School, Brazil (C.E.R.); Rigshospitalet, University of Copenhagen, Denmark (K.F.K); St Luke's International Hospital, Tokyo, Japan (H.N.); and Brigham and Women's Hospital, Boston, MA (M.F.D.C.).
    Background: Coronary computed tomographic angiography (CTA) and myocardial perfusion imaging (CTP) is a validated approach for detection and exclusion of flow-limiting coronary artery disease (CAD), but little data are available on gender-specific performance of these modalities. In this study, we aimed to evaluate the diagnostic accuracy of combined coronary CTA and CTP in detecting flow-limiting CAD in women compared with men.

    Methods And Results: Three hundred and eighty-one patients who underwent both CTA-CTP and single-photon emission computed tomography myocardial perfusion imaging preceding invasive coronary angiography as part of the CORE320 multicenter study (Coronary Artery Evaluation Using 320-row Multidetector Computed Tomography Angiography and Myocardial Perfusion) were included in this ancillary study. Read More

    Noninvasive CT-Derived FFR Based on Structural and Fluid Analysis: A Comparison With Invasive FFR for Detection of Functionally Significant Stenosis.
    JACC Cardiovasc Imaging 2017 Jun 19;10(6):663-673. Epub 2016 Oct 19.
    Monash Cardiovascular Research Centre, MonashHEART, Department of Medicine, Monash Medical Centre, Monash Health, and Monash University, Melbourne, Victoria, Australia.
    Objectives: This study describes the feasibility and accuracy of a novel computed tomography (CT) fractional flow reserve (FFR) technique based on alternative boundary conditions.

    Background: Techniques used to compute FFR based on images acquired from coronary computed tomography angiography (CTA) are described. Boundary conditions were typically determined by allometric scaling laws and assumptions regarding microvascular resistance. Read More

    FFR Derived From Coronary CT Angiography in Nonculprit Lesions of Patients With Recent STEMI.
    JACC Cardiovasc Imaging 2017 Apr 12;10(4):424-433. Epub 2016 Oct 12.
    Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
    Objectives: This study sought to determine the diagnostic performance of noninvasive fractional flow reserve (FFR) derived from coronary computed tomography angiography (CTA) (FFR) for the diagnosis of lesion-specific ischemia in nonculprit vessels of patients with recent in ST-segment elevation myocardial infarction (STEMI).

    Background: In patients with stable angina, FFRhas high diagnostic performance in identification of ischemia-causing lesions. The potential value of FFRfor assessment of multivessel disease in patients with recent STEMI has not been evaluated. Read More

    Early Gadolinium Enhancement for Determination of Area at Risk: A Preclinical Validation Study.
    JACC Cardiovasc Imaging 2017 Feb 21;10(2):130-139. Epub 2016 Sep 21.
    Laboratory for Advanced Cardiovascular Imaging, National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland. Electronic address:
    Objectives: The aim of this study was to determine whether early gadolinium enhancement (EGE) by cardiac magnetic resonance (CMR) in a canine model of reperfused myocardial infarction depicts the area at risk (AAR) as determined by microsphere blood flow analysis.

    Background: It remains controversial whether only the irreversibly injured myocardium enhances when CMR is performed in the setting of acute myocardial infarction. Recently, EGE has been proposed as a measure of the AAR in acute myocardial infarction because it correlates well with T2-weighted imaging of the AAR, but this still requires pathological validation. Read More

    Impact of Longitudinal Lesion Geometry on Location of Plaque Rupture and Clinical Presentations.
    JACC Cardiovasc Imaging 2017 Jun 21;10(6):677-688. Epub 2016 Sep 21.
    Department of Medicine, Seoul National University Hospital, Seoul, South Korea; Institute of Aging, Seoul National University, Seoul, South Korea. Electronic address:
    Objectives: This study sought to investigate the impact of longitudinal lesion geometry on the location of plaque rupture and clinical presentation and its mechanism.

    Background: The relationships among lesion geometry, external hemodynamic forces acting on the plaque, location of plaque rupture, and clinical presentation have not been comprehensively investigated.

    Methods: This study enrolled 125 patients with plaque rupture documented by intravascular ultrasound. Read More

    Integrated Myocardial Perfusion Imaging Diagnostics Improve Detection of Functionally Significant Coronary Artery Stenosis by 13N-ammonia Positron Emission Tomography.
    Circ Cardiovasc Imaging 2016 Sep;9(9)
    From the Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (J.M.L.); Department of Internal Medicine, Cardiovascular Center (C.H.K., B.-K.K., D.H., J.P., J.Z., Y.T., H.-S.K.), Department of Nuclear Medicine (J.-I.B., M.S., J.C.P., G.J.C.), and Department of Internal Medicine, Emergency Medical Center (S.-H.N.), Seoul National University Hospital, Korea; Institute of Aging, Seoul National University, Korea (B.-K.K., S.-H.N.); Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea (K.-H.J.); and Department of Cardiology, Heart Institute, Center for Medical Research and Information, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea (J.-M.A., S.-J.P.).
    Background: Recent evidence suggests that the diagnostic accuracy of myocardial perfusion imaging is improved by quantifying stress myocardial blood flow (MBF) in absolute terms. We evaluated a comprehensive quantitative (13)N-ammonia positron emission tomography ((13)NH3-PET) diagnostic panel, including stress MBF, coronary flow reserve (CFR), and relative flow reserve (RFR) in conjunction with relative perfusion defect (PD) assessments to better detect functionally significant coronary artery stenosis.

    Methods And Results: A total of 130 patients (307 vessels) with coronary artery disease underwent both (13)NH3-PET and invasive coronary angiography with fractional flow reserve (FFR) measurement. Read More

    Magnetic Resonance Characterization of Cardiac Adaptation and Myocardial Fibrosis in Pulmonary Hypertension Secondary to Systemic-To-Pulmonary Shunt.
    Circ Cardiovasc Imaging 2016 Sep;9(9)
    From the Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (D.P., I.G.-L., F.S., C.B., V.F., B.I., A.G.-Á.); Hospital Clínic, IDIBAPS, Barcelona, Spain (D.P., E.S., J.F.E., A.G.-Á.); Hospital Universitario Quirón Madrid, UEM, Spain (I.G.-L.); Facultad de Medicina, Universidad de Extremadura, Badajoz, Spain (D.S.-Q.); IIS-Fundación Jiménez Díaz, Madrid, Spain (B.I.); Philips Healthcare, Madrid, Spain (J.S.-G.); and Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York (V.F.).
    Background: Pulmonary hypertension (PH) and right ventricular (RV) dysfunction are strong predictors of morbidity and mortality among patients with congenital heart disease. Early detection of RV involvement may be useful in the management of these patients. We aimed to assess progressive cardiac adaptation and quantify myocardial extracellular volume in an experimental porcine model of PH because of aorto-pulmonary shunt using cardiac magnetic resonance (CMR). Read More

    Impact of Pulmonary Hemodynamics and Ventricular Interdependence on Left Ventricular Diastolic Function in Children With Pulmonary Hypertension.
    Circ Cardiovasc Imaging 2016 Sep;9(9)
    From the Division of Cardiology, Heart Institute, Children's Hospital Colorado, University of Colorado, Aurora (D.A.B., S.S.P., D.D.I., A.K.Y.); and Division of Cardiology, The Labatt Family Heart Center, Hospital for Sick Children, University of Toronto, Ontario, Canada (C.S., A.N.R., L.M., M.K.F.).
    Background: Through ventricular interdependence, pulmonary hypertension (PH) induces left ventricular (LV) dysfunction. We hypothesized that pediatric PH patients have LV diastolic dysfunction, related to adverse pulmonary hemodynamics, leftward septal shift, and prolonged right ventricular systole.

    Methods And Results: Echocardiography was prospectively performed at 2 institutions in 54 pediatric PH patients during cardiac catheterization and in 54 matched controls. Read More

    Does the Routine Availability of CT-Derived FFR Influence Management of Patients With Stable Chest Pain Compared to CT Angiography Alone?: The FFRRIPCORD Study.
    JACC Cardiovasc Imaging 2016 10 24;9(10):1188-1194. Epub 2016 Aug 24.
    Guy's & St. Thomas' Hospital, London, United Kingdom.
    Objectives: This study sought to determine the effect of adding computed tomography-derived fractional flow reserve (FFR) data to computed tomography angiographic (CTA) data alone for assessment of lesion severity and patient management in 200 patients with chest pain.

    Background: Invasive and noninvasive tests used in the assessment of patients with angina all have disadvantages. The ideal screening test for patients presenting for the first time with chest pain would describe both coronary anatomy and the presence of ischemia and would be readily accessible, low cost, and noninvasive. Read More

    Comparison of Fractional Flow Reserve Assessment With Demand Stress Myocardial Contrast Echocardiography in Angiographically Intermediate Coronary Stenoses.
    Circ Cardiovasc Imaging 2016 Aug;9(8)
    From the Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China (J.W.); Department of Cardiology, Internal Medicine, University of Nebraska Medical Center, Omaha (D.B., F.X., E.O'L., G.P., T.R.P.); and Nebraska Heart, Lincoln (J.S.).
    Background: Real-time myocardial contrast echocardiography (RTMCE) directly measures capillary flow (CBF), which in turn is a major regulator of coronary flow and resistance during demand or hyperemic stress. Although fractional flow reserve (FFR) was developed to assess the physiological relevance of an epicardial stenosis, it assumes maximal microvascular vasodilation and minimal resistance during vasodilator stress. Therefore, we sought to determine the relationship between CBF assessed with RTMCE during stress echocardiography and FFR in intermediate coronary lesions. Read More

    Fractional flow reserve by computerized tomography and subsequent coronary revascularization.
    Eur Heart J Cardiovasc Imaging 2017 Feb 28;18(2):145-152. Epub 2016 Jul 28.
    David Geffen School of Medicine at University of California, 650 Charles E. Young Dr. South, A2-237 CHS, Los Angeles, CA 90095, USA.
    Aims: Fractional flow reserve by computerized tomography (FFR-CT) provides non-invasive functional assessment of the hemodynamic significance of coronary artery stenosis. We determined the FFR-CT values, receiver operator characteristic (ROC) curves, and predictive ability of FFR-CT for actual standard of care guided coronary revascularization.

    Methods And Results: Consecutive outpatients who underwent coronary CT angiography (coronary CTA) followed by invasive angiography over a 24-month period from 2012 to 2014 were identified. Read More

    Characterization of CMR-derived haemodynamic data in children with pulmonary arterial hypertension.
    Eur Heart J Cardiovasc Imaging 2017 Apr;18(4):424-431
    Department of Pediatrics, Section of Cardiology, Children's Hospital Colorado, Denver-Aurora, CO, USA.
    Aims: Paediatric pulmonary arterial hypertension (PAH) is manifested as increased arterial pressure and vascular resistive changes followed by progressive arterial stiffening. The aim of this study was to characterize regional flow haemodynamic patterns and markers of vascular stiffness in the proximal pulmonary arteries of paediatric PAH patients, and to explore the association with right ventricular (RV) function.

    Methods And Results: Forty paediatric PAH patients and 26 age- and size-matched controls underwent cardiac magnetic resonance studies in order to compute time-resolved wall shear stress metrics, oscillatory shear index (OSI), and vascular strain as measured by relative area change (RAC), and RV volumetric and functional parameters. Read More

    Extent of Myocardium at Risk for Left Anterior Descending Artery, Right Coronary Artery, and Left Circumflex Artery Occlusion Depicted by Contrast-Enhanced Steady State Free Precession and T2-Weighted Short Tau Inversion Recovery Magnetic Resonance Imaging.
    Circ Cardiovasc Imaging 2016 Jul;9(7)
    From the Cardiac MR Group, Department of Clinical Physiology (D.N., E.H., M.C., A.H.A., H.E., H.A.) and Department of Cardiology (S.K., D.E.), Skåne University Hospital, Lund University, Sweden; Department of Radiology, Odense University Hospital, Denmark (E.-T.F.); Section for Interventional Cardiology, Division of Cardiovascular and Pulmonary Diseases, Department of Cardiology, Oslo University Hospital, Ullevaal, Norway (P.H.); Department of Cardiology B, Oslo University Hospital Ullevål, and Faculty of Medicine, University of Oslo, Norway (D.A.); and Laboratory of Medical Informatics, School of Medicine, Aristotle University of Thessaloniki, Greece (A.H.A.).
    Background: Contrast-enhanced steady state free precession (CE-SSFP) and T2-weighted short tau inversion recovery (T2-STIR) have been clinically validated to estimate myocardium at risk (MaR) by cardiovascular magnetic resonance while using myocardial perfusion single-photon emission computed tomography as reference standard. Myocardial perfusion single-photon emission computed tomography has been used to describe the coronary perfusion territories during myocardial ischemia. Compared with myocardial perfusion single-photon emission computed tomography, cardiovascular magnetic resonance offers superior image quality and practical advantages. Read More

    Diagnostic performance of on-site CT-derived fractional flow reserve versus CT perfusion.
    Eur Heart J Cardiovasc Imaging 2017 Apr;18(4):432-440
    Departments of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
    Aims: To compare the diagnostic accuracy of on-site computed tomography (CT)-derived fractional flow reserve (FFR) and stress CT myocardial perfusion (CTP) in patients with coronary artery disease.

    Methods And Results: Using a prospective CTP registry, 72 patients with invasive FFR were enrolled. CT-derived FFR was computed on-site using rest-phase CTP data. Read More

    PET-measured longitudinal flow gradient correlates with invasive fractional flow reserve in CAD patients.
    Eur Heart J Cardiovasc Imaging 2017 May;18(5):538-548
    Division of Nuclear Medicine - Cardiovascular Section, Department of Radiology and Radiological Science, School of Medicine, Johns Hopkins University, JHOC 3225, 601 N. Caroline Street, Baltimore, MD 21287, USA.
    Aims: We aimed to evaluate whether a PET-determined longitudinal decrease in myocardial blood flow (MBF) or gradient, assumed as a more specific flow parameter for epicardial resistance, correlates with invasively measured fractional flow reserve (FFR) in coronary artery disease (CAD) patients.

    Methods And Results: In 29 patients with suspected or known CAD, myocardial perfusion and MBF in mL/g/min was determined with 13N-ammonia PET/CT during regadenoson stimulation and at rest, and corresponding myocardial flow reserve (MFR = MBF stress/MBF rest) was calculated. MBF parameters were assessed in the myocardial region with stress-related perfusion defect and with stenosis ≥50% (Region 1), without defect but with stenosis ≥50% (Region 2), or without stenosis ≥50% (Region 3). Read More

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