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Photon-counting detector computed tomography in cardiac imaging. 光子计数探测器计算机断层扫描在心脏成像中的应用。
IF 1.7 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 Epub Date: 2024-10-02 DOI: 10.1007/s12471-024-01904-5
Simran P Sharma, Marie-Julie D K Lemmens, Martijn W Smulders, Ricardo P J Budde, Alexander Hirsch, Casper Mihl

Photon-counting detector computed tomography (PCD-CT) has emerged as a revolutionary technology in CT imaging. PCD-CT offers significant advancements over conventional energy-integrating detector CT, including increased spatial resolution, artefact reduction and inherent spectral imaging capabilities. In cardiac imaging, PCD-CT can offer a more accurate assessment of coronary artery disease, plaque characterisation and the in-stent lumen. Additionally, it might improve the visualisation of myocardial fibrosis through qualitative late enhancement imaging and quantitative extracellular volume measurements. The use of PCD-CT in cardiac imaging holds significant potential, positioning itself as a valuable modality that could serve as a one-stop-shop by integrating both angiography and tissue characterisation into a single examination. Despite its potential, large-scale clinical trials, standardisation of protocols and cost-effectiveness considerations are required for its broader integration into clinical practice. This narrative review provides an overview of the current literature on PCD-CT regarding the possibilities and limitations of cardiac imaging.

光子计数探测器计算机断层扫描(PCD-CT)已成为 CT 成像领域的一项革命性技术。与传统的能量积分探测器 CT 相比,PCD-CT 具有明显的进步,包括提高空间分辨率、减少伪影和固有的光谱成像能力。在心脏成像中,PCD-CT 可以更准确地评估冠状动脉疾病、斑块特征和支架内腔。此外,它还可以通过定性的后期增强成像和定量的细胞外体积测量,改善心肌纤维化的可视化。PCD-CT 在心脏成像中的应用潜力巨大,它将自己定位为一种有价值的模式,可将血管造影和组织特征描述整合到一次检查中,从而提供一站式服务。尽管其潜力巨大,但要将其更广泛地应用于临床实践,还需要进行大规模临床试验、标准化方案和成本效益考量。这篇叙述性综述概述了目前有关 PCD-CT 的文献,涉及心脏成像的可能性和局限性。
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引用次数: 0
Moving towards a uniform diagnosis of coronary artery disease on coronary CTA : Coronary Artery Disease-Reporting and Data System 2.0. 实现冠状动脉 CTA 冠状动脉疾病的统一诊断:冠状动脉疾病报告和数据系统 2.0。
IF 1.7 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 Epub Date: 2024-10-10 DOI: 10.1007/s12471-024-01903-6
Csilla Celeng, Richard A P Takx

The Coronary Artery Disease-Reporting and Data System (CAD-RADS) is a standardised reporting method which was created in order to improve communication with referring physicians as well as for management considerations. The CAD-RADS score denotes the absence or presence of stenosis, while plaque burden and potential modifiers provide insight into plaque extent and characteristics. The modifier ischaemia enables the incorporation of fractional flow reserve CT and CT perfusion, while the modifier exception is used to denote potential coronary abnormalities. Higher CAD-RADS categories demonstrate incremental prognostic value, with further improvement when taking plaque burden into account. CAD-RADS improves communication with the referring clinician as well as guiding therapeutic management and as such is relevant to uniform patient care in the Netherlands.

冠状动脉疾病报告和数据系统(CAD-RADS)是一种标准化的报告方法,旨在改善与转诊医生的沟通,并为管理提供参考。CAD-RADS 评分表示有无血管狭窄,而斑块负荷和潜在的修饰词则能让人了解斑块的范围和特征。缺血修饰符使分数血流储备 CT 和 CT 灌注成为可能,而异常修饰符则用于表示潜在的冠状动脉异常。CAD-RADS 类别越高,预后价值越大,如果考虑到斑块负荷,预后价值还会进一步提高。CAD-RADS 可改善与转诊医生的沟通,并指导治疗管理,因此与荷兰的统一患者护理息息相关。
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引用次数: 0
CT is the new standard for the diagnosis of coronary artery disease in daily practice. CT 是日常诊断冠状动脉疾病的新标准。
IF 1.7 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 Epub Date: 2024-10-07 DOI: 10.1007/s12471-024-01907-2
José P S Henriques, R Nils Planken
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引用次数: 0
The role of artificial intelligence in coronary CT angiography. 人工智能在冠状动脉 CT 血管造影术中的作用。
IF 1.7 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 Epub Date: 2024-10-10 DOI: 10.1007/s12471-024-01901-8
Rudolf L M van Herten, Ioannis Lagogiannis, Tim Leiner, Ivana Išgum

Coronary CT angiography (CCTA) offers an efficient and reliable tool for the non-invasive assessment of suspected coronary artery disease through the analysis of coronary artery plaque and stenosis. However, the detailed manual analysis of CCTA is a burdensome task requiring highly skilled experts. Recent advances in artificial intelligence (AI) have made significant progress toward a more comprehensive automated analysis of CCTA images, offering potential improvements in terms of speed, performance and scalability. This work offers an overview of the recent developments of AI in CCTA. We cover methodological advances for coronary artery tree and whole heart analysis, and provide an overview of AI techniques that have shown to be valuable for the analysis of cardiac anatomy and pathology in CCTA. Finally, we provide a general discussion regarding current challenges and limitations, and discuss prospects for future research.

冠状动脉 CT 血管造影术(CCTA)通过分析冠状动脉斑块和狭窄情况,为无创评估疑似冠状动脉疾病提供了一种高效可靠的工具。然而,对 CCTA 进行详细的人工分析是一项繁重的任务,需要技术娴熟的专家来完成。人工智能(AI)的最新进展在实现更全面的 CCTA 图像自动分析方面取得了重大进展,并在速度、性能和可扩展性方面提供了潜在的改进。本论文概述了人工智能在 CCTA 方面的最新发展。我们介绍了冠状动脉树和整个心脏分析方法的进展,并概述了对 CCTA 中心脏解剖和病理分析有价值的人工智能技术。最后,我们就当前的挑战和局限性进行了一般性讨论,并探讨了未来研究的前景。
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引用次数: 0
Demographics and outcomes of patients younger than 75 years undergoing aortic valve interventions in Rotterdam. 鹿特丹接受主动脉瓣介入治疗的 75 岁以下患者的人口统计学特征和治疗效果。
IF 1.7 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-01 Epub Date: 2024-08-20 DOI: 10.1007/s12471-024-01888-2
Rik Adrichem, A Maarten Mattace-Raso, Thijmen W Hokken, Mark M P van den Dorpel, Marjo J A G de Ronde, Mattie J Lenzen, Paul A Cummins, Isabella Kardys, Rutger-Jan Nuis, Joost Daemen, Jos A Bekkers, Nicolas M Van Mieghem

Background: Transcatheter aortic valve implantation (TAVI) is considered a safe and effective alternative to surgical aortic valve replacement (SAVR) for elderly patients across the operative risk spectrum. In the Netherlands, TAVI is reimbursed only for patients with a high operative risk. Despite this, one fifth of TAVI patients are < 75 years of age. We aim to compare patient characteristics and outcomes of TAVI and SAVR patients < 75 years.

Methods: This study included all patients < 75 years without active endocarditis undergoing TAVI or SAVR for severe aortic stenosis, mixed aortic valve disease or degenerated aortic bioprosthesis between 2015 and 2020 at the Erasmus University Medical Centre. Dutch authority guidelines were used to classify operative risk.

Results: TAVI was performed in 292 patients, SAVR in 386 patients. Based on the Dutch risk algorithm, 59.6% of TAVI patients and 19.4% of SAVR patients were at high operative risk. There was no difference in 30-day all-cause mortality between TAVI and SAVR (2.4% vs 0.8%, p = 0.083). One-year and 5‑year mortality was higher after TAVI than after SAVR (1-year: 12.5% vs 4.3%, p < 0.001; 5‑year: 36.8% vs 12.0%, p < 0.001). Within risk categories we found no difference between treatment strategies. Independent predictors of mortality were cardiovascular comorbidities (left ventricular ejection fraction < 30%, atrial fibrillation, pulmonary hypertension) and the presence of malignancies, liver cirrhosis or immunomodulatory drug use.

Conclusion: At the Erasmus University Medical Centre, in patients < 75 years, TAVI is selected for higher-risk phenotypes and overall has higher long-term mortality than SAVR. We found no evidence for worse outcome within risk categories.

背景:对于各种手术风险的老年患者来说,经导管主动脉瓣植入术(TAVI)被认为是手术主动脉瓣置换术(SAVR)的一种安全有效的替代方法。在荷兰,TAVI 仅对手术风险高的患者报销。尽管如此,仍有五分之一的 TAVI 患者接受了手术:本研究包括所有患者:292 名患者进行了 TAVI,386 名患者进行了 SAVR。根据荷兰风险算法,59.6% 的 TAVI 患者和 19.4% 的 SAVR 患者面临高手术风险。TAVI和SAVR的30天全因死亡率没有差异(2.4% vs 0.8%,p = 0.083)。TAVI 术后 1 年和 5 年的死亡率高于 SAVR 术后(1 年:12.5% 对 4.3%):1 年:12.5% 对 4.3%,P = 0.083):在伊拉斯谟大学医疗中心,患者
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引用次数: 0
Implantable cardioverter-defibrillators might not be necessary in all patients with idiopathic ventricular fibrillation. 并非所有特发性心室颤动患者都需要植入心律转复除颤器。
IF 1.7 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-01 Epub Date: 2024-09-06 DOI: 10.1007/s12471-024-01898-0
Alwin B P Noordman, Alexander H Maass
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引用次数: 0
Trends in adoption of extravascular cardiac implantable electronic devices: the Dutch cohort. 血管外心脏植入电子装置的采用趋势:荷兰队列。
IF 1.7 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-01 Epub Date: 2024-08-19 DOI: 10.1007/s12471-024-01892-6
Karel T N Breeman, Reinoud E Knops, Michelle D van der Stoel, Lucas V A Boersma, Sing-Chien Yap, Lieselot van Erven, Vincent F van Dijk, Alexander H Maass, Arthur A M Wilde, Fleur V Y Tjong

Introduction: Conventional implantable cardioverter-defibrillators (ICDs) and pacemakers carry a risk of pocket- and lead-related complications in particular. To avoid these complications, extravascular devices (EVDs) have been developed, such as the subcutaneous ICD (S-ICD) and leadless pacemaker (LP). However, data on patient or centre characteristics related to the actual adoption of EVDs are lacking.

Objective: To assess real-world nationwide trends in EVD adoption in the Netherlands.

Methods: Using the Netherlands Heart Registration, all consecutive patients with a de novo S‑ICD or conventional single-chamber ICD implantation between 2012-2020, or de novo LP or conventional single-chamber pacemaker implantation between 2014-2020 were included. Trends in adoption are described for various patient and centre characteristics.

Result: From 2012-2020, 2190 S‑ICDs and 10,683 conventional ICDs were implanted; from 2014-2020, 712 LPs and 11,103 conventional pacemakers were implanted. The general use has increased (S-ICDs 8 to 21%; LPs 1 to 8%), but this increase seems to have reached a plateau. S‑ICD recipients were younger than conventional ICD recipients (p < 0.001) and more often female (p < 0.001); LP recipients were younger than conventional pacemaker recipients (p < 0.001) and more often male (p = 0.03). Both S‑ICDs and LPs were mainly implanted in high-volume centres with cardiothoracic surgery on-site, although over time S‑ICDs were increasingly implanted in centres without cardiothoracic surgery (p < 0.001).

Conclusion: This nationwide study demonstrated a relatively quick adoption of innovative EVDs with a plateau after approximately 4 years. S‑ICD use is especially high in younger patients. EVDs are mainly implanted in high-volume centres with cardiothoracic surgery back-up, but S‑ICD use is expanding beyond those centres.

导言:传统的植入式心律转复除颤器(ICD)和心脏起搏器尤其有可能出现口袋和导线相关的并发症。为了避免这些并发症,人们开发了血管外装置(EVD),如皮下 ICD(S-ICD)和无引线起搏器(LP)。然而,有关实际采用 EVDs 的患者或中心特征的数据却很缺乏:评估荷兰全国范围内采用 EVD 的实际趋势:方法:通过荷兰心脏登记,纳入所有在 2012-2020 年间重新植入 S-ICD 或传统单腔 ICD,或在 2014-2020 年间重新植入 LP 或传统单腔起搏器的连续患者。结果:结果:2012-2020年间,共植入2190个S-ICD和10683个传统ICD;2014-2020年间,共植入712个LP和11103个传统起搏器。总体使用率有所上升(S-ICD 的使用率从 8% 上升至 21%;LP 的使用率从 1% 上升至 8% ),但这一增长似乎已达到了一个平稳期。S-ICD 接受者比传统 ICD 接受者更年轻(p 结论:这项全国范围的研究表明,创新型 EVD 的采用速度相对较快,大约 4 年后达到高峰。S-ICD 在年轻患者中的使用率尤其高。EVD 主要在有心胸外科后备力量的大容量中心植入,但 S-ICD 的使用正从这些中心向外扩展。
{"title":"Trends in adoption of extravascular cardiac implantable electronic devices: the Dutch cohort.","authors":"Karel T N Breeman, Reinoud E Knops, Michelle D van der Stoel, Lucas V A Boersma, Sing-Chien Yap, Lieselot van Erven, Vincent F van Dijk, Alexander H Maass, Arthur A M Wilde, Fleur V Y Tjong","doi":"10.1007/s12471-024-01892-6","DOIUrl":"10.1007/s12471-024-01892-6","url":null,"abstract":"<p><strong>Introduction: </strong>Conventional implantable cardioverter-defibrillators (ICDs) and pacemakers carry a risk of pocket- and lead-related complications in particular. To avoid these complications, extravascular devices (EVDs) have been developed, such as the subcutaneous ICD (S-ICD) and leadless pacemaker (LP). However, data on patient or centre characteristics related to the actual adoption of EVDs are lacking.</p><p><strong>Objective: </strong>To assess real-world nationwide trends in EVD adoption in the Netherlands.</p><p><strong>Methods: </strong>Using the Netherlands Heart Registration, all consecutive patients with a de novo S‑ICD or conventional single-chamber ICD implantation between 2012-2020, or de novo LP or conventional single-chamber pacemaker implantation between 2014-2020 were included. Trends in adoption are described for various patient and centre characteristics.</p><p><strong>Result: </strong>From 2012-2020, 2190 S‑ICDs and 10,683 conventional ICDs were implanted; from 2014-2020, 712 LPs and 11,103 conventional pacemakers were implanted. The general use has increased (S-ICDs 8 to 21%; LPs 1 to 8%), but this increase seems to have reached a plateau. S‑ICD recipients were younger than conventional ICD recipients (p < 0.001) and more often female (p < 0.001); LP recipients were younger than conventional pacemaker recipients (p < 0.001) and more often male (p = 0.03). Both S‑ICDs and LPs were mainly implanted in high-volume centres with cardiothoracic surgery on-site, although over time S‑ICDs were increasingly implanted in centres without cardiothoracic surgery (p < 0.001).</p><p><strong>Conclusion: </strong>This nationwide study demonstrated a relatively quick adoption of innovative EVDs with a plateau after approximately 4 years. S‑ICD use is especially high in younger patients. EVDs are mainly implanted in high-volume centres with cardiothoracic surgery back-up, but S‑ICD use is expanding beyond those centres.</p>","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"356-362"},"PeriodicalIF":1.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Strengthening NVVC endorsements for ESC guidelines. 加强国家退伍军人理事会对经社文委员会指导方针的认可。
IF 1.7 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-01 Epub Date: 2024-09-19 DOI: 10.1007/s12471-024-01905-4
Pim van der Harst
{"title":"Strengthening NVVC endorsements for ESC guidelines.","authors":"Pim van der Harst","doi":"10.1007/s12471-024-01905-4","DOIUrl":"10.1007/s12471-024-01905-4","url":null,"abstract":"","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":"32 10","pages":"337"},"PeriodicalIF":1.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reply to 'Implantable cardioverter-defibrillators might not be necessary in all patients with idiopathic ventricular fibrillation'. 回复 "并非所有特发性心室颤动患者都需要植入式心律转复除颤器"。
IF 1.7 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-01 Epub Date: 2024-09-09 DOI: 10.1007/s12471-024-01899-z
Lisa M Verheul, Rutger J Hassink
{"title":"Reply to 'Implantable cardioverter-defibrillators might not be necessary in all patients with idiopathic ventricular fibrillation'.","authors":"Lisa M Verheul, Rutger J Hassink","doi":"10.1007/s12471-024-01899-z","DOIUrl":"10.1007/s12471-024-01899-z","url":null,"abstract":"","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"366"},"PeriodicalIF":1.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transcatheter aortic valve implantation under 75 years of age: only for high surgical risk patients; but for how long? 75 岁以下经导管主动脉瓣植入术:仅适用于手术风险高的患者;但能持续多久?
IF 1.7 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-01 Epub Date: 2024-08-29 DOI: 10.1007/s12471-024-01900-9
Michiel Voskuil, Michael G Dickinson
{"title":"Transcatheter aortic valve implantation under 75 years of age: only for high surgical risk patients; but for how long?","authors":"Michiel Voskuil, Michael G Dickinson","doi":"10.1007/s12471-024-01900-9","DOIUrl":"10.1007/s12471-024-01900-9","url":null,"abstract":"","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"346-347"},"PeriodicalIF":1.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142109661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Netherlands Heart Journal
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