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Kardiol Pol 2021 Jun 24. Epub 2021 Jun 24.

Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique and Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.

Fibromuscular dysplasia (FMD) is a non-atherosclerotic vascular disease that may involve medium-sized muscular arteries throughout the body. The pathogenesis of FMD remains poorly understood, but a combination of genetic and environmental factors may be involved. The majority of FMD patients are women, but men may have a more progressive disease, especially when smoking. Read More

Eur J Cardiothorac Surg 2021 Jun 24. Epub 2021 Jun 24.

Department of Cardiac Surgery, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

Objectives: Despite society guideline recommendations, intraoperative high-frequency ultrasound (HFUS) and transit-time flow measurement (TTFM) use in coronary artery bypass grafting (CABG) has not been widely adopted worldwide. This retrospective review of the REQUEST (REgistry for QUality assESsmenT with Ultrasound Imaging and TTFM in Cardiac Bypass Surgery) study assesses the impact of protocolled high-frequency ultrasound/TTFM use in specific technical circumstances of CABG.

Methods: Three REQUEST study sub-analyses were examined: (i) For off-pump (OPCAB) versus on-pump (ONCAB) procedures: strategy changes from preoperative plans for the aorta, conduits, coronary targets and graft revisions; and for all REQUEST patients, revision rates in: (ii) arterial versus venous grafts; and (iii) grafts to different cardiac territories. Read More

Front Cardiovasc Med 2021 4;8:683434. Epub 2021 Jun 4.

Discipline of Cardiology, Faculty of Medical Science - State University of Campinas - UNICAMP, Campinas, São Paulo, Brazil.

After progressively receding for decades, cardiovascular mortality due to coronary artery disease has recently increased, and the associated healthcare costs are projected to double by 2030. While the 2019 European Society of Cardiology guidelines for chronic coronary syndromes recommend non-invasive cardiac imaging for patients with suspected coronary artery disease, the impact of non-invasive imaging strategies to guide initial coronary revascularization and improve long-term outcomes is still under debate. Recently, the ISCHEMIA trial has highlighted the fundamental role of optimized medical therapy and the lack of overall benefit of early invasive strategies at a median follow-up of 3. Read More

J Cardiovasc Magn Reson 2021 Jun 24;23(1):85. Epub 2021 Jun 24.

Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, G12 8TA, UK.

Background: Vascular calcification is an independent predictor of cardiovascular disease in patients with chronic kidney disease. Computed tomography (CT) is the gold-standard for detecting vascular calcification. Radial volumetric-interpolated breath-hold examination (radial-VIBE), a free-breathing gradient-echo cardiovascular magnetic resonance (CMR) sequence, has advantages over CT as it is ionising radiation-free. Read More

J Cardiovasc Magn Reson 2021 Jun 24;23(1):75. Epub 2021 Jun 24.

Cardiology Division, Department of Medicine, The University of Hong Kong, Hong Kong, China.

Background: Adenosine triphosphate (ATP) has been predominantly used in the Asia-Pacific region for stress perfusion cardiovascular magnetic resonance (CMR). We evaluated the prognosis of patients stressed using ATP, for which there are no current data.

Methods: We performed a retrospective longitudinal study from January 2016 to December 2020 and included 208 subjects with suspected obstructive coronary artery disease (CAD) who underwent ATP stress perfusion CMR. Read More

JAMA Cardiol 2021 Jun 23. Epub 2021 Jun 23.

British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom.

Importance: Coronary artery disease (CAD) and coronary microvascular dysfunction (CMD) may contribute to the pathophysiologic characteristics of heart failure with preserved ejection fraction (HFpEF). However, the prevalence of CAD and CMD have not been systematically studied.

Objective: To examine the prevalence of CAD and CMD in hospitalized patients with HFpEF. Read More

Ethiop J Health Sci 2021 Mar;31(2):439-454

MD, Internist, Interventional Cardiologist, Associate Professor of Medicine, Addis Ababa University.

Cardiovascular diseases are number one cause of death worldwide. Over half of the cardiovascular diseases, 51%, are due to coronary artery disease. Coronary artery disease is a pathological process characterized by atherosclerotic plaque accumulation in the epicardial coronary arteries. Read More

Phys Med Biol 2021 Jun 22. Epub 2021 Jun 22.

School of Optics and Photonics, Beijing Institute of Technology, NO.5 Zhongguancun south street, Beijing, 100081, CHINA.

Vessel centerline extraction from x-ray angiography (XRA) images is essential for vessel structure analysis in the diagnosis of coronary artery disease. However, complete and continuous centerline extraction remains a challenging task due to image noise, poor contrast, and complexity of vessel structure. Thus, an iterative multi-path search framework for automatic vessel centerline extraction is proposed. Read More

Eur Radiol 2021 Jun 22. Epub 2021 Jun 22.

Department of Cardiology, West China Hospital, Sichuan University, #37 Guo Xue Alley, Chengdu, 610041, China.

Objectives: We sought to identify the impact of transcatheter aortic valve implantation (TAVI) on changes of fractional flow reserve computed tomography (FFR) values and the associated clinical impact.

Methods: A retrospective analysis was done with CT obtained pre-TAVI, prior to hospital discharge and at 1-year follow-up, which provided imaging sources for the calculation of FFR values based on an online platform.

Results: A total of 190 patients were enrolled. Read More

JAMA 2021 Jun;325(24):2480-2494

Bluhm Cardiovascular Institute and Departments of Medicine and Cardiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Importance: More than 40 million people are living with either mitral or aortic valve disease worldwide, and more than 180 000 heart valve replacement surgeries are performed each year in the US. Transcatheter valve repair has emerged as an important therapeutic option for patients who are candidates for heart valve replacement.

Observations: All transcatheter valve therapies involve a multidisciplinary team of interventional cardiologists, cardiothoracic surgeons, radiologists, echocardiographers, nurses, and social workers, termed the heart team, to determine the optimal approach for managing each patient. Read More

Eur Heart J Cardiovasc Imaging 2021 Jun 21. Epub 2021 Jun 21.

Department of Geriatric Cardiology & National Clinical Research Center for Geriatric Diseases, Second Medical Center of Chinese PLA General Hospital, 28# Fuxing road, Haidian district, Beijing 100853, China.

Aims: More patients with suspected coronary artery disease underwent coronary computed tomography angiography (CCTA) as gatekeeper. However, the prospective relation of plaque features to acute coronary syndrome (ACS) events has not been previously explored.

Methods And Results: One hundred and one out of 452 patients with documented ACS event and received more than once CCTA during the past 12 years were recruited. Read More

Front Med (Lausanne) 2021 4;8:691893. Epub 2021 Jun 4.

Nuclear Medicine Department, CHRU TOURS, Tours, France.

The aim of this study was to assess the results of cadmium zinc telluride (CZT)- single-photon emission computed tomography (SPECT) myocardial flow reserve (MFR) in coronary artery disease (CAD) screening regarding clinical risk and its correlation to invasive coronary angiography (ICA). A total of 137 patients (61 male and 76 female) referred for CAD screening myocardial perfusion imaging (MPI) between November 2018 and April 2020 were included in the CFR-OR prospective trial. The 10-year risk of cardiovascular death according to the European Society of Cardiology (SCORE) was calculated. Read More

J Interv Cardiol 2021 2;2021:9971874. Epub 2021 Jun 2.

Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium.

Background: To validate a simplified invasive method for the calculation of the index of microvascular resistance (IMR).

Methods: This is a prospective, single-center study of patients with chronic coronary syndromes presenting with nonobstructive coronary artery disease. IMR was obtained using both intravenous (IV) adenosine and intracoronary (IC) papaverine. Read More

Circ J 2021 Jun 18. Epub 2021 Jun 18.

Department of Cardiology, Saitama Medical University International Medical Center.

Coronary artery disease (CAD) remains a leading cause of mortality and morbidity in developed countries. Although urgent revascularization is the cornerstone of management of acute coronary syndrome (ACS), for patients with stable CAD recent large-scale clinical trials indicate that a mechanical 'fix' of a narrowed artery is not obviously beneficial; ACS and stable CAD are increasingly recognized as different clinical entities. We review the perspectives on (1) modifying the diagnostic pathway of stable CAD with the incorporation of modern estimates of pretest probability, (2) non-imaging evaluations based on their availability, (3) the optimal timing of invasive coronary angiography and revascularization, and (4) the implementation of medical therapy during the work-up. Read More

Eur Heart J Cardiovasc Imaging 2021 Jun 20. Epub 2021 Jun 20.

Department of Cardiology, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK.

Aims: Stress echocardiography is widely used to identify obstructive coronary artery disease (CAD). High accuracy is reported in expert hands but is dependent on operator training and image quality. The EVAREST study provides UK-wide data to evaluate real-world performance and accuracy of stress echocardiography. Read More

JACC Cardiovasc Imaging 2021 Jun 9. Epub 2021 Jun 9.

Fiona Stanley Hospital, Harry Perkins Institute of Medical Research, University of Western Australia, Perth, Australia.

JACC Cardiovasc Imaging 2021 Jun 16. Epub 2021 Jun 16.

Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.

Objectives: The aim of this study was to examine prevalence, predictors, and impact of coronary artery calcium (CAC) across different risk factor burdens on the prevalence of obstructive coronary artery disease (CAD) and future coronary heart disease (CHD) risk in young patients.

Background: The interplay of risk factors and CAC for predicting CHD in young patients aged ≤45 years is not clear.

Methods: The study included 3,691 symptomatic patients (18-45 years of age) from the WDHR (Western Denmark Heart Registry) undergoing coronary computed tomographic angiography. Read More

JACC Cardiovasc Imaging 2021 Jun 9. Epub 2021 Jun 9.

Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA; Cardiovascular Imaging Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA. Electronic address:

Int J Cardiol 2021 Jun 15. Epub 2021 Jun 15.

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

Background: Detection of obstructive coronary artery disease (CAD) by stress myocardial perfusion imaging (MPI) is conventionally based on relative differences in perfusion. This may lead to either underestimation of the extent of myocardial ischemia, or the ischemia might be completely missed in case of balanced perfusion reduction. Using absolute quantification of myocardial blood flow (MBF) by positron emission tomography (PET), we evaluated how common are extensive and balanced myocardial perfusion abnormalities in symptomatic patients with suspected obstructive CAD. Read More

Am J Cardiovasc Drugs 2021 Jun 18. Epub 2021 Jun 18.

Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ, USA.

Background: Flecainide is a class IC antiarrhythmic drug that is contraindicated in patients who have a history of myocardial infarction, but its effect on mortality and risk of proarrhythmia in patients with stable obstructive and nonobstructive epicardial coronary artery disease (CAD) has not been assessed.

Objective: We sought to compare the safety of flecainide administration in patients who had angiographic evidence of either no or minimal CAD versus nonobstructive CAD, and those who underwent nuclear stress testing with perfusion defects versus those without perfusion defects.

Methods: We conducted a retrospective chart review of 348 patients who were treated with flecainide for at least 1 year duration and underwent evaluation for CAD with coronary angiography or myocardial perfusion imaging (MPI) stress testing within 3 months of initiating flecainide. Read More

Eur Radiol 2021 Jun 17. Epub 2021 Jun 17.

Institut Cardiovasculaire Paris Sud, Cardiovascular Magnetic Resonance Laboratory, Hôpital Privé Jacques CARTIER, Ramsay Santé, 6 Avenue du Noyer Lambert, 91300, Massy, France.

Objectives: A few studies suggest a significant prognostic value of silent myocardial ischaemia detected in asymptomatic patients. However, the current guidelines do not recommend stress testing in asymptomatic individuals. To assess the long-term prognostic value of vasodilator stress perfusion cardiovascular magnetic resonance (CMR) in asymptomatic individuals without known coronary artery disease (CAD). Read More

Curr Cardiol Rev 2021 Jun 16. Epub 2021 Jun 16.

Cardiology Department, Royal Victoria Hospital, Belfast, United Kingdom.

The 'gold standard' in the management of left main coronary artery disease has historically been coronary artery bypass surgery. Recent innovations in drug-eluting stent technology coupled with the increasing utility of physiology and imaging guidance for procedures has led to an evolving role for percutaneous coronary intervention in left main disease of low and intermediate anatomical complexity. This revascularization modality carries the clear advantage of being less invasive and significantly reducing recovery times. Read More

Tex Heart Inst J 2021 Jun;48(2)

Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, People's Republic of China.

Myocardial ischemia and left ventricular dysfunction have been documented in young adults with familial hypercholesterolemia. We investigated whether speckle-tracking echocardiography can be used to detect subclinically impaired global and regional myocardial function in patients with this lipid disorder. This single-center study included 47 patients with familial hypercholesterolemia and 37 healthy control subjects who underwent transthoracic Doppler echocardiography and speckle-tracking echocardiography from January 2003 through December 2016. Read More

Clinics (Sao Paulo) 2021;76:e2732. Epub 2021 Jun 11.

Departamento de Medicina Interna, Faculdade de Medicina, Campus Botucatu, Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP, BR.

Objectives: Coronary artery disease is the primary cause of death and is responsible for a high number of hospitalizations worldwide. Ventricular remodeling is associated with worse prognosis following ST-segment elevation myocardial infarction (STEMI) and is a risk factor for ventricular dysfunction and heart failure. This study aimed to identify the predictors of ventricular remodeling following STEMI. Read More

EJNMMI Phys 2021 Jun 16;8(1):48. Epub 2021 Jun 16.

Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.

Background: Quantitative SPECT enables absolute quantification of uptake in perfusion defects. The aim of this experimental study is to assess quantitative accuracy and precision of a novel iterative reconstruction technique (Evolution; GE Healthcare) for the potential application of response monitoring using Tc-tetrofosmin SPECT/CT in patients with coronary artery disease (CAD).

Methods: Acquisitions of an anthropomorphic torso phantom with cardiac insert containing defects (with varying sizes), filled with Tc-pertechnetate, were performed on a SPECT/CT (Discovery 670 Pro, GE Healthcare). Read More

Eur Radiol 2021 Jun 15. Epub 2021 Jun 15.

Department of Radiology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.

Objectives: To compare the detection of relevant extracardiac findings (ECFs) on coronary computed tomography angiography (CTA) and invasive coronary angiography (ICA) and evaluate the potential clinical benefit of their detection.

Methods: This is the prespecified subanalysis of ECFs in patients presenting with a clinical indication for ICA based on atypical angina and suspected coronary artery disease (CAD) included in the prospective single-center randomized controlled Coronary Artery Disease Management (CAD-Man) study. ECFs requiring immediate therapy and/or further workup including additional imaging were defined as clinically relevant. Read More

Acad Radiol 2021 Jun 11. Epub 2021 Jun 11.

Department of Radiology, Zhongshan Hospital, Fudan University, and Shanghai Institute of Medical Imaging, Shanghai 200032, China; Department of Medical Imaging, Shanghai Medical school, Fudan University. Electronic address:

Rationale And Objectives: The clinical utility of Dixon water-fat separation coronary MR angiography (CMRA) with compressed sensing (CS) reconstruction has not been determined in a patient population. This study was designed to evaluate the performance of 3.0 T non-contrast-enhanced Dixon water-fat separation CS whole-heart CMRA sequence in vitro and in vivo. Read More

Atherosclerosis 2021 Jun 7;328:100-105. Epub 2021 Jun 7.

Division of Cardiology, Department of Medicine II, Kansai Medical University, Hirakata, Japan.

Background And Aims: We developed a deep learning (DL) model for automated atherosclerotic plaque categorization using optical frequency domain imaging (OFDI) and performed quantitative and visual evaluations.

Methods: A total of 1103 histological cross-sections from 45 autopsy hearts were examined to compare the ex vivo OFDI scans. The images were segmented and annotated considering four histological categories: pathological intimal thickening (PIT), fibrous cap atheroma (FA), fibrocalcific plaque (FC), and healed erosion/rupture (HER). Read More

Can J Cardiol 2021 Jun 11. Epub 2021 Jun 11.

Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK.; Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.; Insigneo Institute for In-silico medicine, Sheffield, UK.

Background: Using fractional flow reserve (FFR) to guide percutaneous coronary intervention for patients with coronary artery disease (CAD) improves clinical decision making but remains under-used. Virtual FFR (vFFR, computed from angiographic images) permits physiological assessment without a pressure wire and can be extended to virtual coronary intervention (VCI) facilitating treatment planning. This study investigated the effect of adding vFFR and VCI to angiography in patient assessment and management. Read More

Kardiol Pol 2021 ;79(5):566-568

National Institute of Cardiology, Warszawa, Poland.