scholarly journals Moderated Posters: Practical applications of cardiac CT and/or radionuclide imagingP806Calcium but not fat is an additional marker for sub-clinical atherosclerosis in type 2 diabetes mellitusP807Assessment of diastolic heart function with multi-detector computed tomography (MDCT)P808Automated measurement of left atrial appendage orifice dimensions and their variation in patients with atrial fibrillation using MDCT imagesP809Presence and extent of cardiac CT angiography defined coronary artery disease in patients presenting with syncopeP810Dobutamine stress myocardial perfusion imaging by SPECT adds incremental prognostic value across a high risk cohortP811Prevalence and consequences of incidental findings detected by computed tomography in patients undergoing pulmonary vein isolation or transcatheter aortic valve implantationP812Low dose computed tomography angiography for evaluation of the thoracic aorta and coronary arteries using 160 mm detector coverage and iterative reconstruction algorithmP813Differential prognostic value of thoracic aorta calcium score on clinical outcomes in elderly individuals according to the presence of left ventricular hypertrophy

2016 ◽  
Vol 17 (suppl 2) ◽  
pp. ii158-ii160
Author(s):  
AAM Farrag ◽  
A. Mustafa ◽  
JY. Wielandts ◽  
S. Altintas ◽  
A. Ahmed ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Thoracic Aorta ◽  
Prognostic Value ◽  
Cardiac Ct ◽  
Heart Function ◽  
Calcium Score ◽  
Left Ventricular ◽  
Practical Applications ◽  
Transcatheter Aortic Valve ◽  
Artery Disease

4935Prognostic influence of MDCT-derived global left ventricular longitudinal strain in patients with aortic stenosis treated with transcatheter aortic valve implantation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Gegenava ◽  
P Bijl ◽  
M Vollema ◽  
F Kley ◽  
A Weger ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Aortic Valve ◽  
Prognostic Value ◽  
Longitudinal Strain ◽  
Left Ventricular ◽  
Transcatheter Aortic Valve ◽  
Kaplan Meier ◽  
All Cause Mortality ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Abstract Introduction Transcatheter aortic valve implantation (TAVI) is an effective treatment for patients with severe aortic stenosis (AS), It can lead to an improvement in symptoms and quality of life but there is also an increasing recognition that some patients simply fail to derive a functional, morbidity, or mortality benefit post-TAVI. Left ventricular (LV) ejection fraction is the LV systolic function parameter to risk stratify patients with severe AS. However, LV global longitudinal strain (GLS) provides incremental prognostic value to LVEF. Computed tomography plays an essential role in the evaluation of TAVI candidates. Novel software permits analysis of LV GLS from dynamic Multi-detector row computed tomography (MDCT) data. Purpose The present study aimed at investigating the prognostic value of MDCT-derived LV GLS in patients undergoing TAVI. Methods LV GLS was measured on dynamic MDCT using novel CT-software (Figure, panel A) at baseline. Patients were followed up for all-cause mortality and cumulative event rates were analyzed with Kaplan-Meier method. Results A total 214 patients (51% male, 80±7 years) were analysed retrospectively. Mean value of MDCT-derived LV GLS was −12.5±4%. During a median follow-up of 1378 days (interquartile range: 881–1895 days), 67 (31%) patients died. The Kaplan-Meier curve shows, that TAVI recipients with MDCT-derived LV GL S>−14% experienced higher cumulative rates of all-cause mortality, compared to patients with MDCT-derived LV GLS ≤−14% (Chi-square 10.549; Log rank p=0.001) (Figure, panel B). On uni- and multivariate Cox-regression models, MDCT-derived LV GLS demonstrated significant association with all-cause mortality (hazard ratio [HR]: 0.851; 95% confidence interval [CI]: 0.772–0.937; p=0.001). MDCT LV GLS and survival Conclusions MDCT-derived LV GLS is independently associated with all-cause mortality in patients treated with TAVI.

scholarly journals The importance of cardiac tomography in the evaluation of cardiac changes and coronary atherosclerosis in patients with betathalassemia major

2020 ◽  
Vol 11 ◽  
pp. 602-611
Author(s):  
Stancă Ionut ◽  
Rizea Ileana Olguta ◽  
Popescu Andreea Caterina ◽  
Albu Alice ◽  
Rus Mihaela ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Arterial Stiffness ◽  
Coronary Atherosclerosis ◽  
Cardiac Ct ◽  
Calcium Score ◽  
Left Ventricular ◽  
Beta Thalassemia ◽  
Control Group ◽  
Atherosclerotic Lesions

Betathalassemic patients demonstrate an increased rate of extracardiac vascular complications, but very low prevalence for coronary artery disease. Computed tomography (CT) achieves excellent tissue characterization, with high spatial resolution and has developed as a gold standard for noninvasive angiography and calcium score assessment.  Methods.  We examined 7 patients with major beta-thalassemia and 7 patients who had an indication for cardiac CT for resting ECG changes, without symptoms of angina pectoris. We investigated the coronary atherosclerosis by assessing the coronary artery calcium (CAC) and arterial stifness. Usual tests and echocardiography measurement were performed. Cardiac computed tomography determined left ventricular mass, left ventricular ejection fraction  (LVEF), coronary calcium score and coronary anatomy. An analysis of myocardial density was also performed. Artery stiffness was assessed by the cardio ankle vascular index  (CAVI). Results. Arterial stiffness index in betathallasemic group was higher than control group, R-CAVI index was 6.21± 0.49 vs 5.65±0.37 and L-CAVI index was 6.21± 0.38 vs 5.71±0.31. The assessment of systolic function by echocardiography and cardiac CT examination in the 2 groups, shows that the LVEF in the betathallasemic group was significantly lower than in the control group, which means that some patients already had cardiomyopathy. LV myocardial mass was significantly higher in the group with beta-thalassemia, which is explained by the appearance of myocardial remodeling. The calcium score in patients with major beta-thalassemia was 0 and 8,5± 5,9  in the control group. Only 3 patients (42,8%) in the control group had a calcium score > 10U. No atherosclerotic lesions were observed in patients with major beta-thalassemia, whereas the control group showed mild coronary atherosclerotic lesions. If myocardial density can be determined, calcium or iron deposits can be detected in the myocardium. In patients with beta-thalassemia, the density of the myocardium was higher, both in the left ventricle (49.29 8.87±HU) and in the septum (56.71± 8.1 HU). Calculation of Pearson’s correlation coefficient revealed a good association between CT and echocardiography, reproducibility of CT was significantly higher on an intra-observer level for LVEF and LV Mass. Conclusions: Patients with β–thalassemia major have a similar calcium score compared to control subjects, but they have an increase in arterial stiffness. However, zero frequencie of coronary heart disease,  denotes coronary protection mechanisms in thalassemia, so future research should focus on the anti-atherogenic potential of blood lipids at these patients. The ability of cardiac tomography to detect calcifications and changes in myocardial density should be valued, as it can be a good tool for establishing the diagnosis of cardiomyopathy by iron loading.

scholarly journals Potential Utility of Multidetector Computed Tomography to Identify both Cardiac Embolic Sources and Coronary Artery Disease in Patients with Embolic Stroke

Cardiology ◽  
2015 ◽  
Vol 133 (4) ◽  
pp. 205-210 ◽  
Author(s):  
Kohichiro Iwasaki ◽  
Takeshi Matsumoto ◽  
Sanami Kawada
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Multidetector Computed Tomography ◽  
Calcium Score ◽  
Left Ventricular ◽  
Embolic Stroke ◽  
Potential Utility ◽  
Spotty Calcification ◽  
Artery Disease

Objectives: Our objective was to study the potential utility of multidetector computed tomography (MDCT) to identify both cardiac embolic sources and coronary artery disease (CAD) in embolic-stroke patients. Methods: We performed MDCT for 184 patients with embolic stroke but without known CAD. Twenty-six patients had atrial fibrillation. We investigated the prevalence of the potential source of the embolism and the coronary characteristics. Results: Overall, 64 potential embolic sources were detected in 59 patients (32.1%). Left atrial appendage thrombus, left ventricular thrombus and aortic atheroma were detected in 3.3, 0.5 and 15.8% of patients, respectively. Circulatory stasis and patent foramen ovale were detected in 8.7 and 6.5%, respectively. As for coronary calcium score, only 47 patients (25.5%) had a score of zero and 51 (27.7%) had a score of ≥400. Significant CAD was detected in 18 patients (9.8%). One hundred and thirty-seven (74.5%) had coronary plaques. The prevalence of positive remodeling, low-attenuation plaque, spotty calcification and a napkin-ring sign was 7.1, 1.6, 5.4 and 2.7%, respectively. Importantly, only 34 patients (13.0%) had no abnormalities detected by MDCT. Conclusions: Our results suggest that MDCT has potential to identify both cardiac embolic sources and CAD in patients with embolic stroke but without known CAD.

Diagnostic Performance of Quantitative Coronary Artery Disease Assessment Using Computed Tomography in Patients with Aortic Stenosis Undergoing Transcatheter Aortic-Valve Implantation

2021 ◽  
Author(s):  
Daniel Malebranche ◽  
Maximilian K.M. Hoffner ◽  
Adrian T. Huber ◽  
Aleksandar Cicovic ◽  
Giancarlo Spano ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Aortic Valve ◽  
Coronary Angiography ◽  
Diagnostic Performance ◽  
Invasive Coronary Angiography ◽  
Calcium Score ◽  
Disease Assessment ◽  
Transcatheter Aortic Valve ◽  
Artery Disease

Abstract Purpose: Computed tomography angiography (CTA) is a cornerstone in the pre- transcatheter aortic valve replacement (TAVI) assessment. We evaluated the diagnostic performance of CTA and coronary artery calcium score (CACS) for CAD evaluation compared to invasive coronary angiography in a cohort of TAVI patients. Methods: In consecutive TAVI patients, CAD was assessment by quantitative analysis in CTA. a) Patients with non-evaluable segments were classified as obstructive CAD. b) In patients with non-evaluable segments a CACS cut-off of 100 was applied for obstructive CAD. The reference standard was quantitative invasive coronary angiography (QCA,i.e.≥50% stenosis). Results: 100 consecutive patients were retrospectively included, age was 82.3±6.5years and 30% of patients had CAD. On a per-patient analysis CTA showed a sensitivity of 100% (95%CI: 88.4-100.0), specificity of 11.4% (95%CI: 5.1-21.3), PPV of 32.6% (95%CI: 30.8-34.5), NPV of 100% and diagnostic accuracy of 38% (95%CI: 28.5-48.3) for obstructive CAD. When applying a combined CTA/CACS approach, the sensitivity and NPV remained at 100% and obstructive CAD could be ruled out in 20% of the TAVI patients, versus 8% using CTA alone. Conclusion: Quantitative combined CTA/CACS assessment from routinely acquired pre-TAVI investigation showed good diagnostic performance to rule-out obstructive CAD and may constitute a valuable strategy to streamline diagnostic workup in selected patients undergoing TAVI.

Association between multimodality measures of aortic stenosis severity and quality-of-life improvement outcomes after transcatheter aortic valve replacement

2021 ◽  
Author(s):  
Michael A Catalano ◽  
Shahryar G Saba ◽  
Bruce Rutkin ◽  
Greg Maurer ◽  
Jacinda Berg ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Computed Tomography ◽  
Aortic Valve ◽  
Transcatheter Aortic Valve Replacement ◽  
Multivariable Analysis ◽  
Calcium Score ◽  
Post Intervention ◽  
Transcatheter Aortic Valve

Abstract Aims Up to 40% of patients with aortic stenosis (AS) present with discordant grading of AS severity based on common transthoracic echocardiography (TTE) measures. Our aim was to evaluate the utility of TTE and multi-detector computed tomography (MDCT) measures in predicting symptomatic improvement in patients with AS undergoing transcatheter aortic valve replacement (TAVR). Methods and results A retrospective review of 201 TAVR patients from January 2017 to November 2018 was performed. Pre- and post-intervention quality-of-life was measured using the Kansas City Cardiomyopathy Questionnaire (KCCQ-12). Pre-intervention measures including dimensionless index (DI), stroke volume index (SVI), mean transaortic gradient, peak transaortic velocity, indexed aortic valve area (AVA), aortic valve calcium score, and AVA based on hybrid MDCT-Doppler calculations were obtained and correlated with change in KCCQ-12 at 30-day follow-up. Among the 201 patients studied, median KCCQ-12 improved from 54.2 pre-intervention to 85.9 post-intervention. In multivariable analysis, patients with a mean gradient >40 mmHg experienced significantly greater improvement in KCCQ-12 at follow-up than those with mean gradient ≤40 mmHg (28.1 vs. 16.4, P = 0.015). Patients with MDCT-Doppler-calculated AVA of ≤1.2 cm2 had greater improvements in KCCQ-12 scores than those with computed tomography-measured AVA of >1.2 cm2 (23.4 vs. 14.1, P = 0.049) on univariate but not multivariable analysis. No association was detected between DI, SVI, peak velocity, calcium score, or AVA index and change in KCCQ-12. Conclusion Mean transaortic gradient is predictive of improvement in quality-of-life after TAVR. This measure of AS severity may warrant greater relative consideration when selecting the appropriateness of patients for TAVR.

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