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


Impact of Ventricular Morphology on Fiber Stress and Strain in Fontan Patients.

Circ Cardiovasc Imaging 2018 Jul;11(7):e006738

Department of Cardiology, Boston Children's Hospital, MA. Department of Pediatrics, Harvard Medical School, Boston, MA.

Background: Right ventricular (RV) morphology has been associated with adverse clinical outcomes in Fontan patients. The impact of RV versus left ventricular morphology on ventricular stress and strain in single ventricles is not well known.

Methods And Results: Cardiac magnetic resonance examinations in 193 patients with the Fontan circulation were retrospectively analyzed. Read More

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The Forgotten Ventricle? The Left Ventricle in Right-Sided Congenital Heart Disease.

Circ Cardiovasc Imaging 2018 Mar;11(3):e007410

From the Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.

The right ventricle has frequently been described as the forgotten ventricle in the circulation. However, its importance both in acquired and congenital heart disease is now unquestioned. This recognition has led to improved risk stratification and development of algorithms for intervention, which incorporate measurements of right ventricular function as key components of the assessment of many conditions. Read More

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March 2018
1 Read

Imaging Right-Left Ventricular Interactions.

Authors:
Mark K Friedberg

JACC Cardiovasc Imaging 2018 May;11(5):755-771

Labatt Family Heart Center, The Hospital for Sick Children, and Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada. Electronic address:

The impact of one ventricle on the adjacent ventricle plays a key role in cardiac function. Ventricular-ventricular interactions are based on the arrangement in-series of the circulation and common pericardium, interventricular septum, and myocardial tracts. Imaging, in particular echocardiography, plays a central role in characterizing these interactions through geometric indices, septal configuration and motion, Doppler flow, timing of events in the ventricles and alterations in strain, remodeling, and diastolic filling with altered loading of the contralateral ventricle. Read More

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Machine Learning Analysis of Left Ventricular Function to Characterize Heart Failure With Preserved Ejection Fraction.

Circ Cardiovasc Imaging 2018 Apr;11(4):e007138

Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain (S.S.-M., G.P., B.H.B.); Asclepios Research Group, Université Côte d'Azur, Inria, Sophia Antipolis, France (N.D.); Wales Heart Research Institute, Cardiff University, United Kingdom (T.E., A.G.F.); Department of Cardiology, Oslo University Hospital, Norway (G.K., S.A.); Department of Circulation and Imaging, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway (S.A.); Clinic of Cardiology, St. Olav Hospital, Trondheim, Norway (S.A.); Department of Cardiology, University of Eastern Piedmont, Novara, Italy (A.D., P.M.); Division of Cardiology, University Hospital "S.Maria della Misericordia", Perugia, Italy (E.C.); and Catalan Institution for Research and Advanced Studies, Barcelona, Spain (B.H.B.).

Background: Current diagnosis of heart failure with preserved ejection fraction (HFpEF) is suboptimal. We tested the hypothesis that comprehensive machine learning (ML) of left ventricular function at rest and exercise objectively captures differences between HFpEF and healthy subjects.

Methods And Results: One hundred fifty-six subjects aged >60 years (72 HFpEF+33 healthy for the initial analyses; 24 hypertensive+27 breathless for independent evaluation) underwent stress echocardiography, in the MEDIA study (Metabolic Road to Diastolic Heart Failure). Read More

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April 2018
3 Reads

The Future of : Expanding Our Reach and Enhancing Our Value.

Authors:
Robert J Gropler

Circ Cardiovasc Imaging 2018 Apr;11(4):e007798

Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MI.

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April 2018
1 Read

Wire-Free and Adenosine-Free Fractional Flow Reserve Derived From the Angiogram: A Promising Future Awaiting Outcomes Data.

Circ Cardiovasc Imaging 2018 Mar;11(3):e007594

From the Cardiovascular Research Center and Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston.

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March 2018
9 Reads

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

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March 2018
1 Read

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

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February 2018
7 Reads

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

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December 2017
7 Reads

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

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November 2017
17 Reads
5.32 Impact Factor

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

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November 2017
8 Reads

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

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November 2017
6 Reads

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

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October 2017
2 Reads

Multi-centre study of whole-heart dynamic 3D cardiac magnetic resonance perfusion imaging for the detection of coronary artery disease defined by fractional flow reserve: gender based analysis of diagnostic performance.

Eur Heart J Cardiovasc Imaging 2017 Oct;18(10):1099-1106

Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, Zurich 8091, Switzerland.

Aims: Coronary artery disease (CAD) is a leading cause of morbidity and mortality in women and non-invasive testing for CAD in women can be more challenging than in men. This study compared the diagnostic performance of whole-heart dynamic 3D cardiovascular magnetic resonance (CMR) stress perfusion imaging in female and male patients with quantitative coronary angiography (QCA) and fractional flow reserve (FFR) as reference tests.

Methods And Results: Four hundred sixteen patients with suspected or known CAD were enrolled in five European centres. Read More

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October 2017
1 Read
3.67 Impact Factor

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

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October 2017
5 Reads

Increased arterial stiffness in childhood onset diabetes: a cardiovascular magnetic resonance study.

Eur Heart J Cardiovasc Imaging 2018 Jun;19(6):694-700

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

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June 2018
2 Reads

Frequency and angiographic characteristics of coronary microvascular dysfunction in stable angina: a hybrid imaging study.

Eur Heart J Cardiovasc Imaging 2017 Nov;18(11):1206-1213

Turku PET Centre, University of Turku, Kiinamyllynkatu 4-8, 20520, Turku, Finland.

Aims: Coronary microvascular dysfunction (CMD) can cause angina in the absence of obstructive coronary artery disease (CAD). We studied the frequency and angiographic characteristics of CMD in symptomatic patients with suspected stable CAD and identified CMD as diffusely abnormal coronary vasodilator capacity by positron emission tomography (PET) perfusion imaging.

Methods And Results: We recruited prospectively 189 patients with intermediate pre-test probability of CAD who underwent coronary computed tomography angiography and quantitative 15O-water PET perfusion imaging followed by invasive coronary angiography, and assessment of fractional flow reserve when feasible. Read More

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November 2017
4 Reads

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

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September 2017
4 Reads

Optical Coherence Tomography Characterization of Coronary Lithoplasty for Treatment of Calcified Lesions: First Description.

JACC Cardiovasc Imaging 2017 Aug;10(8):897-906

Clinique Pasteur, Toulouse, France.

Objectives: This study sought to determine the mechanistic effects of a novel balloon-based lithoplasty system on heavily calcified coronary lesions and subsequent stent placement using optical coherence tomography (OCT).

Background: The Shockwave Coronary Rx Lithoplasty System (Shockwave Medical, Fremont, California) delivers localized, lithotripsy-enhanced disruption of calcium within the target lesion (i.e. Read More

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August 2017
8 Reads

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

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August 2017
9 Reads

Understanding Sex Differences in Coronary Artery Disease Risk: Is Coronary Anatomy Sufficient?

Circ Cardiovasc Imaging 2017 Aug;10(8)

From the Cardiovascular Imaging Program, Division of Cardiovascular Medicine, Department of Medicine and Division of Nuclear Medicine and Molecular Imaging, Department and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.

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August 2017
7 Reads

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

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March 2018
4 Reads

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

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July 2017
2 Reads

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

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July 2017
3 Reads

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

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June 2017
10 Reads

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

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June 2017
18 Reads

Prognostic Value of Coronary CT Angiography With Selective PET Perfusion Imaging in Coronary Artery Disease.

JACC Cardiovasc Imaging 2017 Nov 17;10(11):1361-1370. Epub 2017 May 17.

Turku PET Centre, University of Turku, Turku, Finland; Department of Clinical Physiology, Nuclear Medicine and PET, Turku University Hospital, Turku, Finland. Electronic address:

Objectives: The purpose of this study was to evaluate the prognostic value of sequential hybrid imaging strategy in which positron emission tomography (PET) perfusion imaging is performed selectively in patients with suspected obstructive coronary artery disease (CAD) on coronary computed tomography angiography (CTA).

Background: Coronary CTA is an accurate diagnostic test for excluding obstructive CAD. However, the positive predictive value is suboptimal. Read More

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November 2017
19 Reads

How to Image the Adult Patient With Fontan Circulation.

Circ Cardiovasc Imaging 2017 May;10(5)

From the Department for Cardiovascular Imaging, University College London, UK (J.A.H., A.M.T., B.P.); Cardiorespiratory Division, Great Ormond Street Hospital, London, UK (J.A.H., A.M.T.); and Barts Heart Centre, St Bartholomew's Hospital, London, UK (B.P.).

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May 2017
6 Reads

Noninvasive FFR Derived From Coronary CT Angiography: Management and Outcomes in the PROMISE Trial.

JACC Cardiovasc Imaging 2017 Nov 12;10(11):1350-1358. Epub 2017 Apr 12.

Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.

Objectives: The purpose of this study was to determine whether noninvasive fractional flow reserve derived from computed tomography (FFR) predicts coronary revascularization and outcomes and whether its addition improves efficiency of referral to invasive coronary angiography (ICA) after coronary computed tomography angiography (CTA).

Background: FFR may improve the efficiency of an anatomic CTA strategy for stable chest pain.

Methods: This observational cohort study included patients with stable chest pain in the PROMISE (PROspective Multicenter Imaging Study for Evaluation of Chest Pain) trial referred to ICA within 90 days after CTA. Read More

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November 2017
5 Reads

Unraveling the RV Ejection Doppler Envelope: Insight Into Pulmonary Artery Hemodynamics and Disease Severity.

JACC Cardiovasc Imaging 2017 Oct 12;10(10 Pt B):1268-1277. Epub 2017 Apr 12.

Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota. Electronic address:

Objectives: The purpose of this study was to characterize the profiles of right ventricular outflow tract (RVOT) Doppler flow velocity envelopes in patients with pulmonary arterial hypertension (PAH) and to establish whether changes in the RVOT flow profile related to patient outcome.

Background: The RVOT systolic flow profile is frequently abnormal, with findings of a mid-systolic flow deceleration and notching, previously proposed as an indicator of elevated pulmonary vascular resistance (PVR).

Methods: We reviewed RVOT systolic flow profiles recorded by pulsed-wave Doppler from 159 consecutive patients with PAH and measured deceleration time (DT) of mid-systolic deceleration slope (mid-systolic DT) and the peak velocity of pre- and post-notching flow. Read More

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October 2017

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

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October 2017
3 Reads

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

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May 2017
15 Reads

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

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April 2017
6 Reads

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

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March 2018
8 Reads

Coronary sinus flow measurement-a useful addition to first pass myocardial perfusion cardiovascular magnetic resonance?

Authors:
Sven Plein

Eur Heart J Cardiovasc Imaging 2017 05;18(8):860-861

Division of Biomedical Imaging, Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, LS2 9JT, UK.

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Diagnostic value of global myocardial perfusion reserve assessment based on coronary sinus flow measurements using cardiovascular magnetic resonance in addition to myocardial stress perfusion imaging.

Eur Heart J Cardiovasc Imaging 2017 May;18(8):851-859

Department of Cardiology and Angiology, University Hospital Münster, Albert-Schweitzer-Campus 148149 Münster, Germany.

Aims: Myocardial perfusion reserve (MPR) is defined as the maximal possible increase in myocardial blood flow (MBF) above baseline conditions. Global MBF can be measured non-invasively by means of coronary sinus flow velocity encoded cine (VENC) cardiovascular magnetic resonance (CMR). We aimed to explore the relationship between global MBF/MPR and the extent and severity of coronary artery disease (CAD) in patients referred for CAD work-up by adenosine-stress CMR. Read More

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May 2017
2 Reads

Diagnostic Accuracy of Myocardial Perfusion Imaging With CZT Technology: Systemic Review and Meta-Analysis of Comparison With Invasive Coronary Angiography.

JACC Cardiovasc Imaging 2017 Jul 15;10(7):787-794. Epub 2017 Mar 15.

Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy. Electronic address:

Objectives: This study sought to summarize the evidence on stress myocardial perfusion imaging (MPI) using cadmium-zinc-telluride (CZT) technology for the diagnosis of obstructive coronary artery disease (CAD). The CZT cameras are newly introduced, and comparative data with the conventional Anger technology (Anger-MPI) are lacking.

Background: The diagnostic accuracy of Anger-MPI for detection of angiographically significant CAD is well established; however, less evidence is available on the diagnostic accuracy of CZT-MPI. Read More

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July 2017
2 Reads

Long-term serial non-invasive multislice computed tomography angiography with functional evaluation after coronary implantation of a bioresorbable everolimus-eluting scaffold: the ABSORB cohort B MSCT substudy.

Eur Heart J Cardiovasc Imaging 2017 May;18(8):870-879

Imperial College London Kensington, London SW7 2AZ, UK.

Aims: Multimodality invasive imaging of the first-in-man cohort demonstrated at 5 years stable lumen dimensions and a low rate of major adverse cardiac events (MACE). However, the long-term non-invasive assessment of this device remains to be documented. The objective was to describe the 72-month multislice computed tomography (MSCT) angiographic and functional findings after the implantation of the second iteration of the fully resorbable everolimus-eluting polymeric scaffold. Read More

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May 2017
3 Reads
3.67 Impact Factor

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

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February 2017
5 Reads

Integrating CT Myocardial Perfusion and CT-FFR in the Work-Up of Coronary Artery Disease.

JACC Cardiovasc Imaging 2017 Jul 18;10(7):760-770. Epub 2017 Jan 18.

Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands.

Objectives: The aim of this study was to investigate the individual and combined accuracy of dynamic computed tomography (CT) myocardial perfusion imaging (MPI) and computed tomography angiography (CTA) fractional flow reserve (FFR) for the identification of functionally relevant coronary artery disease (CAD).

Background: Coronary CTA has become an established diagnostic test for ruling out CAD, but it does not allow interpretation of the hemodynamic severity of stenotic lesions. Two recently introduced functional CT techniques are dynamic MPI and CTA FFR using computational fluid dynamics. Read More

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July 2017
7 Reads

Accuracy of Noncontrast Quiescent-Interval Single-Shot Lower Extremity MR Angiography Versus CT Angiography for Diagnosis of Peripheral Artery Disease: Comparison With Digital Subtraction Angiography.

JACC Cardiovasc Imaging 2017 Oct 18;10(10 Pt A):1116-1124. Epub 2017 Jan 18.

Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina.

Objectives: This study sought to evaluate the image quality and diagnostic accuracy of noncontrast quiescent-interval single-shot (QISS) magnetic resonance angiography (MRA) versus iodine-contrast computed tomography angiography (CTA) in patients with peripheral artery disease (PAD), with invasive digital subtraction angiography (DSA) as the reference standard.

Background: QISS is a recently introduced noncontrast MRA technique. Although the diagnostic accuracy of QISS is reportedly similar to that of contrast-enhanced MRA, its performance compared with contrast-enhanced CTA, the most frequently used noninvasive modality for evaluation of PAD, is unknown. Read More

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October 2017
7 Reads

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 applying F-fluorodeoxyglucose to determine inflammation and N-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

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February 2017
13 Reads

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

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January 2017
18 Reads

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.

Department of Cardiology University, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy; and the Department of Biomedical Sciences for Health, University of Milan, IRCCS 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

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October 2017
4 Reads

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

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May 2017
4 Reads

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

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December 2016
2 Reads

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

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December 2016
6 Reads

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

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November 2016
12 Reads

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

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November 2016
7 Reads
5.32 Impact Factor

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

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November 2016
7 Reads