The International Journal of Cardiovascular Imaging

2025

The aim of this study was to compare the detection rate of tissue prolapse (TP) in optical coherence tomography (OCT) and intravascular ultrasound (IVUS) after drug-eluting stent (DES) implantation and evaluate clinical implication of TP at 2 years after percutaneous coronary intervention. In spite of the superiority of OCT in the aspect of resolution when it was compared to IVUS, there was little data about the superiority of OCT in detecting TP. And there has been controversy about the clinical significance of TP. We enrolled 38 patients who treated with DES implantation. OCT and IVUS measurements were performed in stented segments immediately after percutaneous coronary intervention. We matched OCT and IVUS images one by one, and analyzed TP quantitatively in both measurements. Thirty patients (78.9 %) were followed-up for 2 years to evaluate clinical outcome of TP. TP was detected in 95 % of stented lesions by OCT and 45 % of stented lesions by IVUS among 40 stented lesions in 38 patients. The best cut-off values of the area, depth and burden of TP on OCT for the detection of TP on IVUS were 0.17 mm2, 0.17 mm and 1.98 %, respectively. There was no statistically significant relation between TP and major adverse cardiac event during hospitalization and 2-year follow-up.

To retrospectively evaluate the image quality of CT angiography (CTA) reconstructed by model-based iterative reconstruction (MBIR) and to compare this with images obtained by filtered back projection (FBP) and adaptive statistical iterative reconstruction (ASIR) in newborns and infants with congenital heart disease (CHD). Thirty-seven children (age 4.8 ± 3.7 months; weight 4.79 ± 0.47 kg) with suspected CHD underwent CTA on a 64detector MDCT without ECG gating (80 kVp, 40 mA using tube current modulation). Total dose length product was recorded in all patients. Images were reconstructed using FBP, ASIR, and MBIR. Objective image qualities (density, noise) were measured in the great vessels and heart chambers. The contrast-to-noise ratio (CNR) was calculated by measuring the density and noise of myocardial walls. Two radiologists evaluated images for subjective noise, diagnostic confidence, and sharpness at the level prior to the first branch of the main pulmonary artery. Images were compared with respect to reconstruction method, and reconstruction times were measured. Images from all patients were diagnostic, and the effective dose was 0.22 mSv. The objective image noise of MBIR was significantly lower than those of FBP and ASIR in the great vessels and heart chambers (P < 0.05); however, with respect to attenuations in the four chambers, ascending aorta, descending aorta, and pulmonary trunk, no statistically significant difference was observed among the three methods (P > 0.05). Mean CNR values were 8.73 for FBP, 14.54 for ASIR, and 22.95 for MBIR. In addition, the subjective image noise of MBIR was significantly lower than those of the others (P < 0.01). Furthermore, while FBP had the highest score for image sharpness, ASIR had the highest score for diagnostic confidence (P < 0.05), and mean reconstruction times were 5.1 ± 2.3 s for FBP and ASIR and 15.1 ± 2.4 min for MBIR. While CTA with MBIR in newborns and infants with CHD can reduce image noise and improve CNR more than other methods, it is more time-consuming than the other methods.

doi: 10.1007/s10554-014-0520-ypmid: 25129473

Although pericardial effusion (PE) early after transcatheter aortic valve implantation (TAVI) has been reported in few registries, late PE at follow-up remains unexplored. Particularly, after transapical TAVI, diagnosis of PE with transthoracic echocardiography (TTE) may be challenging. The present evaluation assessed the incidence of PE early after TAVI and at 1 month follow-up using TTE and multi-detector computed tomography (MDCT). The agreement between TTE and MDCT to diagnose the presence and severity of PE at 1 month follow-up was evaluated. Overall 293 patients undergoing TAVI were included. Pre-discharge TTE was performed in all patients. At 1 month, repeat TTE was performed in 234 patients and additional MDCT evaluation in 143 patients. Pre-discharge small and moderate PE was observed in 74.1 and 4.1 % of patients, respectively, whereas significant PE was diagnosed in 8 (2.7 %) patients without differences between procedural access: 1.6 versus 3.6 % for transfemoral and transapical respectively, p = 0.474. At 1 month new-onset moderate PE was noted in 6 (2.5 %) patients all of who underwent transapical TAVI. MDCT and TTE disagreed on the grade of PE in 38 patients. Importantly, one patient with small PE on TTE was considered having moderate PE and two patients with small and moderate PE were considered having large PE. Also, two patients with moderate PE on echocardiography were considered small PE on MDCT. In conclusions, significant PE early after TAVI is infrequent. The prevalence of small and moderate PE remains stable at 1 month follow-up. MDCT refines the diagnosis of significant PE.

doi: 10.1007/s10554-014-0529-2pmid: 25421460

Longitudinal strain analysis enables early detection of left ventricular (LV) contraction abnormalities in patients with preserved ejection fraction. Hypertrophic cardiomyopathy (HCM) is associated with low values of regional and global longitudinal myocardial deformations. In addition to contraction abnormalities, LV regional strain abnormalities are partially related to the degree of hypertrophy. This study sought to describe global longitudinal strain (GLS) in HCM patients as categorized using the Maron’s classification. Complete echocardiography examinations, including GLS analysis, were performed in consecutive HCM patients followed up in two French HCM-clinics. A total of 271 patients (mean age 49 ± 16yrs; 71 % male) were evaluated. In this population, the most frequently classified hypertrophy pattern was Type II (47 %), following the Maron’s classification. Type III was characterized by a higher degree of LV hypertrophy in terms of mass and maximal wall thickness, and was more frequently obstructive at rest, with lower GLS values (−15.3 ± 3.9 %, p = 0.016), higher E/E’ ratio (13.4 ± 6.7, p < 0.001), and a more frequently inadequate blood pressure response to exercise (30 %, p = 0.04) compared to other patterns. The variable that correlated best with GLS was LV mass index (r = 0.49, p < 0.01), while GLS did not significantly correlate with left ventricular outflow tract obstruction. This study demonstrated that the Type III HCM pattern presented with lower GLS, which was partially related to higher LV mass index, more elevated LV filling pressures, and a more frequently inadequate blood pressure response to exercise, in comparison with other patterns categorized using the Maron’s classification.

To evaluate phasic function and deformation of the left atrium (LA) and right atrium (RA) in subjects with prediabetes and type 2 diabetes mellitus. This cross-sectional study included 50 untreated normotensive subjects with prediabetes, 60 recently diagnosed normotensive diabetic patients and 60 healthy controls of similar sex and age. All the subjects underwent laboratory analyses and complete echocardiographic examination including strain analysis. LA and RA reservoir and conduit function gradually decreased, while booster pump increased, from the healthy controls, throughout the prediabetics, to the diabetics. The strain analysis of atrial phasic function showed more regular pattern of progressive atrial function deterioration than conventional evaluation with total, active and passive atrial function. In the whole study population HbA1c correlated with LA passive emptying fraction (r = −0.38, p < 0.01), LA active emptying fraction (r = 0.36, p < 0.01), LA longitudinal strain during systole (r = −0.35, p < 0.01), RA passive emptying fraction (r = −0.42, p < 0.01), RA active emptying fraction (r = 0.38, p < 0.01), and RA longitudinal strain during systole (r = −0.32, p < 0.01). However, only LA passive emptying fraction (β = −0.32, p < 0.01) and LA longitudinal strain during systole (β = −0.28, p = 0.02) were independently associated with HbA1c among the LA parameters; whereas solely RA passive emptying fraction (β = −0.37, p < 0.01) and RA active emptying fraction (β = 0.31, p = 0.01) were independently associated with HbA1c among the RA parameters. LA and RA phasic functions are significantly impaired in the prediabetics and the diabetics. The parameter of glucose control correlated with LA and RA reservoir, conduit and pump atrial function.