Mulitmedia Library
Coronary CTA plaque volume severity stages according to invasive coronary angiography and FFR
Atherosclerotic plaque characterization by coronary computed tomography angiography (CCTA) enables quantification of coronary artery disease (CAD) burden and type, which has been demonstrated as the strongest discriminant of future risk of major adverse cardiac events (MACE). To date, there are no clinically useful thresholds to assist with understanding a patient's disease burden and guide diagnosis and management, as there exists with coronary artery calcium (CAC) scoring. The purpose of this manuscript is to establish clinically relevant plaque stages and thresholds based on evidence from invasive angiographic stenosis (ICA) and fractional flow reserve (FFR) data.Coronary volume to left ventricular mass ratio in patients with diabetes mellitus
Diabetes mellitus is a major risk factor for coronary artery disease (CAD) and may provoke structural and functional changes in coronary vasculature. The coronary volume to left ventricular mass (V/M) ratio is a new anatomical parameter capable of revealing a potential physiological imbalance between coronary vasculature and myocardial mass. The aim of this study was to examine the V/M derived from coronary computed tomography angiography (CCTA) in patients with diabetes.Live integration of comprehensive cardiac CT with electroanatomical mapping in patients with refractory ventricular tachycardia
Aim of the present study was to verify the feasibility and accuracy of live integration of myocardial fibrosis evaluated at CCT with EAM (electro-anatomical mapping).Comparison of coronary atherosclerotic plaque progression in East Asians and Caucasians by serial coronary computed tomographic angiography: A PARADIGM substudy
To investigate potential differences in plaque progression (PP) between in East Asians and Caucasians as well as to determine clinical predictors of PP in East Asians.Trans-lesional fractional flow reserve gradient as derived from coronary CT improves patient management: ADVANCE registry
The role of change in fractional flow reserve derived from CT (FFRCT) across coronary stenoses (ΔFFRCT) in guiding downstream testing in patients with stable coronary artery disease (CAD) is unknown.Coronary and total thoracic calcium scores predict mortality and provides pathophysiologic insights in COVID-19 patients
Coronavirus disease 2019 (COVID-19) has spread worldwide determining dramatic impacts on healthcare systems. Early identification of high-risk parameters is required in order to provide the best therapeutic approach. Coronary, thoracic aorta and aortic valve calcium can be measured from a non-gated chest computer tomography (CT) and are validated predictors of cardiovascular events and all-cause mortality. However, their prognostic role in acute systemic inflammatory diseases, such as COVID-19, has not been investigated.The clinical utility of FFRCT stratified by age
CT coronary angiography (CTA) with Fractional Flow Reserve as determined by CT (FFRCT) is a safe alternative to invasive coronary angiography. A negative FFRCT has been shown to have low cardiac event rates compared to those with a positive FFRCT. However, the clinical utility of FFRCT according to age is not known.Percent atheroma volume: Optimal variable to report whole-heart atherosclerotic plaque burden with coronary CTA, the PARADIGM study
Different methodologies to report whole-heart atherosclerotic plaque on coronary computed tomography angiography (CCTA) have been utilized. We examined which of the three commonly used plaque burden definitions was least affected by differences in body surface area (BSA) and sex.Coronary atherosclerosis scoring with semiquantitative CCTA risk scores for prediction of major adverse cardiac events: Propensity score-based analysis of diabetic and non-diabetic patients
We aimed to compare semiquantitative coronary computed tomography angiography (CCTA) risk scores – which score presence, extent, composition, stenosis and/or location of coronary artery disease (CAD) – and their prognostic value between patients with and without diabetes mellitus (DM). Risk scores derived from general chest-pain populations are often challenging to apply in DM patients, because of numerous confounders.State-of-the-art-myocardial perfusion stress testing: Static CT perfusion
Large multicenter studies and meta-analysis have documented the diagnostic accuracy and the prognostic implications of stress echocardiography, cardiac magnetic resonance and, mainly, nuclear stress tests. However, none of them provides a comprehensive anatomical and functional evaluation within the same study as stress CT perfusion. Myocardial CT perfusion is the only non-invasive modality that allows to quantifying coronary stenosis and determining its functional relevance, constituting a potential “one-stop-shop” method for the diagnosis and global management of patients with known or suspected coronary artery disease.Cardiovascular morbidity and mortality in patients with aortic valve calcification: A systematic review and meta-analysis
Aortic valve calcification (AVC) is an active process that involves inflammation, disorganization of matrix disposition, lipid accumulation and lamellar bone formation. AVC without hemodynamic changes has been associated with cardiovascular (CV) risk factors and increased risk of coronary and CV events. Nowadays, echocardiography is the standard imaging technique to evaluate aortic valve pathologies. However, cardiac computed tomography (CT) allows high accuracy and reproducible measurement of AVC, without exposing the patients to excessive radiation or contrast administration.Anomalous origin of the left circumflex artery from the right coronary sinus with retro-aortic course: A potential malign variant
A 46-year-old man with an unremarkable past medical history and no cardiovascular risk factors was referred to perform cardiac magnetic resonance (CMR) for recent suspected myocarditis. CMR showed normal left ventricular volumes and systolic function, hypokinesis at the level of basal to mid inferolateral wall, and transmural late gadolinium enhancement with ischemic pattern was evident in the left circumflex artery territory at the basal and mid inferolateral wall (Fig. 1). To rule out the presence of obstructive coronary artery disease (CAD), an ECG-gated coronary computed tomography angiogram (CCTA) was performed, showing an anomalous origin of the circumflex coronary artery from the right coronary sinus with a retro-aortic course (Fig.A cross-sectional survey of coronary plaque composition in individuals on non-statin lipid lowering drug therapies and undergoing coronary computed tomography angiography
Non-statin therapy (NST) is used as second-line treatment when statin monotherapy is inadequate or poorly tolerated.Submillisievert CT angiography for carotid arteries using wide array CT scanner and latest iterative reconstruction algorithm in comparison with previous generations technologies: Feasibility and diagnostic accuracy
To assess evaluability and diagnostic accuracy of a low dose CT angiography (CTA) protocol for carotid arteries using latest Iterative Reconstruction (IR) algorithm in comparison with standard 100 kVp protocol using previous generation CT and IR.Left atrial appendage closure guided by 3D computed tomography printing technology: A case control study
We sought to evaluate the additional value of left atrial appendage (LAA) 3D printing derived from computed tomography (CCT) in determining the size for LAA occlusion (LAAO) devices as compared to standard measurement by using occurrence of LAA leak as endpoint.Left-dominant arrhythmogenic cardiomyopathy diagnosed at cardiac CT
A 71 years-old man was referred to our Center after detection of a non-sustained ventricular tachycardia (NSVT) at ambulatory electrocardiogram (ECG) monitoring. His previous cardiological history was negative. Rest ECG showed negative T-waves on V4 V6 leads (Panel A). Blood examination was normal including high-sensitive troponin-I and C-reactive protein. Transthoracic echocardiography showed normal biventricular wall kinesis and function. Cardiac CT (CCT) ruled out coronary artery disease but showed a hypodense region (−80 HU), consistent with a fibro-adipose tissue infiltration, in left ventricular (LV) lateral wall with sub-epicardial distribution (Panel B and C, red arrows).
