Fariba Bayat, Mehdi Nazmdeh, M. Safi, Amir H. Karimi, L. Gachkar
Background: Left atrial function can be critical for risk assessment and prediction of adverse cardiac events. Tissue Doppler of atrial contraction can provide regional and global snapshots of atrial systolic function. Objectives: The present study aimed to assess left atrial function by tissue Doppler parameters of strain and strain rate following percutaneous coronary intervention (PCI). Patients and Methods: This prospective study recruited 77 consecutive patients with coronary artery disease who underwent PCI. The study end point was to assess left atrial function by regional strain and strain rate parameters before and after PCI via tissue Doppler imaging. Results: Regarding changes in left trial functional parameters after PCI, those such as the strain of the septal wall and the anterior and inferior walls and the strain rate of the anterior and lateral walls significantly increased following PCI, while the strain of the lateral wall and the strain rate of the septal wall significantly decreased. Conclusions: PCI was accompanied by some improvement in left atrial deformation indices as assessed by tissue Doppler imaging. Revascularization can, therefore, improve patient outcome.
{"title":"Assessment of left atrial function after percutaneous coronary intervention: A doppler-based strain and strain rate study","authors":"Fariba Bayat, Mehdi Nazmdeh, M. Safi, Amir H. Karimi, L. Gachkar","doi":"10.5812/acvi.33258","DOIUrl":"https://doi.org/10.5812/acvi.33258","url":null,"abstract":"Background: Left atrial function can be critical for risk assessment and prediction of adverse cardiac events. Tissue Doppler of atrial contraction can provide regional and global snapshots of atrial systolic function. Objectives: The present study aimed to assess left atrial function by tissue Doppler parameters of strain and strain rate following percutaneous coronary intervention (PCI). Patients and Methods: This prospective study recruited 77 consecutive patients with coronary artery disease who underwent PCI. The study end point was to assess left atrial function by regional strain and strain rate parameters before and after PCI via tissue Doppler imaging. Results: Regarding changes in left trial functional parameters after PCI, those such as the strain of the septal wall and the anterior and inferior walls and the strain rate of the anterior and lateral walls significantly increased following PCI, while the strain of the lateral wall and the strain rate of the septal wall significantly decreased. Conclusions: PCI was accompanied by some improvement in left atrial deformation indices as assessed by tissue Doppler imaging. Revascularization can, therefore, improve patient outcome.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129779636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: High-intensity interval training (HIIT) is a time-efficient alternative to traditional prolonged training. In contrast to ample evidence describing the effects of prolonged training, there are few data describing cardiovascular adaptations arising from HIIT interventions. Objectives: The present study aimed to evaluate the effects of HIIT on heart morphology and function in untrained male subjects. Patients and Methods: Twenty-two young men (age = 23.34 ± 2.56 years, weight = 72.47 ± 12.01 kg, and height = 174.10 ± 5.75 cm) were recruited and randomly assigned into control (n = 10) and HIIT (n = 12) groups. Echocardiography was used to evaluate left ventricular mass (LVM), end-systolic volume (ESV), end-diastolic volume (EDV), interventricular septal wall thickness (IVSWT), stroke volume, and ejection fraction (EF). Also, the Bruce treadmill test was employed to estimate VO2max. Results: The HIIT subjects showed a significant increase in EDV (P = 0.001), LVM (P = 0.002), stroke volume (P = 0.003), and EF (P = 0.001). However, there was no change in ESV due to HIIT (P = 0.916). Additionally, following HIIT, IVSWT (P = 0.227), despite exhibiting a slight increase, was not significantly different from pre-training levels. Conclusions: HIIT in previously untrained subjects led to a significant change in left ventricle (LV) morphology, correlating with improvement in aerobic power (VO2max). Cardiac remodeling was characterized by an increased EDV and a similar increase in LVM.
{"title":"Echocardiographic evaluation of the effects of high-intensity interval training on cardiac morphology and function","authors":"A. Sáadatnia, K. Ebrahim, A. Rashidlamir","doi":"10.5812/acvi.36007","DOIUrl":"https://doi.org/10.5812/acvi.36007","url":null,"abstract":"Background: High-intensity interval training (HIIT) is a time-efficient alternative to traditional prolonged training. In contrast to ample evidence describing the effects of prolonged training, there are few data describing cardiovascular adaptations arising from HIIT interventions. Objectives: The present study aimed to evaluate the effects of HIIT on heart morphology and function in untrained male subjects. Patients and Methods: Twenty-two young men (age = 23.34 ± 2.56 years, weight = 72.47 ± 12.01 kg, and height = 174.10 ± 5.75 cm) were recruited and randomly assigned into control (n = 10) and HIIT (n = 12) groups. Echocardiography was used to evaluate left ventricular mass (LVM), end-systolic volume (ESV), end-diastolic volume (EDV), interventricular septal wall thickness (IVSWT), stroke volume, and ejection fraction (EF). Also, the Bruce treadmill test was employed to estimate VO2max. Results: The HIIT subjects showed a significant increase in EDV (P = 0.001), LVM (P = 0.002), stroke volume (P = 0.003), and EF (P = 0.001). However, there was no change in ESV due to HIIT (P = 0.916). Additionally, following HIIT, IVSWT (P = 0.227), despite exhibiting a slight increase, was not significantly different from pre-training levels. Conclusions: HIIT in previously untrained subjects led to a significant change in left ventricle (LV) morphology, correlating with improvement in aerobic power (VO2max). Cardiac remodeling was characterized by an increased EDV and a similar increase in LVM.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"63 6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116269459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Khosravi, H. hashemi, M. Farahani, Mitra Dolatkhah, Z. Rostami, Y. Panahi
Background: Curcumin, a yellow substance found in turmeric, has not only antioxidative features and beneficial effects in the treatment of cancer, liver, heart, and pulmonary diseases but also anti-inflammatory and anticoagulative effects. This chemical has cardioprotective effects too. Objectives: In this study, we examined the effects of curcumin on left ventricular (LV) function in patients receiving dialysis for chronic renal failure. Methods: This study is a double-blind, placebo-controlled trial conducted on 35 patients with chronic renal failure undergoing dialysis in the dialysis center of Baqiyatallah hospital. The patients were randomly divided into 2 groups: the curcumin group (n = 20) and the control group (n = 15). The curcumin group received curcumin capsules at a dose of 500 mg every 8 hours for 6 weeks (1500 mg/d) and the control group received a placebo for 6 weeks at the same dose. Echocardiography was done before the use of the drug and once after the 6th week. Also, the ejection fraction (EF), representing LV function and size, was measured in both groups. Results: Themeanage was 44.2±13.4 years for the curcumin group and 45.4±6.2 years for the placebo group. The study population comprised 22 male and 13 female patients. There were no significant differences regarding demographic variables such as age, sex, and body mass index between the 2 groups. In the curcumin group, LVEF based on the volume changed from 50.6% ±7.1% to 51.5% ± 6.8% (P = 0.130). In the curcumin group, LVEF based on the diameter changed from 51.8% ± 3.8% to 52.4% ± 3.5% (P = 0.112). The changes in the mean EF before and after the intervention were not significant in each group. The EF, based on ventricular volume and diameter, was not significantly different between the 2 groups. In addition, the pulmonary artery pressuremeanin both groups did not significantly change after the intervention (P > 0.05). Conclusions: The administration of curcumin in patients undergoing dialysis had no positive effects on enhancing LVEF and LV function. Further research is required to shed sufficient light on this issue.
{"title":"The effects of curcumin on left ventricular function in patients with chronic renal failure","authors":"A. Khosravi, H. hashemi, M. Farahani, Mitra Dolatkhah, Z. Rostami, Y. Panahi","doi":"10.5812/acvi.38087","DOIUrl":"https://doi.org/10.5812/acvi.38087","url":null,"abstract":"Background: Curcumin, a yellow substance found in turmeric, has not only antioxidative features and beneficial effects in the treatment of cancer, liver, heart, and pulmonary diseases but also anti-inflammatory and anticoagulative effects. This chemical has cardioprotective effects too. Objectives: In this study, we examined the effects of curcumin on left ventricular (LV) function in patients receiving dialysis for chronic renal failure. Methods: This study is a double-blind, placebo-controlled trial conducted on 35 patients with chronic renal failure undergoing dialysis in the dialysis center of Baqiyatallah hospital. The patients were randomly divided into 2 groups: the curcumin group (n = 20) and the control group (n = 15). The curcumin group received curcumin capsules at a dose of 500 mg every 8 hours for 6 weeks (1500 mg/d) and the control group received a placebo for 6 weeks at the same dose. Echocardiography was done before the use of the drug and once after the 6th week. Also, the ejection fraction (EF), representing LV function and size, was measured in both groups. Results: Themeanage was 44.2±13.4 years for the curcumin group and 45.4±6.2 years for the placebo group. The study population comprised 22 male and 13 female patients. There were no significant differences regarding demographic variables such as age, sex, and body mass index between the 2 groups. In the curcumin group, LVEF based on the volume changed from 50.6% ±7.1% to 51.5% ± 6.8% (P = 0.130). In the curcumin group, LVEF based on the diameter changed from 51.8% ± 3.8% to 52.4% ± 3.5% (P = 0.112). The changes in the mean EF before and after the intervention were not significant in each group. The EF, based on ventricular volume and diameter, was not significantly different between the 2 groups. In addition, the pulmonary artery pressuremeanin both groups did not significantly change after the intervention (P > 0.05). Conclusions: The administration of curcumin in patients undergoing dialysis had no positive effects on enhancing LVEF and LV function. Further research is required to shed sufficient light on this issue.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130085724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Egea-Serrano, Ivan Keituqwa, A. Pelaez, J. Gimeno
Introduction: Takotsubo syndrome (TKS) is generally caused by a stressful condition, and it usually has a good prognosis after the recovery of left ventricular function. About 70% of the cases of hypertrophic cardiomyopathy may develop obstruction in the left ventricular outflow tract (LVOT), which is responsible for heart failure. Case Presentation: We present a unique case where TKS occurred in a middle-aged male patient with hypertrophic obstructive cardiomyopathy (HOCM) without a clearly identifiable initial stress trigger. Conclusions: In the setting of acute left ventricular function depression in HOCM, a comprehensive differential diagnosis should be established. Treatment should be based on hemodynamic changes. After recovery, the prognosis is related to HOCM.
{"title":"Hypertrophic Obstructive Cardiomyopathy and Takotsubo Syndrome: Could They Coexist?","authors":"P. Egea-Serrano, Ivan Keituqwa, A. Pelaez, J. Gimeno","doi":"10.5812/acvi.36507","DOIUrl":"https://doi.org/10.5812/acvi.36507","url":null,"abstract":"Introduction: Takotsubo syndrome (TKS) is generally caused by a stressful condition, and it usually has a good prognosis after the recovery of left ventricular function. About 70% of the cases of hypertrophic cardiomyopathy may develop obstruction in the left ventricular outflow tract (LVOT), which is responsible for heart failure. Case Presentation: We present a unique case where TKS occurred in a middle-aged male patient with hypertrophic obstructive cardiomyopathy (HOCM) without a clearly identifiable initial stress trigger. Conclusions: In the setting of acute left ventricular function depression in HOCM, a comprehensive differential diagnosis should be established. Treatment should be based on hemodynamic changes. After recovery, the prognosis is related to HOCM.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127446830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Stress echocardiography represents one of the best possible imaging choice for the diagnosis and stratification of patients with coronary artery disease (CAD). However, this imaging technique presents some limitations such as the quality of the image, high inter-observer variability, and the operator-dependent expertise. New technologies have been recently developed to provide an objective, operator-independent, and quantitative analysis of regional myocardial function. Objectives: The aim of this study was to investigate regional myocardial dyssynchrony using tissue synchronization imaging (TSI) during exercise stress echocardiography (ESE). PatientsandMethods: The ESE and TSI analysis of left ventricular (LV) segments was performed for 30 patients with CAD previously treated with revascularization therapy (CADr group) and the results were compared to those in 30 healthy subjects (norm group). The echo protocol comprised echocardiographic examinations at baseline, at the peak of exercise, and at 5 minutes after recovery as well as biplane and triplane acquisitions, pulsed wave of mitral flow, continuous wave of tricuspid regurgitation, tissue Doppler at the mitral annulus, TSI with an automatically detected positive time-to-peak velocity (Tp), and the measurement of themaximum activation time delay between myocardial segments and its standard deviation at baseline and peak stress for each patient. Results: The CADr group showed a lower increase in E (P = 0.005), A (P = 0.006), S' (P < 0.001), and E' (P = 0.006) velocities at both baseline and peak stress and a significantly increased ventricular dyssynchrony at baseline and at peak stress (P < 0.01) compared to the norm group. The baseline-peak variations in the CADr group did not show significant differences. The relationships between the maximum activation delay and the other echocardiographic parameters showed a significant negative correlation with LV ejection fraction (r = 0.217; P = 0.031) and S' velocity (r = -0.393; P < 0.001) and a positive correlation with the E/E' ratio (r = 0.376; P < 0.001). The comparison between the different ischemic territories revascularized in terms of the delay in ventricular activation showed the greatest delay in the revascularized territory in 63% of the patients with ischemia. Conclusions: The TSI analysis in patients with CAD may be considered an interesting parameter in addition to the conventional echocardiographic parameters during ESE.
{"title":"Exercise stress echocardiography and tissue synchronization imaging of myocardial dyssynchrony","authors":"V. Bordonaro, S. Buccheri, C. Tamburino, I. Monte","doi":"10.5812/acvi.34396","DOIUrl":"https://doi.org/10.5812/acvi.34396","url":null,"abstract":"Background: Stress echocardiography represents one of the best possible imaging choice for the diagnosis and stratification of patients with coronary artery disease (CAD). However, this imaging technique presents some limitations such as the quality of the image, high inter-observer variability, and the operator-dependent expertise. New technologies have been recently developed to provide an objective, operator-independent, and quantitative analysis of regional myocardial function. Objectives: The aim of this study was to investigate regional myocardial dyssynchrony using tissue synchronization imaging (TSI) during exercise stress echocardiography (ESE). PatientsandMethods: The ESE and TSI analysis of left ventricular (LV) segments was performed for 30 patients with CAD previously treated with revascularization therapy (CADr group) and the results were compared to those in 30 healthy subjects (norm group). The echo protocol comprised echocardiographic examinations at baseline, at the peak of exercise, and at 5 minutes after recovery as well as biplane and triplane acquisitions, pulsed wave of mitral flow, continuous wave of tricuspid regurgitation, tissue Doppler at the mitral annulus, TSI with an automatically detected positive time-to-peak velocity (Tp), and the measurement of themaximum activation time delay between myocardial segments and its standard deviation at baseline and peak stress for each patient. Results: The CADr group showed a lower increase in E (P = 0.005), A (P = 0.006), S' (P < 0.001), and E' (P = 0.006) velocities at both baseline and peak stress and a significantly increased ventricular dyssynchrony at baseline and at peak stress (P < 0.01) compared to the norm group. The baseline-peak variations in the CADr group did not show significant differences. The relationships between the maximum activation delay and the other echocardiographic parameters showed a significant negative correlation with LV ejection fraction (r = 0.217; P = 0.031) and S' velocity (r = -0.393; P < 0.001) and a positive correlation with the E/E' ratio (r = 0.376; P < 0.001). The comparison between the different ischemic territories revascularized in terms of the delay in ventricular activation showed the greatest delay in the revascularized territory in 63% of the patients with ischemia. Conclusions: The TSI analysis in patients with CAD may be considered an interesting parameter in addition to the conventional echocardiographic parameters during ESE.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129650071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The right ventricle (RV) is a complex structure with abstruse function that reveals important differences when compared to the left ventricle (LV), so it cannot be described as a simple geometric form and achromatic physiology. As an inference from this fact, in the present review, weaim to describe RV structure including theembryology, anatomy, and physiology and present a functional, hemodynamic, and imaging assessment of the normal and failing RV. So that, we conducted a thorough review based on the database sources such as MEDLINE, PubMed, Cochrane and Google scholar. No restrictions were placed on study date, study design, or language of publication. We searched all valuable and relevant information considering the anatomy, physiology, mechanics, hemodynamic and imaging evaluation of RV.
{"title":"The right ventricle: A comprehensive review from anatomy, physiology, and mechanics to hemodynamic, functional, and imaging evaluatio","authors":"A. Sadeghpour, A. Alizadehasl","doi":"10.5812/acvi.35717","DOIUrl":"https://doi.org/10.5812/acvi.35717","url":null,"abstract":"The right ventricle (RV) is a complex structure with abstruse function that reveals important differences when compared to the left ventricle (LV), so it cannot be described as a simple geometric form and achromatic physiology. As an inference from this fact, in the present review, weaim to describe RV structure including theembryology, anatomy, and physiology and present a functional, hemodynamic, and imaging assessment of the normal and failing RV. So that, we conducted a thorough review based on the database sources such as MEDLINE, PubMed, Cochrane and Google scholar. No restrictions were placed on study date, study design, or language of publication. We searched all valuable and relevant information considering the anatomy, physiology, mechanics, hemodynamic and imaging evaluation of RV.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"112 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117267231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Romeo, Ezequiel Guzzetti, Aníbal A. Arias, C. Belziti, R. Marenchino
Introduction: Heart failure is the second most common cause of ascites after cirrhosis. There are cardiac and noncardiac etiologies of ascites, and the multimodality imaging approach is a rich tool to redefine the final diagnosis. Case Presentation: We present a case-series where 3 patients were referred to our hospital for further hepatology assessment due to severe abdominal ascites and liver failure. Constrictive pericarditis was diagnosed in all of them. Nowadays, constrictive pericarditis is a well-known disease, but sometimes its clinical presentation may delay the treatment and worsen the prognosis. Our 3 cases had similar clinical scenarios and hemodynamic patterns when undergoing right-heart catheterization, but they had different anatomical pericardium-compromise, requiring different surgical strategies. Conclusions: Nowadays, multimodality imaging, especially cardiac magnetic resonance imaging and cardiac computed tomography, allows us to study a wide spectrum of the same disease in terms of anatomical compromise and cardiac physiology in order to stratify different prognosis and treatment options. We describe 3 unusual clinical cases where the initial differential diagnosis denoted noncardiac etiologies. The level of serum NT-proBNP proved pivotal to the redefinition of the clinical scenario and differentiation between the cardiac and noncardiac etiologies of new-onset ascites. A multidisciplinary approach in this setting between internists, hepatologists, and cardiologists was helpful to establish the final diagnosis in all the patients.
{"title":"New-Onset liver failure: Pitfalls of an unusual diagnosis","authors":"F. Romeo, Ezequiel Guzzetti, Aníbal A. Arias, C. Belziti, R. Marenchino","doi":"10.5812/acvi.33652","DOIUrl":"https://doi.org/10.5812/acvi.33652","url":null,"abstract":"Introduction: Heart failure is the second most common cause of ascites after cirrhosis. There are cardiac and noncardiac etiologies of ascites, and the multimodality imaging approach is a rich tool to redefine the final diagnosis. Case Presentation: We present a case-series where 3 patients were referred to our hospital for further hepatology assessment due to severe abdominal ascites and liver failure. Constrictive pericarditis was diagnosed in all of them. Nowadays, constrictive pericarditis is a well-known disease, but sometimes its clinical presentation may delay the treatment and worsen the prognosis. Our 3 cases had similar clinical scenarios and hemodynamic patterns when undergoing right-heart catheterization, but they had different anatomical pericardium-compromise, requiring different surgical strategies. Conclusions: Nowadays, multimodality imaging, especially cardiac magnetic resonance imaging and cardiac computed tomography, allows us to study a wide spectrum of the same disease in terms of anatomical compromise and cardiac physiology in order to stratify different prognosis and treatment options. We describe 3 unusual clinical cases where the initial differential diagnosis denoted noncardiac etiologies. The level of serum NT-proBNP proved pivotal to the redefinition of the clinical scenario and differentiation between the cardiac and noncardiac etiologies of new-onset ascites. A multidisciplinary approach in this setting between internists, hepatologists, and cardiologists was helpful to establish the final diagnosis in all the patients.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115629426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Goins, A. Henderson, Charles K. Lin, Anthony Charmforoush, Takor B. Arrey-Mbi, R. Prentice, J. Slim, Rosco S Gore, R. Cury, Ahmad M. Slim, Dustin M. Thomas
Introduction: Coronary CT angiography (CCTA) can safely disposition low to intermediate risk chest pain (CP); however, there is conflicting data with respect to cumulative radiation exposure when compared with usual care over short follow-up intervals. Objectives: We report the effective radiation dose from index and downstream testing in low to intermediate risk symptomatic patients evaluated for chest pain in the ED with either CCTA or usual care to define various sources of patient radiation dose and quantify effective dose over a year and a half of follow-up. Patients and Methods: We evaluated radiation exposure from initial and downstream testing in a prospectively collected, matched cohort evaluated for CP in the emergency department (ED) with either CCTA compared with usual care over a median follow-up of 19.6 months. Effective radiation dose was calculated using published conversion factors. Results: Prospective, ECG-triggered acquisition using a 128-slice dual-source multidetector computed tomography (DSCT) scanner was performed in 92.9% of scans with a median effective dose from CCTA of 6.8 mSv (IQR 5.2, 9.1 mSv). CCTA cohort patients were more likely to undergo cardiac testing with exposure to radiation (P < 0.001); however, the median effective dose in patients exposed to radiation from cardiac testing was significantly lower in the CCTA cohort (7.1 mSv vs. 11.8 mSv, P < 0.001). Fewer patients in the CCTA cohort had additional non-cardiac thoracic imaging radiation exposure (40.8%) compared with usual care (92.8%). Total radiation exposure from any source was similar between the CCTA and usual care groups (100% vs 98.4%, P = 0.087), as was median total effective radiation dose (P = 0.105). Upfront CCTA was not associated with higher rates of incidental non-cardiac findings. Conclusions: Initial evaluation of acute chest pain in the ED with CCTA was not associated with an increase in total radiation exposure over a follow-up period of 19 months. CCTA offers a more comprehensive evaluation of multiple thoracic organ systems leading to reduced radiation exposure from non-cardiac thoracic testing and no increase in incidental imaging findings. This may represent an added benefit in this population of patients presenting acutely.
导语:冠状动脉CT血管造影(CCTA)可以安全地诊断低至中危胸痛(CP);然而，与短时间随访期间的常规护理相比，关于累积辐射暴露的数据存在矛盾。目的:我们报告了在CCTA或常规护理中评估ED胸痛的低至中等风险症状患者的指数和下游测试的有效辐射剂量，以确定患者辐射剂量的各种来源，并在一年半的随访中量化有效剂量。患者和方法:我们在一个前瞻性收集的匹配队列中评估了急诊(ED) CP的初始和下游测试的辐射暴露，CCTA与常规护理相比，中位随访时间为19.6个月。有效辐射剂量用已公布的换算系数计算。结果:使用128层双源多探测器计算机断层扫描(DSCT)进行前瞻性心电图触发采集的扫描率为92.9%，CCTA的中位有效剂量为6.8 mSv (IQR为5.2,9.1 mSv)。CCTA队列患者更有可能接受辐射暴露的心脏检查(P < 0.001);然而，在CCTA队列中，心脏试验辐射暴露患者的中位有效剂量显著降低(7.1毫西弗vs 11.8毫西弗，P < 0.001)。与常规护理(92.8%)相比，CCTA队列中有额外非心脏胸部成像辐射暴露的患者较少(40.8%)。在CCTA组和常规护理组之间，任何来源的总辐射暴露相似(100% vs 98.4%， P = 0.087)，中位总有效辐射剂量相似(P = 0.105)。前期CCTA与较高的非心脏偶发发生率无关。结论:在19个月的随访期间，CCTA对急诊科急性胸痛的初步评估与总辐射暴露的增加无关。CCTA对多个胸部器官系统提供了更全面的评估，从而减少了非心脏胸部检查的辐射暴露，并且不会增加附带成像结果。这可能对急性发病的患者群体有额外的好处。
{"title":"Total effective radiation dose attributable to medical imaging in patients with acute chest pain: A single-center comparison study between dual-source coronary CT angiography and usual care","authors":"B. Goins, A. Henderson, Charles K. Lin, Anthony Charmforoush, Takor B. Arrey-Mbi, R. Prentice, J. Slim, Rosco S Gore, R. Cury, Ahmad M. Slim, Dustin M. Thomas","doi":"10.5812/acvi.34647","DOIUrl":"https://doi.org/10.5812/acvi.34647","url":null,"abstract":"Introduction: Coronary CT angiography (CCTA) can safely disposition low to intermediate risk chest pain (CP); however, there is conflicting data with respect to cumulative radiation exposure when compared with usual care over short follow-up intervals. Objectives: We report the effective radiation dose from index and downstream testing in low to intermediate risk symptomatic patients evaluated for chest pain in the ED with either CCTA or usual care to define various sources of patient radiation dose and quantify effective dose over a year and a half of follow-up. Patients and Methods: We evaluated radiation exposure from initial and downstream testing in a prospectively collected, matched cohort evaluated for CP in the emergency department (ED) with either CCTA compared with usual care over a median follow-up of 19.6 months. Effective radiation dose was calculated using published conversion factors. Results: Prospective, ECG-triggered acquisition using a 128-slice dual-source multidetector computed tomography (DSCT) scanner was performed in 92.9% of scans with a median effective dose from CCTA of 6.8 mSv (IQR 5.2, 9.1 mSv). CCTA cohort patients were more likely to undergo cardiac testing with exposure to radiation (P < 0.001); however, the median effective dose in patients exposed to radiation from cardiac testing was significantly lower in the CCTA cohort (7.1 mSv vs. 11.8 mSv, P < 0.001). Fewer patients in the CCTA cohort had additional non-cardiac thoracic imaging radiation exposure (40.8%) compared with usual care (92.8%). Total radiation exposure from any source was similar between the CCTA and usual care groups (100% vs 98.4%, P = 0.087), as was median total effective radiation dose (P = 0.105). Upfront CCTA was not associated with higher rates of incidental non-cardiac findings. Conclusions: Initial evaluation of acute chest pain in the ED with CCTA was not associated with an increase in total radiation exposure over a follow-up period of 19 months. CCTA offers a more comprehensive evaluation of multiple thoracic organ systems leading to reduced radiation exposure from non-cardiac thoracic testing and no increase in incidental imaging findings. This may represent an added benefit in this population of patients presenting acutely.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127822387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Takayasu's arteritis (TA) is a chronic, idiopathic, inflammatory disease that affects large elastic arteries, including the aorta and its main branches. No consensus exists currently on the superiority of surgery over endovascular repair (angioplasty with or without stenting) for vascular lesions in TA. Case Presentation: A 54-year-old woman with an 11-year history of ankylosing spondylitis (AS) presented with left arm weakness and severe left arm claudication. Duplex ultrasonography of the left upper extremity showed vessel-wall edema of the subclavian, axillary, and brachial arteries. Aortic angiography demonstrated a 70 - 80% stenosis of the left subclavian artery and a long, high-grade stenotic segment of the axillary artery. Intravascular ultrasound (IVUS) of the stenotic subclavian segment showed extensive negative remodeling with minimal plaque formation. The patient responded well to balloon angioplasty on this segment with medical therapy for AS. Conclusions: Our case is the first report of IVUS imaging of subclavian stenosis resulting from Takayasu's arteritis and provides insight into the pathology behind such lesions.
{"title":"Subclavian stenosis in a patient with takayasu's arteritis and long-standing ankylosing spondylitis: Utility of IVUS imaging","authors":"A. Sattar, Siegfried W. Yu, W. Laskey","doi":"10.5812/acvi.31552","DOIUrl":"https://doi.org/10.5812/acvi.31552","url":null,"abstract":"Introduction: Takayasu's arteritis (TA) is a chronic, idiopathic, inflammatory disease that affects large elastic arteries, including the aorta and its main branches. No consensus exists currently on the superiority of surgery over endovascular repair (angioplasty with or without stenting) for vascular lesions in TA. Case Presentation: A 54-year-old woman with an 11-year history of ankylosing spondylitis (AS) presented with left arm weakness and severe left arm claudication. Duplex ultrasonography of the left upper extremity showed vessel-wall edema of the subclavian, axillary, and brachial arteries. Aortic angiography demonstrated a 70 - 80% stenosis of the left subclavian artery and a long, high-grade stenotic segment of the axillary artery. Intravascular ultrasound (IVUS) of the stenotic subclavian segment showed extensive negative remodeling with minimal plaque formation. The patient responded well to balloon angioplasty on this segment with medical therapy for AS. Conclusions: Our case is the first report of IVUS imaging of subclavian stenosis resulting from Takayasu's arteritis and provides insight into the pathology behind such lesions.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124235616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daiki Akagaki, T. Oba, Masaharu Nakano, Takaharu Nakayoshi, G. Haraguchi, Ayako Ohbuchi, Hideki Ohshima, M. Nishihara, Y. Fukumoto
Introduction: In patients with acute heart failure, pleural fluid localized in an inter-pleural fissure produces a mass on chest X-ray, which mimics a tumor. Case Presentation: Such masses have been designated as vanishing tumors of the lung. It is extremely rare that a vanishing tumor occurs in the apex of the lung. Conclusions: This is the first case report of a vanishing tumor in the right pulmonary apex.
{"title":"A vanishing tumor in the right pulmonary apex: A ghost on the roof","authors":"Daiki Akagaki, T. Oba, Masaharu Nakano, Takaharu Nakayoshi, G. Haraguchi, Ayako Ohbuchi, Hideki Ohshima, M. Nishihara, Y. Fukumoto","doi":"10.5812/acvi.33809","DOIUrl":"https://doi.org/10.5812/acvi.33809","url":null,"abstract":"Introduction: In patients with acute heart failure, pleural fluid localized in an inter-pleural fissure produces a mass on chest X-ray, which mimics a tumor. Case Presentation: Such masses have been designated as vanishing tumors of the lung. It is extremely rare that a vanishing tumor occurs in the apex of the lung. Conclusions: This is the first case report of a vanishing tumor in the right pulmonary apex.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128693298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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