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

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    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 2017 Jul 13. Epub 2017 Jul 13.
    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

    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 2017 Apr 6. Epub 2017 Apr 6.
    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 applying (18)F-fluorodeoxyglucose to determine inflammation and (13)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

    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

    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 ((18)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 Nov;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

    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) (FFRCT) 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, FFRCT has high diagnostic performance in identification of ischemia-causing lesions. The potential value of FFRCT for 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

    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 FFRCT RIPCORD Study.
    JACC Cardiovasc Imaging 2016 Oct 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 (FFRCT) 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

    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

    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

    MR and CT Imaging for the Evaluation of Pulmonary Hypertension.
    JACC Cardiovasc Imaging 2016 Jun;9(6):715-32
    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. Electronic address:
    Imaging plays a central role in the diagnosis and management of all forms of pulmonary hypertension (PH). Although Doppler echocardiography is essential for the evaluation of PH, its ability to optimally evaluate the right ventricle and pulmonary vasculature is limited by its 2-dimensional planar capabilities. Magnetic resonance and computed tomography are capable of determining the etiology and pathophysiology of PH, and can be very useful in the management of these patients. Read More

    Coronary atherosclerotic plaque burden and composition by CT angiography in Caucasian and South Asian patients with stable chest pain.
    Eur Heart J Cardiovasc Imaging 2017 May;18(5):556-567
    Centre for Advanced Cardiovascular Imaging, NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Barts and The London School of Medicine, Queen Mary University of London and St Bartholomew's Hospital, 2nd floor, King George V Building, West Smithfield, London EC1A 7BE, UK.
    Aims: South Asian (SA) patients are known to have an increased incidence of acute cardiovascular events compared with Caucasians. The aim of this observational study was to compare the prevalence of coronary stenoses, the amount and composition of coronary atherosclerosis in a cohort of Caucasian and SA patients with stable chest pain, in non-acute settings.

    Methods And Results: The study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki. Read More

    Diagnostic Performance of 3D Bull's Eye Display of SPECT and Coronary CTA Fusion.
    JACC Cardiovasc Imaging 2016 Jun 18;9(6):703-11. Epub 2016 May 18.
    Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan.
    Objectives: The aim of this study was to develop a display method to describe the fusion data of myocardial perfusion single-photon emission computed tomography (SPECT) and coronary computed tomography angiography into a single image that we call fusion-based bull's eye (FBE). This study sought to show its generating process and evaluate its diagnostic performance.

    Background: Three-dimensional (3D) display is mostly used when reviewing SPECT/coronary computed tomography angiography fusion images, although multidirection interpretation is required to sweep the entire heart. Read More

    Prognostic Value of Coronary Artery Calcium Scoring in Addition to Single-Photon Emission Computed Tomographic Myocardial Perfusion Imaging in Symptomatic Patients.
    Circ Cardiovasc Imaging 2016 May;9(5)
    From the Departments of Cardiology (E.M.E., J.R.T., J.P.O., M.M.) and Nuclear Medicine (E.M.E., M.M., S.K., P.L.J.), Isala Hospital, Zwolle, Netherlands.
    Background: The prognostic value of coronary artery calcium (CAC) scoring on top of myocardial perfusion imaging with single-photon emission computed tomography (SPECT) in patients suspected for coronary artery disease is not well established.

    Methods And Results: Four thousand eight hundred ninety-seven symptomatic patients without a history of coronary artery disease referred for SPECT and CAC scoring were included. Major adverse cardiac events (MACEs) were defined as late revascularization (>90 days after scanning), nonfatal myocardial infarction, and all-cause mortality. Read More

    CACS and the Frequency of Stress-Induced Myocardial Ischemia During MPI: A Meta-Analysis.
    JACC Cardiovasc Imaging 2016 May 13;9(5):580-9. Epub 2016 Apr 13.
    Division of Cardiology, Mount Sinai St. Luke's and Mount Sinai West Hospitals, and the Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address:
    Objectives: This study sought to systematically assess the relationship between the magnitude of coronary artery calcium (CAC) and presence of myocardial ischemia.

    Background: The likelihood of myocardial ischemia rises with increasing CAC score. However, the likelihood of ischemia according to different CAC abnormality cutoffs has not been systematically evaluated. Read More

    CMR Guidance for Recanalization of Coronary Chronic Total Occlusion.
    JACC Cardiovasc Imaging 2016 May 13;9(5):547-56. Epub 2016 Apr 13.
    Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom. Electronic address:
    Objectives: This study explored whether cardiac magnetic resonance (CMR) could help select patients who could benefit from revascularization by identifying inducible myocardial ischemia and viability in the perfusion territory of the artery with chronic total occlusion (CTO).

    Background: The benefit of revascularization using percutaneous coronary intervention (PCI) in CTO is controversial. CMR offers incomparable left ventricular (LV) systolic function assessment in addition to potent ischemic burden quantification and reliable myocardial viability analysis. Read More

    Imaging Microvascular Dysfunction and Mechanisms for Female-Male Differences in CAD.
    JACC Cardiovasc Imaging 2016 Apr;9(4):465-82
    Weatherhead PET Center for Preventing and Reversing Atherosclerosis, University of Texas Medical School, Houston, Texas. Electronic address:
    Microvascular dysfunction or disease is most commonly associated with diffuse epicardial coronary atherosclerosis and endothelial dysfunction, whereas it is less common as a distinct, separate, isolated pathophysiology. The different manifestations of coronary artery disease in women relate in part to their smaller coronary arteries, higher coronary blood flow, and higher endothelial shear stress, which have profound effects on endothelial function and development or resistance to atherosclerosis, its symptomatic presentation, outcomes, and treatment. The complex interactions of focal stenosis, diffuse epicardial atherosclerotic coronary narrowing, and microvascular dysfunction make definitive diagnosis and management difficult by use of standard noninvasive and invasive physiological and anatomic technologies. Read More

    Peripheral Reactive Hyperemia Index and Coronary Microvascular Function in Women With no Obstructive CAD: The iPOWER Study.
    JACC Cardiovasc Imaging 2016 Apr;9(4):411-7
    Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Denmark.
    Objectives: This study investigated whether digital reactive hyperemia index (RHI) measured by digital pulse amplitude tonometry is a sensitive indicator of coronary microvascular dysfunction (CMD).

    Background: CMD is an early marker of cardiovascular disease. However, CMD is a complex diagnosis and consists of multiple abnormalities of the coronary circulation. Read More

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