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 Coronary 18 F-Fluoride Uptake and Progression of Coronary Artery Calcification

2020 ◽  
Vol 13 (12) ◽  
Author(s):  
Mhairi K. Doris ◽  
Mohammed N. Meah ◽  
Alastair J. Moss ◽  
Jack P.M. Andrews ◽  
Rong Bing ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Computed Tomography Angiography ◽  
Coronary Atherosclerosis ◽  
Calcium Score ◽  
Coronary Calcification ◽  
Rapid Progression ◽  
Calcium Scoring ◽  
Fluoride Uptake ◽  
Patient Level

Background Positron emission tomography (PET) using 18 F-sodium fluoride ( 18 F-fluoride) to detect microcalcification may provide insight into disease activity in coronary atherosclerosis. This study aimed to investigate the relationship between 18 F-fluoride uptake and progression of coronary calcification in patients with clinically stable coronary artery disease. Methods Patients with established multivessel coronary atherosclerosis underwent 18 F-fluoride PET-computed tomography angiography and computed tomography calcium scoring, with repeat computed tomography angiography and calcium scoring at one year. Coronary PET uptake was analyzed qualitatively and semiquantitatively in diseased vessels by measuring maximum tissue-to-background ratio. Coronary calcification was quantified by measuring calcium score, mass, and volume. Results In a total of 183 participants (median age 66 years, 80% male), 116 (63%) patients had increased 18 F-fluoride uptake in at least one vessel. Individuals with increased 18 F-fluoride uptake demonstrated more rapid progression of calcification compared with those without uptake (change in calcium score, 97 [39–166] versus 35 [7–93] AU; P <0.0001). Indeed, the calcium score only increased in coronary segments with 18 F-fluoride uptake (from 95 [30–209] to 148 [61–289] AU; P <0.001) and remained unchanged in segments without 18 F-fluoride uptake (from 46 [16–113] to 49 [20–115] AU; P =0.329). Baseline coronary 18 F-fluoride maximum tissue-to-background ratio correlated with 1-year change in calcium score, calcium volume, and calcium mass (Spearman ρ=0.37, 0.38, and 0.46, respectively; P <0.0001 for all). At the segmental level, baseline 18 F-fluoride activity was an independent predictor of calcium score at 12 months ( P <0.001). However, at the patient level, this was not independent of age, sex, and baseline calcium score ( P =0.50). Conclusions Coronary 18 F-fluoride uptake identifies both patients and individual coronary segments with more rapid progression of coronary calcification, providing important insights into disease activity within the coronary circulation. At the individual patient level, total calcium score remains an important marker of disease burden and progression. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02110303.

scholarly journals Evaluation of Extracellular Volume by Computed Tomography is Useful for Prediction of Prognosis in Dilated Cardiomyopathy

2021 ◽  
Author(s):  
Satomi Yashima ◽  
Hiroyuki Takaoka ◽  
Manami Takahashi ◽  
Makiko Kinoshita ◽  
Haruka Sasaki ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Dilated Cardiomyopathy ◽  
Cardiac Ct ◽  
Volume Fraction ◽  
Extracellular Volume ◽  
Left Ventricular ◽  
Cox Proportional Hazards Model ◽  
Left Ventricular Myocardium ◽  
Operating Characteristics

Abstract Purpose: Dilated cardiomyopathy (DCM) is commonly encountered in daily clinical practice, and screening for coronary artery disease and other cardiomyopathies is necessary for its diagnosis. Cardiac CT is useful for the screening of coronary artery stenosis, and extracellular volume fraction (ECV) analysis by CT has become available using new specific software. Here, we evaluated the utility of ECV analysis using cardiac CT to predict patient prognosis in cases with DCM. Methods: We analyzed 70 cases with DCM and coronary computed tomography (CT) with available late-phase images. We evaluated the ECV of the left ventricular myocardium (LVM) using commercially available software (Ziostation 2, Ziosoft Inc, Japan). Results: ECV on LVM was 34.5±4.9%. Major adverse cardiac events (MACE) occurred in 20 cases (29%). ECV of the LVM on CT and the presence of significant valvular disease were significantly higher in cases with MACE than in those without (37.6±5.9 vs 33.2±3.9% and 55% vs 24%, P=0.0057 and P=0.013). LVEF was significantly lower in cases with MACE than in those without (22.3±7.6 vs 30.8±11.8%, P=0.0008). The best cut-off value of ECV on LVM for prediction of MACE was 32.7% based on receiver operating characteristics analysis. Cases with ECV ≥32.7% had significantly higher MACE based on Kaplan-Meier analysis (P=0.012). Only ECV on LVM was an independent predictor of MACE based on a Cox proportional hazards model (P=0.028). Conclusion: Evaluation of ECV on LVM by CT is useful for predicting MACE in patients with DCM.

scholarly journals Cervicocephalic Spotty Calcium for the Prediction of Coronary Atherosclerosis in Patients With Acute Ischemic Stroke

2021 ◽  
Vol 12 ◽  
Author(s):  
Chong Zheng ◽  
Shaozhen Yan ◽  
Fan Fu ◽  
Cheng Zhao ◽  
Daode Guo ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Coronary Artery ◽  
Acute Ischemic Stroke ◽  
Coronary Atherosclerosis ◽  
Independent Predictor ◽  
Characteristic Curve ◽  
Brain Mri ◽  
Calcium Score ◽  
Added Value ◽  
Control Group

Purpose: To investigate the characteristics of cervicocephalic spotty calcium (SC) and coronary atherosclerosis in patients with acute ischemic stroke (AIS) and to assess the predictive value of SC for coronary atherosclerosis using combined coronary and cervicocephalic CTA.Materials and Methods: Patients with AIS (n = 70) confirmed by brain MRI or CT and patients with asymptomatic carotid atherosclerosis (n = 58) confirmed by carotid ultrasonography were enrolled in our study. Subjects in both groups underwent combined coronary and cervicocephalic CTA. SC was used to evaluate cervicocephalic atherosclerosis. Coronary artery stenosis (CAS) ≥ 50% by segment and coronary artery calcium score (CACS) were used to evaluate coronary atherosclerosis. The SC frequency and the difference in coronary atherosclerosis between the two groups were compared, and the correlation between SC and coronary atherosclerosis was analyzed. Independent factors for CAS ≥ 50% were assessed via logistic regression analysis. Receiver operating characteristic curve analysis was performed to evaluate the added value of SC for predicting CAS ≥ 50%.Results: Both SC and the CACS were significantly higher in the Stroke group than in the Control group (total SC count: 6.83 ± 4.34 vs. 2.98 ± 2.87, P &lt; 0.05; CACS: 477.04 ± 798.01 vs. 136.31 ± 205.65, P &lt; 0.05). There were significant differences in the presence of CAS ≥ 50% (61.4 vs. 27.6%, P &lt; 0.001). SC and coronary atherosclerosis were significantly correlated for both the CACS and CAS ≥ 50% (r = 0.746 and 0.715, respectively; P &lt; 0.001). SC was an independent predictor for CAS ≥ 50%.Conclusion: SC correlates significantly with the CACS and could serve as an independent predictor of CAS ≥ 50% in patients with AIS, which suggests that combined cerebrovascular and cardiovascular assessments are of importance for such patients.

scholarly journals IDENTIFICATION OF CORONARY ATHEROSCLEROTIC LESIONS IN RAT INDUCED BY INTRAVENOUS CANDIDA ALBICANS

2018 ◽  
Vol 11 (12) ◽  
pp. 399
Author(s):  
Rendra Chriestedy Prasetya ◽  
Nadie Fatimatuzzahro ◽  
I Dewa Ayu Susilawati ◽  
Ayu Prativia Yonenda
Keyword(s):  
Candida Albicans ◽  
Coronary Artery ◽  
Treatment Group ◽  
Coronary Atherosclerosis ◽  
Wistar Rat ◽  
Control Group ◽  
Atherosclerotic Lesions ◽  
Sudan Iv ◽  
Picrosirius Red

Objective: This study aimed to identify the sign of coronary atherosclerosis lesion in rat induced by intravenous Candida albicans.Methods: This research was an experimental laboratories (in vivo) that used 15 male Wistar rat, divided into three groups of the control, the first treatment group injected by C. albicans intravenously with concentration of the 10−10 cells/mL and the second treatment group injected by C. albicans intravenously with concentration of the 10−12 cells/mL. 0.2 mL of C. albicans were injected to the first and second treatment group on 1st, 4th, 9th, 16th, and 23rd day. On the 5th week, rats were sacrificed, taken its hearts that contained the coronary artery. Rat’s heart had been fixed; histological preparations were made and painted with Picrosirius Red and Sudan IV, observed by a microscope.Results: The artery walls of the first and second treatment group were thicker than the control group. Lesions and disposition lipids of the first and second treatment group were more frequent than the control group.Conclusion: Intravenous C. albicans can increase the risk of coronary atherosclerosis.

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

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.

scholarly journals Quantification of extracellular volume fraction by cardiac computed tomography for noninvasive assessment of myocardial fibrosis in hemodialysis patients

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Akimasa Yamada ◽  
Kakuya Kitagawa ◽  
Satoshi Nakamura ◽  
Masafumi Takafuji ◽  
Yoshitaka Goto ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Myocardial Fibrosis ◽  
Cardiac Ct ◽  
Cardiac Computed Tomography ◽  
Extracellular Volume ◽  
Hemodialysis Patients ◽  
Left Ventricular ◽  
Volume Index ◽  
Stress Perfusion ◽  
Control Group

Abstract Extent of myocardial fibrosis in hemodialysis patients has been associated with poor prognosis. Myocardial extracellular volume (ECV) quantification using contrast enhanced cardiac computed tomography (CT) is a novel method to determine extent of myocardial fibrosis. Cardiac CT-based myocardial ECV in hemodialysis patients with those of propensity-matched non-hemodialysis control subjects were compared. Twenty hemodialysis patients (mean age, 67.4 ± 9.6 years; 80% male) and 20 propensity-matched non-hemodialysis controls (mean age, 66.3 ± 9.1 years; 85% male) who underwent comprehensive cardiac CT consisted of calcium scoring, coronary CT angiography, stress perfusion CT and delayed enhancement CT were evaluated. Myocardial ECV was significantly greater in the hemodialysis group than in the control group (33.8 ± 4.7% versus 26.6 ± 2.9%; P < 0.0001). In the hemodialysis group, modest correlation was evident between myocardial ECV and left atrial volume index (r = 0.54; P = 0.01), while there was no correlation between myocardial ECV and other cardiac parameters including left ventricular mass index and severity of myocardial ischemia. Cardiac CT-based myocardial ECV may offer a potential imaging biomarker for myocardial fibrosis in HD patients.

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