Erik Andreas Rye Berg, Anders Austlid Taskén, Trym Nordal, Bjørnar Grenne, Torvald Espeland, Idar Kirkeby-Garstad, Håvard Dalen, Espen Holte, Stian Stølen, Svend Aakhus, Gabriel Kiss
{"title":"Fully automatic estimation of global left ventricular systolic function using deep learning in transoesophageal echocardiography.","authors":"Erik Andreas Rye Berg, Anders Austlid Taskén, Trym Nordal, Bjørnar Grenne, Torvald Espeland, Idar Kirkeby-Garstad, Håvard Dalen, Espen Holte, Stian Stølen, Svend Aakhus, Gabriel Kiss","doi":"10.1093/ehjimp/qyad007","DOIUrl":"10.1093/ehjimp/qyad007","url":null,"abstract":"<p><strong>Aims: </strong>To improve monitoring of cardiac function during major surgery and intensive care, we have developed a method for fully automatic estimation of mitral annular plane systolic excursion (auto-MAPSE) using deep learning in transoesophageal echocardiography (TOE). The aim of this study was a clinical validation of auto-MAPSE in patients with heart disease.</p><p><strong>Methods and results: </strong>TOE recordings were collected from 185 consecutive patients without selection on image quality. Deep-learning-based auto-MAPSE was trained and optimized from 105 patient recordings. We assessed auto-MAPSE feasibility, and agreement and inter-rater reliability with manual reference in 80 patients with and without electrocardiogram (ECG) tracings. Mean processing time for auto-MAPSE was 0.3 s per cardiac cycle/view. Overall feasibility was >90% for manual MAPSE and ECG-enabled auto-MAPSE and 82% for ECG-disabled auto-MAPSE. Feasibility in at least two walls was ≥95% for all methods. Compared with manual reference, bias [95% limits of agreement (LoA)] was -0.5 [-4.0, 3.1] mm for ECG-enabled auto-MAPSE and -0.2 [-4.2, 3.6] mm for ECG-disabled auto-MAPSE. Intra-class correlation coefficient (ICC) for consistency was 0.90 and 0.88, respectively. Manual inter-observer bias [95% LoA] was -0.9 [-4.7, 3.0] mm, and ICC was 0.86.</p><p><strong>Conclusion: </strong>Auto-MAPSE was fast and highly feasible. Inter-rater reliability between auto-MAPSE and manual reference was good. Agreement between auto-MAPSE and manual reference did not differ from manual inter-observer agreement. As the principal advantages of deep-learning-based assessment are speed and reproducibility, auto-MAPSE has the potential to improve real-time monitoring of left ventricular function. This should be investigated in relevant clinical settings.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82030887","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":"Prognostic impact of cardiac resynchronization therapy guided by phase analysis: a CZT study.","authors":"Riccardo Liga, Umberto Startari, Davide Spatafora, Erica Michelotti, Alessia Gimelli","doi":"10.1093/ehjimp/qyad004","DOIUrl":"10.1093/ehjimp/qyad004","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate whether phase analysis imaging may predict treatment response and long-term prognosis after cardiac resynchronization therapy (CRT).</p><p><strong>Methods and results: </strong>Sixty-nine patients underwent myocardial perfusion imaging followed by CRT. Patients with ischaemic heart disease and non-ischaemic cardiomyopathy (NICM) were identified. Left ventricular (LV) mechanical dyssynchrony (LVMD) was assessed at phase analysis and the region of the latest mechanical activation was identified. LV pacing lead position was considered 'concordant' when located in the region of the latest mechanical activation, and 'discordant' otherwise. The '6 months post-CRT'/'baseline' ratio of LV ejection fraction was computed as a measure of CRT response. LVMD was revealed in 47/69 patients, 27 of whom (57%) had a concordant LV lead implantation. Only concordant pacing was associated with LV functional improvement (ejection fraction ratio: 1.28 ± 0.25 vs. 1.11 ± 0.32 in discordant stimulation, <i>P</i> = 0.028). However, this relationship persisted only in patients with NICM (<i>P</i> < 0.001), while it disappeared in those with ischaemic heart disease (<i>P</i> = NS). Twenty-eight events occurred during 30 ± 21 months follow-up. While discordant LV lead location was the major predictor of unfavourable prognosis (hazard ratio 3.29, 95% confidence interval 1.25-8.72; <i>P</i> = 0.016), this relationship was confirmed only in patients with NICM.</p><p><strong>Conclusions: </strong>Phase analysis of myocardial perfusion imaging may guide CRT implantation, identifying patients who would most likely benefit from this procedure.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87938341","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}
Tiffany A Dong, Bryan Q Abadie, Erika Hutt Centeno, Christine L Jellis, Paul C Cremer, Wael A Jaber
{"title":"Towards standardization of positron emission testing with computed tomography myocardial perfusion volumes and left ventricular ejection fraction: comparison with cardiac MRI.","authors":"Tiffany A Dong, Bryan Q Abadie, Erika Hutt Centeno, Christine L Jellis, Paul C Cremer, Wael A Jaber","doi":"10.1093/ehjimp/qyad006","DOIUrl":"10.1093/ehjimp/qyad006","url":null,"abstract":"<p><p>Gated positron emission testing with computed tomography (PET-CT) yields left ventricular (LV) volume analysis along with perfusion analysis. The correlation between PET-CT volumes and cardiac magnetic resonance imaging (CMR) volumes remains unknown. Understanding of the accuracy of these volumes and ejection fractions (EF) by PET is clinically relevant, particularly in the sarcoid population where patients receive initial diagnostic CMR and then are followed by PET for inflammation. 89 patients undergoing cardiac sarcoidosis evaluation with both rest PET-CT and CMR within approximately 1 year were identified at Cleveland Clinic from 2011 to 2021. LV volumes and EF were collected. Linear regression and Bland-Altman analyses were performed. Mean PET-CT derived left ventricular ejection fraction (LVEF) was 46 ± 16% with mean LV end diastolic volume (LVEDV) of 127 ± 60 mL and mean LV end systolic volume (LVESV) of 75 ± 54 mL. Mean CMR-derived LVEF was 47 ± 15% with mean LVEDV of 189 ± 61 mL and mean LVESV of 106 ± 60 mL. Pearson correlation coefficient with standard measurements was 0.85 for EF, 0.80 for LVEDV, and 0.86 for LVESV. In our cohort, there is an excellent correlation of LVEF between PET-CT and CMR with a mean difference of 1.1% and a good correlation of volumes between these two imaging modalities. This has potential clinical implications when judging LVEF qualifications for medical and device therapies although future larger validation cohorts are warranted.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75051243","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}
Paul C Cremer, David Lin, Sushil A Luis, John Petersen, Antonio Abbate, Christine L Jellis, Debbie Kwon, Antonio Brucato, Fang Fang, Antonella Insalaco, Martin LeWinter, Basil S Lewis, Liangxing Zou, Stephen J Nicholls, Allan L Klein, Massimo Imazio, John F Paolini
{"title":"Pericardial late gadolinium enhancement and time to recurrence: a substudy from RHAPSODY, a phase 3 clinical trial of rilonacept in recurrent pericarditis.","authors":"Paul C Cremer, David Lin, Sushil A Luis, John Petersen, Antonio Abbate, Christine L Jellis, Debbie Kwon, Antonio Brucato, Fang Fang, Antonella Insalaco, Martin LeWinter, Basil S Lewis, Liangxing Zou, Stephen J Nicholls, Allan L Klein, Massimo Imazio, John F Paolini","doi":"10.1093/ehjimp/qyad003","DOIUrl":"10.1093/ehjimp/qyad003","url":null,"abstract":"<p><strong>Aims: </strong>In this protocol-predefined substudy of the RHAPSODY trial, the primary aim was to assess whether pericardial late gadolinium enhancement (LGE) was associated with time to pericarditis recurrence.</p><p><strong>Methods and results: </strong>RHAPSODY was a Phase 3 double-blind, placebo-controlled, randomized-withdrawal trial that demonstrated the efficacy of rilonacept in recurrent pericarditis (RP). Patients with a history of multiple RP and an active recurrence were enrolled and had the option to participate in a cardiac magnetic resonance (CMR) imaging substudy. CMRs were interpreted by a blinded independent core laboratory with prespecified criteria to define pericardial LGE. Compared to patients with trace or mild pericardial LGE (<i>n</i> = 9), patients with moderate or severe pericardial LGE (<i>n</i> = 16) generally had a higher number of recurrent episodes per year (5.3 vs. 3.9) and a higher mean CRP level (3.6 vs. 1.1 mg/dL). Overall, 10/14 (71.4%) who received a placebo had a recurrence compared to 0/11 (0%) who received rilonacept. In patients randomized to placebo who had moderate or severe pericardial LGE, the median time to recurrence was 4.2 weeks compared to 10.7 weeks in patients who had trace or mild pericardial LGE. At the conclusion of the event-driven randomized-withdrawal period, among patients receiving a placebo, 5/7 (71.4%) with trace or mild pericardial LGE and 5/7 (71.4%) with moderate or severe pericardial LGE had a recurrence.</p><p><strong>Conclusions: </strong>Among patients with multiple RP, these preliminary findings support the concept of pericardial LGE as an imaging biomarker that may inform the duration of treatment and risk of recurrence with cessation of therapy and larger studies should be considered.</p><p><strong>Clinicaltrialsgov identifier: </strong>NCT03737110.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11240150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84233887","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}
Abdelrahman Elhakim, Kawther Karkour, Philip Sauter, Michael Rode, Mohamed Elhakim, Peter W Radke, Mohammed Saad
{"title":"The role of endosonography in cardiology: case series and literature review.","authors":"Abdelrahman Elhakim, Kawther Karkour, Philip Sauter, Michael Rode, Mohamed Elhakim, Peter W Radke, Mohammed Saad","doi":"10.1093/ehjimp/qyad002","DOIUrl":"10.1093/ehjimp/qyad002","url":null,"abstract":"<p><strong>Aims: </strong>Endosonography (EUS) is the diagnostic tool with the highest resolution for the local staging of gastrointestinal tumours and, due to the detailed visualization of the wall layers, is recommended in current guidelines for cancer management. In addition, an endoscope has an ultrasound tip design and balloon insufflation control design, and a 120° bending mechanism to deflect the endoscope tip. These advantages could be beneficial and valuable while investigating the cardiovascular structures during routine gastrointestinal procedures using this diagnostic tool.</p><p><strong>Methods and results: </strong>We present six cases of incidentally diagnosed cardiac pathologies (pulmonary thromboembolism of the main pulmonary artery, patent foramen oval with right to left shunt under Valsalva, left atrial appendage thrombus, aortic dissection, moderate aortic valve stenosis, mitral and aortic valve endocarditis) during routine gastrointestinal endosonographic procedures. These diagnoses influenced changes in management strategies in four cases.</p><p><strong>Conclusion: </strong>The introduction of EUS in cardiovascular medicine allows for a real-time high-resolution assessment of cardiovascular structures and allows early detection of silent cardiac pathologies during routine gastrointestinal procedures. It is the diagnostic tool with the highest resolution for accurate definition of variable gastrointestinal anatomy. Thus, help for accurate definitions of cardiovascular anatomy and pathology, which could influence optimal management strategies with improved safety, efficacy, and economic outcomes.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89941219","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":"European Heart Journal-Imaging Methods and Practice (EHJ-IMP): new perspectives, new partnerships, more IMPact.","authors":"Alessia Gimelli","doi":"10.1093/ehjimp/qyad001","DOIUrl":"10.1093/ehjimp/qyad001","url":null,"abstract":"","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89753956","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}
Sérgio Maltês, Mariana Sousa Paiva, Rita Reis Santos, Bruno M L Rocha, Gonçalo J L Cunha, Cláudia Silva, Sara Guerreiro, Pedro Freitas, João Abecasis, António M Ferreira
{"title":"Critical appraisal of a non-invasive model to derive pulmonary capillary wedge pressure from cardiac magnetic resonance in heart failure patients: insights from a large Portuguese Observational Study","authors":"Sérgio Maltês, Mariana Sousa Paiva, Rita Reis Santos, Bruno M L Rocha, Gonçalo J L Cunha, Cláudia Silva, Sara Guerreiro, Pedro Freitas, João Abecasis, António M Ferreira","doi":"10.1093/ehjimp/qyad017","DOIUrl":"https://doi.org/10.1093/ehjimp/qyad017","url":null,"abstract":"","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135517228","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}
Federico Fortuni, Filippo Zilio, Gianmarco Iannopollo, Giuseppe Ciliberti, Paolo Trambaiolo, Laura Ceriello, Francesca Musella, Pietro Scicchitano, Stefano Albani, Stefania Angela Di Fusco, Michele Massimo Gulizia, Domenico Gabrielli, Fabrizio Oliva, Furio Colivicchi
{"title":"Management of temporary mechanical circulatory support devices in cath-lab and cardiac intensive care unit","authors":"Federico Fortuni, Filippo Zilio, Gianmarco Iannopollo, Giuseppe Ciliberti, Paolo Trambaiolo, Laura Ceriello, Francesca Musella, Pietro Scicchitano, Stefano Albani, Stefania Angela Di Fusco, Michele Massimo Gulizia, Domenico Gabrielli, Fabrizio Oliva, Furio Colivicchi","doi":"10.1093/ehjimp/qyad011","DOIUrl":"https://doi.org/10.1093/ehjimp/qyad011","url":null,"abstract":"Abstract Different temporary mechanical circulatory support (tMCS) devices are available and can be used to maintain end-organ perfusion while reducing cardiac work and myocardial oxygen demand. tMCS can provide support to the right ventricle, left ventricle, or both, and its use can be considered in emergency situations such as cardiogenic shock or in elective procedures such as high-risk percutaneous coronary intervention to prevent haemodynamic deterioration. Invasive and, most importantly, non-invasive haemodynamic parameters should be taken into account when choosing the type of tMCS device and its initiation and weaning timing, determining the need for a device upgrade, and screening for complications. In this context, ultrasound tools, specifically echocardiography, can provide important data. This review aims to provide a description of the different tMCS devices, the invasive and non-invasive tools and parameters to guide their management, and their advantages and drawbacks.","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135466111","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}
{"title":"How to: a practical guide to cardiac conduction devices on chest radiograph","authors":"Kyaw Soe Tun, Donnchadh Reidy, Una Buckley","doi":"10.1093/ehjimp/qyad009","DOIUrl":"https://doi.org/10.1093/ehjimp/qyad009","url":null,"abstract":"Abstract With the increasing number of cardiac conduction devices (CCDs) insertions with various complexities in recent decades, it is crucial for clinicians (especially internal medicine residents and cardiologists) to have an up-to-date review of the current devices on chest radiograph. Chest X-ray remains the most cost-effective and accessible imaging modality to assess the device position and its associated complications, not only immediately after insertion but also during the follow-up visit as outpatient. Various types of CCDs such as permanent pacemaker, implantable cardioverter defibrillator, and cardiac resynchronization therapy (CRT, CRT with defibrillation or pacing) with their appearances on chest radiograph and possible complications with a step-by-step guide to how to assess are discussed in this article.","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135466154","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}