European heart journal. Imaging methods and practice最新文献

{"title":"Predictors and clinical outcomes of true mitral stenosis in patients undergoing transcatheter aortic valve implantation.","authors":"Mitsuki Yamaga, Masaki Izumo, Yukio Sato, Tatsuro Shoji, Daisuke Miyahara, Yoshikuni Kobayashi, Takahiko Kai, Taishi Okuno, Shingo Kuwata, Masashi Koga, Yasuhiro Tanabe, Yoshihiro J Akashi","doi":"10.1093/ehjimp/qyae109","DOIUrl":"10.1093/ehjimp/qyae109","url":null,"abstract":"<p><strong>Aims: </strong>Predictors of true degenerative mitral stenosis (MS) in patients with aortic stenosis who underwent transcatheter aortic valve implantation (TAVI) remain unknown. This study aimed to investigate the predictors and prognostic value of true degenerative MS in this population.</p><p><strong>Methods and results: </strong>We retrospectively reviewed the records of 760 consecutive patients who underwent TAVI. The mitral valve area (MVA) was assessed using transthoracic echocardiography, and mitral valve calcification was assessed using multi-detector computed tomography. MS was defined as an MVA of ≤2.0 cm², and true MS was defined as moderate or severe MS following TAVI. In our TAVI cohort, we identified 72 (9.5%) patients with degenerative MS. Among these, true MS was observed in 38 (52.7%) patients. Echocardiographic data showed that the true MS group had a significantly lower MVA and higher trans-mitral gradient. The severity of mitral annular calcification was not significantly different between the two groups; however, the true MS group had significantly more posterior mitral leaflet and anterior mitral leaflet (AML) calcification. Multivariable logistic regression analysis showed that AML calcification was the independent predictor of true MS [adjusted odds ratio, 9.23; 95% confidence interval (CI) 2.84-29.9]. True MS was independently associated with poor prognosis (adjusted hazard ratio, 2.76; 95% CI 1.09-6.98).</p><p><strong>Conclusion: </strong>Approximately half of the patients with concomitant degenerative MS who underwent TAVI had true MS, which was associated with a poor prognosis. Computed tomographic analysis of AML calcification was useful for predicting true MS.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"2 3","pages":"qyae109"},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning improves test-retest reproducibility of regional strain in echocardiography.","authors":"John Nyberg, Andreas Østvik, Ivar M Salte, Sindre Olaisen, Sigve Karlsen, Thomas Dahlslett, Erik Smistad, Torfinn Eriksen-Volnes, Harald Brunvand, Thor Edvardsen, Kristina H Haugaa, Lasse Lovstakken, Havard Dalen, Bjørnar Grenne","doi":"10.1093/ehjimp/qyae092","DOIUrl":"10.1093/ehjimp/qyae092","url":null,"abstract":"<p><strong>Aims: </strong>The clinical utility of regional strain measurements in echocardiography is challenged by suboptimal reproducibility. In this study, we aimed to evaluate the test-retest reproducibility of regional longitudinal strain (RLS) per coronary artery perfusion territory (RLS_Territory) and basal-to-apical level of the left ventricle (RLS_Level), measured by a novel fully automated deep learning (DL) method based on point tracking.</p><p><strong>Methods and results: </strong>We measured strain in a dual-centre test-retest data set that included 40 controls and 40 patients with suspected non-ST elevation acute coronary syndrome. Two consecutive echocardiograms per subject were recorded by different operators. The reproducibility of RLS_Territory and RLS_Level measured by the DL method and by three experienced observers using semi-automatic software (2D Strain, EchoPAC, GE HealthCare) was evaluated as minimal detectable change (MDC). The DL method had MDC for RLS_Territory and RLS_Level ranging from 3.6 to 4.3%, corresponding to a 33-35% improved reproducibility compared with the inter- and intraobserver scenarios (MDC 5.5-6.4% and 4.9-5.4%). Furthermore, the DL method had a lower variance of test-retest differences for both RLS_Territory and RLS_Level compared with inter- and intraobserver scenarios (all <i>P</i> < 0.001). Bland-Altman analyses demonstrated superior reproducibility by the DL method for the whole range of strain values compared with the best observer scenarios. The feasibility of the DL method was 93% and measurement time was only 1 s per echocardiogram.</p><p><strong>Conclusion: </strong>The novel DL method provided fully automated measurements of RLS, with improved test-retest reproducibility compared with semi-automatic measurements by experienced observers. RLS measured by the DL method has the potential to advance patient care through a more detailed, more efficient, and less user-dependent clinical assessment of myocardial function.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"2 4","pages":"qyae092"},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11498295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A blood cyst in the aortic root after acute myocardial infarction.","authors":"Masaya Hirayama, Satoshi Kainuma, Takeshi Kitai, Kisaki Amemiya, Satsuki Fukushima","doi":"10.1093/ehjimp/qyae107","DOIUrl":"https://doi.org/10.1093/ehjimp/qyae107","url":null,"abstract":"","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"2 3","pages":"qyae107"},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142684064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transient ST-segment elevation myocardial infarction without flow-limiting obstructions in the epicardial coronary arteries on angiography: coronary artery vasospasm, myocardial infarction with non-obstructive coronary arteries or spontaneous coronary artery dissection?","authors":"Sahrai Saeed, Trond Cooper, Anne Margrethe Tveit, Svein Rotevatn, Terje H Larsen","doi":"10.1093/ehjimp/qyae104","DOIUrl":"https://doi.org/10.1093/ehjimp/qyae104","url":null,"abstract":"","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"2 3","pages":"qyae104"},"PeriodicalIF":0.0,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HoloPatch: improving intracardiac patch fit through holographically modelled templates.","authors":"Matthias Lippert, Gabriella d' Albenzio, Kathrine Rydén Suther, Karl-Andreas Dumont, Rafael Palomar, Hans Henrik Odland, Ole Jakob Elle, Bjørn Bendz, Henrik Brun","doi":"10.1093/ehjimp/qyae103","DOIUrl":"10.1093/ehjimp/qyae103","url":null,"abstract":"<p><strong>Aims: </strong>Structural heart defects, including congenital ventricular septal defect closure or intracardiac rerouting, frequently require surgical reconstruction using hand-cut patch materials. Digitally modelled patch templates may improve patch fit and reduce outflow tract obstruction, residual defect risk, and conduction system damage. In this study, we benchmarked mixed-reality and a desktop application against a digitalized model of a real implanted patch.</p><p><strong>Methods and results: </strong>Ten patients scheduled for the repair of various defects consented to prospective inclusion in the study. After surgery, a digital model of the implanted patch was created from the residual material. Five clinical experts created 10 digital patches, 1 per patient, both in mixed-reality and desktop application, for comparison with the reference measurements, including the digitalized model of the real patch used during the surgery. Subjective residual shunt risk prediction was performed using both modalities. Digital patches created in mixed-reality closely matched the surgical material, whereas those created using desktop applications were significantly smaller. Different evaluators showed varying preferences for the application of the residual shunt risk and area.</p><p><strong>Conclusion: </strong>Digitally created patches can assist surgeons in preoperatively sizing of patch implants, potentially reducing post-operative complications.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"2 3","pages":"qyae103"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echocardiographic red flags of ATTR cardiomyopathy a single centre validation.","authors":"Michael Y Henein, Björn Pilebro, Per Lindqvist","doi":"10.1093/ehjimp/qyae105","DOIUrl":"10.1093/ehjimp/qyae105","url":null,"abstract":"<p><strong>Aims: </strong>Echocardiography plays an important role in suspecting the presence of transthyretin cardiomyopathy (ATTR-CM) in patients with heart failure, based on parameters proposed as 'red flags' for the diagnosis of ATTR-CM. We aimed to validate those measurements in a group of patients with ATTR-CM including ATTRv and ATTRwt.</p><p><strong>Methods and results: </strong>We tested a number of echocardiographic red flags in 118 patients with confirmed diagnosis of ATTR-CM. These variables were validated against healthy controls and patients with heart failure with left ventricular hypertrophy (LVH) but not ATTR-CM. The red flag measures outside the proposed cut-off values were also revalidated. In ATTR-CM, all conventional echocardiographic parameters were significantly abnormal compared with controls. Comparing ATTR-CM and LVH, LV wall thickness, LV diameter, E velocity, and relative apical sparing (RELAPS) were all different. Eighty-three per cent of ATTR-CM patients had RELAPS > 1.0, 73% had relative wall thickness (RWT) > 0.6, 72% had LVEF > 50%, 24% had global longitudinal strain (GLS) > -13%, 33% had LVEF/GLS > 4, and 54% had increased left atrial volume index (>34 mL/m²). Forty per cent of ATTR-CM patients had stroke volume index < 30 mL/m² and 52% had cardiac index < 2.5 L/min/m². RELAPS, LVEF, and RWT, in order of accuracy, were the three best measures for the presence ATTR-CM in the patient cohort, who all had thick myocardium. The concomitant presence of the three disturbances was found in only 50% but the combination of RELAPS > 1.0 and RWT > 0.6 was found in 72% of the patient cohort.</p><p><strong>Conclusion: </strong>Increased relative apical sparing proved the most accurate independent marker of the presence of ATTR-CM followed by normal LV ejection fraction and then increased relative wall thickness. The other proposed red flags for diagnosing ATTR-CM did not feature as reliable disease predictors.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"2 3","pages":"qyae105"},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11645131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Issue at a glance.","authors":"Oliver Gaemperli","doi":"10.1093/ehjimp/qyae090","DOIUrl":"https://doi.org/10.1093/ehjimp/qyae090","url":null,"abstract":"","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"2 2","pages":"qyae090"},"PeriodicalIF":0.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11456829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated computed tomography-derived fractional flow reserve model for diagnosing haemodynamically significant coronary artery disease: a prospective validation study.","authors":"Anders T Bråten, Fredrik E Fossan, Lucas O Muller, Arve Jørgensen, Knut H Stensæth, Leif R Hellevik, Rune Wiseth","doi":"10.1093/ehjimp/qyae102","DOIUrl":"10.1093/ehjimp/qyae102","url":null,"abstract":"<p><strong>Aims: </strong>This study aims to assess the diagnostic performance of a novel computed tomography-derived fractional flow reserve (CT-FFR) algorithm and to compare its accuracy at three predefined sites: (i) at the location of invasive FFR measurements (CT-FFR_atloc), (ii) at selected sites determined by an automated module integrated within the algorithm (CT-FFR_auto), and (iii) distally in the vessel (CT-FFR_distal).</p><p><strong>Methods and results: </strong>We prospectively recruited 108 consecutive patients with stable symptoms of coronary artery disease and at least one suspected obstructive lesion on coronary computed tomography angiography (CCTA). CT-FFR was validated against invasive FFR as gold standard using FFR ≤ 0.80 to define myocardial ischaemia. CT-FFR_atloc showed good correlation with invasive FFR (<i>r</i> = 0.67) and improved the ability to detect myocardial ischaemia compared with CCTA at both lesion [area under the curve (AUC) 0.83 vs. 0.65, <i>P</i> < 0.001] and patient level (AUC 0.87 vs. 0.74, <i>P</i> = 0.007). CT-FFR_auto demonstrated similar diagnostic accuracy to CT-FFR_atloc and significantly improved specificity compared with CT-FFR_distal (86% vs. 49%, <i>P</i> < 0.001). High end CT quality improved the diagnostic performance of CT-FFR_auto, demonstrating an AUC of 0.92; similarly, the performance was improved in patients with low-to-intermediate coronary artery calcium score with an AUC of 0.88.</p><p><strong>Conclusion: </strong>Implementing an automated module to determine the site of CT-FFR evaluations was feasible, and CT-FFR_auto demonstrated comparable diagnostic accuracy to CT-FFR_atloc when assessed against invasive FFR. Both CT-FFR_atloc and CT-FFR_auto improved the diagnostic performance compared with CCTA and improved specificity compared with CT-FFR_distal. High end CT quality and low-to-intermediate calcium burden improved the diagnostic performance of our algorithm.</p><p><strong>Clinicaltrialsgov identifier: </strong>NCT03045601.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"2 3","pages":"qyae102"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent coronary and extra-coronary spontaneous artery dissection in Ehlers-Danlos syndrome: multimodal imaging insights.","authors":"Marta Zielonka, Tania Ramírez-Martínez, Ramon Bascompte Claret, Isabel Hernández-Martín, Kristian Rivera","doi":"10.1093/ehjimp/qyae101","DOIUrl":"https://doi.org/10.1093/ehjimp/qyae101","url":null,"abstract":"","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"2 3","pages":"qyae101"},"PeriodicalIF":0.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11481008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing left atrial dysfunction in cardiac amyloidosis using LA-LV strain slope.","authors":"Fredrik Edbom, Per Lindqvist, Urban Wiklund, Björn Pilebro, Intissar Anan, Frank A Flachskampf, Sandra Arvidsson","doi":"10.1093/ehjimp/qyae100","DOIUrl":"10.1093/ehjimp/qyae100","url":null,"abstract":"<p><strong>Aims: </strong>Transthyretin amyloid cardiomyopathy (ATTR-CM) is an infiltrative disease of the myocardium in which extracellular deposits of amyloid cause progressive cardiac impairment. We aimed to evaluate left atrial (LA) deformation and its association with left ventricular (LV) deformation using LA-LV strain loops in patients with ATTR-CM and patients with LV hypertrophy (LVH). We hypothesized that LA strain in ATTR-CM patients is abnormal and more independent of LV strain, compared to LVH patients.</p><p><strong>Methods and results: </strong>Retrospective study based on echocardiographic data including 30 patients diagnosed with ATTR-CM based on an end-diastolic interventricular septal (IVSd) thickness of ≥14 mm, and 29 patients with LVH (IVSd ≥ 14 mm and no ATTR-CM diagnosis) together with 30 controls. LV global longitudinal strain (LV-GLS) and LA strain, assessed as peak atrial longitudinal strain (PALS), were acquired and plotted to construct LA-LV strain loops and used regression line to determine a LA-LV strain slope. Significantly lower PALS and LA-LV strain slope values were detected in ATTR-CM patients compared to LVH patients (<i>P</i> = 0.004 and <i>P</i> = 0.014, respectively). A receiver operating characteristic (ROC) curve demonstrated similar area under the curve (AUC) using PALS (AUC 0.72) and LA-LV slope (AUC 0.71), with both resulting in higher values than recorded for LV-GLS (AUC 0.62).</p><p><strong>Conclusion: </strong>LA deformation demonstrates an independent ability to differentiate ATTR-CM from LVH. Combining LV strain and LA deformation analysis displays the mechanical LA-LV dissociation in ATTR cardiac amyloidosis and potentially unmasks LA amyloid infiltration; this could potentially enable quicker diagnosis and initiation of treatment for ATTR-CM.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"2 3","pages":"qyae100"},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}