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Int J Cardiovasc Imaging 2019 Apr 23. Epub 2019 Apr 23.

Department of Cardiology, Hospital Unit West Jutland, Gl. Landevej 61, Herning, 7400, Denmark.

We aimed to identify factors influencing the sensitivity of perfusion imaging after an initial positive coronary computed tomography angiography (CCTA) using invasive coronary angiography (ICA) with conditional fractional flow reserve (FFR) as reference. Secondly we aimed to identify factors associated with revascularisation and to evaluate treatment outcome after ICA. We analysed 292 consecutive patients with suspected significant coronary artery disease (CAD) at CCTA, who underwent perfusion imaging with either cardiac magnetic resonance (CMR) or myocardial perfusion scintigraphy (MPS) followed by ICA with conditional FFR. Read More

Eur J Epidemiol 2019 Apr 23. Epub 2019 Apr 23.

Department of Radiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.

Lung cancer, chronic obstructive pulmonary disease (COPD), and coronary artery disease (CAD) are expected to cause most deaths by 2050. State-of-the-art computed tomography (CT) allows early detection of lung cancer and simultaneous evaluation of imaging biomarkers for the early stages of COPD, based on pulmonary density and bronchial wall thickness, and of CAD, based on the coronary artery calcium score (CACS), at low radiation dose. To determine cut-off values for positive tests for elevated risk and presence of disease is one of the major tasks before considering implementation of CT screening in a general population. Read More

Rev Port Cardiol 2019 Apr 20. Epub 2019 Apr 20.

Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia Espinho, Vila Nova de Gaia, Portugal.

Introduction: Single coronary artery (SCA) with no associated congenital heart disease is a rare congenital anomaly. Most cases are asymptomatic and incidental findings, but SCA can cause ischemia, congestive heart failure, and sudden cardiac death (SCD).

Case Report: A 44-year-old woman presented with Takotsubo cardiomyopathy and cardiogenic shock. Read More

Cardiovasc Diabetol 2019 Apr 23;18(1):51. Epub 2019 Apr 23.

Institute of Cardiovascular Science, University College London, London, UK.

Background: Evidence from imaging studies suggests a high prevalence of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM). However, there are no criteria for initiating screening for CAD in this population. The current study investigated whether clinical and demographic characteristics can be used to predict significant CAD in patients with T2DM. Read More

Echocardiography 2019 Apr 22. Epub 2019 Apr 22.

Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart disease, with an incidence of <1 in 300 000 live births. We describe a rare case of a 23-month-old infant admitted for cough and fever. Echocardiography showed a branch of the left coronary artery originating from the pulmonary artery. Read More

J Cardiovasc Echogr 2019 Jan-Mar;29(1):29-31

Division of Cardiology, "La Memoria" Hospital, Brescia, Italy.

Coronary artery aneurysms (CAAs) are rare findings caused by atherosclerosis in about 50% of cases. They are usually diagnosed using coronary angiography, cardiac computed tomography, or magnetic resonance imaging. In this report, we present a rare case of giant, isolated right CAA, detected by transthoracic echocardiography in an adult patient with unstable angina. Read More

Heart Views 2018 Jul-Sep;19(3):102-105

Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.

We report the case of a 54-year-old female patient with a history of rheumatoid arthritis (RA) who presented with dyspnea on exertion. Her pulsation on both arms was weak. Magnetic resonance (MR) angiography revealed Takayasu's arteritis (TA) characterized by multiple stenosis involving innominate, left common carotid, and left subclavian arteries. Read More

Nephrol Dial Transplant 2019 Apr 21. Epub 2019 Apr 21.

Division of Cardiology, Cook County Health, Chicago, IL, USA.

Background: Mitral annular calcification (MAC) is associated with increased risk of major adverse cardiac events. We hypothesized that MAC, identified on a pretransplant transthoracic echocardiography (TTE), is predictive of cardiac events following renal transplantation (RT).

Methods: In a retrospective cohort of consecutive RT recipients, pretransplant MAC presence and severity were determined on TTE performed within 1 year prior to transplant. Read More

BMJ Case Rep 2019 Apr 20;12(4). Epub 2019 Apr 20.

Nephrology, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India.

Splenic artery aneurysm (SAA) is rare, with risk of rupture especially if diameter is >2 cm. It is usually asymptomatic and detected incidentally on imaging either in young pregnant women or elderly cirrhotic patients. Extracranial vascular abnormalities known to be associated with autosomal dominant polycystic kidney disease (ADPKD) include ascending aortic aneurysms, dissections of coronary and vertebral arteries and rarely SAA. Read More

JACC Cardiovasc Imaging 2019 Mar 15. Epub 2019 Mar 15.

Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland. Electronic address:

Objectives: This study thoroughly explored the demographic and imaging characteristics, as well as the all-cause and cause-specific mortality risks of patients with a coronary artery calcium (CAC) score ≥1,000 in the largest dataset of this population to date.

Background: CAC is commonly used to quantify cardiovascular risk. Current guidelines classify a CAC score of >300 or 400 as the highest risk group, yet little is known about the potentially unique imaging characteristics and mortality risk in individuals with a CAC score ≥1,000. Read More

JACC Cardiovasc Imaging 2019 Mar 17. Epub 2019 Mar 17.

Department of Radiology, Providence Health Care, St. Paul's Hospital, University of British Columbia, Vancouver, Canada.

Objectives: The 1-year data from the international ADVANCE (Assessing Diagnostic Value of Non-invasive FFR in Coronary Care) Registry of patients undergoing coronary computed tomography angiography (CTA) was used to evaluate the relationship of fractional flow reserve derived from coronary CTA (FFR) with downstream care and clinical outcomes.

Background: Guidelines for management of chest pain using noninvasive imaging pathways are based on short- to intermediate-term outcomes.

Methods: Patients (N = 5,083) evaluated for clinically suspected coronary artery disease and in whom atherosclerosis was identified by coronary CTA were prospectively enrolled at 38 international sites from July 15, 2015, to October 20, 2017. Read More

JACC Cardiovasc Imaging 2019 Apr 10. Epub 2019 Apr 10.

Centro Cardiologico Monzino, IRCCS, Milan, Italy.

Objectives: The aims of the study were to test the diagnostic accuracy of integrated evaluation of dynamic myocardial computed tomography perfusion (CTP) on top of coronary computed tomography angiography (cCTA) plus fractional flow reserve computed tomography derived (FFR) by using a whole-heart coverage computed tomography (CT) scanner as compared with clinically indicated invasive coronary angiography (ICA) and invasive fractional flow reserve (FFR).

Background: Recently, new techniques such as dynamic stress computed tomography perfusion (stress-CTP) emerged as potential strategies to combine anatomical and functional evaluation in a one-shot scan. However, previous experiences with this technique were associated with high radiation exposure. Read More

JACC Cardiovasc Imaging 2019 Apr 10. Epub 2019 Apr 10.

Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address:

JACC Cardiovasc Imaging 2019 Mar 15. Epub 2019 Mar 15.

Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois; Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina. Electronic address:

Objectives: The purpose of this study was to determine the prognostic value of feature-tracking global longitudinal strain (GLS) measured during vasodilator stress cardiac magnetic resonance (CMR) imaging.

Background: Prior studies have suggested that blunted myocardial strain during dobutamine stress echocardiography may be associated with adverse prognosis. Recent developments in CMR feature-tracking techniques now allow assessment of strain in clinical practice using standard cine images without specialized pulse sequences or complex post-processing. Read More

Eur J Radiol 2019 May 2;114:1-5. Epub 2019 Mar 2.

Departments of Medicine and Radiology, University of Chicago Medical Center, Chicago, IL, United States. Electronic address:

Background: Vasodilator stress computed tomography perfusion (sCTP) imaging is complementary to coronary CT angiography (CCTA), used to determine the hemodynamic significance of coronary artery disease. However, it requires a separate image acquisition due to motion artifacts caused by higher heart rates during stress, resulting in increased iodine contrast dose and radiation. We sought to determine whether a novel motion correction algorithm applied to stress images would improve the visualization of the coronary arteries to potentially allow CCTA + sCTP evaluation in a single scan. Read More

Comput Biol Med 2019 Mar 14;108:111-121. Epub 2019 Mar 14.

Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, 2109, Australia; School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia.

Although intravascular ultrasound (IVUS) is the commonest intravascular imaging modality, it still is inefficient for clinical use as it requires laborious manual analysis. This study demonstrates the feasibility of a near real-time fully automated technology for accurate identification, detection, and quantification of luminal borders in intravascular images. This technology uses a combination of the novel approaches of a self-tuning engine, dynamic and static masking systems, radar-wise scan, and contour correction cycle method. Read More

J Emerg Med 2019 Apr 15. Epub 2019 Apr 15.

Department of Emergency Medicine, Huntington Hospital, Huntington, New York.

Background: Hemorrhagic cholecystitis is a rare complication of acute cholecystitis and is a potentially fatal diagnosis. It may be difficult to detect because the symptoms are similar to more common diagnoses. Point-of-care ultrasound is a useful imaging technique in the emergency setting and is readily available to allow for immediate interpretation and application of the results to guide medical decision making. Read More

JACC Cardiovasc Interv 2019 Apr;12(8):721-730

Department of Cardiology, Rigshospitalet, Copenhagen, Denmark; Department of Cardiology, University of Lund, Lund, Sweden.

Objectives: The aim of this study was to evaluate the effect of fractional flow reserve (FFR)-guided revascularization compared with culprit-only percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) on infarct size, left ventricular (LV), function, LV remodeling, and the presence of nonculprit infarctions.

Background: Patients with STEMI with multivessel disease might have improved clinical outcomes after complete revascularization compared with PCI of the infarct-related artery only, but the impact on infarct size, LV function, and remodeling as well as the risk for periprocedural infarction are unknown.

Methods: In this substudy of the DANAMI-3 (Third Danish Trial in Acute Myocardial Infarction)-PRIMULTI (Primary PCI in Patients With ST-Elevation Myocardial Infarction and Multivessel Disease: Treatment of Culprit Lesion Only or Complete Revascularization) randomized trial, patients with STEMI with multivessel disease were randomized to receive either complete FFR-guided revascularization or PCI of the culprit vessel only. Read More

Circ Cardiovasc Imaging 2019 Apr;12(4):e008794

Department of Ultrasound (B.W., W.G., Y.L., L.Z., M.X.), Wuhan, China.

Open Heart 2019 27;6(1):e000930. Epub 2019 Feb 27.

BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.

The aim of this article is to review the role of Health Technology Assessment (HTA) organisations in appraising and recommending innovative cardiovascular technologies. We consider how bias impairs the quality of evidence from clinical trials involving cardiovascular healthcare technologies. Finally, we provide recommendations to HTA organisations to take account of bias when making guideline recommendations. Read More

Open Heart 2019 9;6(1):e000917. Epub 2019 Feb 9.

Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden.

Objectives: The objectives of this study were to investigate if findings by intracoronary near-infrared spectroscopy (NIRS) and intravascular ultrasound (IVUS) are associated with future cardiovascular events and if NIRS can differentiate culprit from non-culprit segments in patients with coronary artery disease.

Methods: The study included 144 patients with coronary artery disease undergoing percutaneous coronary intervention and combined NIRS-IVUS imaging at two Swedish hospitals. The NIRS-derived lipid core burden index (LCBI), the 4 mm segment with maximum LCBI (MaxLCBI) and the IVUS-derived maximum plaque burden (MaxPB) were analysed within the culprit segment and continuous 10 mm non-culprit segments of the index culprit vessels. Read More

J Cardiovasc Imaging 2019 Apr;27(2):73-92

Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Multimodality imaging is indicated for the evaluation of left ventricular (LV) myocardial diseases. Cardiac magnetic resonance (CMR) allows morphological and functional assessment of the LV along with soft tissue characterization. Technological advances in cardiac computed tomography (CT) have led to the development of techniques for diagnostic acquisition in LV myocardial disease. Read More

Clin Cardiol 2019 Apr 17. Epub 2019 Apr 17.

Department of Cancer Pathology, Hokkaido University Faculty of Medicine, Sapporo, Japan.

Background: The relationship between eicosapentaenoic acid (EPA) therapy and coronary plaque stability assessed by optical frequency domain imaging (OFDI) has not been thoroughly described.

Hypothesis: EPA therapy is associated with decreased plaque instability in patients undergoing percutaneous coronary intervention (PCI) using OFDI.

Methods: Data on coronary artery plaques from 121 patients who consecutively underwent PCI between October 2015 and July 2018 were retrospectively analyzed. Read More

Eur Heart J Cardiovasc Imaging 2019 Apr 16. Epub 2019 Apr 16.

Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA.

Aims: The long-term prognostic value of coronary computed tomography angiography (CCTA)-identified coronary artery disease (CAD) has not been evaluated in elderly patients (≥70 years). We compared the ability of coronary CCTA to predict 5-year mortality in older vs. younger populations. Read More

Eur Heart J 2019 Apr 17. Epub 2019 Apr 17.

Division of Molecular and Clinical Medicine, School of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK.

Aim: We tested the hypothesis that metformin may regress left ventricular hypertrophy (LVH) in patients who have coronary artery disease (CAD), with insulin resistance (IR) and/or pre-diabetes.

Methods And Results: We randomly assigned 68 patients (mean age 65 ± 8 years) without diabetes who have CAD with IR and/or pre-diabetes to receive either metformin XL (2000 mg daily dose) or placebo for 12 months. Primary endpoint was change in left ventricular mass indexed to height1. Read More

Kardiologiia 2019 Apr 13;59(3):78-96. Epub 2019 Apr 13.

City Clinical Hospital №52 Moscow.

Stress echocardiography is an established technique for the assessment of extent and severity of coronary artery disease. The combination of echocardiography with a physical, pharmacological or electrical stress allows detecting myocardial ischemia with an excellent accuracy. A transient worsening of regional function during stress is the hallmark of inducible ischemia. Read More

Clin Nucl Med 2019 Apr 12. Epub 2019 Apr 12.

Department of PET Center, Xiangya Hospital, Central South University, Changsha, China.

We present a 53-year-old woman who had shortness of breath and atypical chest pain and underwent Tc-sestamibi myocardial perfusion imaging to detect coronary artery disease. The raw data in cine format showed an incidental focus close to the heart, and SPECT/CT fused images revealed a focus of intense uptake in the left breast. The subsequent histopathologic findings and F-FDG PET/CT imaging confirmed the diagnosis as primary breast lymphoma. Read More

Eur Heart J Cardiovasc Imaging 2019 Apr 14. Epub 2019 Apr 14.

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

Aims: To provide a pooled estimation of contemporary pre-test probabilities (PTPs) of significant coronary artery disease (CAD) across clinical patient categories, re-evaluate the utility of the application of diagnostic techniques according to such estimates, and propose a comprehensive diagnostic technique selection tool for suspected CAD.

Methods And Results: Estimates of significant CAD prevalence across sex, age, and type of chest pain categories from three large-scale studies were pooled (n = 15 815). The updated PTPs and diagnostic performance profiles of exercise electrocardiogram, invasive coronary angiography, coronary computed tomography angiography (CCTA), positron emission tomography (PET), stress cardiac magnetic resonance (CMR), and SPECT were integrated to define the PTP ranges in which ruling-out CAD is possible with a post-test probability of <10% and <5%. Read More

Circ J 2019 Apr 13. Epub 2019 Apr 13.

Cardiology Division, Massachusetts General Hospital, Harvard Medical School.

Background: Fibrous cap thickness (FCT) is one of the key features of coronary vulnerable plaque. FCT is measured at an arbitrary point, determined on visual assessment of 2-D cross-sectional imaging. This method has poor reproducibility. Read More

JACC Cardiovasc Imaging 2019 Apr 11. Epub 2019 Apr 11.

University of Maryland School of Medicine, Department of Diagnostic Radiology and Nuclear Medicine, Baltimore, Maryland.

Chest pain in patients without obstructive coronary artery disease has been realized as a frequent problem encountered in clinical practice. Invasive flow investigations have suggested that up to two-thirds of patients with nonobstructive coronary atherosclerosis may have microvascular dysfunction (MVD). Positron emission tomography myocardial perfusion imaging in conjunction with tracer-kinetic modeling enables the concurrent quantification of myocardial blood flow (MBF) in milliliters per minute per gram of tissue. Read More

Int J Cardiol 2019 Mar 28. Epub 2019 Mar 28.

Cardiovascular Pathology Unit, Department of Pathology, Sant'Orsola-Malpighi University Hospital, Bologna, Italy.

Background: Although imaging techniques have demonstrated the existence of microvascular abnormalities in hypertrophic cardiomyopathy (HCM), a detailed histopathological assessment is lacking as well as a comparison between different phases of the disease. We aimed to compare microvasculopathy and myocardial fibrosis in hypertrophic obstructive cardiomyopathy (HOCM) versus end-stage (ES) HCM.

Methods: 27 myectomy specimens of HOCM patients and 30 ES-HCM explanted hearts were analyzed. Read More

Int J Cardiol 2019 Apr 2. Epub 2019 Apr 2.

Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, UK; Royal Stoke University Hospital, Stoke-on-Trent, UK. Electronic address:

Background: The rates of readmission for serious cardiovascular events among patients admitted with a diagnosis of non-specific chest pain are unknown.

Methods: A national retrospective cohort study in the United States was undertaken to evaluate the rates, trends and predictors of readmission for serious cardiovascular events (acute coronary syndrome (ACS), pulmonary embolism (PE) and aortic dissection (AD)) after an inpatient episode with a primary diagnosis of non-specific chest pain.

Results: Among 1,172,430 patients with an index diagnosis of non-specific chest pain between 2010 and 2014, 2. Read More

Int J Cardiovasc Imaging 2019 Apr 11. Epub 2019 Apr 11.

Biomedicine Department, Institute of Clinical Physiology, CNR, CNR Research Campus, Via Moruzzi, 1, 56124, Pisa, Italy.

The peak stress/rest ratio of left ventricular (LV) elastance, or LV force, is a load-independent index of left ventricular contractile reserve (LVCR) with stress echo (SE). To assess the accuracy of LVCR calculated during SE with approaches of different complexity. Two-hundred-forty patients were referred to SE for known or suspected coronary artery disease or heart failure and, of those, 200 patients, age 61 ± 15, 99 females, with interpretable volumetric SE were enrolled. Read More

Front Neurol 2019 27;10:294. Epub 2019 Mar 27.

Department of Neurology, Geisinger Medical Center, Danville, PA, United States.

Although the risk of recurrent cerebral ischemia is higher after a transient ischemic attack (TIA), there is limited data on the outcome of TIA mimics. The goal of this study is to compare the 6-month outcome of patients with negative and positive diffusion-weighted imaging (DWI) TIAs (DWI-neg TIA vs. DWI-pos TIA) and also TIA mimics. Read More

Monaldi Arch Chest Dis 2019 Jan 29;89(1). Epub 2019 Jan 29.

Cardiology Department, Vila Nova de Gaia/Espinho Hospital Centre.

Exercise stress testing can have a central role in the assessment of cardiovascular disease. Contemporary data, however, has highlighted the added value of imaging modalities over the exercise electrocardiogram in the investigation of coronary artery disease. Given the physiological changes associated with exercise and the possibility to address other parameters such as rhythm changes and the chronotropic response, exercise stress testing with continuous electrocardiographic monitoring can still have an important place in contemporary clinical practice. Read More

Eur J Prev Cardiol 2019 Apr 9:2047487319843396. Epub 2019 Apr 9.

1 Department of Public Health, Erasmus Medical Centre, The Netherlands.

Introduction: A teachable moment for preventive behavioural change can occur when asymptomatic individuals receive their cardiovascular disease screening result. This study investigated prevention-seeking behaviour and compliance with preventive treatment of participants of the population-based Risk Or Benefit IN Screening for CArdiovascular disease (ROBINSCA) trial after receiving a screening result.

Methods: Asymptomatic Dutch individuals ( n = 43,447) were randomly assigned (1:1:1) to screening for cardiovascular disease by either traditional risk assessment (intervention arm A), or determining the amount of coronary artery calcification (intervention arm B), or to usual care (control arm). Read More

J Gen Intern Med 2019 Apr 8. Epub 2019 Apr 8.

Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA.

Background: Outpatient primary care experience is vital to internal medicine resident training but may impact quality and equity of care delivered in practices that include resident physicians. Understanding whether quality differences exist among resident and staff primary care physicians (PCPs) may present an opportunity to address health disparities within academic medical centers.

Objective: To determine whether there are differences in the quality of primary care provided by resident PCPs compared to staff PCPs. Read More

Arch Med Sci Atheroscler Dis 2019 11;4:e25-e31. Epub 2019 Mar 11.

Department of Cardiology, Istanbul Medipol University, Istanbul, Turkey.

Introduction: Catheter ablation (CA) for atrial fibrillation (AF) has been a major cornerstone in the management of AF. Despite promising advances in CA techniques, long-term results reveal a high rate of recurrence after the procedure. Left atrial diverticulum (LAD), a common anatomic variant of the left atrium, was previously shown to be associated with increased risk of thrombus formation, cardiac perforation and arrhythmia. Read More

J Thorac Dis 2019 Feb;11(2):393-399

Department of Cardiovascular Surgery, Chiba University Hospital, Chiba, Japan.

Background: The objective of this study was to evaluate hemodynamic patterns in end-side coronary artery bypass grafting with different anastomosis length by computational fluid dynamic study in the native coronary stenosis model.

Methods: The fluid dynamic computations were carried out using ANSYS CFX. Incision length was set to be 2, 4, 6, 8, 10 mm. Read More

Clin Infect Dis 2019 Apr 8. Epub 2019 Apr 8.

Department of Medicine and Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital Baselland, University of Basel, Bruderholz, Switzerland.

Background: Coronary artery disease (CAD) events have been associated with certain antiretroviral therapy (ART) agents. In contrast, the influence of ART on subclinical atherosclerosis is not clear. The study objective was to assess the association between individual ART agents and the prevalence and extent of subclinical CAD. Read More

Expert Rev Cardiovasc Ther 2019 Apr 8;17(4):275-291. Epub 2019 Apr 8.

a Division of Cardiology , Vancouver General Hospital , Vancouver , BC , Canada.

Introduction: Spontaneous coronary artery dissection (SCAD) accounts for up to 4% of acute coronary syndromes (ACS) on coronary angiography and predominantly affects women (>90%). SCAD most often occurs in patients with few or no conventional cardiovascular risk factors. This condition remains underdiagnosed due to a lack of awareness among health-care providers and misdiagnosis on coronary angiography. Read More

J Cardiovasc Comput Tomogr 2019 Mar 27. Epub 2019 Mar 27.

Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA; Department of Medicine, Duke University School of Medicine, Durham, NC, USA. Electronic address:

Background: Obesity is a risk factor for coronary artery disease (CAD), but adiposity may mimic symptoms of CAD and reduce the accuracy of diagnostic testing.

Methods: Patients from the PROMISE trial (n = 8889) were classified according to body mass index (BMI). We assessed relationships between BMI, physician's preference of functional test, test positivity, and results of invasive coronary angiography (Cath) using logistic regression models. Read More

Atherosclerosis 2019 Mar 24. Epub 2019 Mar 24.

The Johns Hopkins Ciccarone Center for Prevention of Heart Disease, Baltimore, MD, USA. Electronic address:

Background And Aims: Left main (LM) coronary artery disease is associated with greater myocardial infarction-related mortality, however, coronary artery calcium (CAC) scoring does not account for disease location. We explored whether LM CAC predicts excess mortality in asymptomatic adults.

Methods: Cause-specific cardiovascular and all-cause mortality was studied in 28,147 asymptomatic patients with non-zero CAC scores in the CAC Consortium. Read More

J Cardiovasc Comput Tomogr 2019 Mar 28. Epub 2019 Mar 28.

Johns Hopkins Ciccarone Center for Prevention of Heart Disease, Baltimore, MD, United States; Department of Medicine, The Johns Hopkins Hospital, Baltimore, MD, United States. Electronic address:

Background: The Coronary Artery Calcium Data and Reporting System (CAC-DRS), which takes into account the Agatston score category (A) and the number of calcified vessels (N) has not yet been validated in terms of its prognostic significance.

Methods: We included 54,678 patients from the CAC Consortium, a large retrospective clinical cohort of asymptomatic individuals free of baseline cardiovascular disease (CVD). CAC-DRS groups were derived from routine, cardiac-gated CAC scans. Read More

J Cardiovasc Comput Tomogr 2019 Mar 29. Epub 2019 Mar 29.

Royal Brompton and Harefield NHS Foundation Trust Departments of Cardiology and Radiology, London, UK; National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, UK.

Coronary artery disease remains an important cause of morbidity and mortality world-wide. Coronary Computed Tomography Angiography (CCTA) has excellent diagnostic accuracy and the identification and stratification of coronary artery disease is associated with improved prognosis in multiple studies. Recent randomized controlled trials have shown that in patients with stable coronary artery disease, CCTA is associated with improved diagnosis, changes in investigations, changes in medical treatment and appropriate selection for revascularization. Read More

J Cardiovasc Comput Tomogr 2019 Mar 29. Epub 2019 Mar 29.

Department of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Perivascular adipose tissue (PVAT) surrounding the human coronary arteries, secretes a wide range of adipocytokines affecting the biology of the adjacent vascular wall in a paracrine way. However, we have recently found that PVAT also behaves as a sensor of signals coming from the vascular wall, to which it reacts by changing its morphology and secretory profile. Indeed, vascular inflammation, a key feature of vascular disease pathogenesis, leads to the release of inflammatory signals that disseminate into local fat, inducing local lipolysis and inhibiting adipogenesis. Read More

Acta Cardiol 2019 Apr 4:1-6. Epub 2019 Apr 4.

a 2nd Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine , Charles University in Prague and General University Hospital in Prague , Prague , Czech Republic.

Background: We tested whether the level of endothelial dysfunction assessed by digital tonometry, and expressed as reactive hyperemia index (RHI), is related to occurrences of a discrepancy between fractional flow reserve (FFR) and the instantaneous wave free ratio (iFR) (ClinicalTrials.gov identifier: NCT03033810).

Methods: We examined patients with coronary stenosis in the range of 40-70%, assessed by both FFR and iFR (system Philips-Volcano) for stable angina. Read More

Eur Radiol Exp 2019 Apr 3;3(1):16. Epub 2019 Apr 3.

Department of Radiological Sciences, Medical Sciences I, B-140, University of California, Irvine, Irvine, CA, 92697, USA.

Background: Myocardial perfusion measurement with a low-dose first-pass analysis (FPA) dynamic computed tomography (CT) perfusion technique depends upon acquisition of two whole-heart volume scans at the base and peak of the aortic enhancement. Hence, the objective of this study was to validate an optimal timing protocol for volume scan acquisition at the base and peak of the aortic enhancement.

Methods: Contrast-enhanced CT of 28 Yorkshire swine (weight, 55 ± 24 kg, mean ± standard deviation) was performed under rest and stress conditions over 20-30 s to capture the aortic enhancement curves. Read More

Arterioscler Thromb Vasc Biol 2019 Apr 4:ATVBAHA118312166. Epub 2019 Apr 4.

From the Divison of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (R.-H.C., P.-H.H., H.-B.L., S.-J.L., J.-W.C.).

Objective- Basic research indicates that TNFSF14 (tumor necrosis factor superfamily 14) may be involved in the pathogenesis of atherosclerosis. Given the requirements of new biomarkers for risk classification in coronary artery disease (CAD), we conducted a longitudinal analysis to investigate if TNFSF14 levels are associated with the risk of cardiovascular events among patients with stable CAD. Approach and Results- In total, 894 patients with CAD were enrolled in a multicenter prospective study. Read More