Patient selection for LIVE therapy - From clinical indications to multimodality imaging individual case planning

Background LIVE (Less Invasive Ventricular Enhancement) with Revivent TC™ is an innovative therapy for symptomatic ischemic Heart Failure (HF). It is designed to reconstruct a negatively remodeled left ventricle (LV) after an anterior myocardial infarction (MI) by plication of the scar tissue. Its indications are specific and, as with any other structural heart intervention, the success of the procedure starts with appropriate patient selection. We aim to present the indications of the technique, crucial aspects in patient selection and individual case planning approach. Methods and Results After clinical evaluation, transthoracic echocardiography is the first imaging modality to be performed in a potential candidate for the therapy. However, definitive indication and detailed case planning rely on late gadolinium-enhanced cardiac magnetic resonance imaging or multiphasic contrast-enhanced cardiac computed tomography. These imaging modalities also assist with relative or absolute contra-indications for the procedure. Individual assessment is done to tailor the procedure to the specifics of the LV anatomy and location of the myocardial scar. Conclusion LIVE procedure is a unique intervention to treat symptomatic heart failure and ischemic cardiomyopathy after anterior MI. It is a highly customizable intervention that allows a patient-tailored approach, based on multimodality imaging assessment and planification.

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Patient selection for LIVE therapy: From clinical indications to multimodality imaging individual case planning

Echocardiography ◽

10.1111/echo.15182 ◽

2021 ◽

Author(s):

Paulo Neves ◽

Thasee Pillay ◽

Lon Annest ◽

Kevin Bladel ◽

Erhard Kaiser ◽

...

Keyword(s):

Patient Selection ◽

Multimodality Imaging ◽

Individual Case ◽

Clinical Indications ◽

Case Planning ◽

Selection For

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Mitral annular calcification and valvular dysfunction: multimodality imaging evaluation, grading, and management

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeab185 ◽

2021 ◽

Author(s):

Bo Xu ◽

Duygu Kocyigit ◽

Tom Kai Ming Wang ◽

Carmela D Tan ◽

E Rene Rodriguez ◽

...

Keyword(s):

Mitral Valve ◽

Classification System ◽

Multimodality Imaging ◽

Imaging Modality ◽

Cardiac Computed Tomography ◽

Calcium Deposition ◽

Mitral Annular Calcification ◽

Imaging Evaluation ◽

Line Imaging ◽

Annular Calcification

Abstract Mitral annular calcification (MAC) refers to calcium deposition in the fibrous skeleton of the mitral valve. It has many cardiovascular associations, including mitral valve dysfunction, elevated cardiovascular risk, arrhythmias, and endocarditis. Echocardiography conventionally is the first-line imaging modality for anatomic assessment, and evaluation of mitral valve function. Cardiac computed tomography (CT) has demonstrated importance as an imaging modality for the evaluation and planning of related procedures. It also holds promise in quantitative grading of MAC. Currently, there is no universally accepted definition or classification system of MAC severity. We review the multimodality imaging evaluation of MAC and associated valvular dysfunction and propose a novel classification system based on qualitative and quantitative measurements derived from echocardiography and cardiac CT.

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Ruptured Sinus of Valsalva Aneurysm: Use of Multimodality Imaging in Delineating Structure and Function

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/23247096211020684 ◽

2021 ◽

Vol 9 ◽

pp. 232470962110206

Author(s):

Kameel Kassab ◽

Subuhi Kaul ◽

Javier Gomez ◽

Jean-Luc Delafontaine ◽

Ray Sawaqed ◽

...

Keyword(s):

Heart Failure ◽

Surgical Planning ◽

Multimodality Imaging ◽

Intraoperative Imaging ◽

Cardiac Computed Tomography ◽

Heart Catheterization ◽

Sinus Of Valsalva ◽

Cardiac Computed Tomography Angiography ◽

Sinus Of Valsalva Aneurysm ◽

Hemodynamic Assessment

Sinus of Valsalva aneurysm is a rare defect that can present with fatal complications in case of rupture. Heart failure symptoms are common due to high fraction of the resultant shunt. Multimodality imaging and invasive hemodynamic assessment is essential for comprehensive evaluation of the defect and guiding surgical planning. We describe the case of a 40-year-old woman who presented with heart failure symptoms and was found to have ruptured sinus of Valsalva aneurysm on transthoracic echocardiogram. Cardiac computed tomography angiography further characterized the defect and the associated anomalies. Right heart catheterization assessed the hemodynamic significance of the left to right shunt. Intraoperative findings highlighted the associated congenital anomalies including supracristal ventricular septal defect. The use of intraoperative transesophageal echocardiography proved essential in detecting worsening of the right ventricular outflow track infundibular dynamic obstruction post repair thus delineating the importance of maintaining adequate cardiac preload. This case highlights a stepwise approach in the anatomical characterization of sinus of Valsalva aneurysm using multimodality imaging and the use of hemodynamic assessment and intraoperative imaging to guide surgical planning.

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40 Years Anniversary of Cardiac 123I-mIBG Imaging: State of the Heart

Current Cardiovascular Imaging Reports ◽

10.1007/s12410-021-09555-5 ◽

2021 ◽

Vol 14 (5) ◽

Author(s):

D. O. Verschure ◽

K. Nakajima ◽

A. F. Jacobson ◽

H. J. Verberne

Keyword(s):

Heart Failure ◽

Linear Relationship ◽

Patient Selection ◽

Imaging Modality ◽

The Body ◽

Mibg Imaging ◽

Clinical Role ◽

Selection For ◽

Shape Curve ◽

Clinical Potential

Abstract Purpose of Review This narrative review reflects on the body of evidence on cardiac 123I-mIBG imaging that has accumulated since the introduction in the late 1970s and focusses on to what extent cardiac 123I-mIBG imaging has fulfilled its potential in cardiology especially. Recent Findings In contrast to the linear relationship between 123I-mIBG-derived parameters and overall prognosis in heart failure, there seems a “bell-shape” curve for 123I-mIBG-derived parameters and arrhythmic events. In addition, there is a potential clinical role for cardiac 123I-mIBG in optimizing patient selection for expensive devices (i.e., ICD and CRT). This needs of course to be established in future trials. Summary Cardiac 123I-mIBG imaging is, despite the numerous of studies, sometimes mistakenly seen as a nice to have technique rather than a must have imaging modality. Although cardiac 123I-mIBG imaging has grown and matured over the years, its full clinical potential has still not been tested to the maximum.

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Imaging of Valvular Heart Disease in Heart Failure

Cardiac Failure Review ◽

10.15420/cfr.2018.16.1 ◽

2018 ◽

Vol 4 (2) ◽

pp. 78 ◽

Cited By ~ 2

Author(s):

Tomaz Podlesnikar ◽

Victoria Delgado ◽

Jeroen J Bax ◽

◽

...

Keyword(s):

Heart Failure ◽

Heart Disease ◽

Valvular Heart Disease ◽

Systolic Function ◽

Multimodality Imaging ◽

Imaging Modality ◽

Transoesophageal Echocardiography ◽

Left Ventricular ◽

Transcatheter Aortic Valve ◽

Valvular Stenosis

Valvular heart disease (VHD) and heart failure (HF) are major health issues that are steadily increasing in prevalence in Western populations. VHD and HF frequently co-exist, which can complicate the accurate diagnosis of the severity of valve stenosis or regurgitation and affect decisions about therapeutic options. Transthoracic echocardiography is the first-line imaging modality to determine left ventricular (LV) systolic function, to grade valvular stenosis or regurgitation and to characterise the mechanism underlying valvular dysfunction. 3D transoesophageal echocardiography, cardiovascular magnetic resonance and cardiac CT are alternative imaging modalities that help in the diagnosis of patients with HF and VHD. The integration of multimodality cardiovascular imaging is important when deciding whether the patient should receive transcatheter aortic valve repair and replacement therapies. In this article, the use of multimodality imaging to diagnose and treat patients with VHD and HF is reviewed.

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The Relation of Body Mass Index to Biochemical Parameters and Profile of Heart Failure

Revista de Chimie ◽

10.37358/rc.18.7.6392 ◽

2018 ◽

Vol 69 (7) ◽

pp. 1673-1677

Author(s):

Viviana Aursulesei ◽

Andrei Manta ◽

Razan Al Namat ◽

Monica Hugianu ◽

Angela Maria Moloce ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Body Mass Index ◽

Body Mass ◽

Patient Selection ◽

Biochemical Parameters ◽

Obesity Paradox ◽

Lipid Levels ◽

Randomized Control ◽

Selection Parameters

The bidirectional relation between body mass index (BMI) and heart failure (HF) is complex and not fully understood. The obesity paradox phenomena is controversial and related to patient selection, parameters used for defining abnormal weight, characteristics of HF. Our study sustain the importance of controlling risk factors, in particular plasma glucose, lipid levels, as well as hypertension in patients with HF and BMI over 25 kg/m2. Also, in contrast to the randomized control studies our results can only partially support data related to obesity paradox phenomena.

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Transcatheter Closure of PFO and ASD: Multimodality Imaging for Patient Selection and Perioperative Guidance

Journal of Cardiovascular Development and Disease ◽

10.3390/jcdd8070078 ◽

2021 ◽

Vol 8 (7) ◽

pp. 78

Author(s):

Gabriele Egidy Assenza ◽

Luca Spinardi ◽

Elisabetta Mariucci ◽

Anna Balducci ◽

Luca Ragni ◽

...

Keyword(s):

Patient Selection ◽

Transcatheter Closure ◽

Multimodality Imaging ◽

Deep Understanding ◽

Volume Overload ◽

Arterial Embolization ◽

Ventricular Volume ◽

Intracardiac Echocardiography ◽

Technical Details ◽

Asd Closure

Transcatheter closure of patent foramen ovale (PFO) and secundum type atrial septal defect (ASD) are common transcatheter procedures. Although they share many technical details, these procedures are targeting two different clinical indications. PFO closure is usually considered to prevent recurrent embolic stroke/systemic arterial embolization, ASD closure is indicated in patients with large left-to-right shunt, right ventricular volume overload, and normal pulmonary vascular resistance. Multimodality imaging plays a key role for patient selection, periprocedural monitoring, and follow-up surveillance. In addition to routine cardiovascular examinations, advanced neuroimaging studies, transcranial-Doppler, and interventional transesophageal echocardiography/intracardiac echocardiography are now increasingly used to deliver safely and effectively such procedures. Long-standing collaboration between interventional cardiologist, neuroradiologist, and cardiac imager is essential and it requires a standardized approach to image acquisition and interpretation. Periprocedural monitoring should be performed by experienced operators with deep understanding of technical details of transcatheter intervention. This review summarizes the specific role of different imaging modalities for PFO and ASD transcatheter closure, describing important pre-procedural and intra-procedural details and providing examples of procedural pitfall and complications.

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Challenges in the diagnosis of peripartum cardiomyopathy: a case series

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytab001 ◽

2021 ◽

Vol 5 (2) ◽

Author(s):

Fabio Chirillo ◽

Anna Baritussio ◽

Umberto Cucchini ◽

Ermanno Toniolli ◽

Angela Polo ◽

...

Keyword(s):

Heart Failure ◽

Multimodality Imaging ◽

Systolic Dysfunction ◽

Case Series ◽

Left Ventricular ◽

Peripartum Cardiomyopathy ◽

Lv Function ◽

Prognostic Information ◽

Clinical Scenarios ◽

Anterolateral Wall

Abstract Background Peripartum cardiomyopathy (PPCM) is usually characterized by overt heart failure, but other clinical scenarios are possible, sometimes making the diagnosis challenging. Case summary We report a case series of four patients with PPCM. The first patient presented with acute heart failure due to left ventricular (LV) systolic dysfunction. Following medical treatment, LV function recovered completely at 1 month. The second patient had systemic and pulmonary thromboembolism, secondary to severe biventricular dysfunction with biventricular thrombi. The third patient presented with myocardial infarction with non-obstructed coronary arteries and evidence of an aneurysm of the mid-anterolateral LV wall. The fourth patient, diagnosed with PPCM 11 years earlier, presented with sustained ventricular tachycardia. A repeat cardiac magnetic resonance, compared to the previous one performed 11 years earlier, showed an enlarged LV aneurysm in the mid-LV anterolateral wall with worsened global LV function. Discussion Peripartum cardiomyopathy may have different clinical presentations. Attentive clinical evaluation and multimodality imaging can provide precise diagnostic and prognostic information.

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