Moderated poster presentations最新文献

M7 Radiation dose in the investigation of stable chest pain M7辐射剂量在稳定性胸痛研究中的应用

Moderated poster presentations Pub Date : 2020-09-01 DOI: 10.1136/HEARTJNL-2020-BSCI.12

J. Chiong, A. Nania, N. Weir, E. V. Beek, G. Roditi, D. Newby, M. Williams

{"title":"M7 Radiation dose in the investigation of stable chest pain","authors":"J. Chiong, A. Nania, N. Weir, E. V. Beek, G. Roditi, D. Newby, M. Williams","doi":"10.1136/HEARTJNL-2020-BSCI.12","DOIUrl":"https://doi.org/10.1136/HEARTJNL-2020-BSCI.12","url":null,"abstract":"Introduction Radiation exposure in cardiac imaging is an important healthcare concern. For patients with stable chest pain this includes computed tomography (CT) coronary angiography (CTCA), coronary artery calcium score (CACS), single photon emission tomography (SPECT) and invasive angiography (ICA). Methods Radiation dose data for 1000 consecutive patients from the SCOT-HEART trial were obtained from electronic patient records. Radiation dose from the first occurrence of each form of imaging was recorded including dose area product (DAP) for ICA, dose length product (DLP) for CT and injected activity (megabecquerel, MBq) for SPECT (99 mTc tetrofosmin). Conversion factors to calculate effective dose were 0.024 for ICA, 0.028 for CT and 0.009 for SPECT. Results Patients had a mean age 57±10 years, body mass index 29±6 kg/m2 and 57% were male. ICA was performed in 337 patients with a median DAP of 181.7 [IQR 129.2, 279.8] mCycm2 for diagnostic imaging and 430.6 [IQR 299.5, 612.1] mCycm2 when percutaneous coronary intervention was also performed. SPECT was performed in 52 patients with a median total injected activity of 988 [IQR 954, 1137] MBq. CT was performed in 441 patients with a median total DLP of 276 [IQR 210, 353] mGy.cm. Median radiation dose for CACS was 115 [102, 125] mGy.cm and CTCA was 191 [IQR 100, 293] mGy.cm. Effective radiation doses were 4.4 mSv for diagnostic ICA, 5.4 mSv for CTCA and 8.9 mSv for SPECT. Conclusion Radiation dose for diagnostic imaging for stable chest pain was similar for CTCA and ICA and highest for SPECT.","PeriodicalId":219485,"journal":{"name":"Moderated poster presentations","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114963661","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}

引用次数: 0

M2 Improving arterial opacification in computed tomography for transcatheter aortic valve replacement M2改善经导管主动脉瓣置换术中ct显示的动脉混浊

Moderated poster presentations Pub Date : 2020-09-01 DOI: 10.1136/HEARTJNL-2020-BSCI.7

H. Komber, S. Neumann, J. Paull, M. G. Andrade, S. Lyen, N. Manghat, M. Hamilton

{"title":"M2 Improving arterial opacification in computed tomography for transcatheter aortic valve replacement","authors":"H. Komber, S. Neumann, J. Paull, M. G. Andrade, S. Lyen, N. Manghat, M. Hamilton","doi":"10.1136/HEARTJNL-2020-BSCI.7","DOIUrl":"https://doi.org/10.1136/HEARTJNL-2020-BSCI.7","url":null,"abstract":"Introduction Computed tomography (CT) prior to trans-catheter aortic valve implantation (TAVI) requires adequate vascular opacification. With expert radiographer-led contrast dosing (standard protocol), a wide variation in arterial opacification was observed. Methods Considering the time required for the electrocardiographically (ECG)-gated and helical acquisitions (Siemens Somatom AS+ 128-slice scanner), an optimised weight-based protocol was developed using 30 s contrast bolus of iodine flux 15–19 mg/kg/s. Radiodensity [Hounsfield Units (HU)] was assessed with a circular region of interest in (a) ascending aorta (0.75 mm ECG-gated systolic acquisition) and (b) ascending, descending thoracic (at carina), infra-renal abdominal aorta and right external iliac artery (1–1.5 mm helical acquisition). Thirty-six sequential optimised scans were compared to 36 prior standard scans. All patients had adequate renal function (eGFR>45 ml/min/1.73 m2). There was no difference in the CARE kV between the protocols (p=0.67). Results The mean patient age was 78 and 80 years (standard, optimised). The male to female ratio was 47:53 and 61:39 (standard, optimised). The mean bolus durations were 25±5.3 s and 30±0.3 s (standard, optimised); a significant variation (p 0.9), there was a significant improvement in the arterial radiodensity at all other anatomical points in the helical scans of the optimised protocol (p Conclusion Optimising contrast flux and matching bolus duration to the CT technology dramatically improves TAVI planning scans with objectively improved arterial opacification. This results in better contrast opacification for optimal assessment of aortic valve prosthesis sizing and access strategies.","PeriodicalId":219485,"journal":{"name":"Moderated poster presentations","volume":"121 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122000015","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}

引用次数: 0

M8 The influence of anatomy on prognosis of an aortic arch anomaly– a radiological view 解剖学对主动脉弓异常预后的影响——影像学观察

Moderated poster presentations Pub Date : 2020-09-01 DOI: 10.1136/HEARTJNL-2020-BSCI.13

Elena Ctori, A. Crucean, B. Pinkey, S. Mcguirk, Robert H. Anderson, J. Stickley, T. Jones, A. Seale

{"title":"M8 The influence of anatomy on prognosis of an aortic arch anomaly– a radiological view","authors":"Elena Ctori, A. Crucean, B. Pinkey, S. Mcguirk, Robert H. Anderson, J. Stickley, T. Jones, A. Seale","doi":"10.1136/HEARTJNL-2020-BSCI.13","DOIUrl":"https://doi.org/10.1136/HEARTJNL-2020-BSCI.13","url":null,"abstract":"Introduction Due to the incorporation of the three vessel and trachea view to antenatal screening, understanding the prognosis of aortic arch anomalies (AAAs) is important. Certain morphological characteristics, detectable on cross-sectional imaging, may influence symptom development. This study aims to explore the radiological features of AAAs which may increase risk of symptomatic presentation and surgery. Methods A retrospective observational study from a single cardiac surgical unit. Individuals with an AAA who underwent computed tomography/magnetic resonance imaging between 6/2014 and 9/2018 were included. Imaging studies were evaluated for arch morphology. In double aortic arches (DAA), arch patency was assessed. Presence of Kommerell diverticulum was noted in aberrant subclavian cases. The laterality of the arterial ligament was observed in those with a right aortic arch/mirrored branching. Case notes were reviewed to assess presence of vascular-ring symptoms and surgical intervention. Results We identified 167 individuals. Of cases with aberrant subclavian, 24/79(30.4%) had a Kommerell. The infants with a Kommerell were more likely to be symptomatic (p≤0.001) and undergo surgery (p≤0.001). 55% of DAA patients had dual arch patency. Patency did not influence symptoms (p=0.396) or surgery (p=0.250). The arterial ligament was identified in 28/70(40%) of right arch/mirrored branching patients. Laterality did not influence symptom development (p=0.692). Conclusion Infants with an aberrant subclavian and Kommerell have increased risk of symptoms/surgical intervention and should remain under monitoring. This study did not identify the arterial ligament insertion point in those with a right aortic arch/mirrored branching, which may be a useful prognostic tool. Better foetal imaging methods could help antenatal prediction.","PeriodicalId":219485,"journal":{"name":"Moderated poster presentations","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134281456","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}

引用次数: 0

M5 Reporting incidental coronary and cardiac calcification on thoracic CT– BSCI/BSCCT survey of radiologist opinions M5报告胸椎CT附带冠状动脉和心脏钙化- BSCI/BSCCT调查的放射科医生意见

Moderated poster presentations Pub Date : 2020-09-01 DOI: 10.1136/HEARTJNL-2020-BSCI.10

M. Williams, J. Weir-McCall, A. Moss, M. Schmitt, J. Stirrup, B. Holloway, D. Gopalan, A. Deshpande, G. M. Hughes, B. Agrawal, E. Nicol, G. Roditi, J. Shambrook, R. Bull

{"title":"M5 Reporting incidental coronary and cardiac calcification on thoracic CT– BSCI/BSCCT survey of radiologist opinions","authors":"M. Williams, J. Weir-McCall, A. Moss, M. Schmitt, J. Stirrup, B. Holloway, D. Gopalan, A. Deshpande, G. M. Hughes, B. Agrawal, E. Nicol, G. Roditi, J. Shambrook, R. Bull","doi":"10.1136/HEARTJNL-2020-BSCI.10","DOIUrl":"https://doi.org/10.1136/HEARTJNL-2020-BSCI.10","url":null,"abstract":"Introduction Coronary and cardiac calcifications are common incidental findings on thoracic CT which are frequently not reported. This survey sought the opinions of UK radiologists regarding reporting of incidental calcification. Methods Using an online survey form UK radiologists were invited to answer questions regarding reporting of coronary, aortic valve, mitral and thoracic aorta calcification on routine non-cardiac/vascular thoracic CT. Results 210 radiologists completed the survey including 24 (11%) trainees and 186 (89%) consultants. 30% were not sub-specialists in cardiac, thoracic or vascular imaging. Calcification was not reported by 11% for the coronary arteries, 21% for the aortic valve, 25% for the mitral valve and 38% for the aorta. Age and indication for imaging were the most frequent factors influencing the reporting of calcification. For coronary calcification a per patient visual assessment was the most frequently used (66%), followed by per vessel visual assessment (14%), semi-quantitative scoring (5%) and Agatston scoring (2%). Several comments suggested that guidelines for reporting incidental coronary and cardiac calcification would be useful. Conclusion Reporting of incidental coronary and cardiac calcification varies widely and guidelines are required.","PeriodicalId":219485,"journal":{"name":"Moderated poster presentations","volume":"82 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122604284","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}

引用次数: 0

M1 Computed tomography prior to transcatheter aortic valve implantation in the United Kingdom 英国经导管主动脉瓣植入术前的计算机断层扫描

Moderated poster presentations Pub Date : 2020-09-01 DOI: 10.1136/HEARTJNL-2020-BSCI.6

Iwan Harries, Jonathan R. Weir-McCall, Michelle C. Williams, James Shambrook, Giles Roditi, Russell Bull, Gareth J Morgan-Hughes, Edward Nicol, A. Moss

{"title":"M1 Computed tomography prior to transcatheter aortic valve implantation in the United Kingdom","authors":"Iwan Harries, Jonathan R. Weir-McCall, Michelle C. Williams, James Shambrook, Giles Roditi, Russell Bull, Gareth J Morgan-Hughes, Edward Nicol, A. Moss","doi":"10.1136/HEARTJNL-2020-BSCI.6","DOIUrl":"https://doi.org/10.1136/HEARTJNL-2020-BSCI.6","url":null,"abstract":"Introduction This cross-sectional study sought to survey the current practice of computed tomography prior to transcatheter aortic valve implantation (CT-TAVI) in the United Kingdom. Methods All members of the British Society of Cardiovascular Imaging (BSCI) were invited to complete a 27-item online CT-TAVI survey. Results 47 responses were received from 40 cardiac centres, 23 (58%) of which performed TAVI on-site (TAVI centres). Only 6 respondents (13%) performed high volume activity (>200 scans per year) compared with 13 (28%) performing moderate (100–200 scans per year) and 27 (59%) performing low (0–99 scans per year) volume activity. Acquisition protocols varied (41% retrospective, 12% prospective with wide padding, 47% prospective with narrow padding), as did the phase of reporting (45% systolic, 37% diastolic, 11% both, 6% unreported) and use of beta blockade (22%). Median dose length product (DLP) was 675 mGy.cm (interquartile range 477 - 954 mGy.cm). Compared with non-TAVI centres, TAVI centres were more likely to report minimum ilio-femoral luminal diameter (n=25, 96% versus n=7, 58%, p=0.003) and optimal tube angulation for intervention (n=12, 46% versus n=1, 8%, p=0.02). TAVI centres trended towards using lower contrast volume than non-TAVI centres (98±27 vs. 118±42 ml, p=0.06); radiation doses did not differ (766±502 vs 801±461mGy.cm, p=0.66). Conclusion This national survey formally describes current CT-TAVI practice in the United Kingdom. High volume activity was only present at 1 in 7 cardiac CT centres. There is wide variation in scan acquisition, scan reporting and radiation dose exposure.","PeriodicalId":219485,"journal":{"name":"Moderated poster presentations","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128370577","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}

引用次数: 4

M4 Annular versus supra-annular sizing for transcatheter aortic valve replacement in bicuspid aortic valve disease 经导管主动脉瓣置换术中环形与环上尺寸的比较

Moderated poster presentations Pub Date : 2020-09-01 DOI: 10.1136/HEARTJNL-2020-BSCI.9

J. Weir-McCall, Adrian Attinger-Toller, P. Blanke, G. Perlman, S. Sellers, D. Wood, J. Webb, J. Leipsic

{"title":"M4 Annular versus supra-annular sizing for transcatheter aortic valve replacement in bicuspid aortic valve disease","authors":"J. Weir-McCall, Adrian Attinger-Toller, P. Blanke, G. Perlman, S. Sellers, D. Wood, J. Webb, J. Leipsic","doi":"10.1136/HEARTJNL-2020-BSCI.9","DOIUrl":"https://doi.org/10.1136/HEARTJNL-2020-BSCI.9","url":null,"abstract":"Introduction CT measurement of supra-annular area (SA) has been proposed as an alternative to annular area (AA) for sizing of trancatheter valves in biscuspid aortic valves (BAV). This study examines the reproducibility of SA and AA measurements and their potential impact on downstream transcatheter heart valve sizing and clinical outcomes. Methods 44 consecutive patients (mean age: 73±15 years, 57% male) undergoing CTA with subsequent SAPIEN 3 valve insertion for severe bicuspid aortic stenosis (AS) were included. AA was measured at the basal ring. SA was measured by generating a circle defined by the intercommisural distance. AA and SA were measured by 2 independent observers. Baseline characteristics, TAVR procedural data, and discharge echocardiography data were collected. Results The SA was significantly larger than the AA (562±146 mm2 vs. 518±112 mm2,p=0.013). Interobserver agreement was high using both techniques (ICC AA=0.98,p Conclusion Supra-annular sizing is less reproducible than annular sizing, with no difference in procedural complication rates in patients in whom supra-annular sizing would have altered the device size used. These results suggest no role for supra-annular sizing in current clinical practice.","PeriodicalId":219485,"journal":{"name":"Moderated poster presentations","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127446602","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}

引用次数: 0

M6 Comparing CTCA and CACS in assessing risk in high hazard occupations 比较CTCA和CACS在高危害职业风险评估中的作用

Moderated poster presentations Pub Date : 2020-03-01 DOI: 10.1136/HEARTJNL-2020-BSCI.11

J. Holland, L. Eveson, E. Nicol

{"title":"M6 Comparing CTCA and CACS in assessing risk in high hazard occupations","authors":"J. Holland, L. Eveson, E. Nicol","doi":"10.1136/HEARTJNL-2020-BSCI.11","DOIUrl":"https://doi.org/10.1136/HEARTJNL-2020-BSCI.11","url":null,"abstract":"Introduction The role of Computed Tomography Coronary Angiography (CTCA) in assessing occupational risk in individuals in high hazard occupations with suspected CAD has not been fully explored. We explored how CTCA alters occupational disposition compared with coronary artery calcium scores (CACS), currently used by employers and regulatory bodies. Methods 6-year consecutive data from high hazard employees undergoing CTCA were analysed. Demographics, CTCA (maximal stenosis and aggregate stenosis), CACS and occupational disposition pre- and post-CTCA were captured. Results CTCA data from 139 individuals were collected; comprising 82 pilots and air traffic controllers, and 57 non-pilot aircrew and ground-based employees. Initially, all individuals were medically restricted due to an abnormal exercise test (35%) or resting ECG (36%), cardiac symptoms (27%) or ≥2 risk factors (25%). After CTCA, 61% of pilots and controllers were returned to unrestricted flying, and 60% of non-pilot aircrew/ground-based employees were fully employable. Of the pilots and controllers with a CACS of Conclusion CTCA effectively excludes CAD in most high hazard employees, allowing return to unrestricted roles. However, a substantial proportion with occupationally significant stenoses are not identified with CACS. Current use of these investigations by regulatory authorities/employers allows those at significant risk of coronary events to return to unrestricted high hazard employment. CTCA appears the most accurate non-invasive test to confirm or exclude suspected occupationally relevant CAD in high-hazard occupations.","PeriodicalId":219485,"journal":{"name":"Moderated poster presentations","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116948818","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}

引用次数: 0