Journal of Cardiovascular Imaging最新文献

英文中文

Path to Accurate and Universal Strain Measurement: Insights From a Validation Study. 通往准确和通用应变测量之路:来自验证研究的见解。

Q2 Medicine

Journal of Cardiovascular Imaging

Pub Date : 2023-07-01 DOI: 10.4250/jcvi.2023.0029

Goo-Yeong Cho

https://e-jcvi.org While myocardial strain measurement is not currently considered a mandatory assessment in the guidelines of various cardiac disease, unlike left ventricular ejection fraction, it is a topic of active research among many investigators due to its potential clinical utility.1) The results of these studies have been promising, suggesting that myocardial strain measurement could become a necessary assessment in the near future. However, there are several challenges that need to be addressed before myocardial strain can be widely used in routine clinical practice. One of the main issues is that strain values can vary depending on the software used for measurement, and there is currently no standardization method for correcting these differences. As a result, it can be difficult to compare strain values obtained using different software programs, which can limit the utility of strain measurements in clinical decision-making. As such, the validation of strain measurement software is a critical step in establishing the reliability and accuracy of this tool. As these developments continue, it is likely that myocardial strain measurement will become an increasingly important tool for the diagnosis, treatment, and management of cardiac disease.

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引用次数: 0

Dynamic Cardiac Magnetic Resonance Fingerprinting During Vasoactive Breathing Maneuvers: First Results. 动态心脏磁共振指纹在血管活动性呼吸操作:初步结果。

Q2 Medicine

Journal of Cardiovascular Imaging

Pub Date : 2023-04-01 DOI: 10.4250/jcvi.2022.0080

Luuk H G A Hopman, Elizabeth Hillier, Yuchi Liu, Jesse Hamilton, Kady Fischer, Nicole Seiberlich, Matthias G Friedrich

BACKGROUND Cardiac magnetic resonance fingerprinting (cMRF) enables simultaneous mapping of myocardial T1 and T2 with very short acquisition times. Breathing maneuvers have been utilized as a vasoactive stress test to dynamically characterize myocardial tissue in vivo. We tested the feasibility of sequential, rapid cMRF acquisitions during breathing maneuvers to quantify myocardial T1 and T2 changes. METHODS We measured T1 and T2 values using conventional T1 and T2-mapping techniques (modified look locker inversion [MOLLI] and T2-prepared balanced-steady state free precession), and a 15 heartbeat (15-hb) and rapid 5-hb cMRF sequence in a phantom and in 9 healthy volunteers. The cMRF5-hb sequence was also used to dynamically assess T1 and T2 changes over the course of a vasoactive combined breathing maneuver. RESULTS In healthy volunteers, the mean myocardial T1 of the different mapping methodologies were: MOLLI 1,224 ± 81 ms, cMRF15-hb 1,359 ± 97 ms, and cMRF5-hb 1,357 ± 76 ms. The mean myocardial T2 measured with the conventional mapping technique was 41.7 ± 6.7 ms, while for cMRF15-hb 29.6 ± 5.8 ms and cMRF5-hb 30.5 ± 5.8 ms. T2 was reduced with vasoconstriction (post-hyperventilation compared to a baseline resting state) (30.15 ± 1.53 ms vs. 27.99 ± 2.07 ms, p = 0.02), while T1 did not change with hyperventilation. During the vasodilatory breath-hold, no significant change of myocardial T1 and T2 was observed. CONCLUSIONS cMRF5-hb enables simultaneous mapping of myocardial T1 and T2, and may be used to track dynamic changes of myocardial T1 and T2 during vasoactive combined breathing maneuvers.

背景:心脏磁共振指纹图谱(cMRF)能够在非常短的采集时间内同时绘制心肌T1和T2。呼吸动作已被用作血管活性应激测试来动态表征体内心肌组织。我们测试了在呼吸动作期间连续、快速获取cMRF以量化心肌T1和T2变化的可行性。方法:我们使用传统的T1和T2映射技术(改进的look locker反演[MOLLI]和T2制备的平衡稳态自由进动)测量T1和T2值，并在幻影和9名健康志愿者中使用15心跳(15-hb)和快速5-hb cMRF序列。cMRF5-hb序列也用于动态评估血管活动性联合呼吸操作过程中T1和T2的变化。结果:在健康志愿者中，不同作图方法的平均心肌T1为:MOLLI 1,224±81 ms, cMRF15-hb 1,359±97 ms, cMRF5-hb 1,357±76 ms。常规测图方法测得的心肌T2均值为41.7±6.7 ms, cMRF15-hb为29.6±5.8 ms, cMRF5-hb为30.5±5.8 ms。T2随血管收缩而降低(过度通气后与基线静息状态相比)(30.15±1.53 ms vs. 27.99±2.07 ms, p = 0.02)，而T1不随过度通气而改变。在血管扩张性屏气期间，心肌T1、T2无明显变化。结论:cMRF5-hb可同时绘制心肌T1和T2，可用于跟踪血管活动性联合呼吸动作时心肌T1和T2的动态变化。

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引用次数: 1

Longitudinal Changes of Left Atrial Volume Index as a Prognosticator in Hypertrophic Cardiomyopathy. 左房容积指数纵向变化作为肥厚性心肌病的预后指标。

Q2 Medicine

Journal of Cardiovascular Imaging

Pub Date : 2023-04-01 DOI: 10.4250/jcvi.2022.0143

Sungseek Kim, Wook-Jin Chung

outflow tract obstruction, LAVI, E/e ′ , tricuspid regurgitation velocity

引用次数: 0

Is a Low Dose Computed Tomography Angiography Protocol Feasible in Terms of Maintaining Adequate Diagnostic Image Quality for TAVR Candidates? 低剂量计算机断层血管造影方案在维持TAVR候选人足够的诊断图像质量方面可行吗?

Q2 Medicine

Journal of Cardiovascular Imaging

Pub Date : 2023-04-01 DOI: 10.4250/jcvi.2023.0022

Sung Min Ko

https://e-jcvi.org Transcatheter aortic valve replacement (TAVR) has been initiated first for inoperable patients with severe aortic stenosis (AS) and prohibitive comorbidities, then in high-, intermediateand, more recently, low-risk patients. Nowadays, TAVR has been established as the firstline treatment method for symptomatic patients of any age with severe AS and a high or prohibitive surgical risk.1) Computed tomography angiography (CTA) allows pre-procedural comprehensive evaluation for TAVR including coronary artery, aortic valve, aortic root, entire aorta, and vascular access site suitability at the same time.2) Accordingly, large amount of contrast medium is mandatory for obtaining good quality of images from the subclavian arteries to the femoral arteries. Chronic kidney disease is a common underlying disease in patients with severe AS and is significantly associated with aggravation of renal function in case of excessive use of iodinated contrast medium during both the pre-TAVR planning and TAVR procedure.3)4) Therefore, reducing the use of contrast medium for pre-procedural CTA imaging in TAVR is required for prevention of deteriorating renal function and worsening clinical outcomes in patients with renal dysfunction.

{"title":"Is a Low Dose Computed Tomography Angiography Protocol Feasible in Terms of Maintaining Adequate Diagnostic Image Quality for TAVR Candidates?","authors":"Sung Min Ko","doi":"10.4250/jcvi.2023.0022","DOIUrl":"https://doi.org/10.4250/jcvi.2023.0022","url":null,"abstract":"https://e-jcvi.org Transcatheter aortic valve replacement (TAVR) has been initiated first for inoperable patients with severe aortic stenosis (AS) and prohibitive comorbidities, then in high-, intermediateand, more recently, low-risk patients. Nowadays, TAVR has been established as the firstline treatment method for symptomatic patients of any age with severe AS and a high or prohibitive surgical risk.1) Computed tomography angiography (CTA) allows pre-procedural comprehensive evaluation for TAVR including coronary artery, aortic valve, aortic root, entire aorta, and vascular access site suitability at the same time.2) Accordingly, large amount of contrast medium is mandatory for obtaining good quality of images from the subclavian arteries to the femoral arteries. Chronic kidney disease is a common underlying disease in patients with severe AS and is significantly associated with aggravation of renal function in case of excessive use of iodinated contrast medium during both the pre-TAVR planning and TAVR procedure.3)4) Therefore, reducing the use of contrast medium for pre-procedural CTA imaging in TAVR is required for prevention of deteriorating renal function and worsening clinical outcomes in patients with renal dysfunction.","PeriodicalId":15229,"journal":{"name":"Journal of Cardiovascular Imaging","volume":"31 2","pages":"116-117"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0c/b7/jcvi-31-116.PMC10133808.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9390404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Strain Measurement for Assessment of Treatment Response: One Step Closer to Routine Clinical Practice. 应变测量用于评估治疗反应:更接近常规临床实践。

Q2 Medicine

Journal of Cardiovascular Imaging

Pub Date : 2023-04-01 DOI: 10.4250/jcvi.2023.0001

In-Chang Hwang

. The post-KT improvements in LV-GLS shown in the present study should be interpreted in the context of a recently published study in JACC Cardiovascular Imaging by the same group, which expands the clinical implications of the present JCVI study.

引用次数: 0

Temporary Arteriovenous Fistula Compression for Clinical Decision-Making in Patients on Hemodialysis With Significant Aortic Stenosis. 临时动静脉瘘压迫在血液透析伴明显主动脉狭窄患者临床决策中的应用。

Q2 Medicine

Journal of Cardiovascular Imaging

Pub Date : 2023-04-01 DOI: 10.4250/jcvi.2022.0088

Ga Yun Kim, Sang Hyun Lee, Seok Hyun Kim, Jeongsu Kim, Yong Hyun Park

https://e-jcvi.org A 57-year-old woman complained of dyspnea of New York Heart Association (NYHA) class III–IV and was transferred for surgery for severe degenerative aortic stenosis (AS). She had past history of chronic kidney disease on hemodialysis and hypertension. Initial echocardiography revealed moderate to severe degenerative AS with severe resting pulmonary hypertension (PH) and preserved left ventricular ejection fraction. Right heart catheterization was performed to find the cause of PH. The results showed combined post-capillary and pre-capillary PH with elevated cardiac index (CI) to 4.28 L/min/m2 (Table 1). Considering these results, the patient underwent intensive hemodialysis to reduce intravascular volume. However, AS peak jet velocity (Vpeak) was still high of 4.7 m/s with severe resting PH after volume reduction (Figure 1A). While evaluating causes of elevated CI, we found arteriovenous fistula (AVF) with high access flow rate (Figure 2). To determine the effects of increased transvalvular flow on measured parameters, we temporarily compressed AVF with blood pressure cuff to reduce shunt flow during echocardiography. During compression, Vpeak of aortic valve decreased to 3.6 m/s (Movies 1 and 2). The patient had revision of AVF to reduce shunt flow. After revision, echocardiography revealed moderate AS (Vpeak: 3.4 m/s) with mild resting PH (Figure 1B) and dyspnea was improved to NYHA class II. Continuity equation valve area was the same before and after surgery with value of 1.1 cm2 (Figure 3). High-flow state can overestimate AS severity.1) Causes of high-flow state should be identified and severity should be re-assessed when normal flow is restored.2) Temporary compression of AVF may be used for this purpose.1) J Cardiovasc Imaging. 2023 Apr;31(2):118-120 https://doi.org/10.4250/jcvi.2022.0088 pISSN 2586-7210·eISSN 2586-7296

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引用次数: 0

Low Contrast and Low kV CTA Before Transcatheter Aortic Valve Replacement: A Systematic Review. 经导管主动脉瓣置换术前低对比度和低千伏CTA:一项系统综述。

Q2 Medicine

Journal of Cardiovascular Imaging

Pub Date : 2023-04-01 DOI: 10.4250/jcvi.2022.0108

Spencer C Lacy, Mina M Benjamin, Mohammed Osman, Mushabbar A Syed, Menhel Kinno

Background: Minimizing contrast dose and radiation exposure while maintaining image quality during computed tomography angiography (CTA) for transcatheter aortic valve replacement (TAVR) is desirable, but not well established. This systematic review compares image quality for low contrast and low kV CTA versus conventional CTA in patients with aortic stenosis undergoing TAVR planning.

Methods: We performed a systematic literature review to identify clinical studies comparing imaging strategies for patients with aortic stenosis undergoing TAVR planning. The primary outcomes of image quality as assessed by the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were reported as random effects mean difference with 95% confidence interval (CI).

Results: We included 6 studies reporting on 353 patients. There was no difference in cardiac SNR (mean difference, -1.42; 95% CI, -5.71 to 2.88; p = 0.52), cardiac CNR (mean difference, -3.83; 95% CI, -9.98 to 2.32; p = 0.22), aortic SNR (mean difference, -0.23; 95% CI, -7.83 to 7.37; p = 0.95), aortic CNR (mean difference, -3.95; 95% CI, -12.03 to 4.13; p = 0.34), and ileofemoral SNR (mean difference, -6.09; 95% CI, -13.80 to 1.62; p = 0.12) between the low dose and conventional protocols. There was a difference in ileofemoral CNR between the low dose and conventional protocols with a mean difference of -9.26 (95% CI, -15.06 to -3.46; p = 0.002). Overall, subjective image quality was similar between the 2 protocols.

Conclusions: This systematic review suggests that low contrast and low kV CTA for TAVR planning provides similar image quality to conventional CTA.

背景:在进行经导管主动脉瓣置换术(TAVR)时，在保持图像质量的同时最小化造影剂和辐射暴露是可取的，但尚未得到很好的证实。本系统综述比较了低对比度和低kV CTA与常规CTA在主动脉瓣狭窄患者接受TAVR计划时的图像质量。方法:我们进行了系统的文献综述，以确定比较主动脉瓣狭窄患者接受TAVR计划的影像学策略的临床研究。通过信噪比(SNR)和对比噪声比(CNR)评估的图像质量的主要结果报告为随机效应平均差异，95%置信区间(CI)。结果:我们纳入了6项研究，报告了353例患者。两组心脏信噪比无显著差异(平均差异-1.42;95% CI， -5.71 ~ 2.88;p = 0.52)，心脏CNR(平均差值-3.83;95% CI， -9.98 ~ 2.32;p = 0.22)，主动脉信噪比(平均差异-0.23;95% CI， -7.83 ~ 7.37;p = 0.95)，主动脉CNR(平均差值-3.95;95% CI， -12.03 ~ 4.13;p = 0.34)，回肠股信噪比(平均差异为-6.09;95% CI， -13.80 ~ 1.62;P = 0.12)。低剂量组与常规组的回股CNR的平均差值为-9.26 (95% CI， -15.06 ~ -3.46;P = 0.002)。总体而言，两种方案的主观图像质量相似。结论:本系统综述表明，低对比度和低kV CTA用于TAVR规划可提供与传统CTA相似的图像质量。

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引用次数: 1

Aortic Root Honeycomb: A Rare Cardiac Surgery Complication. 主动脉根部蜂窝:一种罕见的心脏手术并发症。

Q2 Medicine

Journal of Cardiovascular Imaging

Pub Date : 2023-04-01 DOI: 10.4250/jcvi.2022.0100

Joana Laranjeira Correia, Vanda Devesa Neto, Gonçalo Rm Ferreira, Davide Moreira, Rogério Teixeira

https://e-jcvi.org A 33-year-old male was being followed in the cardiology outpatient clinic, after a tricuspid aortic valve replacement with a double-disc mechanical valve due to rheumatic aortic valve disease (Movies 1 and 2). The postoperative period was complicated by mediastinitis and Saphylococcus aureus bacteremia (without evidence of endocarditis), which resolved after a four-week course of targeted antibiotic therapy. The patient had no other relevant past medical conditions and was medicated with warfarin. No other clinically relevant events were reported since the valvular surgery and an echocardiography performed one year after the surgery revealed a normally functioning aortic prosthesis.

引用次数: 0

Dynamic Rapid Cardiac Magnetic Resonance Fingerprinting. 动态快速心脏磁共振指纹识别。

Q2 Medicine

Journal of Cardiovascular Imaging

Pub Date : 2023-04-01 DOI: 10.4250/jcvi.2022.0133

Jin Young Kim

Cardiac Magnetic Resonance Fingerprinting During Vasoactive Breathing

引用次数: 0

Role and Clinical Importance of Progressive Changes in Echocardiographic Parameters in Predicting Outcomes in Patients With Hypertrophic Cardiomyopathy. 超声心动图参数进行性变化在肥厚性心肌病预后预测中的作用及临床意义。

Q2 Medicine

Journal of Cardiovascular Imaging

Pub Date : 2023-04-01 DOI: 10.4250/jcvi.2022.0053

Kyehwan Kim, Seung Do Lee, Hyo Jin Lee, Hangyul Kim, Hye Ree Kim, Yun Ho Cho, Jeong Yoon Jang, Min Gyu Kang, Jin-Sin Koh, Seok-Jae Hwang, Jin-Yong Hwang, Jeong Rang Park

Background: The prognostic utility of follow-up transthoracic echocardiography (FU-TTE) in patients with hypertrophic cardiomyopathy (HCM) is unclear, specifically in terms of whether changes in echocardiographic parameters in routine FU-TTE parameters are associated with cardiovascular outcomes.

Methods: From 2010 to 2017, 162 patients with HCM were retrospectively enrolled in this study. Using echocardiography, HCM was diagnosed based on morphological criteria. Patients with other diseases that cause cardiac hypertrophy were excluded. TTE parameters at baseline and FU were analyzed. FU-TTE was designated as the last recorded value in patients who did not develop any cardiovascular event or the latest exam before event development. Clinical outcomes were acute heart failure, cardiac death, arrhythmia, ischemic stroke, and cardiogenic syncope.

Results: Median interval between the baseline TTE and FU-TTE was 3.3 years. Median clinical FU duration was 4.7 years. Septal trans-mitral velocity/mitral annular tissue Doppler velocity (E/e'), tricuspid regurgitation velocity, left ventricular ejection fraction (LVEF), and left atrial volume index (LAVI) at baseline were recorded. LVEF, LAVI, and E/e' values were associated with poor outcomes. However, no delta values predicted HCM-related cardiovascular outcomes. Logistic regression models incorporating changes in TTE parameters had no significant findings. Baseline LAVI was the best predictor of a poor prognosis. In survival analysis, an already enlarged or increased size LAVI was associated with poorer clinical outcomes.

Conclusions: Changes in echocardiographic parameters extracted from TTE did not assist in predicting clinical outcomes. Cross-sectionally evaluated TTE parameters were superior to changes in TTE parameters between baseline and FU at predicting cardiovascular events.

背景:随访经胸超声心动图(FU-TTE)在肥厚性心肌病(HCM)患者中的预后应用尚不清楚，特别是超声心动图参数在常规FU-TTE参数中的变化是否与心血管结局相关。方法:2010年至2017年，回顾性纳入162例HCM患者。超声心动图根据形态学标准诊断HCM。排除其他导致心脏肥厚的疾病患者。分析基线和FU时的TTE参数。FU-TTE被指定为未发生任何心血管事件或事件发生前最近一次检查的患者的最后记录值。临床结果为急性心力衰竭、心源性死亡、心律失常、缺血性中风和心源性晕厥。结果:基线TTE和FU-TTE之间的中位间隔为3.3年。临床FU持续时间中位数为4.7年。记录基线时室间隔经二尖瓣速度/二尖瓣环组织多普勒速度(E/ E’)、三尖瓣反流速度、左室射血分数(LVEF)、左房容积指数(LAVI)。LVEF、LAVI和E/ E值与预后不良相关。然而，没有delta值预测hcm相关的心血管结局。纳入TTE参数变化的Logistic回归模型没有显著的发现。基线LAVI是不良预后的最佳预测因子。在生存分析中，已经增大或增大的LAVI与较差的临床结果相关。结论:TTE超声心动图参数的变化不能帮助预测临床结果。横断面评估的TTE参数在预测心血管事件方面优于基线和FU之间TTE参数的变化。

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