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1. Diagnostic performance of deep learning algorithm for analysis of computed tomography myocardial perfusion

Author

Muscogiuri, G, Chiesa, M, Baggiano, A, Spadafora, P, De Santis, R, Guglielmo, M, Scafuri, S, Fusini, L, Mushtaq, S, Conte, E, Annoni, A, Formenti, A, Mancini, M, Ricci, F, Ariano, F, Spiritigliozzi, L, Babbaro, M, Mollace, R, Maragna, R, Giacari, C, Andreini, D, Guaricci, A, Colombo, G, Rabbat, M, Pepi, M, Sardanelli, F, Pontone, G, Muscogiuri G, Chiesa M, Baggiano A, Spadafora P, De Santis R, Guglielmo M, Scafuri S, Fusini L, Mushtaq S, Conte E, Annoni A, Formenti A, Mancini ME, Ricci F, Ariano FP, Spiritigliozzi L, Babbaro M, Mollace R, Maragna R, Giacari CM, Andreini D, Guaricci AI, Colombo GI, Rabbat MG, Pepi M, Sardanelli F, Pontone G., Muscogiuri, G, Chiesa, M, Baggiano, A, Spadafora, P, De Santis, R, Guglielmo, M, Scafuri, S, Fusini, L, Mushtaq, S, Conte, E, Annoni, A, Formenti, A, Mancini, M, Ricci, F, Ariano, F, Spiritigliozzi, L, Babbaro, M, Mollace, R, Maragna, R, Giacari, C, Andreini, D, Guaricci, A, Colombo, G, Rabbat, M, Pepi, M, Sardanelli, F, Pontone, G, Muscogiuri G, Chiesa M, Baggiano A, Spadafora P, De Santis R, Guglielmo M, Scafuri S, Fusini L, Mushtaq S, Conte E, Annoni A, Formenti A, Mancini ME, Ricci F, Ariano FP, Spiritigliozzi L, Babbaro M, Mollace R, Maragna R, Giacari CM, Andreini D, Guaricci AI, Colombo GI, Rabbat MG, Pepi M, Sardanelli F, and Pontone G.

Abstract

Purpose: To evaluate the diagnostic accuracy of a deep learning (DL) algorithm predicting hemodynamically significant coronary artery disease (CAD) by using a rest dataset of myocardial computed tomography perfusion (CTP) as compared to invasive evaluation. Methods: One hundred and twelve consecutive symptomatic patients scheduled for clinically indicated invasive coronary angiography (ICA) underwent CCTA plus static stress CTP and ICA with invasive fractional flow reserve (FFR) for stenoses ranging between 30 and 80%. Subsequently, a DL algorithm for the prediction of significant CAD by using the rest dataset (CTP-DLrest) and stress dataset (CTP-DLstress) was developed. The diagnostic accuracy for identification of significant CAD using CCTA, CCTA + CTP stress, CCTA + CTP-DLrest, and CCTA + CTP-DLstress was measured and compared. The time of analysis for CTP stress, CTP-DLrest, and CTP-DLStress was recorded. Results: Patient-specific sensitivity, specificity, NPV, PPV, accuracy, and area under the curve (AUC) of CCTA alone and CCTA + CTPStress were 100%, 33%, 100%, 54%, 63%, 67% and 86%, 89%, 89%, 86%, 88%, 87%, respectively. Patient-specific sensitivity, specificity, NPV, PPV, accuracy, and AUC of CCTA + DLrest and CCTA + DLstress were 100%, 72%, 100%, 74%, 84%, 96% and 93%, 83%, 94%, 81%, 88%, 98%, respectively. All CCTA + CTP stress, CCTA + CTP-DLRest, and CCTA + CTP-DLStress significantly improved detection of hemodynamically significant CAD compared to CCTA alone (p < 0.01). Time of CTP-DL was significantly lower as compared to human analysis (39.2 ± 3.2 vs. 379.6 ± 68.0 s, p < 0.001). Conclusion: Evaluation of myocardial ischemia using a DL approach on rest CTP datasets is feasible and accurate. This approach may be a useful gatekeeper prior to CTP stress..

Published
2022

3. Stress CMR in Known or Suspected CAD: Diagnostic and Prognostic Role

Author

Baessato, F, Guglielmo, M, Muscogiuri, G, Baggiano, A, Fusini, L, Scafuri, S, Babbaro, M, Mollace, R, Collevecchio, A, Guaricci, A, Pontone, G, Baessato F, Guglielmo M, Muscogiuri G, Baggiano A, Fusini L, Scafuri S, Babbaro M, Mollace R, Collevecchio A, Guaricci AI, Pontone G, Baessato, F, Guglielmo, M, Muscogiuri, G, Baggiano, A, Fusini, L, Scafuri, S, Babbaro, M, Mollace, R, Collevecchio, A, Guaricci, A, Pontone, G, Baessato F, Guglielmo M, Muscogiuri G, Baggiano A, Fusini L, Scafuri S, Babbaro M, Mollace R, Collevecchio A, Guaricci AI, and Pontone G

Abstract

The recently published 2019 guidelines on chronic coronary syndromes (CCS) focus on the need for noninvasive imaging modalities to accurately establish the diagnosis of coronary artery disease (CAD) and assess the risk of clinical scenario occurrence. Appropriate patient management should rely on controlling symptoms, improving prognosis, and guiding each therapeutic strategy as well as monitoring disease progress. Among the noninvasive imaging modalities, cardiovascular magnetic resonance (CMR) has gained broad acceptance in past years due to its unique features in providing a complete assessment of CAD through data on cardiac anatomy and function and myocardial viability, with high spatial and temporal resolution and without ionizing radiation. In detail, evaluation of the presence and extent of myocardial ischemia through stress CMR (S-CMR) has shown a high rule-in power in detecting functionally significant coronary artery stenosis in patients suspected of CCS. Moreover, S-CMR technique may add significant prognostic value, as demonstrated by different studies which have progressively evidenced the valuable power of this multiparametric imaging modality in predicting adverse cardiac events. The latest scientific progress supports a greater expansion of S-CMR with improvement of quantitative myocardial perfusion analysis, myocardial strain, and native mapping within the same examination. Although further study is warranted, these techniques, which are currently mostly restricted to the research field, are likely to become increasingly prevalent in the clinical setting with the scope of increasing accuracy in the selection of patients to be sent to invasive revascularization. This review investigates the diagnostic and prognostic role of S-CMR in the context of CAD, by analysing a strong, long-standing, scientific evidence together with an appraisal of new advanced techniques which may potentially enrich CAD management in the next future.

Published
2021

4. CarDiac magnEtic Resonance for prophylactic Implantable-cardioVerter defibrillAtor ThErapy in Non-Ischaemic dilated CardioMyopathy: an international Registry

Author

Guaricci, A, Masci, P, Muscogiuri, G, Guglielmo, M, Baggiano, A, Fusini, L, Lorenzoni, V, Martini, C, Andreini, D, Pavon, A, Aquaro, G, Barison, A, Todiere, G, Rabbat, M, Tat, E, Raineri, C, Valentini, A, Varga-Szemes, A, Schoepf, U, De Cecco, C, Bogaert, J, Dobrovie, M, Symons, R, Focardi, M, Gismondi, A, Lozano-Torres, J, Rodriguez-Palomares, J, Lanzillo, C, Di Roma, M, Moro, C, Di Giovine, G, Margonato, D, De Lazzari, M, Perazzolo Marra, M, Nese, A, Casavecchia, G, Gravina, M, Marzo, F, Carigi, S, Pica, S, Lombardi, M, Censi, S, Squeri, A, Palumbo, A, Gaibazzi, N, Camastra, G, Sbarbati, S, Pedrotti, P, Masi, A, Carrabba, N, Pradella, S, Timpani, M, Cicala, G, Presicci, C, Puglisi, S, Sverzellati, N, Santobuono, V, Pepi, M, Schwitter, J, Pontone, G, Guaricci AI, Masci PG, Muscogiuri G, Guglielmo M, Baggiano A, Fusini L, Lorenzoni V, Martini C, Andreini D, Pavon AG, Aquaro GD, Barison A, Todiere G, Rabbat MG, Tat E, Raineri C, Valentini A, Varga-Szemes A, Schoepf UJ, De Cecco CN, Bogaert J, Dobrovie M, Symons R, Focardi M, Gismondi A, Lozano-Torres J, Rodriguez-Palomares JF, Lanzillo C, Di Roma M, Moro C, Di Giovine G, Margonato D, De Lazzari M, Perazzolo Marra M, Nese A, Casavecchia G, Gravina M, Marzo F, Carigi S, Pica S, Lombardi M, Censi S, Squeri A, Palumbo A, Gaibazzi N, Camastra G, Sbarbati S, Pedrotti P, Masi A, Carrabba N, Pradella S, Timpani M, Cicala G, Presicci C, Puglisi S, Sverzellati N, Santobuono VE, Pepi M, Schwitter J, Pontone G, Guaricci, A, Masci, P, Muscogiuri, G, Guglielmo, M, Baggiano, A, Fusini, L, Lorenzoni, V, Martini, C, Andreini, D, Pavon, A, Aquaro, G, Barison, A, Todiere, G, Rabbat, M, Tat, E, Raineri, C, Valentini, A, Varga-Szemes, A, Schoepf, U, De Cecco, C, Bogaert, J, Dobrovie, M, Symons, R, Focardi, M, Gismondi, A, Lozano-Torres, J, Rodriguez-Palomares, J, Lanzillo, C, Di Roma, M, Moro, C, Di Giovine, G, Margonato, D, De Lazzari, M, Perazzolo Marra, M, Nese, A, Casavecchia, G, Gravina, M, Marzo, F, Carigi, S, Pica, S, Lombardi, M, Censi, S, Squeri, A, Palumbo, A, Gaibazzi, N, Camastra, G, Sbarbati, S, Pedrotti, P, Masi, A, Carrabba, N, Pradella, S, Timpani, M, Cicala, G, Presicci, C, Puglisi, S, Sverzellati, N, Santobuono, V, Pepi, M, Schwitter, J, Pontone, G, Guaricci AI, Masci PG, Muscogiuri G, Guglielmo M, Baggiano A, Fusini L, Lorenzoni V, Martini C, Andreini D, Pavon AG, Aquaro GD, Barison A, Todiere G, Rabbat MG, Tat E, Raineri C, Valentini A, Varga-Szemes A, Schoepf UJ, De Cecco CN, Bogaert J, Dobrovie M, Symons R, Focardi M, Gismondi A, Lozano-Torres J, Rodriguez-Palomares JF, Lanzillo C, Di Roma M, Moro C, Di Giovine G, Margonato D, De Lazzari M, Perazzolo Marra M, Nese A, Casavecchia G, Gravina M, Marzo F, Carigi S, Pica S, Lombardi M, Censi S, Squeri A, Palumbo A, Gaibazzi N, Camastra G, Sbarbati S, Pedrotti P, Masi A, Carrabba N, Pradella S, Timpani M, Cicala G, Presicci C, Puglisi S, Sverzellati N, Santobuono VE, Pepi M, Schwitter J, and Pontone G

Abstract

Aims: The aim of this registry was to evaluate the additional prognostic value of a composite cardiac magnetic resonance (CMR)-based risk score over standard-of-care (SOC) evaluation in a large cohort of consecutive unselected non-ischaemic cardiomyopathy (NICM) patients. Methods and results: In the DERIVATE registry (www.clinicaltrials.gov/registration: RCT#NCT03352648), 1000 (derivation cohort) and 508 (validation cohort) NICM patients with chronic heart failure (HF) and left ventricular ejection fraction [removed]3 segments with midwall fibrosis on late gadolinium enhancement (LGE) were the only independent predictors of all-cause mortality (HR: 1.036, 95% CI: 1.0117-1.056, P < 0.001 and HR: 2.077, 95% CI: 1.211-3.562, P = 0.008, respectively). For MAACE, the independent predictors were male gender, left ventricular end-diastolic volume index by CMR (CMR-LVEDVi), and >3 segments with midwall fibrosis on LGE (HR: 2.131, 95% CI: 1.231-3.690, P = 0.007; HR: 3.161, 95% CI: 1.750-5.709, P < 0.001; and HR: 1.693, 95% CI: 1.084-2.644, P = 0.021, respectively). A composite clinical and CMR-based risk score provided a net reclassification improvement of 63.7% (P < 0.001) for MAACE occurrence when added to the model based on SOC evaluation. These findings were confirmed in the validation cohort. Conclusion: In a large multicentre, multivendor cohort registry reflecting daily clinical practice in NICM work-up, a composite clinical and CMR-based risk score provides incremental prognostic value beyond SOC evaluation, which may have impact on the indication of implantable cardioverter-defibrillator implantation.

Published
2021

5. Role of computed tomography in COVID-19

Author

Pontone, G, Scafuri, S, Mancini, M, Agalbato, C, Guglielmo, M, Baggiano, A, Muscogiuri, G, Fusini, L, Andreini, D, Mushtaq, S, Conte, E, Annoni, A, Formenti, A, Gennari, A, Guaricci, A, Rabbat, M, Pompilio, G, Pepi, M, Rossi, A, Pontone G, Scafuri S, Mancini ME, Agalbato C, Guglielmo M, Baggiano A, Muscogiuri G, Fusini L, Andreini D, Mushtaq S, Conte E, Annoni A, Formenti A, Gennari AG, Guaricci AI, Rabbat MR, Pompilio G, Pepi M, Rossi A, Pontone, G, Scafuri, S, Mancini, M, Agalbato, C, Guglielmo, M, Baggiano, A, Muscogiuri, G, Fusini, L, Andreini, D, Mushtaq, S, Conte, E, Annoni, A, Formenti, A, Gennari, A, Guaricci, A, Rabbat, M, Pompilio, G, Pepi, M, Rossi, A, Pontone G, Scafuri S, Mancini ME, Agalbato C, Guglielmo M, Baggiano A, Muscogiuri G, Fusini L, Andreini D, Mushtaq S, Conte E, Annoni A, Formenti A, Gennari AG, Guaricci AI, Rabbat MR, Pompilio G, Pepi M, and Rossi A

Abstract

Coronavirus disease 2019 (COVID-19) has become a rapid worldwide pandemic. While COVID-19 primarily manifests as an interstitial pneumonia and severe acute respiratory distress syndrome, severe involvement of other organs has been documented. In this article, we will review the role of non-contrast chest computed tomography in the diagnosis, follow-up and prognosis of patients affected by COVID-19 pneumonia with a detailed description of the imaging findings that may be encountered. Given that patients with COVID-19 may also suffer from coagulopathy, we will discuss the role of CT pulmonary angiography in the detection of acute pulmonary embolism. Finally, we will describe more advanced applications of CT in the differential diagnosis of myocardial injury with an emphasis on ruling out acute coronary syndrome and myocarditis.

Published
2021

6. T1 mapping and cardiac magnetic resonance feature tracking in mitral valve prolapse

Author

Guglielmo, M, Fusini, L, Muscogiuri, G, Baessato, F, Loffreno, A, Cavaliere, A, Rizzon, G, Baggiano, A, Rabbat, M, Muratori, M, Tamborini, G, Danza, L, Del Torto, A, Tonet, E, Viani, G, Mushtaq, S, Conte, E, Bonalumi, G, Gripari, P, Zanobini, M, Andreini, D, Alamanni, F, Pepi, M, Guaricci, A, Pontone, G, Guglielmo M, Fusini L, Muscogiuri G, Baessato F, Loffreno A, Cavaliere A, Rizzon G, Baggiano A, Rabbat MG, Muratori M, Tamborini G, Danza LML, Del Torto A, Tonet E, Viani G, Mushtaq S, Conte E, Bonalumi G, Gripari P, Zanobini M, Andreini D, Alamanni F, Pepi M, Guaricci AI, Pontone G, Guglielmo, M, Fusini, L, Muscogiuri, G, Baessato, F, Loffreno, A, Cavaliere, A, Rizzon, G, Baggiano, A, Rabbat, M, Muratori, M, Tamborini, G, Danza, L, Del Torto, A, Tonet, E, Viani, G, Mushtaq, S, Conte, E, Bonalumi, G, Gripari, P, Zanobini, M, Andreini, D, Alamanni, F, Pepi, M, Guaricci, A, Pontone, G, Guglielmo M, Fusini L, Muscogiuri G, Baessato F, Loffreno A, Cavaliere A, Rizzon G, Baggiano A, Rabbat MG, Muratori M, Tamborini G, Danza LML, Del Torto A, Tonet E, Viani G, Mushtaq S, Conte E, Bonalumi G, Gripari P, Zanobini M, Andreini D, Alamanni F, Pepi M, Guaricci AI, and Pontone G

Abstract

Objectives: T1 mapping (T1-map) and cardiac magnetic resonance feature tracking (CMR-FT) techniques have been introduced for the early detection of interstitial myocardial fibrosis and deformation abnormalities. We sought to demonstrate that T1-map and CMR-FT may identify the presence of subclinical myocardial structural changes in patients with mitral valve prolapse (MVP). Methods: Consecutive MVP patients with moderate-to-severe mitral regurgitation and comparative matched healthy subjects were prospectively enrolled and underwent CMR-FT analysis to calculate 2D global and segmental circumferential (CS) and radial strain (RS) and T1-map to determine global and segmental native T1 (nT1) values. Results: Seventy-three MVP patients (mean age, 57 ± 13 years old; male, 76%; regurgitant volume, 57 ± 21 mL) and 42 matched control subjects (mean age, 56 ± 18 years; male, 74%) were included. MVP patients showed a lower global CS (− 16.3 ± 3.4% vs. − 17.8 ± 1.9%, p = 0.020) and longer global nT1 (1124.9 ± 97.7 ms vs. 1007.4 ± 26.1 ms, p < 0.001) as compared to controls. Moreover, MVP patients showed lower RS and CS in basal (21.6 ± 12.3% vs. 27.6 ± 8.9%, p = 0.008, and − 13.0 ± 6.7% vs. − 14.9 ± 4.1%, p = 0.013) and mid-inferolateral (20.6 ± 10.7% vs. 28.4 ± 8.7%, p < 0.001, and − 12.8 ± 6.3% vs. − 16.5 ± 4.0%, p < 0.001) walls as compared to other myocardial segments. Similarly, MVP patients showed longer nT1 values in basal (1080 ± 68 ms vs. 1043 ± 43 ms, p < 0.001) and mid-inferolateral (1080 ± 77 ms vs. 1034 ± 37 ms, p < 0.001) walls as compared to other myocardial segments. Of note, nT1 values were significantly correlated with CS (r, 0.36; p < 0.001) and RS (r, 0.37; p < 0.001) but not with regurgitant volume. Conclusions: T1-map and CMR-FT identify subclinical left ventricle tissue changes in patients with MVP. Further studies are required to correlate these subclinical tissue changes with the outcome. Key Points: • T1 mapping (T1-map) and cardia

Published
2021

7. Artificial Intelligence in Coronary Computed Tomography Angiography: From Anatomy to Prognosis

Author

Muscogiuri, G, Van Assen, M, Tesche, C, De Cecco, C, Chiesa, M, Scafuri, S, Guglielmo, M, Baggiano, A, Fusini, L, Guaricci, A, Rabbat, M, Pontone, G, Muscogiuri G, Van Assen M, Tesche C, De Cecco CN, Chiesa M, Scafuri S, Guglielmo M, Baggiano A, Fusini L, Guaricci AI, Rabbat MG, Pontone G, Muscogiuri, G, Van Assen, M, Tesche, C, De Cecco, C, Chiesa, M, Scafuri, S, Guglielmo, M, Baggiano, A, Fusini, L, Guaricci, A, Rabbat, M, Pontone, G, Muscogiuri G, Van Assen M, Tesche C, De Cecco CN, Chiesa M, Scafuri S, Guglielmo M, Baggiano A, Fusini L, Guaricci AI, Rabbat MG, and Pontone G

Abstract

Cardiac computed tomography angiography (CCTA) is widely used as a diagnostic tool for evaluation of coronary artery disease (CAD). Despite the excellent capability to rule-out CAD, CCTA may overestimate the degree of stenosis; furthermore, CCTA analysis can be time consuming, often requiring advanced postprocessing techniques. In consideration of the most recent ESC guidelines on CAD management, which will likely increase CCTA volume over the next years, new tools are necessary to shorten reporting time and improve the accuracy for the detection of ischemia-inducing coronary lesions. The application of artificial intelligence (AI) may provide a helpful tool in CCTA, improving the evaluation and quantification of coronary stenosis, plaque characterization, and assessment of myocardial ischemia. Furthermore, in comparison with existing risk scores, machine-learning algorithms can better predict the outcome utilizing both imaging findings and clinical parameters. Medical AI is moving from the research field to daily clinical practice, and with the increasing number of CCTA examinations, AI will be extensively utilized in cardiac imaging. This review is aimed at illustrating the state of the art in AI-based CCTA applications and future clinical scenarios.

Published
2020

8. Sequential Strategy Including FFR CT Plus Stress-CTP Impacts on Management of Patients with Stable Chest Pain: The Stress-CTP RIPCORD Study

Author

Baggiano, A, Fusini, L, Del Torto, A, Vivona, P, Guglielmo, M, Muscogiuri, G, Soldi, M, Martini, C, Fraschini, E, Rabbat, M, Baessato, F, Cicala, G, Danza, M, Cavaliere, A, Loffreno, A, Palmisano, V, Ricci, F, Rizzon, G, Tonet, E, Viani, G, Mushtaq, S, Conte, E, Annoni, A, Formenti, A, Mancini, M, Fabbiocchi, F, Montorsi, P, Trabattoni, D, Rossi, A, Fazzari, F, Gaibazzi, N, Andreini, D, Assanelli, E, Bartorelli, A, Pepi, M, Guaricci, A, Pontone, G, Baggiano A, Fusini L, Del Torto A, Vivona P, Guglielmo M, Muscogiuri G, Soldi M, Martini C, Fraschini E, Rabbat MG, Baessato F, Cicala G, Danza ML, Cavaliere A, Loffreno A, Palmisano V, Ricci F, Rizzon G, Tonet E, Viani GM, Mushtaq S, Conte E, Annoni AD, Formenti A, Mancini ME, Fabbiocchi F, Montorsi P, Trabattoni D, Rossi A, Fazzari F, Gaibazzi N, Andreini D, Assanelli EM, Bartorelli AL, Pepi M, Guaricci AI, Pontone G, Baggiano, A, Fusini, L, Del Torto, A, Vivona, P, Guglielmo, M, Muscogiuri, G, Soldi, M, Martini, C, Fraschini, E, Rabbat, M, Baessato, F, Cicala, G, Danza, M, Cavaliere, A, Loffreno, A, Palmisano, V, Ricci, F, Rizzon, G, Tonet, E, Viani, G, Mushtaq, S, Conte, E, Annoni, A, Formenti, A, Mancini, M, Fabbiocchi, F, Montorsi, P, Trabattoni, D, Rossi, A, Fazzari, F, Gaibazzi, N, Andreini, D, Assanelli, E, Bartorelli, A, Pepi, M, Guaricci, A, Pontone, G, Baggiano A, Fusini L, Del Torto A, Vivona P, Guglielmo M, Muscogiuri G, Soldi M, Martini C, Fraschini E, Rabbat MG, Baessato F, Cicala G, Danza ML, Cavaliere A, Loffreno A, Palmisano V, Ricci F, Rizzon G, Tonet E, Viani GM, Mushtaq S, Conte E, Annoni AD, Formenti A, Mancini ME, Fabbiocchi F, Montorsi P, Trabattoni D, Rossi A, Fazzari F, Gaibazzi N, Andreini D, Assanelli EM, Bartorelli AL, Pepi M, Guaricci AI, and Pontone G

Abstract

Stress computed tomography perfusion (Stress-CTP) and computed tomography-derived fractional flow reserve (FFRCT) are functional techniques that can be added to coronary computed tomography angiography (cCTA) to improve the management of patients with suspected coronary artery disease (CAD). This retrospective analysis from the PERFECTION study aims to assess the impact of their availability on the management of patients with suspected CAD scheduled for invasive coronary angiography (ICA) and invasive FFR. The management plan was defined as optimal medical therapy (OMT) or revascularization and was recorded for the following strategies: cCTA alone, cCTA+FFRCT, cCTA+Stress-CTP and cCTA+FFRCT+Stress-CTP. In 291 prospectively enrolled patients, cCTA+FFRCT, cCTA+Stress-CTP and cCTA+FFRCT+Stress-CTP showed a similar rate of reclassification of cCTA findings when FFRCT and Stress-CTP were added to cCTA. cCTA, cCTA+FFRCT, cCTA+Stress-CTP and cCTA+FFRCT+Stress-CTP showed a rate of agreement versus the final therapeutic decision of 63%, 71%, 89%, 84% (cCTA+Stress-CTP and cCTA+FFRCT+Stress-CTP vs cCTA and cCTA+FFRCT: p < 0.01), respectively, and a rate of agreement in terms of the vessels to be revascularized of 57%, 64%, 74%, 71% (cCTA+Stress-CTP and cCTA+FFRCT+Stress-CTP vs cCTA and cCTA+FFRCT: p < 0.01), respectively, with an effective radiation dose (ED) of 2.9 ± 1.3 mSv, 2.9 ± 1.3 mSv, 5.9 ± 2.7 mSv, and 3.1 ± 2.1 mSv. The addition of FFRCT and Stress-CTP improved therapeutic decision-making compared to cCTA alone, and a sequential strategy with cCTA+FFRCT+Stress-CTP represents the best compromise in terms of clinical impact and radiation exposure.

Published
2020

9. Diagnostic Accuracy of Single-shot 2-Dimensional Multisegment Late Gadolinium Enhancement in Ischemic and Nonischemic Cardiomyopathy

Author

Muscogiuri, G, Gatti, M, Dell'Aversana, S, Andreini, D, Guaricci, A, Guglielmo, M, Baggiano, A, Mushtaq, S, Conte, E, Annoni, A, Formenti, A, Mancini, M, Gripari, P, Rabbat, M, Pepi, M, Pontone, G, Muscogiuri G, Gatti M, Dell'Aversana S, Andreini D, Guaricci AI, Guglielmo M, Baggiano A, Mushtaq S, Conte E, Annoni A, Formenti A, Mancini ME, Gripari P, Rabbat MG, Pepi M, Pontone G., Muscogiuri, G, Gatti, M, Dell'Aversana, S, Andreini, D, Guaricci, A, Guglielmo, M, Baggiano, A, Mushtaq, S, Conte, E, Annoni, A, Formenti, A, Mancini, M, Gripari, P, Rabbat, M, Pepi, M, Pontone, G, Muscogiuri G, Gatti M, Dell'Aversana S, Andreini D, Guaricci AI, Guglielmo M, Baggiano A, Mushtaq S, Conte E, Annoni A, Formenti A, Mancini ME, Gripari P, Rabbat MG, Pepi M, and Pontone G.

Abstract

Purpose:The aim of this study was to assess the reliability of single-shot 2-dimensional multislice late gadolinium enhancement (2D-MSLGE) compared with gold standard single-slice 2D inversion recovery segmented gradient echo (2D-SSLGE).Materials and Methods:Sixty-seven patients prospectively underwent clinically indicated cardiac magnetic resonance (CMR) imaging and were enrolled. The image quality was assessed using a 4-point scale. Segments positive for LGE were classified as ischemic or nonischemic for 2D-MSLGE and 2D-SSLGE. Interobserver and intraobserver variability was assessed for both sequences by 2 readers. The endpoints were as follows: (a) detection of myocardial segments involved by LGE and (b) classification of LGE as ischemic and nonischemic pattern. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy value were calculated for the 2 endpoints.Results:2D-MSLGE and 2D-SSLGE were successfully performed in all patients with comparable image quality (1.56±0.59 vs. 1.54±0.58, P=0.84). For the overall population, 2D-MSLGE correctly identified 1093 of 1139 myocardial segments positive for LGE (96%; 95% confidence interval [CI]: 95%-97%), as compared with 2D-SSLGE. Similarly, 2D-MSLGE correctly identified 1128 of 1139 (99%; 95% CI: 98%-99%) and 1108 of 1139 (97%; 95% CI: 96%-98%) of nonischemic and ischemic LGE patterns.Interobserver and intraobserver variability for quantification of LGE using 2D-MSLGE was 0.98 and 0.99, respectively. The acquisition time was shorter for 2D-MSLGE as compared with 2D-SSLGE (2.0±0.5 vs. 6.0±2.0 min, P: 0.01).Conclusions:As compared with 2D-SSLGE, 2D-MSLGE is a reliable tool in both ischemic and nonischemic cardiac disease; it is associated with shorter scan times without the need for prolonged breath holding and may be beneficial for those with dysrhythmia.

Published
2020

10. (Epicardial and microvascular) angina or atypical chest pain: Differential diagnoses with cardiovascular magnetic resonance

Author

Baggiano, A, Guglielmo, M, Muscogiuri, G, Guaricci, A, Del Torto, A, Pontone, G, Baggiano A, Guglielmo M, Muscogiuri G, Guaricci AI, Del Torto A, Pontone G, Baggiano, A, Guglielmo, M, Muscogiuri, G, Guaricci, A, Del Torto, A, Pontone, G, Baggiano A, Guglielmo M, Muscogiuri G, Guaricci AI, Del Torto A, and Pontone G

Abstract

Angina pectoris is a chest discomfort caused by myocardial ischaemia, and it is classified as 'typical' or 'atypical' if specific features are present. Unfortunately, there is a heterogeneous list of cardiac diseases characterized by this symptom as onset sign. Mostly, angina is due to significant epicardial coronary artery stenosis, which causes inadequate oxygen supply increase after raised myocardial oxygen demand. In the absence of significant epicardial stenoses, another potential cause of angina is microvascular dysfunction, related to inadequate response of resistance coronary vessels to vasodilator stimuli. The unique capability of cardiovascular magnetic resonance (CMR) in providing extremely detailed morphological and functional information, along with precise stress perfusion defects and wall motion abnormalities depiction, translates it into the test with one of the best diagnostic performance and prognostic stratification among non-invasive cardiac imaging modality. Moreover, CMR is also extremely accurate in detecting non-ischaemic cardiac causes of chest pain (such as myocardial and pericardial inflammation, or stress-related cardiomyopathy), and is very useful in helping physicians to correctly approach patients affected by chest pain.

Published
2020

11. Role of CMR Mapping Techniques in Cardiac Hypertrophic Phenotype

Author

Baggiano, A, Del Torto, A, Guglielmo, M, Muscogiuri, G, Fusini, L, Babbaro, M, Collevecchio, A, Mollace, R, Scafuri, S, Mushtaq, S, Conte, E, Annoni, A, Formenti, A, Mancini, M, Mostardini, G, Andreini, D, Guaricci, A, Pepi, M, Fontana, M, Pontone, G, Baggiano A, Del Torto A, Guglielmo M, Muscogiuri G, Fusini L, Babbaro M, Collevecchio A, Mollace R, Scafuri S, Mushtaq S, Conte E, Annoni AD, Formenti A, Mancini ME, Mostardini G, Andreini D, Guaricci AI, Pepi M, Fontana M, Pontone G, Baggiano, A, Del Torto, A, Guglielmo, M, Muscogiuri, G, Fusini, L, Babbaro, M, Collevecchio, A, Mollace, R, Scafuri, S, Mushtaq, S, Conte, E, Annoni, A, Formenti, A, Mancini, M, Mostardini, G, Andreini, D, Guaricci, A, Pepi, M, Fontana, M, Pontone, G, Baggiano A, Del Torto A, Guglielmo M, Muscogiuri G, Fusini L, Babbaro M, Collevecchio A, Mollace R, Scafuri S, Mushtaq S, Conte E, Annoni AD, Formenti A, Mancini ME, Mostardini G, Andreini D, Guaricci AI, Pepi M, Fontana M, and Pontone G

Abstract

Non-ischemic cardiomyopathies represent a heterogeneous group of myocardial diseases potentially leading to heart failure, life-threatening arrhythmias, and eventually death. Myocardial dysfunction is associated with different underlying pathological processes, ultimately inducing changes in morphological appearance. Thus, classification based on presenting morphological phenotypes has been proposed, i.e., dilated, hypertrophic, restrictive, and right ventricular cardiomyopathies. In light of the key diagnostic and prognostic role of morphological and functional features, cardiovascular imaging has emerged as key element in the clinical workflow of suspected cardiomyopathies, and above all, cardiovascular magnetic resonance (CMR) represents the ideal technique to be used: thanks to its physical principles, besides optimal spatial and temporal resolutions, incomparable contrast resolution allows to assess myocardial tissue abnormalities in detail. Traditionally, weighted images and late enhancement images after gadolinium-based contrast agent administration have been used to perform tissue characterization, but in the last decade quantitative assessment of pre-contrast longitudinal relaxation time (native T1), post-contrast longitudinal relaxation time (post-contrast T1) and transversal relaxation time (T2), all displayed with dedicated pixel-wise color-coded maps (mapping), has contributed to give precious knowledge insight, with positive influence of diagnostic accuracy and prognosis assessment, mostly in the setting of the hypertrophic phenotype. This review aims to describe the available evidence of the role of mapping techniques in the assessment of hypertrophic phenotype, and to suggest their integration in the routine CMR evaluation of newly diagnosed cardiomyopathies with increased wall thickness.

Published
2020

12. The incremental role of coronary computed tomography in chronic coronary syndromes

Author

Baessato, F, Guglielmo, M, Muscogiuri, G, Baggiano, A, Fusini, L, Scafuri, S, Babbaro, M, Mollace, R, Collevecchio, A, Guaricci, A, Rabbat, M, D'Andrea, A, Pontone, G, Baessato F, Guglielmo M, Muscogiuri G, Baggiano A, Fusini L, Scafuri S, Babbaro M, Mollace R, Collevecchio A, Guaricci AI, Rabbat M, D'Andrea A, Pontone G, Baessato, F, Guglielmo, M, Muscogiuri, G, Baggiano, A, Fusini, L, Scafuri, S, Babbaro, M, Mollace, R, Collevecchio, A, Guaricci, A, Rabbat, M, D'Andrea, A, Pontone, G, Baessato F, Guglielmo M, Muscogiuri G, Baggiano A, Fusini L, Scafuri S, Babbaro M, Mollace R, Collevecchio A, Guaricci AI, Rabbat M, D'Andrea A, and Pontone G

Abstract

In the context of chronic coronary syndromes (CCS), coronary computed tomography angiography (CCTA) has gained broad acceptance as a noninvasive anatomical imaging tool with ability of excluding coronary stenosis with strong negative predictive value. Atherosclerotic plaque lesions are independent predictors of cardiovascular outcomes in high risk patients with known coronary artery disease (CAD). Calcium detection is commonly expressed through the coronary artery calcium score (CACS), but further research is warranted to confirm the powerness of a CACS-only strategy in both diagnosis and prognosis assessment. Recent studies evidence how defined plaque composition characteristics effectively relate to the risk of plaque instabilization and the overall ischemic burden. Fractional flow reserve from CCTA (FFR-CT) has been demonstrated as a reliable method for noninvasive functional evaluation of coronary lesions severity, while the assessment of perfusion imaging under stress conditions is growing as a useful tool for assessment of myocardial ischemia. Moreover, specific applications in procedural planning of transcatheter valve substitution and follow-up of heart transplantation have gained recent importance. This review illustrates the incremental role of CCTA, which can potentially revolutionize the diagnosis and management pathway within the wide clinical spectrum of CCS.

Published
2020

13. Diagnostic performance of non-invasive imaging for stable coronary artery disease: A meta-analysis

Author

Pontone, G, Guaricci, A, Palmer, S, Andreini, D, Verdecchia, M, Fusini, L, Lorenzoni, V, Guglielmo, M, Muscogiuri, G, Baggiano, A, Rabbat, M, Cademartiri, F, Strippoli, G, Guaricci, AI, Palmer, SC, Rabbat, MG, Strippoli, GF, Pontone, G, Guaricci, A, Palmer, S, Andreini, D, Verdecchia, M, Fusini, L, Lorenzoni, V, Guglielmo, M, Muscogiuri, G, Baggiano, A, Rabbat, M, Cademartiri, F, Strippoli, G, Guaricci, AI, Palmer, SC, Rabbat, MG, and Strippoli, GF

Abstract

Background: To determine diagnostic performance of non-invasive tests using invasive fractional flow reserve (FFR) as reference standard for coronary artery disease (CAD). Methods: Medline, Embase, and citations of articles, guidelines, and reviews for studies were used to compare non-invasive tests with invasive FFR for suspected CAD published through March 2017. Results: Seventy-seven studies met inclusion criteria. The diagnostic test with the highest sensitivity to detect a functionally significant coronary lesion was coronary computed tomography (CT) angiography [88%(85%–90%)], followed by FFR derived from coronary CT angiography (FFRCT) [85%(81%–88%)], positron emission tomography (PET) [85%(82%–88%)], stress cardiac magnetic resonance (stress CMR) [81%(79%–84%)], stress myocardial CT perfusion combined with coronary CT angiography [79%(74%–83%)], stress myocardial CT perfusion [77%(73%–80%)], stress echocardiography (Echo) [72%(64%–78%)] and stress single-photon emission computed tomography (SPECT) [64%(60%–68%)]. Specificity to rule out CAD was highest for stress myocardial CT perfusion added to coronary CT angiography [91%(88%–93%)], stress CMR [91%(90%–93%)], and PET [87%(86%–89%)]. Conclusion: A negative coronary CT angiography has a higher test performance than other index tests to exclude clinically-important CAD. A positive stress myocardial CT perfusion added to coronary CT angiography, stress cardiac MR, and PET have a higher test performance to identify patients requiring invasive coronary artery evaluation.

Published
2020

14. Resources and outcome impact of routine availability of computed tomography perfusion

Author

Baggiano, A, primary, Del Torto, A, additional, Fusini, L, additional, Guglielmo, M, additional, Muscogiuri, G, additional, Andreini, D, additional, Mushtaq, S, additional, Conte, E, additional, Annoni, AD, additional, Formenti, A, additional, Mancini, ME, additional, Guaricci, AI, additional, Bartorelli, AL, additional, Pepi, M, additional, and Pontone, G, additional

Published
2021
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15. Computed tomography for the prediction of structural valve deterioration in patients undergoing transcatheter aortic valve implantation

Author

Guglielmo, M, primary, Fusini, L, additional, Muratori, M, additional, Tamborini, G, additional, Mantegazza, V, additional, Muscogiuri, G, additional, Baggiano, A, additional, Stefano, S, additional, Babbaro, M, additional, Mollace, R, additional, Mushtaq, S, additional, Conte, E, additional, Guaricci, AI, additional, Pepi, M, additional, and Pontone, G, additional

Published
2021
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16. Additional prognostic role of strain with stress cardiac magnetic resonance (PROGRESS)

Author

Guglielmo, M, primary, Fusini, L, additional, Baessato, F, additional, Loffreno, A, additional, Muscogiuri, G, additional, Baggiano, A, additional, Del Torto, A, additional, Scafuri, S, additional, Babbaro, M, additional, Mollace, R, additional, Guaricci, AI, additional, Mushtaq, S, additional, Conte, E, additional, Pepi, M, additional, and Pontone, G, additional

Published
2021
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17. Association Between Haptoglobin Phenotype and Microvascular Obstruction in Patients With ST-Segment Elevation Myocardial Infarction

Author

Pontone G, Andreini D, Guaricci AI, Guglielmo M, Baggiano A, Muscogiuri G, Fusini L, Fazzari F, Berzovini C, Pasquini A, Mushtaq S, Conte E, Cosentino N, Rabbat MG, Marenzi G, Bartorelli AL, Pepi M, Tremoli E, Banfi C., Pontone, G, Andreini, D, Guaricci, A, Guglielmo, M, Baggiano, A, Muscogiuri, G, Fusini, L, Fazzari, F, Berzovini, C, Pasquini, A, Mushtaq, S, Conte, E, Cosentino, N, Rabbat, M, Marenzi, G, Bartorelli, A, Pepi, M, Tremoli, E, and Banfi, C

Subjects
myocardial infarction, microvascular obstruction, cardiac magnetic resonance, haptoglobin
Abstract

Objectives: This study aimed to evaluate the correlation between different haptoglobin (Hp)phenotypes and myocardial infarction characteristics as detected by cardiac magnetic resonance (CMR)in consecutive patients after ST-segment elevation myocardial infarction (STEMI). Background: Hp is a plasma protein that prevents iron-mediated oxidative tissue damage. CMR has emerged as the gold standard technique to detect left ventricular ejection fraction (LVEF), extent of scar with late gadolinium enhancement (LGE)technique, microvascular obstruction (MVO), and myocardial hemorrhage (MH)in patients with STEMI treated by primary percutaneous coronary intervention (pPCI). Methods: A total of 145 consecutive STEMI patients (mean age 62.2 ± 10.3 years; 78% men)were prospectively enrolled and underwent Hp phenotyping and CMR assessment within 1 week after STEMI. Results: CMR showed an area at risk (AAR)involving 26.6 ± 19.1% of left ventricular (LV)mass with a late LGE extent of 15.2 ± 13.1% of LV mass. MVO and MH occurred in 38 (26%)and 12 (8%)patients, respectively. Hp phenotypes 1-1, 2-1, 2-2 were observed in 15 (10%), 62 (43%), and 68 (47%), respectively. Multivariable analysis demonstrated that body mass index, Hp2-2, diabetes, and peak troponin I were independent predictors of MVO with Hp2-2 associated with the highest odds ratio (OR)(OR: 5.5 [95% confidence interval [CI]: 2.1 to 14.3; p < 0.001]). Hp2-2 significantly predicted both the presence (area under the curve [AUC]: 0.63 [95% CI: 0.53 to 0.72; p = 0.008])and extent of MVO (AUC: 0.63 [95% CI: 0.54 to 0.72; p = 0.007]). Conclusions: Hp phenotype is an independent predictor of MVO. Therefore, Hp phenotyping could be used for risk stratification and may be useful in assessing new therapies to reduce myocardial reperfusion injury in patients with STEMI.

Published
2019

18. Stress Computed Tomography Perfusion Versus Fractional Flow Reserve CT Derived in Suspected Coronary Artery Disease: The PERFECTION Study

Author

Pontone G, Baggiano A, Andreini D, Guaricci AI, Guglielmo M, Muscogiuri G, Fusini L, Fazzari F, Mushtaq S, Conte E, Calligaris G, De Martini S, Ferrari C, Galli S, Grancini L, Ravagnani P, Teruzzi G, Trabattoni D, Fabbiocchi F, Lualdi A, Montorsi P, Rabbat MG, Bartorelli AL, Pepi M, Pontone, G, Baggiano, A, Andreini, D, Guaricci, A, Guglielmo, M, Muscogiuri, G, Fusini, L, Fazzari, F, Mushtaq, S, Conte, E, Calligaris, G, De Martini, S, Ferrari, C, Galli, S, Grancini, L, Ravagnani, P, Teruzzi, G, Trabattoni, D, Fabbiocchi, F, Lualdi, A, Montorsi, P, Rabbat, M, Bartorelli, A, and Pepi, M

Subjects
accuracy, computed tomography, fractional flow reserve, coronary artery disease, perfusion
Abstract

Objectives: This study sought to compare the diagnostic accuracy of coronary computed tomography angiography (cCTA) with that of cCTA+fractional flow reserve derived from cCTA datasets (FFRCT) and that of cCTA+static stress-computed tomography perfusion (stress-CTP) in detecting functionally significant coronary artery lesions using invasive coronary angiography (ICA) plus invasive FFR as the reference standard. Background: FFRCT and static stress-CTP are new techniques that combine anatomy and functional evaluation to improve assessment of coronary artery disease (CAD) using cCTA. Methods: A total of 147 consecutive symptomatic patients scheduled for clinically indicated ICA+invasive FFR were evaluated with cCTA, FFRCT, and stress-CTP. Results: Vessel-based and patient-based sensitivity, specificity, and negative predictive values, and positive predictive values, and accuracy rates of cCTA were 99%, 76%, 100%, 61%, 82%, and 95%, 54%, 94%, 63%, 73%, respectively. cCTA+FFRCT showed vessel-based and patient-based sensitivity, specificity, and negative predictive values, and positive predictive values and accuracy rates of 88%, 94%, 95%, 84%, 92%, and 90%, 85%, 92%, 83%, 87%, respectively. Finally, cCTA+stress-CTP showed vessel-based and patient-based sensitivity, specificity, and negative predictive values, and positive predictive values and accuracy rates of 92%, 95%, 97%, 87%, 94% and 98%, 87%, 99%, 86%, 92%, respectively. Both FFRCT and stress-CTP significantly improved specificity and positive predictive values compared to those of cCTA alone. The area under the curve to detect flow-limiting stenoses of cCTA, cCTA+FFRCT, and cCTA+CTP were 0.89, 0.93, 0.92, and 0.90, 0.94, and 0.93 in a vessel-based and patient-based model, respectively, with significant additional values for both cCTA+FFRCT and cCTA+CTP versus cCTA alone (p < 0.001) but no differences between cCTA+FFRCT versus cCTA+CTP. Conclusions: FFRCT and stress-CTP in addition to cCTA are valid and comparable tools to evaluate the functional relevance of CAD.

Published
2019

19. Stress Computed Tomography Perfusion Versus Fractional Flow Reserve CT Derived in Suspected Coronary Artery Disease: The PERFECTION Study

Author

Pontone, G, Baggiano, A, Andreini, D, Guaricci, A, Guglielmo, M, Muscogiuri, G, Fusini, L, Fazzari, F, Mushtaq, S, Conte, E, Calligaris, G, De Martini, S, Ferrari, C, Galli, S, Grancini, L, Ravagnani, P, Teruzzi, G, Trabattoni, D, Fabbiocchi, F, Lualdi, A, Montorsi, P, Rabbat, M, Bartorelli, A, Pepi, M, Pontone G, Baggiano A, Andreini D, Guaricci AI, Guglielmo M, Muscogiuri G, Fusini L, Fazzari F, Mushtaq S, Conte E, Calligaris G, De Martini S, Ferrari C, Galli S, Grancini L, Ravagnani P, Teruzzi G, Trabattoni D, Fabbiocchi F, Lualdi A, Montorsi P, Rabbat MG, Bartorelli AL, Pepi M, Pontone, G, Baggiano, A, Andreini, D, Guaricci, A, Guglielmo, M, Muscogiuri, G, Fusini, L, Fazzari, F, Mushtaq, S, Conte, E, Calligaris, G, De Martini, S, Ferrari, C, Galli, S, Grancini, L, Ravagnani, P, Teruzzi, G, Trabattoni, D, Fabbiocchi, F, Lualdi, A, Montorsi, P, Rabbat, M, Bartorelli, A, Pepi, M, Pontone G, Baggiano A, Andreini D, Guaricci AI, Guglielmo M, Muscogiuri G, Fusini L, Fazzari F, Mushtaq S, Conte E, Calligaris G, De Martini S, Ferrari C, Galli S, Grancini L, Ravagnani P, Teruzzi G, Trabattoni D, Fabbiocchi F, Lualdi A, Montorsi P, Rabbat MG, Bartorelli AL, and Pepi M

Abstract

Objectives: This study sought to compare the diagnostic accuracy of coronary computed tomography angiography (cCTA) with that of cCTA+fractional flow reserve derived from cCTA datasets (FFRCT) and that of cCTA+static stress-computed tomography perfusion (stress-CTP) in detecting functionally significant coronary artery lesions using invasive coronary angiography (ICA) plus invasive FFR as the reference standard. Background: FFRCT and static stress-CTP are new techniques that combine anatomy and functional evaluation to improve assessment of coronary artery disease (CAD) using cCTA. Methods: A total of 147 consecutive symptomatic patients scheduled for clinically indicated ICA+invasive FFR were evaluated with cCTA, FFRCT, and stress-CTP. Results: Vessel-based and patient-based sensitivity, specificity, and negative predictive values, and positive predictive values, and accuracy rates of cCTA were 99%, 76%, 100%, 61%, 82%, and 95%, 54%, 94%, 63%, 73%, respectively. cCTA+FFRCT showed vessel-based and patient-based sensitivity, specificity, and negative predictive values, and positive predictive values and accuracy rates of 88%, 94%, 95%, 84%, 92%, and 90%, 85%, 92%, 83%, 87%, respectively. Finally, cCTA+stress-CTP showed vessel-based and patient-based sensitivity, specificity, and negative predictive values, and positive predictive values and accuracy rates of 92%, 95%, 97%, 87%, 94% and 98%, 87%, 99%, 86%, 92%, respectively. Both FFRCT and stress-CTP significantly improved specificity and positive predictive values compared to those of cCTA alone. The area under the curve to detect flow-limiting stenoses of cCTA, cCTA+FFRCT, and cCTA+CTP were 0.89, 0.93, 0.92, and 0.90, 0.94, and 0.93 in a vessel-based and patient-based model, respectively, with significant additional values for both cCTA+FFRCT and cCTA+CTP versus cCTA alone (p < 0.001) but no differences between cCTA+FFRCT versus cCTA+CTP. Conclusions: FFRCT and stress-CTP in addition to cCTA are valid and compara

Published
2019

20. Association Between Haptoglobin Phenotype and Microvascular Obstruction in Patients With ST-Segment Elevation Myocardial Infarction

Author

Pontone, G, Andreini, D, Guaricci, A, Guglielmo, M, Baggiano, A, Muscogiuri, G, Fusini, L, Fazzari, F, Berzovini, C, Pasquini, A, Mushtaq, S, Conte, E, Cosentino, N, Rabbat, M, Marenzi, G, Bartorelli, A, Pepi, M, Tremoli, E, Banfi, C, Pontone G, Andreini D, Guaricci AI, Guglielmo M, Baggiano A, Muscogiuri G, Fusini L, Fazzari F, Berzovini C, Pasquini A, Mushtaq S, Conte E, Cosentino N, Rabbat MG, Marenzi G, Bartorelli AL, Pepi M, Tremoli E, Banfi C., Pontone, G, Andreini, D, Guaricci, A, Guglielmo, M, Baggiano, A, Muscogiuri, G, Fusini, L, Fazzari, F, Berzovini, C, Pasquini, A, Mushtaq, S, Conte, E, Cosentino, N, Rabbat, M, Marenzi, G, Bartorelli, A, Pepi, M, Tremoli, E, Banfi, C, Pontone G, Andreini D, Guaricci AI, Guglielmo M, Baggiano A, Muscogiuri G, Fusini L, Fazzari F, Berzovini C, Pasquini A, Mushtaq S, Conte E, Cosentino N, Rabbat MG, Marenzi G, Bartorelli AL, Pepi M, Tremoli E, and Banfi C.

Abstract

Objectives: This study aimed to evaluate the correlation between different haptoglobin (Hp)phenotypes and myocardial infarction characteristics as detected by cardiac magnetic resonance (CMR)in consecutive patients after ST-segment elevation myocardial infarction (STEMI). Background: Hp is a plasma protein that prevents iron-mediated oxidative tissue damage. CMR has emerged as the gold standard technique to detect left ventricular ejection fraction (LVEF), extent of scar with late gadolinium enhancement (LGE)technique, microvascular obstruction (MVO), and myocardial hemorrhage (MH)in patients with STEMI treated by primary percutaneous coronary intervention (pPCI). Methods: A total of 145 consecutive STEMI patients (mean age 62.2 ± 10.3 years; 78% men)were prospectively enrolled and underwent Hp phenotyping and CMR assessment within 1 week after STEMI. Results: CMR showed an area at risk (AAR)involving 26.6 ± 19.1% of left ventricular (LV)mass with a late LGE extent of 15.2 ± 13.1% of LV mass. MVO and MH occurred in 38 (26%)and 12 (8%)patients, respectively. Hp phenotypes 1-1, 2-1, 2-2 were observed in 15 (10%), 62 (43%), and 68 (47%), respectively. Multivariable analysis demonstrated that body mass index, Hp2-2, diabetes, and peak troponin I were independent predictors of MVO with Hp2-2 associated with the highest odds ratio (OR)(OR: 5.5 [95% confidence interval [CI]: 2.1 to 14.3; p < 0.001]). Hp2-2 significantly predicted both the presence (area under the curve [AUC]: 0.63 [95% CI: 0.53 to 0.72; p = 0.008])and extent of MVO (AUC: 0.63 [95% CI: 0.54 to 0.72; p = 0.007]). Conclusions: Hp phenotype is an independent predictor of MVO. Therefore, Hp phenotyping could be used for risk stratification and may be useful in assessing new therapies to reduce myocardial reperfusion injury in patients with STEMI.

Published
2019

21. Left atrial appendage closure guided by 3D computed tomography printing technology: A case control study

Author

Conti, M, Marconi, S, Muscogiuri, G, Guglielmo, M, Baggiano, A, Italiano, G, Mancini, M, Auricchio, F, Andreini, D, Rabbat, M, Guaricci, A, Fassini, G, Gasperetti, A, Costa, F, Tondo, C, Maltagliati, A, Pepi, M, Pontone, G, Conti M, Marconi S, Muscogiuri G, Guglielmo M, Baggiano A, Italiano G, Mancini ME, Auricchio F, Andreini D, Rabbat MG, Guaricci AI, Fassini G, Gasperetti A, Costa F, Tondo C, Maltagliati A, Pepi M, Pontone G, Conti, M, Marconi, S, Muscogiuri, G, Guglielmo, M, Baggiano, A, Italiano, G, Mancini, M, Auricchio, F, Andreini, D, Rabbat, M, Guaricci, A, Fassini, G, Gasperetti, A, Costa, F, Tondo, C, Maltagliati, A, Pepi, M, Pontone, G, Conti M, Marconi S, Muscogiuri G, Guglielmo M, Baggiano A, Italiano G, Mancini ME, Auricchio F, Andreini D, Rabbat MG, Guaricci AI, Fassini G, Gasperetti A, Costa F, Tondo C, Maltagliati A, Pepi M, and Pontone G

Abstract

Background: We sought to evaluate the additional value of left atrial appendage (LAA) 3D printing derived from computed tomography (CCT) in determining the size for LAA occlusion (LAAO) devices as compared to standard measurement by using occurrence of LAA leak as endpoint. Methods: We evaluated 6 patients with LAA leak (cases) and 14 matched patients without LAA leak (controls) after LAAO. For each group, a patient-specific 3D printed model of LAA was manufactured using CT pre-operative images. The size recommended by the 3D printed model was compared with the size of the implanted device. Results: Compared to the 3D printed model, 55% of the devices were underestimated, the two sizing approaches agreed in 35% of the patients, while the 3D printed model overestimated the size in 10% of patients. The prevalence of LAA leak was significantly higher in the subset of patients with underestimation of prosthesis implanted with the standard approach as compared to the other patients (p = 0.019). Conclusion: 3D printing of the LAA may provide additional value to standard practice for LAAO device prosthesis sizing with the potential impact to reduce LAA leak.

Published
2019

22. Determinants of Rejection Rate for Coronary CT Angiography Fractional Flow Reserve Analysis

Author

Pontone, G, Weir-McCall, J, Baggiano, A, Del Torto, A, Fusini, L, Guglielmo, M, Muscogiuri, G, Guaricci, A, Andreini, D, Patel, M, Nieman, K, Akasaka, T, Rogers, C, Nørgaard, B, Bax, J, Raff, G, Chinnaiyan, K, Berman, D, Fairbairn, T, Koweek, L, Leipsic, J, Pontone G, Weir-McCall JR, Baggiano A, Del Torto A, Fusini L, Guglielmo M, Muscogiuri G, Guaricci AI, Andreini D, Patel M, Nieman K, Akasaka T, Rogers C, Nørgaard BL, Bax J, Raff GL, Chinnaiyan K, Berman D, Fairbairn T, Koweek LH, Leipsic J, Pontone, G, Weir-McCall, J, Baggiano, A, Del Torto, A, Fusini, L, Guglielmo, M, Muscogiuri, G, Guaricci, A, Andreini, D, Patel, M, Nieman, K, Akasaka, T, Rogers, C, Nørgaard, B, Bax, J, Raff, G, Chinnaiyan, K, Berman, D, Fairbairn, T, Koweek, L, Leipsic, J, Pontone G, Weir-McCall JR, Baggiano A, Del Torto A, Fusini L, Guglielmo M, Muscogiuri G, Guaricci AI, Andreini D, Patel M, Nieman K, Akasaka T, Rogers C, Nørgaard BL, Bax J, Raff GL, Chinnaiyan K, Berman D, Fairbairn T, Koweek LH, and Leipsic J

Abstract

Background: Coronary artery fractional flow reserve (FFR) derived from CT angiography (FFTCT) enables functional assessment of coronary stenosis. Prior clinical trials showed 13%-33% of coronary CT angiography studies had insufficient quality for quantitative analysis with FFRCT. Purpose: To determine the rejection rate of FFRCT analysis and to determine factors associated with technically unsuccessful calculation of FFRCT. Materials and Methods: Prospectively acquired coronary CT angiography scans submitted as part of the Assessing Diagnostic Value of Noninvasive FFRCT in Coronary Care (ADVANCE) registry (https://ClinicalTrials.gov: NCT02499679) and coronary CT angiography series submitted for clinical analysis were included. The primary outcome was the FFRCT rejection rate (defined as an inability to perform quantitative analysis with FFRCT). Factors that were associated with FFRCT rejection rate were assessed with multiple linear regression. Results: In the ADVANCE registry, FFRCT rejection rate due to inadequate image quality was 2.9% (80 of 2778 patients; 95% confidence interval [CI]: 2.1%, 3.2%). In the 10 621 consecutive patients who underwent clinical analysis, the FFRCT rejection rate was 8.4% (n = 892; 95% CI: 6.2%, 7.2%; P , .001 vs the ADVANCE cohort). The main reason for the inability to perform FFRCT analysis was the presence of motion artifacts (63 of 80 [78%] and 729 of 892 [64%] in the ADVANCE and clinical cohorts, respectively). At multivariable analysis, section thickness in the ADVANCE (odds ratio [OR], 1.04; 95% CI: 1.001, 1.09; P = .045) and clinical (OR, 1.03; 95% CI: 1.02, 1.04; P , .001) cohorts and heart rate in the ADVANCE (OR, 1.05; 95% CI: 1.02, 1.08; P , .001) and clinical (OR, 1.06; 95% CI: 1.05, 1.07; P , .001) cohorts were independent predictors of rejection. Conclusion: The rates for technically unsuccessful CT-derived fractional flow reserve in the ADVANCE registry and in a large clinical cohort were 2.9% and 8.4%, respectively. Th

Published
2019

23. Quantitative vs. qualitative evaluation of static stress computed tomography perfusion to detect haemodynamically significant coronary artery disease

Author

Pontone, G, Andreini, D, Guaricci, A, Guglielmo, M, Baggiano, A, Muscogiuri, G, Fusini, L, Soldi, M, Fazzari, F, Berzovini, C, Pasquini, A, Ciancarella, P, Mushtaq, S, Conte, E, Calligaris, G, De Martini, S, Ferrari, C, Galli, S, Grancini, L, Ravagnani, P, Teruzzi, G, Trabattoni, D, Fabbiocchi, F, Lualdi, A, Montorsi, P, Rabbat, M, Bartorelli, A, Pepi, M, Pontone G, Andreini D, Guaricci AI, Guglielmo M, Baggiano A, Muscogiuri G, Fusini L, Soldi M, Fazzari F, Berzovini C, Pasquini A, Ciancarella P, Mushtaq S, Conte E, Calligaris G, De Martini S, Ferrari C, Galli S, Grancini L, Ravagnani P, Teruzzi G, Trabattoni D, Fabbiocchi F, Lualdi A, Montorsi P, Rabbat MG, Bartorelli AL, Pepi M., Pontone, G, Andreini, D, Guaricci, A, Guglielmo, M, Baggiano, A, Muscogiuri, G, Fusini, L, Soldi, M, Fazzari, F, Berzovini, C, Pasquini, A, Ciancarella, P, Mushtaq, S, Conte, E, Calligaris, G, De Martini, S, Ferrari, C, Galli, S, Grancini, L, Ravagnani, P, Teruzzi, G, Trabattoni, D, Fabbiocchi, F, Lualdi, A, Montorsi, P, Rabbat, M, Bartorelli, A, Pepi, M, Pontone G, Andreini D, Guaricci AI, Guglielmo M, Baggiano A, Muscogiuri G, Fusini L, Soldi M, Fazzari F, Berzovini C, Pasquini A, Ciancarella P, Mushtaq S, Conte E, Calligaris G, De Martini S, Ferrari C, Galli S, Grancini L, Ravagnani P, Teruzzi G, Trabattoni D, Fabbiocchi F, Lualdi A, Montorsi P, Rabbat MG, Bartorelli AL, and Pepi M.

Abstract

Aims To compare the diagnostic accuracy of stress computed tomography myocardial perfusion (CTP) for the detection of significant coronary artery disease with visual approach vs. quantitative analysis with transmural perfusion ratio (TPR) in consecutive symptomatic patients scheduled for invasive coronary angiography (ICA) plus invasive fractional flow reserve (FFR). Methods and results Eighty-eight consecutive symptomatic patients underwent rest coronary computed tomography angiography (cCTA) followed by static stress-CTP. Diagnostic accuracy of cCTA + stress-CTP with visual evaluation and with TPR measurement was calculated and compared with ICA and invasive FFR. Addition of stress-CTP with qualitative evaluation to rest-cCTA showed sensitivity, specificity, negative and positive predictive values, and accuracy at a vessel and patient level of 92%, 92%, 97%, 82%, 92% and 98%, 80%, 97%, 82%, 89%, respectively indicating a significant improvement of specificity, positive predictive value, and accuracy values vs. rest-cCTA in both models. Similarly, addition of stress-CTP with TPR evaluation to rest-cCTA showed sensitivity, specificity, negative and positive predictive values, and accuracy at a vessel and patient level of 84%, 90%, 93%, 76%, 88% and 91%, 71%, 89%, 75%, 81%, respectively indicating a significant improvement of specificity, positive predictive value values vs. rest-cCTA only in a vessel-based model and of positive predictive value in a patient-based model. When cCTA + stress-CTP with qualitative evaluation was compared with cCTA + stress-CTP with TPR estimation, no differences were found in terms of diagnostic performance. Conclusion The addition of stress-CTP with visual evaluation to cCTA imaging has similar diagnostic performance when compared with the quantitative analysis of myocardial perfusion based on TPR measurement.

Published
2018

24. Coronary Atherosclerosis Assessment by Coronary CT Angiography in Asymptomatic Diabetic Population: A Critical Systematic Review of the Literature and Future Perspectives

Author

Guaricci, A, De Santis, D, Carbone, M, Muscogiuri, G, Guglielmo, M, Baggiano, A, Serviddio, G, Pontone, G, Guaricci AI, De Santis D, Carbone M, Muscogiuri G, Guglielmo M, Baggiano A, Serviddio G, Pontone G., Guaricci, A, De Santis, D, Carbone, M, Muscogiuri, G, Guglielmo, M, Baggiano, A, Serviddio, G, Pontone, G, Guaricci AI, De Santis D, Carbone M, Muscogiuri G, Guglielmo M, Baggiano A, Serviddio G, and Pontone G.

Abstract

The prognostic impact of diabetes mellitus (DM) on cardiovascular outcomes is well known. As a consequence of previous studies showing the high incidence of coronary artery disease (CAD) in diabetic patients and the relatively poor outcome compared to nondiabetic populations, DM is considered as CAD equivalent which means that diabetic patients are labeled as asymptomatic individuals at high cardiovascular risk. Lessons learned fromthe analysis of prognostic studies over the past decade have challenged this dogma and now support the idea that diabetic population is not uniformly distributed in the highest risk box. Detecting CAD in asymptomatic high risk individuals is controversial and, what ismore, in patients with diabetes is challenging, and that is why the reliability of traditional cardiac stress tests for detectingmyocardial ischemia is limited. Cardiac computed tomography angiography (CCTA) represents an emerging noninvasive technique able to explore the atherosclerotic involvement of the coronary arteries and, thus, to distinguish different risk categories tailoring this evaluation on each patient. The aim of the review is to provide a wide overview on the clinical meaning of CCTA in this field and to integrate the anatomical information with a reliable therapeutic approach.

Published
2018

25. Prognostic relevance of subclinical coronary and carotid atherosclerosis in a diabetic and non-diabetic asymptomatic population

Author

Guaricci, A, Lorenzoni, V, Guglielmo, M, Mushtaq, S, Muscogiuri, G, Cademartiri, F, Rabbat, M, Andreini, D, Serviddio, G, Gaibazzi, N, Pepi, M, Pontone, G, Guaricci AI, Lorenzoni V, Guglielmo M, Mushtaq S, Muscogiuri G, Cademartiri F, Rabbat M, Andreini D, Serviddio G, Gaibazzi N, Pepi M, Pontone G., Guaricci, A, Lorenzoni, V, Guglielmo, M, Mushtaq, S, Muscogiuri, G, Cademartiri, F, Rabbat, M, Andreini, D, Serviddio, G, Gaibazzi, N, Pepi, M, Pontone, G, Guaricci AI, Lorenzoni V, Guglielmo M, Mushtaq S, Muscogiuri G, Cademartiri F, Rabbat M, Andreini D, Serviddio G, Gaibazzi N, Pepi M, and Pontone G.

Abstract

Background: We sought to evaluate the incremental prognostic benefit of carotid artery disease and subclinical coronary artery disease (CAD) features in addition to clinical evaluation in an asymptomatic population. Methods: Over a 6-year period, 10-year Framingham risk score together with carotid ultrasound and coronary computed tomography angiography were evaluated for prediction of major adverse cardiac events (MACE). Results: We enrolled 517 consecutive asymptomatic patients (63% male, mean age 64 ±10 years; 17.6% with diabetes). Median (interquartile range) coronary artery calcium score (CACS) was 34 (0–100). Over a median follow-up of 4.4 (3.4–5.1) years, there were 53 MACE (10%). Patients experiencing MACE had higher CACS, incidence of carotid disease, presence of CAD ≥50%, and remodeled plaque as compared with patients without MACE. At multivariable analyses, presence of CAD ≥50% (HR: 5.14, 95% CI: 2.1–12.4) and percentage of segments with remodeled plaque (HR: 1.04, 95% CI: 1.03–1.06) independently predicted MACE (P < 0.001). Models adding CAD ≥50% or percentage of segments with remodeled plaque resulted in higher discrimination and reclassification ability compared with a model based on 10-year FRS, carotid disease, and CACS. Specifically, the C-statistic improved to 0.75 with addition of CAD and 0.84 when adding percentage of segments with remodeled plaque, whereas net reclassification improvement indices were 0.86 and 0.92, respectively. Conclusions: In an asymptomatic population, CAD and plaque positive remodeling increase MACE prediction compared with a model based on 10-year FRS, carotid disease, and CACS estimation. In the diabetes subgroup, percentage of segments with remodeled plaque was the only predictor of MACE.

Published
2018

27. Prognostic Value and Therapeutic Perspectives of Coronary CT Angiography: A Literature Review

Author

Carità, P, Guaricci, A, Muscogiuri, G, Carrabba, N, Pontone, G, Carità P, Guaricci AI, Muscogiuri G, Carrabba N, Pontone G., Carità, P, Guaricci, A, Muscogiuri, G, Carrabba, N, Pontone, G, Carità P, Guaricci AI, Muscogiuri G, Carrabba N, and Pontone G.

Abstract

Coronary stenosis severity is both a powerful and a still debated predictor of prognosis in coronary artery disease. Coronary computed tomographic angiography (CCTA) has emerged as a noninvasive technique that enables anatomic visualization of coronary artery disease (CAD). CCTA with newer applications, plaque characterization and physiologic/functional evaluation, allows a comprehensive diagnostic and prognostic assessment of otherwise low-intermediate subjects for primary prevention. CCTA measures the overall plaque burden, differentiates plaque subtypes, and identifies high-risk plaque with good reproducibility. Research in this field may also advance towards an era of personalized risk prediction and individualized medical therapy. It has been demonstrated that statins may delay plaque progression and change some plaque features. The potential effects on plaque modifications induced by other medical therapies have also been investigated. Although it is not currently possible to recommend routinely serial scans to monitor the therapeutic efficacy of medical interventions, the plaque modulation, as a part of risk modification, appears a feasible strategy. In this review we summarize the current evidence regarding vulnerable plaque and effects of lipid lowering therapy on morphological features of CAD. We also discuss the potential ability of CCTA to characterize coronary atherosclerosis, stratify prognosis of asymptomatic subjects, and guide medical therapy.

Published
2018

28. Impact of a New Adaptive Statistical Iterative Reconstruction (ASIR)-V Algorithm on Image Quality in Coronary Computed Tomography Angiography

Author

Pontone, G, Muscogiuri, G, Andreini, D, Guaricci, A, Guglielmo, M, Baggiano, A, Fazzari, F, Mushtaq, S, Conte, E, Annoni, A, Formenti, A, Mancini, E, Verdecchia, M, Campari, A, Martini, C, Gatti, M, Fusini, L, Bonfanti, L, Consiglio, E, Rabbat, M, Bartorelli, A, Pepi, M, Pontone G, Muscogiuri G, Andreini D, Guaricci AI, Guglielmo M, Baggiano A, Fazzari F, Mushtaq S, Conte E, Annoni A, Formenti A, Mancini E, Verdecchia M, Campari A, Martini C, Gatti M, Fusini L, Bonfanti L, Consiglio E, Rabbat MG, Bartorelli AL, Pepi M., Pontone, G, Muscogiuri, G, Andreini, D, Guaricci, A, Guglielmo, M, Baggiano, A, Fazzari, F, Mushtaq, S, Conte, E, Annoni, A, Formenti, A, Mancini, E, Verdecchia, M, Campari, A, Martini, C, Gatti, M, Fusini, L, Bonfanti, L, Consiglio, E, Rabbat, M, Bartorelli, A, Pepi, M, Pontone G, Muscogiuri G, Andreini D, Guaricci AI, Guglielmo M, Baggiano A, Fazzari F, Mushtaq S, Conte E, Annoni A, Formenti A, Mancini E, Verdecchia M, Campari A, Martini C, Gatti M, Fusini L, Bonfanti L, Consiglio E, Rabbat MG, Bartorelli AL, and Pepi M.

Abstract

Rationale and objectives: A new postprocessing algorithm named adaptive statistical iterative reconstruction (ASIR)-V has been recently introduced. The aim of this article was to analyze the impact of ASIR-V algorithm on signal, noise, and image quality of coronary computed tomography angiography. Materials and Methods: Fifty consecutive patients underwent clinically indicated coronary computed tomography angiography (Revolution CT; GE Healthcare, Milwaukee, WI). Images were reconstructed using filtered back projection and ASIR-V 0%, and a combination of filtered back projection and ASIR-V 20%–80% and ASIR-V 100%. Image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were calculated for left main coronary artery (LM), left anterior descending artery (LAD), left circumflex artery (LCX), and right coronary artery (RCA) and were compared between the different postprocessing algorithms used. Similarly a four-point Likert image quality score of coronary segments was graded for each dataset and compared. A cutoff value of P <.05 was considered statistically significant. Results: Compared to ASIR-V 0%, ASIR-V 100% demonstrated a significant reduction of image noise in all coronaries (P <.01). Compared to ASIR-V 0%, SNR was significantly higher with ASIR-V 60% in LM (P <.01), LAD (P <.05), LCX (P <.05), and RCA (P <.01). Compared to ASIR-V 0%, CNR for ASIR-V ≥60% was significantly improved in LM (P <.01), LAD (P <.05), and RCA (P <.01), whereas LCX demonstrated a significant improvement with ASIR-V ≥80%. ASIR-V 60% had significantly better Likert image quality scores compared to ASIR-V 0% in segment-, vessel-, and patient-based analyses (P <.01). Conclusions: Reconstruction with ASIR-V 60% provides the optimal balance between image noise, SNR, CNR, and image quality.

Published
2018

29. Diagnostic accuracy of simultaneous evaluation of coronary arteries and myocardial perfusion with single stress cardiac computed tomography acquisition compared to invasive coronary angiography plus invasive fractional flow reserve

Author

Pontone, G, Baggiano, A, Andreini, D, Guaricci, A, Guglielmo, M, Muscogiuri, G, Fusini, L, Soldi, M, Del Torto, A, Mushtaq, S, Conte, E, Calligaris, G, De Martini, S, Ferrari, C, Galli, S, Grancini, L, Olivares, P, Ravagnani, P, Teruzzi, G, Trabattoni, D, Fabbiocchi, F, Montorsi, P, Rabbat, M, Bartorelli, A, Pepi, M, Pontone G, Baggiano A, Andreini D, Guaricci AI, Guglielmo M, Muscogiuri G, Fusini L, Soldi M, Del Torto A, Mushtaq S, Conte E, Calligaris G, De Martini S, Ferrari C, Galli S, Grancini L, Olivares P, Ravagnani P, Teruzzi G, Trabattoni D, Fabbiocchi F, Montorsi P, Rabbat MG, Bartorelli AL, Pepi M., Pontone, G, Baggiano, A, Andreini, D, Guaricci, A, Guglielmo, M, Muscogiuri, G, Fusini, L, Soldi, M, Del Torto, A, Mushtaq, S, Conte, E, Calligaris, G, De Martini, S, Ferrari, C, Galli, S, Grancini, L, Olivares, P, Ravagnani, P, Teruzzi, G, Trabattoni, D, Fabbiocchi, F, Montorsi, P, Rabbat, M, Bartorelli, A, Pepi, M, Pontone G, Baggiano A, Andreini D, Guaricci AI, Guglielmo M, Muscogiuri G, Fusini L, Soldi M, Del Torto A, Mushtaq S, Conte E, Calligaris G, De Martini S, Ferrari C, Galli S, Grancini L, Olivares P, Ravagnani P, Teruzzi G, Trabattoni D, Fabbiocchi F, Montorsi P, Rabbat MG, Bartorelli AL, and Pepi M.

Abstract

Background: Coronary computed tomography angiography (cCTA) has limited diagnostic accuracy in patients with intermediate to high pre-test likelihood of coronary artery disease (CAD) that may have large amounts of coronary calcium. Stress computed tomography myocardial perfusion (CTP) has emerged as a valuable strategy, combining anatomical and functional assessment of CAD. Purpose of the study is to evaluate the diagnostic accuracy of combining coronary artery imaging and myocardial perfusion in a single stress dataset versus invasive coronary angiography (ICA) and invasive fractional flow reserve (FFR) as reference standard. Methods: One-hundred-thirty consecutive symptomatic patients (age: 65 ± 9 years; men: 70%) scheduled for clinically indicated ICA plus invasive FFR were prospectively enrolled. cCTA + CTP were simultaneously evaluated in a single stress-dataset by blinded readers and compared to ICA and invasive FFR findings. Results: CTP was successfully performed in all patients. The most common artifacts observed in the stress dataset for coronary artery imaging were blooming effect and motion effect related. Overall evaluability of coronary arteries by using cCTA stress dataset was 93%. In a vessel and patient-based model, stress cCTA + stress CTP showed sensitivity, specificity, negative predictive value, positive predictive value and diagnostic accuracy of 93%, 94%, 97%, 85%, 94%, and 98%, 86%, 98%, 85%, 92%, respectively. The overall effective dose (ED) of stress protocol acquisition alone was 2.5 ± 1.1 mSv. Conclusions: Simultaneous evaluation of coronary arteries and myocardial perfusion with single stress acquisition is feasible and it has diagnostic accuracy and low ED to identify functionally significant stenosis in patients with intermediate to high risk for CAD.

Published
2018

30. Prognostic Stratification of Patients With ST-Segment-Elevation Myocardial Infarction (PROSPECT): A Cardiac Magnetic Resonance Study

Author

Pontone, G, Guaricci, A, Andreini, D, Ferro, G, Guglielmo, M, Baggiano, A, Fusini, L, Muscogiuri, G, Lorenzoni, V, Mushtaq, S, Conte, E, Annoni, A, Formenti, A, Mancini, M, Carità, P, Verdecchia, M, Pica, S, Fazzari, F, Cosentino, N, Marenzi, G, Rabbat, M, Agostoni, P, Bartorelli, A, Pepi, M, Masci, P, Pontone G, Guaricci AI, Andreini D, Ferro G, Guglielmo M, Baggiano A, Fusini L, Muscogiuri G, Lorenzoni V, Mushtaq S, Conte E, Annoni A, Formenti A, Mancini ME, Carità P, Verdecchia M, Pica S, Fazzari F, Cosentino N, Marenzi G, Rabbat MG, Agostoni P, Bartorelli AL, Pepi M, Masci PG., Pontone, G, Guaricci, A, Andreini, D, Ferro, G, Guglielmo, M, Baggiano, A, Fusini, L, Muscogiuri, G, Lorenzoni, V, Mushtaq, S, Conte, E, Annoni, A, Formenti, A, Mancini, M, Carità, P, Verdecchia, M, Pica, S, Fazzari, F, Cosentino, N, Marenzi, G, Rabbat, M, Agostoni, P, Bartorelli, A, Pepi, M, Masci, P, Pontone G, Guaricci AI, Andreini D, Ferro G, Guglielmo M, Baggiano A, Fusini L, Muscogiuri G, Lorenzoni V, Mushtaq S, Conte E, Annoni A, Formenti A, Mancini ME, Carità P, Verdecchia M, Pica S, Fazzari F, Cosentino N, Marenzi G, Rabbat MG, Agostoni P, Bartorelli AL, Pepi M, and Masci PG.

Abstract

Background-Cardiac magnetic resonance (CMR) is a robust tool to evaluate left ventricular ejection fraction (LVEF), myocardial salvage index, microvascular obstruction, and myocardial hemorrhage in patients with ST-segment-elevation myocardial infarction. We evaluated the additional prognostic benefit of a CMR score over standard prognostic stratification with global registry of acute coronary events (GRACE) score and transthoracic echocardiography LVEF measurement. Methods and Results-Two hundred nine consecutive patients with ST-segment-elevation myocardial infarction (age, 61.4±11.4 years; 162 men) underwent transthoracic echocardiography and CMR after succesful primary percutaneous coronary intervention. Major adverse cardiac events (MACE) were assessed at a mean follow-up of 2.5±1.2 years. MACE occurred in 24 (12%) patients who at baseline showed higher GRACE risk score (P<0.01), lower LVEF with both transthoracic echocardiography and CMR, lower myocardial salvage index, and higher per-patient myocardial hemorrhage and microvascular obstruction prevalence and amount as compared with patients without MACE (P<0.01). The best cut-off values of transthoracic echocardiography-LVEF, CMR-LVEF, myocardial salvage index, and microvascular obstruction to predict MACE were 46.7%, 37.5%, 0.4, and 2.6% of left ventricular mass, respectively. Accordingly, a weighted CMR score, including the following 4 variables (CMR-LVEF, myocardial salvage index, microvascular obstruction, and myocardial hemorrhage), with a maximum of 17 points was calculated and included in the multivariable analysis showing that only CMR score (hazard ratio, 1.867 per SD increase [1.311-2.658]; P<0.001) was independently associated with MACE with the highest net reclassification improvement as compared to GRACE score and transthoracic echocardiography-LVEF measurement. Conclusions-CMR score provides incremental prognostic stratification as compared with GRACE score and transthoracic echocardiogr

Published
2017

31. Additional value of inflammatory biomarkers and carotid artery disease in prediction of significant coronary artery disease as assessed by coronary computed tomography angiography

Author

Guaricci, A, Pontone, G, Fusini, L, De Luca, M, Cafarelli, F, Guglielmo, M, Baggiano, A, Beltrama, V, Muscogiuri, G, Mushtaq, S, Conte, E, Guglielmi, G, Andreini, D, Brunetti, N, Di Biase, M, Bartorelli, A, Pepi, M, Guaricci AI, Pontone G, Fusini L, De Luca M, Cafarelli FP, Guglielmo M, Baggiano A, Beltrama V, Muscogiuri G, Mushtaq S, Conte E, Guglielmi G, Andreini D, Brunetti ND, Di Biase M, Bartorelli AL, Pepi M., Guaricci, A, Pontone, G, Fusini, L, De Luca, M, Cafarelli, F, Guglielmo, M, Baggiano, A, Beltrama, V, Muscogiuri, G, Mushtaq, S, Conte, E, Guglielmi, G, Andreini, D, Brunetti, N, Di Biase, M, Bartorelli, A, Pepi, M, Guaricci AI, Pontone G, Fusini L, De Luca M, Cafarelli FP, Guglielmo M, Baggiano A, Beltrama V, Muscogiuri G, Mushtaq S, Conte E, Guglielmi G, Andreini D, Brunetti ND, Di Biase M, Bartorelli AL, and Pepi M.

Abstract

Aims To evaluate the relationship between an incremental model including cardiovascular risk factors, carotid disease, and inflammatory biomarkers to predict the presence of obstructive coronary artery disease (CAD). Methods and results A total of 134 consecutive and asymptomatic intermediate-risk patients (mean age 61+9 years, 52% men) were enrolled. Each subject underwent circulating levels assessment of interleukin (IL)-2r, IL-6, IL-8, IL-10, high-sensitivity Creactive protein (hs-CRP) and carotid and coronary artery evaluation using carotid ultrasound and coronary computed tomography angiography (CCTA), respectively. Carotid disease was diagnosed in 71 (53%) patients. Obstructive and multi-vessel CAD were found in 50 (37%) and 18 (14%) patients, respectively. Patients in whom CCTA showed multi-vessel CAD had a higher rate of carotid disease (89 vs. 46%, P ? 0.001) and increased values of all interleukins when compared with patients without multi-vessel obstructive CAD. The univariate and multivariate analysis showed that male gender, diabetes, carotid disease, and IL-6 were independently associated with obstructive CAD. At receiver operating characteristic curve analysis, the multivariate model (including male gender, carotid disease, IL-6. 5.9 pg/mL, and diabetes) showed the highest area under the curve for prediction of obstructive CAD, multi-vessel CAD, and high-risk plaque defined as mixed and/or remodelled plaque when compared with all other models (P, 0.001). Conclusion Among asymptomatic intermediate-risk patients, the presence of increased IL6 levels in addition to traditional risk factors (male gender with diabetes) and carotid artery disease predicts higher rates of obstructive CAD and it could be of help to identify which subset of asymptomatic patients could be referred to CCTA for screening.

Published
2017

32. Role of Cardiac Magnetic Resonance Imaging in Myocardial Infarction

Author

Pontone, G, Carità, P, Rabbat, M, Guglielmo, M, Baggiano, A, Muscogiuri, G, Guaricci, A, Pontone G, Carità P, Rabbat MG, Guglielmo M, Baggiano A, Muscogiuri G, Guaricci AI., Pontone, G, Carità, P, Rabbat, M, Guglielmo, M, Baggiano, A, Muscogiuri, G, Guaricci, A, Pontone G, Carità P, Rabbat MG, Guglielmo M, Baggiano A, Muscogiuri G, and Guaricci AI.

Abstract

Purpose of Review: The purpose of the present paper is to analytically review the diagnostic and prognostic role of CMR in ST-segment elevation myocardial infarction (STEMI) survivors. Percutaneous coronary intervention (PCI) is the treatment of choice in patients STEMI. However, risk of future events remains substantial. Assessment of the extent of myocardial infarction (MI), cardiac function and ventricular remodelling has become the focus of recent studies. Electrocardiography, angiography and echocardiography parameters, as well as risk scores, lack sensitivity and reproducibility in predicting future cardiovascular events. A major advantage of cardiac magnetic resonance imaging (CMR) is that it provides myocardial tissue characterization. Recent Findings: CMR is able to quantify both reversible and irreversible myocardial injury and correlates with future events. Summary: This review will illustrate how microvascular function indices (myocardial salvage index, presence and amount of microvascular obstruction and intramyocardial haemorrhage) detectable by CMR add prognostic information and could impact on future strategies to improve outcomes in revascularized patients.

Published
2017

33. Rapid Fire Abstract: Coronary artery disease: the crucial role of imaging369Left ventricular longitudinal strain is superior to blood biomarkers in prediction of poor exercise capacity in patients with a first-ever STEMI370Early identification of STEMI patients treated with pPCI at risk to develop heart failure during follow-up: speckle tracking echocardiographic study371The clinical and cost effectiveness of stress echocardiography in patients with new onset chest pain and high pre-test probability372PROSPECT CMR study: PROgnostic Stratification in Patients with ST-Elevation myoCardialinfaction over Transthoracic echocardiography by CMR373Exercise induced changes in global longitudinal strain in patients with chest pain and normal troponin-t may identify and rule out coronary artery disease.

Author

Przewlocka-Kosmala, M., primary, Trifunovic, D., primary, Papachristidis, A., primary, Pontone, G., primary, Karlsen, S., primary, Woznicka, AK., additional, Rojek, A., additional, Mysiak, A., additional, Kosmala, W., additional, Krljanac, G., additional, Savic, L., additional, Asanin, M., additional, Lasica, R., additional, Matovic, D., additional, Stepanovic, J., additional, Stankovic, G., additional, Mrdovic, I., additional, Casar Demarco, D., additional, Roper, D., additional, Tsironis, I., additional, Papitsas, M., additional, Byrne, J., additional, Alfakih, K., additional, Monaghan, MJ., additional, Andreini, D., additional, Ferro, G., additional, Guaricci, AI., additional, Guglielmo, M., additional, Mushtaq, S., additional, Baggiano, A., additional, Carita', P., additional, Verdecchia, M., additional, Pepi, M., additional, Dahlslett, T., additional, Grenne, B., additional, Sjoli, B., additional, Smiseth, OA., additional, Edvardsen, T., additional, and Brunvand, H., additional

Published
2016
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34. Poster Session 4The imaging examination and quality assessmentP957Economic impact analysis and quality performance of working with cardiovascular sonographers in high-volume echocardiography laboratoryP958Feasibility of temporal super resolution enhancement of echocardiographic images to diagnose cardiac DiseasesP959Remote medical diagnostician project - Achievements and limitation in tele-echocardiographyP960Right atrial remodeling and galectin-3 are associated with functional capacity in patients with pulmonary arterial hypertensionP961Interatrial electromechanical delay assessed by tissue doppler imaging can separate adults with prehypertension from healthy normotensive controlsP962Preliminary results of an extensive echocardiographic pacemaker optimization protocol for cardiac resynchronization therapyP963Left ventricular global and regional myocardial function in patients with double orifice mitral valve after radical correction on atrioventricular septal defectP964Improving quantitation of left ventricular ejection fraction in a tertiary echocardiography lab - marrying (or merging) guidelines and new technologyP965Echocardiographic evaluation of cardiac function and hemodynamics during LVAD-based resuscitation from cardiac arrest - a porcine studyP966Systolic excursion of the right ventricular outflow tract as a marker of right ventricular dysfunctionP967The impact of the new 2016 ASE/EACVI recommendations in the prevalence and grades of diastolic dysfunction: an analysis from the general populationP968Differential microRNA-21 and microRNA-133 gene expression levels in peripheral blood mononuclear cells from patients with heart failure with preserved ejection fractionP969CMR evaluation of cardiac thrombi and masses by T1 and T2 mapping : an observational studyP970Effect of coronary artery ectasia on left ventricular deformation mechanics. A 2D Speckle Tracking Echocardiography studyP971Diagnostic performance of stress Echo, SPECT, PET, stress CMR, CTCA, CTP and FFRCT for the assessment of CAD versus invasive FFR: a metaanalysisP972Utility of early assessment of myocardial mechanics in STEMI patients treated by primary percutaneous coronary intervention to predict major adverse cardiac events during the first 12 months of folloP973Role of left atrial reservoir in the prediction of increased left ventricular filling pressures in patients with ST-segment elevation myocardial infarctionP974Does the left ventricle ejection fraction improves the Grace risk score accuracy? P975Can we predict significant coronary stenosis using regional strain analysis in non-ST elevation acute coronary syndrome?P976Persistence of pulmonary hypertension after transcatheter aortic valve replacement: incidence and prognostic impactP977Global longitudinal strain is an independent predictor of all cause mortality in patients with severe aortic valve stenosis undergoing valve replacement or treated conservativallyP978Contribution of left ventricular diastolic dysfunction and myocardial fibrosis to pulmonary hypertension in severe aortic stenosisP979Left atrial dysfunction as a determinant of pulmonary hypertension in patients with isolated severe aortic stenosis and preserved left ventricular ejection fractionP980Intraprocedural monitoring protocol using routine transthoracic echocardiography with backup transesophageal probe in transcatheter aortic valve replacement: a single center experience

Author

De Chiara, B., primary, Ranjbar, S., primary, Szczesniak-Stanczyk, D., primary, Gabrielli, L., primary, Djikic, D., primary, Barbier, P., primary, Hristova, K., primary, Erne, D., primary, Zayat, R., primary, Crowe, TM., primary, Almeida, J., primary, Marketou, M., primary, Caspar, T., primary, Kouris, N., primary, Pontone, G., primary, Trifunovic, D., primary, Cusma Piccione, M., primary, Madeira, M., primary, Lovric, D., primary, Drakopoulou, M., primary, Fries, B., primary, Krivickiene, A., primary, Mateescu, AD., primary, Stella, S., primary, Casadei, F., additional, Peritore, A., additional, Spano, F., additional, Santambrogio, G., additional, Vicario, M., additional, Trolese, I., additional, Gallina, C., additional, Giannattasio, C., additional, Moreo, A., additional, Karvandi, M., additional, Badano, LP., additional, Brzozowski, W., additional, Blaszczyk, R., additional, Szyszko, M., additional, Zarczuk, R., additional, Janowski, M., additional, Wysokinski, A., additional, Stanczyk, B., additional, Sitges, M., additional, Castro, P., additional, Verdejo, H., additional, Ocaranza, MP., additional, Sepulveda, P., additional, Llevaneras, S., additional, Baraona, F., additional, Salinas, M., additional, Lavanderos, S., additional, Mujovic, N., additional, Dejanovic, B., additional, Peric, V., additional, Marinkovic, M., additional, Jankovic, N., additional, Orbovic, B., additional, Simic, D., additional, Guglielmo, M., additional, Salvini, L., additional, Savioli, G., additional, Dasheva, A., additional, Marinov, R., additional, Lasarov, S., additional, Mitev, I., additional, M, P., additional, Rhodes, K., additional, Bartlett, M., additional, Chong, A., additional, Wahi, S., additional, Derwall, M., additional, Ebeling, A., additional, Nix, C., additional, Marx, G., additional, Autschbach, R., additional, Hatam, N., additional, Sonecki, P., additional, Brewis, MJ., additional, Church, AC., additional, Johnson, MK., additional, Peacock, AJ., additional, Fontes-Carvalho, R., additional, Sampaio, F., additional, Ribeiro, J., additional, Bettencourt, P., additional, Leite-Moreira, A., additional, Azevedo, A., additional, Kontaraki, J., additional, Parthenakis, P., additional, Maragkoudakis, S., additional, Touloupaki, M., additional, Patrianakos, A., additional, Konstantinou, J., additional, Vernardos, M., additional, Logakis, J., additional, Vardas, P., additional, El Ghannudi, S., additional, Ohlmann, P., additional, Lawson, A., additional, Morel, O., additional, Ohana, M., additional, Roy, C., additional, Gangi, A., additional, Germain, P., additional, Kostakou, P., additional, Dagre, A., additional, Trifou, E., additional, Rodis, I., additional, Kostopoulos, V., additional, Olympios, CD., additional, Guaricci, AI., additional, Verdecchia, M., additional, Andreini, D., additional, Baggiano, A., additional, Beltrama, V., additional, Ferro, G., additional, Carita', P., additional, Pepi, M., additional, Krljanac, G., additional, Savic, L., additional, Asanin, M., additional, Matovic, D., additional, Stepanovic, J., additional, Stankovic, G., additional, Mrdovic, I., additional, Terrizzi, A., additional, Trio, O., additional, Oteri, A., additional, D'amico, G., additional, Ioppolo, A., additional, Nucifora, G., additional, Zucco, M., additional, Sergi, M., additional, Nicotera, A., additional, Boretti, I., additional, Carerj, S., additional, Zito, C., additional, Teixeira, R., additional, Reis, L., additional, Dinis, P., additional, Fernandes, A., additional, Caetano, F., additional, Almeida, I., additional, Costa, M., additional, Goncalves, L., additional, Reskovic Luksic, V., additional, Baricevic, Z., additional, Dosen, D., additional, Pasalic, M., additional, Ostojic, Z., additional, Brestovac, M., additional, Bulum, J., additional, Separovic Hanzevacki, J., additional, Toutouzas, K., additional, Stathogiannis, K., additional, Michelongona, A., additional, Latsios, G., additional, Synetos, A., additional, Trantalis, G., additional, Kaitozis, O., additional, Brili, S., additional, Tousoulis, D., additional, Liu, D., additional, Hu, K., additional, Voelker, W., additional, Ertl, G., additional, Weidemann, F., additional, Herrmann, S., additional, Gumauskiene, B., additional, Drebickaite, E., additional, Ereminiene, E., additional, Vaskelyte, JJ., additional, Calin, A., additional, Rosca, M., additional, Beladan, CC., additional, Enache, R., additional, Calin, C., additional, Cosei, I., additional, Botezatu, S., additional, Simion, M., additional, Ginghina, C., additional, Popescu, BA., additional, Rosa, I., additional, Marini, C., additional, Ancona, F., additional, Latib, A., additional, Monitorano, M., additional, Colombo, A., additional, Margonato, A., additional, and Agricola, E., additional

Published
2016
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35. The STRATEGY Study (Stress Cardiac Magnetic Resonance Versus Computed Tomography Coronary Angiography for the Management of Symptomatic Revascularized Patients) Resources and Outcomes Impact

Author

Pontone, G, Andreini, D, Guaricci, A, Rota, C, Guglielmo, M, Mushtaq, S, Baggiano, A, Beltrama, V, Fusini, L, Solbiati, A, Segurini, C, Conte, E, Gripari, P, Annoni, A, Formenti, A, Petulla', M, Lombardi, F, Muscogiuri, G, Bartorelli, A, Pepi, M, Pontone G, Andreini D, Guaricci AI, Rota C, Guglielmo M, Mushtaq S, Baggiano A, Beltrama V, Fusini L, Solbiati A, Segurini C, Conte E, Gripari P, Annoni A, Formenti A, Petulla' M, Lombardi F, Muscogiuri G, Bartorelli AL, Pepi M., Pontone, G, Andreini, D, Guaricci, A, Rota, C, Guglielmo, M, Mushtaq, S, Baggiano, A, Beltrama, V, Fusini, L, Solbiati, A, Segurini, C, Conte, E, Gripari, P, Annoni, A, Formenti, A, Petulla', M, Lombardi, F, Muscogiuri, G, Bartorelli, A, Pepi, M, Pontone G, Andreini D, Guaricci AI, Rota C, Guglielmo M, Mushtaq S, Baggiano A, Beltrama V, Fusini L, Solbiati A, Segurini C, Conte E, Gripari P, Annoni A, Formenti A, Petulla' M, Lombardi F, Muscogiuri G, Bartorelli AL, and Pepi M.

Abstract

Background - Computed tomography coronary angiography (cTCA) and stress cardiac magnetic resonance (stress-CMR) are suitable tools for diagnosing obstructive coronary artery disease in symptomatic patients with previous history of revascularization. However, performance appraisal of noninvasive tests must take in account the consequent diagnostic testing, invasive procedures, clinical outcomes, radiation exposure, and cumulative costs rather than their diagnostic accuracy only. We aimed to compare an anatomic (cTCA) versus a functional (stress-CMR) strategy in symptomatic patients with previous myocardial revascularization procedures. Methods and Results - Six hundred patients with chest pain and previous revascularization included in a prospective observational registry and evaluated by clinically indicated cTCA (n=300, mean age 68.2±9.7 years, male 255) or stress-CMR (n=300, mean age 67.6±9.7 years, male 263) were enrolled and followed-up in terms of subsequent noninvasive tests, invasive coronary angiography, revascularization procedures, cumulative effective radiation dose, major adverse cardiac events, defined as a composite end point of nonfatal myocardial infarction and cardiac death, and medical costs. The mean follow-up for cTCA and stress-CMR groups was similar (773.6±345 versus 752.8±291 days; P=0.21). Compared with stress-CMR, cTCA was associated with a higher rate of subsequent noninvasive tests (28% versus 17%; P=0.0009), invasive coronary angiography (31% versus 20%; P=0.0009), and revascularization procedures (24% versus 16%; P=0.007). Stress-CMR strategy was associated with a significant reduction of radiation exposure and cumulative costs (59% and 24%, respectively; P<0.001). Finally, patients undergoing stress-CMR showed a lower rate of major adverse cardiac events (5% versus 10%; P<0.010) and cost-effectiveness ratio (119.98±250.92 versus 218.12±298.45 Euro/y; P<0.001). Conclusions - Compared with cTCA, stress-CMR is more cost-effective

Published
2016

36. Prognostic Benefit of Cardiac Magnetic Resonance over Transthoracic Echocardiography for the Assessment of Ischemic and Nonischemic Dilated Cardiomyopathy Patients Referred for the Evaluation of Primary Prevention Implantable Cardioverter-Defibrillator Therapy

Author

Pontone, G, Guaricci, A, Andreini, D, Solbiati, A, Guglielmo, M, Mushtaq, S, Baggiano, A, Beltrama, V, Fusini, L, Rota, C, Segurini, C, Conte, E, Gripari, P, Dello Russo, A, Moltrasio, M, Tundo, F, Lombardi, F, Muscogiuri, G, Lorenzoni, V, Tondo, C, Agostoni, P, Bartorelli, A, Pepi, M, Pontone G, Guaricci AI, Andreini D, Solbiati A, Guglielmo M, Mushtaq S, Baggiano A, Beltrama V, Fusini L, Rota C, Segurini C, Conte E, Gripari P, Dello Russo A, Moltrasio M, Tundo F, Lombardi F, Muscogiuri G, Lorenzoni V, Tondo C, Agostoni P, Bartorelli AL, Pepi M., Pontone, G, Guaricci, A, Andreini, D, Solbiati, A, Guglielmo, M, Mushtaq, S, Baggiano, A, Beltrama, V, Fusini, L, Rota, C, Segurini, C, Conte, E, Gripari, P, Dello Russo, A, Moltrasio, M, Tundo, F, Lombardi, F, Muscogiuri, G, Lorenzoni, V, Tondo, C, Agostoni, P, Bartorelli, A, Pepi, M, Pontone G, Guaricci AI, Andreini D, Solbiati A, Guglielmo M, Mushtaq S, Baggiano A, Beltrama V, Fusini L, Rota C, Segurini C, Conte E, Gripari P, Dello Russo A, Moltrasio M, Tundo F, Lombardi F, Muscogiuri G, Lorenzoni V, Tondo C, Agostoni P, Bartorelli AL, and Pepi M.

Abstract

Background - The aim of this study was to determine the prognostic benefit of cardiac magnetic resonance (CMR) over transthoracic echocardiography (TTE) in ischemic cardiomyopathy and nonischemic dilated cardiomyopathy patients evaluated for primary prevention implantable cardioverter-defibrillator therapy. Methods and Results - We enrolled 409 consecutive ischemic and dilated cardiomyopathy patients (mean age: 64±12 years; 331 men). All patients underwent TTE and CMR, and left ventricle end-diastolic volume, left ventricle end-systolic volume, and left ventricle ejection fraction (LVEF) were evaluated. In addition, late gadolinium enhancement was also assessed. All patients were followed up for major adverse cardiac events (MACE) defined as a composite end point of long runs of nonsustained ventricular tachycardia, sustained ventricular tachycardia, aborted sudden cardiac death, or sudden cardiac death. The median follow-up was 545 days. CMR showed higher left ventricle end-diastolic volume (mean difference: 43±22.5 mL), higher left ventricle end-systolic volume (mean difference: 34±20.5 mL), and lower LVEF (mean difference: -4.9±10%) as compared to TTE (P<0.01). MACE occurred in 103 (25%) patients. Patients experiencing MACE showed higher left ventricle end-diastolic volume, higher left ventricle end-systolic volume, and lower LVEF with both imaging modalities and higher late gadolinium enhancement per-patient prevalence as compared to patients without MACE. At multivariable analysis, CMR-LVEF ≤35% (hazard ratio=2.18 [1.3-3.8]) and the presence of late gadolinium enhancement (hazard ratio=2.2 [1.4-3.6]) were independently associated with MACE (P<0.01). A model based on CMR-LVEF ≤35% or CMR-LVEF ≤35% plus late gadolinium enhancement detection showed a higher performance in the prediction of MACE as compared to TTE-LVEF resulting in net reclassification improvement of 0.468 (95% confidence interval, 0.283-0.654; P<0.001) and 0.413 (95% confidence interval

Published
2016

37. The New Frontier of Cardiac Computed Tomography Angiography: Fractional Flow Reserve and Stress Myocardial Perfusion

Author

Pontone, G, Muscogiuri, G, Andreini, D, Guaricci, A, Guglielmo, M, Mushtaq, S, Baggiano, A, Conte, E, Beltrama, V, Annoni, A, Formenti, A, Mancini, E, Rabbat, M, Pepi, M, Pontone G, Muscogiuri G, Andreini D, Guaricci AI, Guglielmo M, Mushtaq S, Baggiano A, Conte E, Beltrama V, Annoni A, Formenti A, Mancini E, Rabbat MG, Pepi M., Pontone, G, Muscogiuri, G, Andreini, D, Guaricci, A, Guglielmo, M, Mushtaq, S, Baggiano, A, Conte, E, Beltrama, V, Annoni, A, Formenti, A, Mancini, E, Rabbat, M, Pepi, M, Pontone G, Muscogiuri G, Andreini D, Guaricci AI, Guglielmo M, Mushtaq S, Baggiano A, Conte E, Beltrama V, Annoni A, Formenti A, Mancini E, Rabbat MG, and Pepi M.

Abstract

The increased number of patients with coronary artery disease (CAD) in developed countries is of great clinical relevance and involves a large burden of the healthcare system. The management of these patients is focused on relieving symptoms and improving clinical outcomes. Therefore the ideal test would provide the correct diagnosis and actionable information. To this aim, several non-invasive functional imaging modalities are usually used as gatekeeper to invasive coronary angiography (ICA), but their diagnostic yield remains low with limited accuracy when compared to obstructive CAD at the time of ICA or invasive fractional flow reserve (FFR). Invasive FFR is considered the gold standard for the evaluation of functionally relevant CAD. Therefore, an urgent need for non-invasive techniques that evaluate both the functional and morphological severity of CAD is growing. Coronary computed tomography angiography (CCTA) has emerged as a unique non-invasive technique providing coronary artery anatomic imaging. More recently, the evaluation of FFR with CCTA (FFRCT) has demonstrated high diagnostic performance compared to invasive FFR. Additionally, stress myocardial computed tomography perfusion (CTP) represents a novel tool for the diagnosis of ischemia with high diagnostic accuracy. Compared to nuclear imaging and cardiac magnetic resonance imaging, both FFRCT and stress-CTP, allow us to integrate the anatomical evaluation of coronary arteries with the functional relevance of coronary artery lesions having the potential to revolutionize the diagnostic paradigm of suspected CAD. FFRCT and stress-CTP could be assimilated in diagnostic pathways of patients with stable CAD and will likely result in a decrease of invasive diagnostic procedures and costs. The current review evaluates the technical aspects and clinical experience of FFRCT and stress-CTP in the evaluation of functionally relevant CAD discussing the strengths and weaknesses of each approach. ï¿1⁄2 2016, Spring

Published
2016

38. Poster session 2THE IMAGING EXAMINATIONP536Appropriate use criteria of transthoracic echocardiography and its clinical impact: a continuous challengeP537Implementation of proprietary plug-ins in the DICOM-based computerized echo reporting system fuels the use of 3D echo and deformation imaging in the clinical routine of a multivendor laboratoryP538Exercise stress echocardiography appropriate use criteria: real-life cases classification ease and agreement among cardiologistsANATOMY AND PHYSIOLOGY OF THE HEART AND GREAT VESSELSP539Functional capacity in older people with normal ejection fraction correlates with left ventricular functional reserve and carotid-femoral pulse wave velocity but not with E/e and augmentation indexP540Survey of competency of practitioners for diagnosis of acute cardiopulmonary diseases manifest on chest x-rayASSESSMENT OF DIAMETERS, VOLUMES AND MASSP541Left atrium remodeling in dialysis patients with normal ejection fractionP542The prediction of postinfarction left ventricular remodeling and the role of of leptin and MCP-1 in regard to the presence of metabolic syndromeP543Ascending aorta and common carotid artery: diameters and stiffness in a group of 584 healthy subjectsAssessments of haemodynamicsP544Alternate echo parameters in patients without estimable RVSPAssessment of systolic functionP545Reduced contractile performance in heart failure with preserved ejection fraction: determination using novel preload-adjusted maximal left ventricular ejection forceP546Left ventricular dimensions and prognosis in acute coronary syndromesP547Time course of myocardial alterations in a murine model of high fat diet: A strain rate imaging studyP548Subclinical left ventricular systolic dysfunction in patients with premature ventricular contractionsP549Global myocardial strain by CMR-based feature tracking (FT) and tagging to predict development of severe left ventricular systolic dysfunction after acute st-elevation myocardial infarctionP550Echocardiographic analysis of left and right ventricular function in patients after mitral valve reconstructionP551The role of regional longitudinal strain assessment in predicting response to cardiac resynchronization therapy in patients with left ventricular systolic dysfunction and left bundle branch blockP552Speckle tracking automatic border detection improves echocardiographic evaluation of right ventricular systolic function in repaired tetralogy of fallot patients: comparison with MRI findingsP553Echocardiography: a reproducible and relevant tool in pah? intermediate results of the multicentric efort echogardiographic substudy (evaluation of prognostic factors and therapeutic targets in pah)Assessment of diastolic functionP554Relationship between left ventricular filling pressures and myocardial fibrosis in patients with uncomplicated arterial hypertensionP555Cardiac rehabilitation improves echocardiographic parameters of diastolic function in patients with ischemic heart diseaseP556Diastolic parameters in the calcified mitral annulusP557Biomarkers and echocardiography - combined weapon to diagnose and prognose heart failure with and without preserved ejection fractionP558Diastolic function changes of the maternal heart in twin and singleton pregnancyIschemic heart diseaseP559Syntax score as predictor for the correlation between epicardial adipose tissue and the severity of coronary lesions in patients with significant coronary diseaseP560Impact of strain analysis in ergonovine stress echocardiography for diagnosis vasospastic anginaP561Cardiac magnetic resonance tissue tracking: a novel method to predict infarct transmurality in acute myocardial infarctionP562Infarct size is correlated to global longitudinal strain but not left ventricular ejection fraction in the early stage of acute myocardial infarctionP563Magnetic resonance myocardial deformation assessment with tissue tracking and risk stratification in acute myocardial infarction patientsP564Increase in regional end-diastolic wall thickness by transthoracic echocardiography as a biomarker of successful reperfusion in anterior ST elevation acute myocardial infarctionP565Mitral regurgitation is associated with worse long-term prognosis in ST-segment elevation myocardial infarction treated with primary percutaneous coronary interventionP566Statistical significance of 3D motion and deformation indexes for the analysis of LAD infarctionHeart valve DiseasesP567Paradoxical low gradient aortic stenosis: echocardiographic progression from moderate to severe diseaseP568The beneficial effects of TAVI in mitral insufficiencyP569Impact of thoracic aortic calcification on the left ventricular hypertrophy and its regression after aortic valve replacement in patients with severe aortic stenosisP570Additional value of exercise-stress echocardiography in asymptomatic patients with aortic valve stenosisP571Valvulo-arterial impedance in severe aortic stenosis: a dual imaging modalities studyP572Left ventricular mechanics: novel tools to evaluate left ventricular performance in patients with aortic stenosisP573Comparison of long-term outcome after percutaneous mitral valvuloplasty versus mitral valve replacement in moderate to severe mitral stenosis with left ventricular dysfunctionP574Incidence of de novo left ventricular dysfunction in patient treated with aortic valve replacement for severe aortic regurgitationP575Transforming growth factor-beta dependant progression of the mitral valve prolapseP576Quantification of mitral regurgitation with multiple jets: in vitro validation of three-dimensional PISA techniqueP577Impaired pre-systolic contraction and saddle-shape deepening of mitral annulus contributes to atrial functional regurgitation: a three-dimensional echocardiographic studyP578Incidence and determinants of left ventricular (lv) reverse remodeling after MitraClip implantation in patients with moderate-to severe or severe mitral regurgitation and reduced lv ejection fractionP579Severe functional tricuspid regurgitation in rheumatic heart valve disease. New insights from 3D transthoracic echocardiographyP58015 years of evolution of the etiologic profile for prosthetic heart valve replacement through an echocardiography laboratoryP581The role of echocardiography in the differential diagnosis of prolonged fever of unknown originP582Predictive value for paravalvular regurgitation of 3-dimensional anatomic aortic annulus shape assessed by multidetector computed tomography post-transcatheter aortic valve replacementP583The significance and advantages of echo and CT imaging & measurement at transcatherter aortic valve implantation through the left common carotid accessP584Comparison of the self-expandable Medtronic CoreValve versus the balloon-expandable Edwards SAPIEN bioprostheses in high-risk patients undergoing transfemoral aortic valve implantationP585The impact of transcatheter aortic valve implantation on mitral regurgitation severityP586Echocardiographic follow up of children with valvular lesions secondary to rheumatic heart disease: Data from a prospective registryP587Valvular heart disease and different circadian blood pressure profilesCardiomyopathiesP588Comparison of transthoracic echocardiography versus cardiac magnetic for implantable cardioverter defibrillator therapy in primary prevention strategy dilated cardiomyopathy patientsP589Incidence and prognostic significance of left ventricle reverse remodeling in a cohort of patients with idiopathic dilated cardiomyopathyP590Early evaluation of diastolic function in fabry diseaseP591Echocardiographic predictors of atrial fibrillation development in hypertrophic cardiomyopathyP592Altered Torsion mechanics in patients with hypertrophic cardiomyopathy: LVOT-obstruction is the topdog?P593Prevention of sudden cardiac death in hypertrophic cardiomyopathy: what has changed in the guidelines?P594Coronary microcirculatory function as determinator of longitudinal systolic left ventricular function in hypertrophic cardiomyopathyP595Detection of subclinical myocardial dysfunction by tissue Doppler ehocardiography in patients with muscular dystrophiesP596Speckle tracking myocardial deformation analysis and three dimensional echocardiography for early detection of chemotherapy induced cardiac dysfunction in bone marrow transplantation patientsP597Left ventricular non compaction or hypertrabeculation: distinguishing between physiology and pathology in top-level athletesP598Role of multi modality imaging in familiar screening of Danon diseaseP599Early impairment of global longitudinal left ventricular systolic function independently predicts incident atrial fibrillation in type 2 diabetes mellitusP600Fetal cardiovascular programming in maternal diabetes mellitus and obesity: insights from deformation imagingP601Longitudinal strain stress echo evaluation of aged marginal donor hearts: feasibility in the Adonhers project.P602Echocardiographic evaluation of left ventricular size and function following heart transplantation - Gender mattersSystemic diseases and other conditionsP603The impact of septal kinetics on adverse ventricular-ventricular interactions in pulmonary stenosis and pulmonary arterial hypertensionP604Improvement in right ventricular mechanics after inhalation of iloprost in pulmonary hypertensionP605Does the treatment of patients with metabolic syndrome correct the right ventricular diastolic dysfunction?P606Predictors of altered cardiac function in breast cancer survivors who were treated with anthracycline-based therapyP607Prevalence and factors related to left ventricular systolic dysfunction in asymptomatic patients with rheumatoid arthritis: a prospective tissue-doppler echocardiography studyP608Diastolic and systolic left ventricle dysfunction presenting different prognostic implications in cardiac amyloidosisP609Diagnostic accuracy of Bedside Lung Ultrasonography in Emergency (BLUE) protocol for the diagnosis of pulmonary embolismP610Right ventricular systolic dysfunction and its incidence in breast cancer patients submitted to anthracycline therapyP611Right ventricular dysfunction is an independent predictor of survival among cirrhotic patients undergoing liver transplantCongenital heart diseaseP612Hypoplasia or absence of posterior leaflet: a rare congenital anomaly of the mitral valveP613ECHO screening for Barlow disease in proband's relativesDiseases of the aortaP614Aortic size distribution and prognosis in an unselected population of patients referred for standard transthoracic echocardiographyP615Abdominal aorta aneurysm ultrasonographic screening in a large cohort of asympromatic volounteers in an Italian urban settingP616Thoracic aortic aneurysm and left ventricular systolic functionStress echocardiographyP617Wall motion score index, systolic mitral annulus velocity and left ventricular mass predicted global longitudinal systolic strain in 238 patients examined by stress echocardiographyP618Prognostic parameters of exercise-induced severe mitral valve regurgitation and exercise-induced systolic pulmonary hypertensionP619Risk stratification after myocardial infarction: prognostic value of dobutamine stress echocardiographyP620relationship between LV and RV myocardial contractile reserve and metabolic parameters during incremental exercise and recovery in healthy children using 2-D strain analysisP621Increased peripheral extraction as a mechanism compensatory to reduced cardiac output in high risk heart failure patients with group 2 pulmonary hypertension and exercise oscillatory ventilationP622Can exercise induced changes in cardiac synchrony predict response to CRT?Transesophageal echocardiographyP623Fully-automated software for mitral valve assessment in chronic mitral regurgitation by three-dimensional transesophageal echocardiographyP624Real-time 3D transesophageal echocardiography provides more accurate orifice measurement in percutaneous transcatheter left atrial appendage closureP625Percutaneous closure of left atrial appendage: experience of 36 casesReal-time three-dimensional TEEP626Real-time three-dimensional transesophageal echocardiography during pulmonary vein cryoballoon ablation for atrial fibrilationP627Three dimensional ultrasound anatomy of intact mitral valve and in the case of type 2 disfunctionTissue Doppler and speckle trackingP629Left ventricle wall motion tracking from echocardiographic images by a non-rigid image registrationP630The first experience with the new prototype of a robotic system for remote echocardiographyP631Non-invasive PCWP influence on a loop diuretics regimen monitoring model in ADHF patients.P632Normal range of left ventricular strain, dimensions and ejection fraction using three-dimensional speckle-tracking echocardiography in neonatesP633Circumferential ascending aortic strain: new parameter in the assessment of arterial stiffness in systemic hypertensionP634Aortic vascular properties in pediatric osteogenesis imperfecta: a two-dimensional echocardiography derived aortic strain studyP635Assessment of cardiac functions in children with sickle cell anemia: doppler tissue imaging studyP636Assessment of left ventricular function in type 1 diabetes mellitus patients by two-dimensional speckle tracking echocardiography: relation to duration and control of diabetesP637A study of left ventricular torsion in l-loop ventricles using speckle-tracking echocardiographyP638Despite No-Reflow, global and regional longitudinal strains assessed by two-dimensional speckle tracking echocardiography are predictive indexes of left ventricular remodeling in patients with STEMIP639The function of reservoir of the left atrium in patients with medicaly treated arterial hypertensionP640The usefulness of speckle tracking analysis for predicting the recovery of regional systolic function after myocardial infarctionP641Two dimensional speckle tracking echocardiography in assessment of left ventricular systolic function in patients with rheumatic severe mitral regurgitation and normal ejection fractionP642The prediction of left-main and tripple vessel coronary artery disease by tissue doppler based longitudinal strain and strain rate imagingP643Role of speckle tracking in predicting arrhythmic risk and occurrence of appropriate implantable defibrillator Intervention in patients with ischemic and non-ischemic cardiomyopathyComputed Tomography & Nuclear CardiologyP644Cardiac adrenergic activity in patients with nonischemic dilated cardiomyopathy. Correlation with echocardiographyP645Different vascular territories and myocardial ischemia, there is a gradient of association?

Author

Martins Fernandes, S, primary, Badano, L, primary, Garcia Campos, A, primary, Erdei, T, primary, Mehdipoor, G, primary, Hanboly, N, primary, Michalski, BW, primary, Vriz, O, primary, Mo, VY, primary, Le, T T, primary, Ribeiro, JM, primary, Ternacle, J, primary, Yurdakul, SELEN, primary, Shetye, A, primary, Stoebe, S, primary, Lisowska, A, primary, Chinali, M, primary, Orabona, M, primary, Contaldi, C, primary, De La Chica, JA, primary, Codolosa, JN, primary, Trzcinski, P, primary, Prado Diaz, S, primary, Morales Portano, J D, primary, Ha, SJ, primary, Valente, F, primary, Joseph, G, primary, Scali, MC, primary, Cordeiro, F, primary, Duchateau, N, primary, Fabris, E, primary, Costantino, MF, primary, Cho, I J, primary, Goublaire, C, primary, Lam, W, primary, Galli, E, primary, Kim, KH, primary, Mariani, M, primary, Malev, E, primary, Zuercher, F, primary, Tang, Z, primary, Cimino, S, primary, Mahia, P, primary, Petrovic, J, primary, Ciobotaru, V, primary, Remsey- Semmelweiss, E, primary, Kogoj, P, primary, Guerreiro, S, primary, Saxena, A, primary, Mozenska, O, primary, Pontone, G, primary, Macaya Ten, F, primary, Caballero, L, primary, Avegliano, G, primary, Halmai, L, primary, Reis, L, primary, Trifunovic, D, primary, Gospodinova, M, primary, Makavos, G, primary, D'ascenzi, F, primary, Dantas Tavares De Melo, M, primary, Bonapace, S, primary, Kulkarni, A, primary, Cameli, M, primary, Ingvarsson, A, primary, Driessen, MMP, primary, Tufekcioglu, O, primary, Radulescu, D, primary, Barac, A, primary, Cioffi, G, primary, Almeida Morais, L, primary, Ledakowicz-Polak, A, primary, Portugal, G, primary, Naksuk, N, primary, Parato, V M, primary, Kovalova, S, primary, Cherubini, A, primary, Corrado, G, primary, Wierzbowska-Drabik, K, primary, Lesevic, H, primary, Laredj, N, primary, Pieles, G E, primary, Generati, G, primary, Van Zalen, JJ, primary, Aquila, I, primary, Cheng, H-L, primary, Lanzoni, L, primary, Asmarats Serra, L, primary, Kadrabulatova, S, primary, Ranjbar, S, primary, Szczesniak-Stanczyk, D, primary, Sharka, I, primary, Di Salvo, G, primary, Ben Kahla, S, primary, Li, L, primary, Hadeed, HA, primary, Habeeb, H A, primary, Toscano, A, primary, Granata, F, primary, Djikic, D, primary, Wdowiak-Okrojek, K, primary, Girgis, H Y A, primary, Sharma, A, primary, Soro, C, primary, Gallego Page, J C, primary, Corneli, M, primary, Teixeira, R, additional, Roussin, I, additional, Lynch, M, additional, Muraru, D, additional, Romeo, G, additional, Ermacora, D, additional, Marotta, C, additional, Aruta, P, additional, Cucchini, U, additional, Iliceto, S, additional, Martin-Fernandez, M, additional, De La Hera Galarza, JM, additional, Corros-Vicente, C, additional, Colunga Blanco, S, additional, Velasco-Alonso, E, additional, Leon-Aguero, V, additional, Rodriguez-Suarez, ML, additional, Moris De La Tassa, C, additional, Edwards, J, additional, Braim, D, additional, Price, C, additional, Fraser, AG, additional, Salmani, F, additional, Arjmand Shabestari, A, additional, Szymczyk, E, additional, Kupczynska, K, additional, Peczek, L, additional, Nawrot, B, additional, Lipiec, P, additional, Kasprzak, JD, additional, Driussi, C, additional, Ferrara, F, additional, Brosolo, G, additional, Antonini-Canterin, F, additional, Magne, J, additional, Aboyans, V, additional, Bossone, E, additional, Bellucci, BM, additional, Fisher, JM, additional, Balekian, AA, additional, Idapalapati, S, additional, Huang, F, additional, Wong, JI, additional, Tan, RS, additional, Madeira, M, additional, Almeida, I, additional, Reis, L, additional, Siserman, A, additional, Dinis, P, additional, Dias, L, additional, Ramos, AP, additional, Goncalves, L, additional, Wan, FW, additional, Sawaki, DS, additional, Dubois-Rande, JLDR, additional, Adnot, SA, additional, Czibik, GC, additional, Derumeaux, GD, additional, Ercan, G, additional, Tekkesin, ILKER, additional, Sahin, ST, additional, Cengiz, B, additional, Celik, G, additional, Demircan, S, additional, Aytekin, SAIDE, additional, Razvi, NA, additional, Nazir, SA, additional, Price, N, additional, Khan, JN, additional, Kanagala, P, additional, Singh, A, additional, Squire, I, additional, Mccann, GP, additional, Langel, M, additional, Pfeiffer, D, additional, Hagendorff, A, additional, Ptaszynska-Kopczynska, K, additional, Marcinkiewicz-Siemion, M, additional, Knapp, M, additional, Witkowski, M, additional, Musial, WJ, additional, Kaminski, K, additional, Natali, B, additional, D' Anna, C, additional, Leonardi, B, additional, Secinaro, A, additional, Pongiglione, G, additional, Rinelli, G, additional, Renard, S, additional, Michel, N, additional, Mancini, J, additional, Haentjens, J, additional, Sitbon, O, additional, Habib, G, additional, Imbriaco, M, additional, Alcidi, G, additional, Santoro, C, additional, Buonauro, A, additional, Lo Iudice, F, additional, Lembo, M, additional, Cuocolo, A, additional, Trimarco, B, additional, Galderisi, M, additional, Mora Robles, J, additional, Roldan Jimenez, MA, additional, Mancisidor, MA, additional, De Mora, MA, additional, Alnabelsi, T, additional, Goykhman, I, additional, Koshkelashvili, N, additional, Romero-Corral, A, additional, Pressman, GS, additional, Michalski, BW, additional, Miskowiec, D, additional, Montoro Lopez, N, additional, Refoyo Salicio, E, additional, Valbuena Lopez, SC, additional, Gonzalez, O, additional, Alvarez, C, additional, Moreno Yanguela, M, additional, Bartha Rasero, JL, additional, De La Calle, M, additional, Guzman Martinez, G, additional, Suarez-Cuenca, JA, additional, Merino, JA, additional, Gomez Alvarez, E B, additional, Delgado, LG, additional, Woo, YM, additional, Bang, WD, additional, Sohn, GH, additional, Cheong, SS, additional, Yoo, SY, additional, Rodriguez Palomares, JF, additional, Gutierrez, L, additional, Maldonado, G, additional, Pineda, V, additional, Galian, L, additional, Teixido, G, additional, Gonzalez Allujas, MT, additional, Evangelista, A, additional, Garcia Dorado, D, additional, Zaremba, T, additional, Ekeloef, S, additional, Heiberg, E, additional, Engblom, H, additional, Jensen, SE, additional, Sogaard, P, additional, Garcia, G, additional, Dini, FL, additional, Galli, F, additional, Lattanzi, F, additional, Picano, E, additional, Marzilli, M, additional, Leao, S, additional, Moz, M, additional, Magalhaes, P, additional, Trigo, J, additional, Mateus, PS, additional, Ferreira, A, additional, Moreira, JI, additional, De Craene, M, additional, Legallois, D, additional, Labombarda, F, additional, Pellissier, A, additional, Sermesant, M, additional, Saloux, E, additional, Merlo, M, additional, Moretti, M, additional, Barbati, G, additional, Stolfo, D, additional, Gigli, M, additional, Pinamonti, B, additional, Sinagra, G, additional, Dores, E, additional, Matera, A, additional, Innelli, P, additional, Lopizzo, A, additional, Violini, R, additional, Fiorilli, R, additional, Cappabianca, G, additional, Tarsia, G, additional, Seo, J, additional, Chang, HJ, additional, Heo, R, additional, Kim, IC, additional, Shim, CY, additional, Hong, GR, additional, Chung, N, additional, Melissopoulou, MM, additional, Nguyen, V, additional, Brochet, E, additional, Cimadevilla, C, additional, Codogno, I, additional, Vahanian, A, additional, Messika-Zeitoun, D, additional, Pontana, F, additional, Vassiliou, V, additional, Prasad, S, additional, Leclercq, C, additional, Samset, E, additional, Donal, E, additional, Lim, DS, additional, Bianchi, G, additional, Rossi, F, additional, Gianetti, J, additional, Marchi, F, additional, Cerone, E, additional, Nardelli, A, additional, Terrazzi, M, additional, Solinas, M, additional, Maffei, S, additional, Pshepiy, A, additional, Vasina, L, additional, Timofeev, E, additional, Reeva, S, additional, Zemtsovsky, E, additional, Brugger, N, additional, Jahren, S, additional, De Marchi, SF, additional, Seiler, C, additional, Jin, CN, additional, Tang, H, additional, Fan, K, additional, Kam, K, additional, Yan, BP, additional, Yu, CM, additional, Lee, PW, additional, Reali, M, additional, Silvetti, E, additional, Salatino, T, additional, Mancone, M, additional, Pennacchi, M, additional, Giordano, A, additional, Sardella, G, additional, Agati, L, additional, Tirado, G, additional, Nogales-Romo, MT, additional, Marcos-Alberca, P, additional, De Agustin, A, additional, Almeria, C, additional, Rodrigo, JL, additional, Garcia Fernandez, MA, additional, Macaya, C, additional, Perez De Isla, L, additional, Mancisidor, M, additional, Lara Garcia, C, additional, Vivancos, R, additional, De Mora, M, additional, Petrovic, M, additional, Vujisic-Tesic, B, additional, Trifunovic, D, additional, Boricic-Kostic, M, additional, Petrovic, I, additional, Draganic, G, additional, Petrovic, O, additional, Tomic-Dragovic, M, additional, Furlan, T, additional, Ambrozic, J, additional, Mohorko Pleskovic, PN, additional, Bunc, M, additional, Ribeiras, R, additional, Abecasis, J, additional, Andrade, MJ, additional, Mendes, M, additional, Ramakrishnan, S, additional, Gupta, SK, additional, Juneja, R, additional, Kothari, SS, additional, Zaleska, M, additional, Segiet, A, additional, Chwesiuk, S, additional, Kroc, A, additional, Kosior, DA, additional, Andreini, D, additional, Solbiati, A, additional, Guglielmo, M, additional, Mushtaq, S, additional, Baggiano, A, additional, Beltrama, V, additional, Rota, C, additional, Guaricci, AI, additional, Pepi, M, additional, Pons Llinares, J, additional, Asmarats Serra, L, additional, Pericas Ramis, P, additional, Caldes Llull, O, additional, Grau Sepulveda, A, additional, Frontera, G, additional, Vaquer Segui, A, additional, Noris, M, additional, Bethencourt Gonzalez, A, additional, Climent Paya, V, additional, Martinez Moreno, M, additional, Saura, D, additional, Oliva, MJ, additional, Sanchez Quinones, J, additional, Garcia Honrubia, A, additional, Valdes, M, additional, De La Morena, G, additional, Terricabras, M, additional, Costabel, JP, additional, Ronderos, R, additional, Venturini, C, additional, Galve, E, additional, Nemes, A, additional, Neubauer, S, additional, Rahman Haley, S, additional, Banner, N, additional, Caetano, F, additional, Botelho, A, additional, Silva, J, additional, Nascimento, J, additional, Tesic, M, additional, Jovanovic, I, additional, Dragovic, M, additional, Stepanovic, J, additional, Banovic, M, additional, Guergelcheva, V, additional, Chamova, T, additional, Sarafov, S, additional, Tournev, I, additional, Denchev, S, additional, Ikonomidis, I, additional, Psarogiannakopoulos, P, additional, Tsirigotis, P, additional, Paraskevaidis, I, additional, Lekakis, J, additional, Pelliccia, A, additional, Natali, BM, additional, Cameli, M, additional, Focardi, M, additional, Bonifazi, M, additional, Mondillo, S, additional, Lima, C, additional, Assed, L, additional, Kalil Filho, R, additional, Mady, C, additional, Bochi, E A, additional, Salemi, V M C, additional, Targher, G, additional, Valbusa, F, additional, Rossi, A, additional, Lanzoni, L, additional, Lipari, P, additional, Zenari, L, additional, Molon, G, additional, Canali, G, additional, Barbieri, E, additional, Li, L, additional, Craft, M, additional, Nanda, M, additional, Lorenzo, JM, additional, Kutty, S, additional, Bombardini, T, additional, Sparla, S, additional, Di Tommaso, C, additional, Losito, M, additional, Incampo, E, additional, Maccherini, M, additional, Werther Evaldsson, A, additional, Radegran, G, additional, Stagmo, M, additional, Waktare, J, additional, Roijer, A, additional, Meurling, CJ, additional, Hui, W, additional, Meijboom, FJ, additional, Bijnens, B, additional, Dragulescu, A, additional, Mertens, L, additional, Friedberg, MK, additional, Sensoy, B, additional, Suleymanoglu, M, additional, Akin, Y, additional, Sahan, E, additional, Sasmaz, H, additional, Pasca, L, additional, Buzdugan, E, additional, Chis, B, additional, Stoicescu, L, additional, Lynce, FC, additional, Smith, KL, additional, Mete, M, additional, Isaacs, C, additional, Viapiana, O, additional, Di Nora, C, additional, Ognibeni, F, additional, Fracassi, E, additional, Giollo, A, additional, Mazzone, C, additional, Faganello, G, additional, Di Lenarda, A, additional, Rossini, M, additional, Galrinho, A, additional, Branco, L, additional, Timoteo, A T, additional, Rodrigues, I, additional, Daniel, P, additional, Rosa, S, additional, Ferreira, L, additional, Ferreira, R, additional, Polak, L, additional, Krauza, G, additional, Stokfisz, K, additional, Zielinska, M, additional, Branco, L M, additional, Mota Carmo, M, additional, Teresa Timoteo, A, additional, Aguiar Rosa, S, additional, Abreu, J, additional, Pinto Teixeira, P, additional, Viveiros Monteiro, A, additional, Cruz Ferreira, R, additional, Peeraphatdit, T, additional, Chaiteerakij, R, additional, Klarich, KW, additional, Masia, S, additional, Necas, J, additional, Nistri, S, additional, Negri, F, additional, Cioffi, G, additional, Russo, G, additional, Pandullo, C, additional, Durante, A, additional, Rovelli, E, additional, Genchi, V, additional, Trabattoni, L, additional, Zerboni, SC, additional, Cattaneo, L, additional, Butti, E, additional, Ferrari, G, additional, Luneva, E, additional, Mitrofanova, L, additional, Uspensky, V, additional, Rosner, S, additional, Karl, M, additional, Ott, I, additional, Sonne, C, additional, Ali Lahmar, HM, additional, Hammou, L, additional, Forsey, J, additional, Gowing, L, additional, Miller, F, additional, Ramanujam, P, additional, Stuart, AG, additional, Williams, CA, additional, Bandera, F, additional, Pellegrino, M, additional, Carbone, F, additional, Labate, V, additional, Alfonzetti, E, additional, Guazzi, M, additional, Patel, NR, additional, Raju, P, additional, Beale, L, additional, Brickley, G, additional, Lloyd, GW, additional, Fernandez-Golfin, C, additional, Gonzalez, A, additional, Rincon, LM, additional, Hinojar, R, additional, Garcia, A, additional, Megias, A, additional, Jimenez-Nacher, JJ, additional, Moya, JL, additional, Zamorano, JL, additional, Bonapace, S, additional, Chiampan, A, additional, Albrigi, L, additional, Noris Mora, M, additional, Rodriguez Fernandez, A, additional, Exposito Pineda, C, additional, Grande, C, additional, Gonzalez Colino, R, additional, Macaya Ten, F, additional, Fernandez Vazquez, X, additional, Fortuny Frau, E, additional, Karvandi, M, additional, Blaszczyk, R, additional, Zarczuk, R, additional, Brzozowski, W, additional, Janowski, M, additional, Wysokinski, A, additional, Stanczyk, B, additional, Myftiu, S, additional, Teferici, D, additional, Quka, A, additional, Dado, E, additional, Djamandi, J, additional, Kresto, L, additional, Duka, A, additional, Kristo, A, additional, Balla, I, additional, Issa, Z, additional, Moiduddin, N, additional, Siblini, G, additional, Bulbul, Z, additional, Abid, L, additional, Abid, D, additional, Kammoun, S, additional, Rush, E, additional, Goodwin, J, additional, Kreikemeier, R, additional, Cantinotti, M, additional, Zolaly, M A, additional, Khoshhal, SQ, additional, El-Harbi, K, additional, Tarawah, A, additional, Al-Hawsawi, Z, additional, Al-Mozainy, I, additional, Bakhoum, S W G, additional, Nabil, M N, additional, Elebrashy, I N, additional, Chinali, M, additional, Albanese, S, additional, Carotti, A, additional, Iacobelli, R, additional, Esposito, C, additional, Moscogiuri, G, additional, Pasquini, L, additional, Malvezzi Caracciolo, M, additional, Bianchi, RM, additional, Caso, P, additional, Arenga, F, additional, Riegler, L, additional, Scarafile, R, additional, D'andrea, A, additional, Russo, MG, additional, Calabro', P, additional, Simic, DS, additional, Peric, VP, additional, Mujovic, NM, additional, Marinkovic, MM, additional, Jankovic, NJ, additional, Shim, A, additional, Wejner-Mik, P, additional, Jain, N, additional, Kharwar, R, additional, Saran, RK, additional, Narain, VS, additional, Dwivedi, SK, additional, Sethi, R, additional, Chandra, S, additional, Pradhan, A, additional, Safal, S, additional, Marchetti, MF, additional, Cacace, C, additional, Congia, M, additional, Nissardi, V, additional, Ruscazio, M, additional, Meloni, L, additional, Montisci, R, additional, Gallego Sanchez, G, additional, Calero, S, additional, Portero, JJ, additional, Tercero, A, additional, Garcia, JC, additional, Barambio, M, additional, Martinez Lazaro, R, additional, Meretta, AH, additional, Perea, GO, additional, Belcastro, F, additional, Aguirre, E, additional, De Luca, I, additional, Henquin, R, additional, and Masoli, O, additional

Published
2015
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39. Poster session 5The imaging examinationP1097Correlation between visual and quantitative assessment of left ventricle: intra- and inter-observer agreementP1099Incremental prognostic value of late gadolinium-enhanced by cardiac magnetic resonance in patients with heart failureAnatomy and physiology of the heart and great vesselsP1100Left ventricular geometry and diastolic performance in erectile dysfunction patients; a topic of differential arterial stiffness influenceAssessment of diameters, volumes and massP1101Impact of the percutaneous closure of atrial septal defect on the right heart "remodeling"P1102Left Ventricular Mass Indexation in Infants, Children and Adolescents: a Simplified Approach for the Identification of Left Ventricular Hypertrophy in Clinical PracticeP1103Impact of trabecules while quantifying cardiac magnetic resonance exams in patients with systemic right ventricleP1104Detection of subclinical atherosclerosis by carotid intima-media thickness: correlation with leukocytes telomere shorteningAssessments of haemodynamicsP1105Flow redirection towards the left ventricular outflow tract: vortex formation is not affected by variations in atrio-ventricular delayAssessment of systolic functionP1106Reproducibility and feasibility of cardiac MRI feature tracking in Fabry diseaseP1107Normal left ventricular strain values by two-dimensional strain echocardiography; result of normal (normal echocardiographic dimensions and functions in korean people) studyP1108Test-retest repeatability of global strain following st-elevation myocardial infarction - a comparison of tagging and feature trackingP1109Cardiotoxicity induced by tyrosine kinase inhibitors in patients with gastrointestinal stromal tumors (GIST)P1110Finite strain ellipses for the analysis of left ventricular principal strain directions using 3d speckle tracking echocardiographyP1111Antihypertensive therapy reduces time to peak longitudinal strainP1112Right ventricular systolic function as a marker of prognosis after inferior myocardial infarction - 5-year follow-upP1113Is artery pulmonary dilatation related with right but also early left ventricle dysfunction in pulmonary artery hypertension?P1114Right ventricular mechanics changes according to pressure overload increasing, a 2D-speckle tracking echocardiographic evaluationAssessment of diastolic functionP1115Paired comparison of left atrial strain from P-wave to P-wave and R-wave to R-waveP1116Diagnostic role of Tissue Doppler Imaging echocardiographic criteria in obese heart failure with preserved ejection fraction patientsP1117Evaluation of diastolic function of right ventricle in idiopathic pulmonary arterial hypertensionP1118Severity and predictors of diastolic dysfunction in a non-hypertensive non-ischemic cohort of Egyptian patients with documented systemic autoimmune disease; pilot reportP1119correlation between ST segment shift and cardiac diastolic function in patients with acute myocardial infarctionIschemic heart diseaseP1120Computed tomography coronary angiography verSus sTRess cArdiac magneTic rEsonance for the manaGement of sYmptomatic revascularized patients: a cost effectiveness study (STRATEGY study)P1121Utility of transmural myocardial mechanic for early infarct size prediction after primary percutaneous coronary intervention in STEMI patientsP1122Progressive Improvements of the echocardiographic deformation parameters in ST Elevation Myocardial Infarction after five years follow-upP1123Long-term prognostic value of left ventricular dyssynchrony as assessed by cardiac magnetic resonance feature-tracking imaging after a first st-segment elevation myocardial infarctionP1124Differences in mitral annulus remodeling in acute anterior ST elevation and acute inferior ST elevation myocardial infarctionP1125Reduction of microvascular injury using a novel theragnostic ultrasound strategy: a first in men feasibility and safety studyP1126Impact of focused echocardiography in clinical decision of patient presented with st elevation myocardial infarction underwent primary angioplastyHeart valve DiseasesP1127Aortic valve area calculation in aortic stenosis: a comparison among conventional and 3D-transesophageal echocardiography and computed tomographyP1128Myocardial fibrosis and microRNA-21 expression in patients with severe aortic valve stenosis and preserved ejection fraction: a 2D speckle tracking echocardiography, tissutal and plasmatic studyP1129Quantification of calcium amount in a new experimental model: a comparison between calibrated integrated backscatter of ultrasound and computed tomographyP1130Altered diffusion capacity in aortic stenosis: role of the right heartP1131Osteoprotegerin predicts all-cause mortality in calcific aortic stenosis patients with preserved left ventricle ejection fraction in long term observationP1132Mitral regurgitation as a risk factor for pulmonary hypertension in patients with aortic stenosisP1133The relationship between the level of plasma B-type natriuretic peptide and mitral stenosisP1134Aortic regurgitation, left ventricle mechanics and vascular load: a single centre 2d derived-speckle tracking studyP1135Feasibility and reproducibility issues limit the usefulness of quantitative colour Doppler parameters in the assessment of chronic aortic and mitral regurgitation severityP1136Predictors of postoperative outcome in degenerative mitral regurgitationP1137Left ventricular mechanical dyssynchrony in patients with severe mitral regurgitation of rheumatic etiology; three dimensional echocardiography studyP1138Functional mitral regurgitation and left atrial dysfunction concur in determining pulmonary hypertension and functional status in subjects with left ventricular systolic dysfunctionP11393D echocardiography allows more effective quantitative assessment of the severity of functional tricuspid regurgitation than conventional 2D/Doppler echocardiographyP1140Prosthetic valve thrombosis: still a severe disease? 10-years experience in a university hospitalP1141Validity of echocardiography in the hospital course of patients with feverP1142Do baseline 3DTEE characteristics of mitral valve apparatus predict long term result in patients undergoing percutaneous valve repair for degenerative regurgitation?P1143Influence of baseline aortic regurgitation on mitral regurgitation change after transcatheter aortic valve replacement for aortic stenosisP1144Prevalence of echocardiography detected significant valvular regurge in subclinical rheumatic carditis in assiut childrenCardiomyopathiesP1145Can we early detect left ventricular systolic dysfunction in patients with Duchenne muscular dystrophy using global longitudinal strain assessment?P1146Prevalence of isolated papillary muscle hypertrophy in young competitive athletesP1147Troponin release after exercise in patients with hypertrophic cardiomyopathy: associations with clinical and mr imaging characteristicsP1148Atrial fibrillation in hypertrophic cardiomyopathy: can we score the risk?P1149Impact of hypertrophy on multiple layer longitudinal deformation in hypertrophy cardiomyopathy and cardiac amyloidosis compared to controlsP1150Functional evaluation in hypertrophic cardiomyopathy combining cardiopulmonary exercise testing combined with exercise-echocardiographyP1151Refinement of the old diagnostic criteria of left ventricular noncompaction cardiomyopathy (LVNC) based on cardiac magnetic resonance (CMR)P1152Differences of clinical characteristics and outcomes between acute myocarditis with preserved and reduced left ventricular systolic functionP1153Value of longitudinal strain for distinguishing left ventricular non-compaction from idiopathic dilated cardiomyopathyP1154Speed of recovery of left ventricular function is not related to the prognosis of Takotsubo cardiomyopathy. A Portuguese multicentre studyP1155Predictors of in-hospital left ventricular systolic function recovery after admission with takotsubo cardiomyopathy. Portuguese multicentre studyP1156Mid-ventricular takotsubo detected by initial echocardiogram associates with recurrence of takotsubo cardiomyopathy - a portuguese multicentre studySystemic diseases and other conditionsP1157Relations between left ventricle remodelling and expression of angiotensin 2 AT2R1 geneP1158Impact of renal denervation on long-term blood pressure variability and surrogate markers of target organ damage in individuals with drug-resistant arterial hypertensionP1159Greater improvement of coronary artery function, left ventricular deformation and twisting by IL12/23 compared to TNF-a inhibition in psoriasisP1160Advanced glycation end products play a role in adverse LV remodeling following MIP1161Incidence of subclinical myocardial dysfunction in patients with systemic sclerosis and normal left ventricular systolic and diastolic functionP1162Left atrial remodeling and dysfunction occur early in patients with systemic sclerosis and normal left ventricular functionP1163Intrinsic vortex formation : a unique performance indicatorP1164P-wave morphology is unaffected by training-induced biatrial dilatation: a prospective, longitudinal study in healthy athletesP1165Usefulness of transthoracic echocardiography in diagnosis of young patients with ischemic strokeP1166Primary cardiac lymphoma: role of echocardiography in the clinical managementP1167Abnormal echocardiographic findings in cancer patients before chemotherapyMasses, tumors and sources of embolismP1168Three-dimensional transesophageal echocardiography of the left atrial appendage reduces rate of postpone electrical cardioversionP1169Detection of ventricular thrombus by cmr after reperfused st-segment elevation myocardial infarction correlated with echocardiographyP1170Clinical and transthoracic echocardiographic predictors of left atrial appendage thrombus in patients with atrial fibrillationStress echocardiographyP1171Pharmacological stress echocardiography complications: a 4-year single center experienceP1172Myocardial functional and perfusion reserve in type I diabetesP1173Feasibility of incorporating 3D Dobutamine stress echocardiography into routine clinical practiceP1174Right ventricular isovolumic acceleration at rest and during exercise in children after heart transplantP1175Right ventricular systolic and diastolic response to exercise in children after heart transplant -a bicycle exercise studyP1176Determinants of functional capacity in heart failure patients with reduced ejection fractionP1177Handgrip stress echocardiography with emotional component compared to conventional isometric exercise in coronary artery disease diagnosisP1178The relationship between resting transthoracic echocardiography and exercise capacity in patients with paroxysmal atrial fibrillationP1179Correlation between NT-proBNP and selected echocardiography parameters at rest and after exercise in patients with functional ischemic mitral regurgitation qualified for cardiosurgical treatmentReal-time three-dimensional TEEP1180Vena contracta area for severity grading in functional and degenerative mitral regurgitation: A study based on transesophageal 3D colour Doppler in 419 patientsP1181Proximal flow convergence by 3D echocardiography in the evaluation of mitral valve area in rheumatic mitral stenosisP1182Quantification of valve dimensions by transesophageal 3D echocardiography in patients with functional and degenerative mitral regurgitationTissue Doppler and speckle trackingP1183Automatic calculation of left ventricular volume changes over a cardiac cycle from echocardiography images by nonlinear dimensionality reductionP1184Effect of the mitral valve repairs on the left ventricular blood flow formationP1185Quantification of left atrial strain using cardiovascular magnetic resonance. a comparison between hypertrophic cardiomyopathy and healthy controlsP1186The role of early systolic lengthening in patients with non-ST elevation acute coronary syndrome and its relation to syntax scoreP1187Different standard two dimensional strain methods to quantity left ventricular mechanicsP1188Atrial function and electrocardiography caracteristics in sportsmen with or without paroxysmal atrial fibrillationP1189Right ventricular outflow premature contractions induce regional left ventricular dysfunctionP1190Ultrasound guided venous access for pacemaker and defibrillators. Randomized TrialP1191Atrial function analysis correlates with symptoms and quality of life of heart failure patientsP1192The use of tissue doppler echocardiography in myocardial iron overload in patients with thalassaemia majorP1193Independent association between pulse pressure and left ventricular global longitudinal strainP1194Global and regional longitudinal strain identifies the presence of coronary artery disease in patients with suspected reduction of coronary flow reserve and absence of wall motion abnormalitiesP1195Prognostic value of invasive and noninvasive parameters of right ventricular function in patients with pulmonary arterial hypertension receiving specific vasodilator therapyP1196Myocardial deformation analysis to improve arrhythmic risk stratificationP1197Quantitative assessment of regional systolic and diastolic function parameters for detecting prior transient ischemia in normokinetic segmentsP1198Left atrial function in patients with corrected tetralogy of Fallot - a three-dimensional speckle-tracking echocardiographic studyP1199Left atrial ejection force correlates with left atrial strain and volume-based functional properties as assessed by three-dimensional speckle tracking echocardiographyP1200Acute angulation of the aortic arch late after the arterial switch operation for transposition of the great arteries: impact on cardiac mechanicsP1201Circumferential deformation of the ascending thoracic aorta in hypertensive patients by three-dimensional speckle tracking echocardiographyCardiac Magnetic ResonanceP1202The incremental value of cardiac magnetic resonance on diagnosis myocardial infarction and non-obstructed coronary arteriesP1204Reference ranges of global and regional myocardial T1 values derived from MOLLI and shMOLLI at 3TComputed Tomography & Nuclear CardiologyP1205Deformation of the left atrial appendage after percutaneous closure with the Amplatzer cardiac plugP1206Prognostic impact of non-obstructive coronary artery disease on coronary computed tomographic angiography: A single-center study

Author

Colunga Blanco, S, primary, Gonzalez Matos, C, primary, Angelis, A, primary, Dinis, P G, primary, Chinali, M, primary, Toth, A, primary, Andreassi, M G, primary, Rodriguez Munoz, D, primary, Reid, A B, primary, Park, JH, primary, Shetye, A, primary, Novo, G, primary, De Marchi, S F, primary, Cikes, M, primary, Smarz, K, primary, Illatopa, V, primary, Peluso, D, primary, Wellnhofer, E, primary, De La Rosa Riestra, A, primary, Sattarzadeh Badkoubeh, R, primary, Mandour Ali, M, primary, Azoz, A, primary, Pontone, G, primary, Krljanac, G, primary, Acar, R, primary, Nucifora, G, primary, Sirtautas, A, primary, Roos, S T, primary, Qasem, M S, primary, Marini, C, primary, Fabiani, I, primary, Gillis, K, primary, Bandera, F, primary, Borowiec, A, primary, Lim, YJ, primary, Chalbia, T E, primary, Santos, M, primary, Gao, S A, primary, Zilberszac, R, primary, Farrag, AAM, primary, Palmiero, G, primary, Aruta, P, primary, De Diego Soler, O, primary, Fasano, D, primary, Tamborini, G, primary, Ancona, F, primary, Raafat, D M, primary, Marchel, M, primary, De Gregorio, C, primary, Gommans, D H F, primary, Godinho, A R, primary, Mielczarek, M, primary, Kubik, M, primary, Cho, J Y, primary, Tarando, F, primary, Lourenco Marmelo, B F, primary, Reis, L, primary, Domingues, K, primary, Krestjyaninov, MV, primary, Mesquita, J, primary, Ikonomidis, I, primary, Ferferieva, V, primary, King, GJ, primary, D'ascenzi, F, primary, Ferrera Duran, C, primary, Sormani, P, primary, Gonzalez Fernandez, O, primary, Tereshina, O, primary, Cambronero Cortinas, E, primary, Kupczynska, K, primary, Carvalho, J F, primary, Shivalkar, B, primary, Aghamohammadzadeh, R, primary, Cifra, B, primary, Kuznetsov, VA, primary, Van Zalen, JJ, primary, Kochanowski, J, primary, Goebel, B, primary, Ladeiras-Lopes, R, primary, Karvandi, M, primary, Alonso Salinas, G, primary, Unkun, T, primary, Ranjbar, S, primary, Hubert, A, primary, Enescu, OA, primary, Liccardo, M, primary, Cameli, M, primary, Ako, E, primary, Lembo, M, primary, Goffredo, C, primary, Enache, R, primary, Wdowiak-Okrojek, K, primary, Nemes, A, primary, Di Salvo, G, primary, Capotosto, L, primary, Caravaca, P, primary, Maceira Gonzalez, A M, primary, Iriart, X, primary, Jug, B, primary, Garcia Campos, A, additional, Capin Sampedro, E, additional, Corros Vicente, C, additional, Martin Fernandez, M, additional, Leon Arguero, V, additional, Fidalgo Arguelles, A, additional, Velasco Alonso, E, additional, Lopez Iglesias, F, additional, De La Hera Galarza, JM, additional, Chaparro-Munoz, M, additional, Recio-Mayoral, A, additional, Vlachopoulos, C, additional, Ioakeimidis, N, additional, Felekos, I, additional, Abdelrasoul, M, additional, Aznaouridis, K, additional, Chrysohoou, C, additional, Rousakis, G, additional, Aggeli, K, additional, Tousoulis, D, additional, Faustino, AC, additional, Paiva, L, additional, Fernandes, A, additional, Costa, M, additional, Cachulo, MC, additional, Goncalves, L, additional, Emma, F, additional, Rinelli, G, additional, Esposito, C, additional, Franceschini, A, additional, Doyon, A, additional, Raimondi, F, additional, Schaefer, F, additional, Pongiglione, G, additional, Mateucci, MC, additional, Vago, H, additional, Juhasz, C, additional, Janosa, C, additional, Oprea, V, additional, Balint, OH, additional, Temesvari, A, additional, Simor, T, additional, Kadar, K, additional, Merkely, B, additional, Bruno, R M, additional, Borghini, A, additional, Stea, F, additional, Gargani, L, additional, Mercuri, A, additional, Sicari, R, additional, Picano, E, additional, Lozano Granero, C, additional, Carbonell San Roman, A, additional, Moya Mur, JL, additional, Fernandez-Golfin, C, additional, Moreno Planas, J, additional, Fernandez Santos, S, additional, Casas Rojo, E, additional, Hernandez-Madrid, A, additional, Zamorano Gomez, JL, additional, Pearce, K, additional, Gamlin, W, additional, Miller, C, additional, Schmitt, M, additional, Seong, IW, additional, Kim, KH, additional, Kim, MJ, additional, Jung, HO, additional, Sohn, IS, additional, Park, SM, additional, Cho, GY, additional, Choi, JO, additional, Park, SW, additional, Nazir, SA, additional, Khan, JN, additional, Singh, A, additional, Kanagala, P, additional, Squire, I, additional, Mccann, GP, additional, Di Lisi, D, additional, Meschisi, MC, additional, Brunco, V, additional, Badalamenti, G, additional, Bronte, E, additional, Russo, A, additional, Novo, S, additional, Von Tscharner, M, additional, Urheim, S, additional, Aakhus, S, additional, Seiler, C, additional, Schmalholz, S, additional, Biering-Sorensen, T, additional, Cheng, S, additional, Oparil, S, additional, Izzo, J, additional, Pitt, B, additional, Solomon, SD, additional, Zaborska, B, additional, Jaxa-Chamiec, T, additional, Tysarowski, M, additional, Budaj, A, additional, Cordova, F, additional, Aguirre, O, additional, Sanabria, S, additional, Ortega, J, additional, Romeo, G, additional, Perazzolo Marra, M, additional, Tona, F, additional, Famoso, G, additional, Pigatto, E, additional, Cozzi, F, additional, Iliceto, S, additional, Badano, LP, additional, Kriatselis, C, additional, Gerds-Li, JH, additional, Kropf, M, additional, Pieske, B, additional, Graefe, M, additional, Martinez Santos, P, additional, Batlle Lopez, E, additional, Vilacosta, I, additional, Sanchez Sauce, B, additional, Espana Barrio, E, additional, Jimenez Valtierra, J, additional, Campuzano Ruiz, R, additional, Alonso Bello, J, additional, Martin Rios, MD, additional, Farrashi, M, additional, Abtahi, H, additional, Sadeghi, H, additional, Sadeghipour, P, additional, Tavoosi, A, additional, Abdel Rahman, TA, additional, Mohamed, LA, additional, Maghraby, HM, additional, Kora, IM, additional, Abdel Hameed, FR, additional, Ali, MN, additional, Al Shehri, A, additional, Youssef, A, additional, Gad, A, additional, Alsharqi, M, additional, Alsaikhan, L, additional, Andreini, D, additional, Rota, C, additional, Guglielmo, M, additional, Mushtaq, S, additional, Baggiano, A, additional, Beltrama, V, additional, Solbiati, A, additional, Guaricci, AI, additional, Pepi, M, additional, Trifunovic, D, additional, Sobic Saranovic, D, additional, Savic, L, additional, Grozdic Milojevic, I, additional, Asanin, M, additional, Srdic, M, additional, Petrovic, M, additional, Zlaic, N, additional, Mrdovic, I, additional, Dogan, C, additional, Izci, S, additional, Gecmen, C, additional, Unkun, T, additional, Cap, M, additional, Erdogan, E, additional, Onal, C, additional, Yilmaz, F, additional, Ozdemir, N, additional, Muser, D, additional, Tioni, C, additional, Zanuttini, D, additional, Morocutti, G, additional, Spedicato, L, additional, Bernardi, G, additional, Proclemer, A, additional, Pranevicius, R, additional, Zapustas, N, additional, Briedis, K, additional, Valuckiene, Z, additional, Jurkevicius, R, additional, Juffermans, LJM, additional, Enait, V, additional, Van Royen, N, additional, Van Rossum, AC, additional, Kamp, O, additional, Khalaf, HASSEN, additional, Hitham, SAKER, additional, Osama, AS, additional, Abazid, RAMI, additional, Guall, RAHIM, additional, Durdan, SHAFAT, additional, Mohammed, ZYAD, additional, Stella, S, additional, Rosa, I, additional, Ancona, F, additional, Spartera, M, additional, Italia, L, additional, Latib, A, additional, Colombo, A, additional, Margonato, A, additional, Agricola, E, additional, Scatena, C, additional, Mazzanti, C, additional, Conte, L, additional, Pugliese, N, additional, Barletta, V, additional, Bortolotti, U, additional, Naccarato, AG, additional, Di Bello, V, additional, Bala, G, additional, Roosens, B, additional, Hernot, S, additional, Remory, I, additional, Droogmans, S, additional, Cosyns, B, additional, Generati, G, additional, Labate, V, additional, Donghi, V, additional, Pellegrino, M, additional, Carbone, F, additional, Alfonzetti, E, additional, Guazzi, M, additional, Dabrowski, R, additional, Kowalik, I, additional, Firek, B, additional, Chwyczko, T, additional, Szwed, H, additional, Kawamura, A, additional, Kawano, S, additional, Zaroui, A, additional, Ben Said, R, additional, Ben Halima, M, additional, Kheder, N, additional, Farhati, A, additional, Mourali, S, additional, Mechmech, R, additional, Leite, L, additional, Martins, R, additional, Baptista, R, additional, Barbosa, A, additional, Ribeiro, N, additional, Oliveira, A, additional, Castro, G, additional, Pego, M, additional, Polte, C L, additional, Lagerstrand, K, additional, Johnsson, Å A, additional, Janulewicz, M, additional, Bech-Hanssen, O, additional, Gabriel, H, additional, Wisser, W, additional, Maurer, G, additional, Rosenhek, R, additional, El Aroussy, W, additional, Abdel Ghany, M, additional, Al Adeeb, K, additional, Ascione, L, additional, Carlomagno, G, additional, Sordelli, C, additional, Ferro, A, additional, Ascione, R, additional, Severino, S, additional, Caso, P, additional, Muraru, D, additional, Janei, C, additional, Haertel Miglioranza, M, additional, Cavalli, G, additional, Peluso, D, additional, Cucchini, U, additional, Badano, L, additional, Armario Bel, X, additional, Garcia-Garcia, C, additional, Ferrer Sistach, E, additional, Rueda Sobella, F, additional, Oliveras Vila, T, additional, Labata Salvador, C, additional, Serra Flores, J, additional, Lopez-Ayerbe, J, additional, Bayes-Genis, A, additional, Conte, E, additional, Gonella, A, additional, Morena, L, additional, Civelli, D, additional, Losardo, L, additional, Margaria, F, additional, Riva, L, additional, Tanga, M, additional, Carminati, C, additional, Muratori, M, additional, Gripari, P, additional, Ghulam Ali, S, additional, Fusini, L, additional, Vignati, C, additional, Bartorelli, AL, additional, Alamanni, F, additional, Marini, C, additional, Montorfano, M, additional, Ismaiel, A, additional, Ali, N, additional, Amry, S, additional, Serafin, A, additional, Kochanowski, J, additional, Filipiak, KJ, additional, Opolski, G, additional, Speranza, G, additional, Ando', G, additional, Magaudda, L, additional, Cramer, GE, additional, Bakker, J, additional, Michels, M, additional, Dieker, HJ, additional, Fouraux, MA, additional, Marcelis, CLM, additional, Timmermans, J, additional, Brouwer, MA, additional, Kofflard, MJM, additional, Vasconcelos, M, additional, Araujo, V, additional, Almeida, P, additional, Sousa, C, additional, Macedo, F, additional, Cardoso, JS, additional, Maciel, MJ, additional, Voilliot, D, additional, Huttin, O, additional, Venner, C, additional, Olivier, A, additional, Villemin, T, additional, Deballon, R, additional, Manenti, V, additional, Juilliere, Y, additional, Selton-Suty, C, additional, Dabrowska-Kugacka, A, additional, Dorniak, K, additional, Lewicka, E, additional, Szalewska, D, additional, Kutniewska-Kubik, M, additional, Raczak, G, additional, Kim, K H, additional, Yoon, H J, additional, Park, H J, additional, Ahn, Y, additional, Jeong, M H, additional, Cho, J G, additional, Park, J C, additional, Kim, J H, additional, Galli, E, additional, Habib, G, additional, Schnell, F, additional, Lederlin, M, additional, Daubert, JC, additional, Mabo, P, additional, Donal, E, additional, Faria, R, additional, Magalhaes, P, additional, Marques, N, additional, Domingues, K, additional, Lourenco, C, additional, Almeida, AR, additional, Teles, L, additional, Picarra, B, additional, Azevedo, O, additional, Oliveira, M, additional, Marmelo, B, additional, Almeida, A, additional, Bento, D, additional, Cruz, I, additional, Reis, L, additional, Gimaev, RH, additional, Melnikova, MA, additional, Olezov, NV, additional, Ruzov, VI, additional, Goncalves, P, additional, Almeida, M S, additional, Branco, P, additional, Carvalho, M S, additional, Dores, H, additional, Gaspar, M A, additional, Sousa, H, additional, Andrade, M J, additional, Mendes, M, additional, Makavos, G, additional, Varoudi, M, additional, Papadavid, E, additional, Andreadou, I, additional, Gravanis, K, additional, Liarakos, N, additional, Pavlidis, G, additional, Rigopoulos, D, additional, Lekakis, J, additional, Deluyker, D, additional, Bito, V, additional, Punzi, L, additional, Neilan, T, additional, Coen, K, additional, Gannon, S, additional, Bennet, K, additional, Clarke, JG, additional, Solari, M, additional, Cameli, M, additional, Focardi, M, additional, Corrado, D, additional, Bonifazi, M, additional, Henein, M, additional, Mondillo, S, additional, Gomez-Escalonilla, C, additional, De Agustin, A, additional, Egido, J, additional, Islas, F, additional, Simal, P, additional, Gomez De Diego, JJ, additional, Luaces, M, additional, Macaya, C, additional, Perez De Isla, L, additional, Zancanella, M, additional, Rusconi, C, additional, Musca, F, additional, Santambrogio, G, additional, De Chiara, B, additional, Vallerio, P, additional, Cairoli, R, additional, Giannattasio, G, additional, Moreo, A, additional, Alvarez Ortega, C, additional, Mori Junco, R, additional, Caro Codon, J, additional, Meras Colunga, P, additional, Ponz De Antonio, I, additional, Lopez Fernandez, T, additional, Valbuena Lopez, S, additional, Moreno Yanguela, M, additional, Lopez-Sendon, JL, additional, Surkova, E, additional, Bonanad-Lozano, C, additional, Lopez-Lereu, MP, additional, Monmeneu-Menadas, JV, additional, Gavara, J, additional, De Dios, E, additional, Paya-Chaume, A, additional, Escribano-Alarcon, D, additional, Chorro-Gasco, FJ, additional, Bodi-Peris, V, additional, Michalski, BW, additional, Miskowiec, D, additional, Kasprzak, JD, additional, Lipiec, P, additional, Morgado, G, additional, Caldeira, D, additional, Joao, I, additional, Almeida, A R, additional, Lopes, L, additional, Fazendas, P, additional, Cotrim, C, additional, Pereira, H, additional, De Block, C, additional, Buys, D, additional, Salgado, R, additional, Vrints, C, additional, Van Gaal, L, additional, Mctear, C, additional, Irwin, RB, additional, Dragulescu, A, additional, Friedberg, M, additional, Mertens, L, additional, Krinochkin, DV, additional, Yaroslavskaya, EI, additional, Zaharova, EH, additional, Pushkarev, GS, additional, Sugihara, C, additional, Patel, NR, additional, Sulke, AN, additional, Lloyd, GW, additional, Piatkowski, R, additional, Scislo, P, additional, Grabowski, M, additional, Marchel, M, additional, Roland, H, additional, Hamadanchi, A, additional, Otto, S, additional, Jung, C, additional, Lauten, A, additional, Figulla, HC, additional, Poerner, TC, additional, Sampaio, F, additional, Fonseca, P, additional, Fontes-Carvalho, R, additional, Pinho, M, additional, Campos, AS, additional, Castro, P, additional, Fonseca, C, additional, Ribeiro, J, additional, Gama, V, additional, Heck, R, additional, Hamdanchi, A, additional, Figulla, HR, additional, Ranjbar, S, additional, Ghaffaripour Jahromi, M, additional, Hinojar, R, additional, Fernandez Golfin, C, additional, Esteban, A, additional, Pascual-Izco, M, additional, Garcia-Martin, A, additional, Jimenez-Nacher, JJ, additional, Zamorano, JL, additional, Acar, R, additional, Bakal, RB, additional, Kaymaz, C, additional, Karvandi, M, additional, Galand, V, additional, Matelot, D, additional, Leclercq, C, additional, Carre, F, additional, Suran, BC, additional, Margulescu, AD, additional, Rimbas, RC, additional, Siliste, C, additional, Vinereanu, D, additional, Nocerino, P, additional, Urso, AC, additional, Borrino, A, additional, Carbone, C, additional, Follero, P, additional, Ciardiello, C, additional, Prato, L, additional, Salzano, G, additional, Marino, F, additional, Ruspetti, A, additional, Sparla, S, additional, Di Tommaso, C, additional, Loiacono, F, additional, D'ascenzi, F, additional, Porter, J, additional, Walker, M, additional, Lo Iudice, F, additional, Esposito, R, additional, Santoro, C, additional, Cocozza, S, additional, Izzo, R, additional, De Luca, N, additional, De Simone, G, additional, Trimarco, B, additional, Galderisi, M, additional, Gervasi, F, additional, Patti, G, additional, Mega, S, additional, Bono, M, additional, Di Sciascio, G, additional, Buture, A, additional, Badea, R, additional, Platon, P, additional, Ghiorghiu, I, additional, Jurcut, R, additional, Coman, IM, additional, Popescu, BA, additional, Ginghina, C, additional, Lunetta, M, additional, Spoto, MS, additional, Lo Vi, AM, additional, Pensabene, G, additional, Carita, P, additional, Coppola, G, additional, Assennato, P, additional, Shim, A, additional, Wejner-Mik, P, additional, Havasi, K, additional, Domsik, P, additional, Kalapos, A, additional, Forster, T, additional, Piros, GA, additional, Lengyel, C, additional, Orosz, A, additional, Bulbul, Z, additional, Issa, Z, additional, Al Sehly, A, additional, Pergola, V, additional, Oufi, S, additional, Conde, Y, additional, Cimino, E, additional, Rinaldi, E, additional, Ashurov, R, additional, Ricci, S, additional, Pergolini, M, additional, Vitarelli, A, additional, Lujan Valencia, JE, additional, Chaparro, M, additional, Garcia-Guerrero, A, additional, Cristo Ropero, MJ, additional, Izquierdo Bajo, A, additional, Madrona, L, additional, Monmeneu, JV, additional, Igual, B, additional, Lopez Lereu, P, additional, Garcia, MP, additional, Selmi, W, additional, Jalal, Z, additional, Thambo, JB, additional, Kosuta, D, additional, and Fras, Z, additional

Published
2015
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40. Left and right ventricle assessment with Cardiac CT: validation study vs. Cardiac MR

Author

Maffei, E, Messalli, G, Martini, C, Nieman, Koen, Catalano, O, Rossi, Alexia, Seitun, S, Guaricci, AI, Tedeschi, C, Mollet, Nico, Cademartiri, F., Maffei, E, Messalli, G, Martini, C, Nieman, Koen, Catalano, O, Rossi, Alexia, Seitun, S, Guaricci, AI, Tedeschi, C, Mollet, Nico, and Cademartiri, F.

Abstract

Objectives To compare Magnetic Resonance (MR) and Computed Tomography (CT) for the assessment of left (LV) and right (RV) ventricular functional parameters. Methods Seventy nine patients underwent both Cardiac CT and Cardiac MR. Images were acquired using short axis (SAX) reconstructions for CT and 2D cine b-SSFP (balanced-steady state free precession) SAX sequence for MR, and evaluated using dedicated software. Results CT and MR images showed good agreement: LV EF (Ejection Fraction) (52+/-14% for CT vs. 52+/-14% for MR; r=0.73; p>0.05); RV EF (47+/-12% for CT vs. 47+/-12% for MR; r=0.74; p>0.05); LV EDV (End Diastolic Volume) (74+/-21 ml/m(2) for CT vs. 76+/-25 ml/m(2) for MR; r=0.59; p>0.05); RV EDV (84+/-25 ml/m(2) for CT vs. 80+/-23 ml/m(2) for MR; r=0.58; p>0.05); LV ESV (End Systolic Volume)(37+/-19 ml/m(2) for CT vs. 38+/-23 ml/m(2) for MR; r=0.76; p>0.05); RV ESV (46+/-21 ml/m(2) for CT vs. 43+ Conclusions Cardiac CT provides accurate and reproducible LV and RV volume parameters compared with MR, and can be considered as a reliable alternative for patients who are not suitable to undergo MR. Key Points Cardiac-CT is able to provide Left and Right Ventricular function. Cardiac-CT is accurate as MR for LV and RV volume assessment. Cardiac-CT can provide accurate evaluation of coronary arteries and LV and RV function.

Published
2012

41. Assessment of coronary artery disease and calcified coronary plaque burden by computed tomography in patients with and without diabetes mellitus

Author

Maffei, E, Seitun, S, Nieman, Koen, Martini, C, Guaricci, AI, Tedeschi, C, Weustink, A.C., Mollet, Nico, Berti, E, Grilli, R, Messalli, G, Cademartiri, F., Maffei, E, Seitun, S, Nieman, Koen, Martini, C, Guaricci, AI, Tedeschi, C, Weustink, A.C., Mollet, Nico, Berti, E, Grilli, R, Messalli, G, and Cademartiri, F.

Abstract

To compare the coronary atherosclerotic burden in patients with and without type-2 diabetes using CT Coronary Angiography (CTCA). 147 diabetic (mean age: 65 +/- 10 years; male: 89) and 979 nondiabetic patients (mean age: 61 +/- 13 years; male: 567) without a history of coronary artery disease (CAD) underwent CTCA. The per-patient number of diseased coronary segments was determined and each diseased segment was classified as showing obstructive lesion (luminal narrowing > 50%) or not. Coronary calcium scoring (CCS) was assessed too. Diabetics showed a higher number of diseased segments (4.1 +/- 4.2 vs. 2.1 +/- 3.0; p < 0.0001); a higher rate of CCS > 400 (p < 0.001), obstructive CAD (37% vs. 18% of patients; p < 0.0001), and fewer normal coronary arteries (20% vs. 42%; p < 0.0001), as compared to nondiabetics. The percentage of patients with obstructive CAD paralleled increasing CCS in both groups. Diabetics with CCS <= 10 had a higher prevalence of coronary plaque (39.6% vs. 24.5%, p = 0.003) and obstructive CAD (12.5% vs. 3.8%, p = 0.01). Among patients with CCS <= 10 all diabetics with obstructive CAD had a zero CCS and one patient was asymptomatic. Diabetes was associated with higher coronary plaque burden. The present study demonstrates that the absence of coronary calcification does not exclude obstructive CAD especially in diabetics.

Published
2011

42. Assessment of coronary artery disease and calcified coronary plaque burden by computed tomography in patients with and without diabetes mellitus.

Author

Maffei E, Seitun S, Nieman K, Martini C, Guaricci AI, Tedeschi C, Weustink AC, Mollet NR, Berti E, Grilli R, Messalli G, Cademartiri F, Maffei, Erica, Seitun, Sara, Nieman, Koen, Martini, Chiara, Guaricci, Andrea Igoren, Tedeschi, Carlo, Weustink, Annick C, and Mollet, Nico R

Abstract

Purpose: To compare the coronary atherosclerotic burden in patients with and without type-2 diabetes using CT Coronary Angiography (CTCA).Methods and Materials: 147 diabetic (mean age: 65 ± 10 years; male: 89) and 979 nondiabetic patients (mean age: 61 ± 13 years; male: 567) without a history of coronary artery disease (CAD) underwent CTCA. The per-patient number of diseased coronary segments was determined and each diseased segment was classified as showing obstructive lesion (luminal narrowing >50%) or not. Coronary calcium scoring (CCS) was assessed too.Results: Diabetics showed a higher number of diseased segments (4.1 ± 4.2 vs. 2.1 ± 3.0; p < 0.0001); a higher rate of CCS > 400 (p < 0.001), obstructive CAD (37% vs. 18% of patients; p < 0.0001), and fewer normal coronary arteries (20% vs. 42%; p < 0.0001), as compared to nondiabetics. The percentage of patients with obstructive CAD paralleled increasing CCS in both groups. Diabetics with CCS ≤ 10 had a higher prevalence of coronary plaque (39.6% vs. 24.5%, p = 0.003) and obstructive CAD (12.5% vs. 3.8%, p = 0.01). Among patients with CCS ≤ 10 all diabetics with obstructive CAD had a zero CCS and one patient was asymptomatic.Conclusions: Diabetes was associated with higher coronary plaque burden. The present study demonstrates that the absence of coronary calcification does not exclude obstructive CAD especially in diabetics. [ABSTRACT FROM AUTHOR]

Published
2011
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44. Poster session 2

Author

Martins Fernandes, S, Teixeira, R, Roussin, I, Lynch, M, Badano, L, Muraru, D, Romeo, G, Ermacora, D, Marotta, C, Aruta, P, Cucchini, U, Iliceto, S, Garcia Campos, A, Martin-Fernandez, M, De La Hera Galarza, JM, Corros-Vicente, C, Colunga Blanco, S, Velasco-Alonso, E, Leon-Aguero, V, Rodriguez-Suarez, ML, Moris De La Tassa, C, Erdei, T, Edwards, J, Braim, D, Price, C, Fraser, AG, Cardiff, Investigators, MEDIA, Mehdipoor, G, Salmani, F, Arjmand Shabestari, A, Hanboly, N, Michalski, BW, Szymczyk, E, Kupczynska, K, Peczek, L, Nawrot, B, Lipiec, P, Kasprzak, JD, Vriz, O, Driussi, C, Ferrara, F, Brosolo, G, Antonini-Canterin, F, Magne, J, Aboyans, V, Bossone, E, Mo, VY, Bellucci, BM, Fisher, JM, Balekian, AA, Le, T T, Idapalapati, S, Huang, F, Wong, JI, Tan, RS, Ribeiro, JM, Teixeira, R, Madeira, M, Almeida, I, Reis, L, Siserman, A, Dinis, P, Dias, L, Ramos, AP, Goncalves, L, Ternacle, J, Wan, FW, Sawaki, DS, Dubois-Rande, JLDR, Adnot, SA, Czibik, GC, Derumeaux, GD, Yurdakul, SELEN, Ercan, G, Tekkesin, ILKER, Sahin, ST, Cengiz, B, Celik, G, Demircan, S, Aytekin, SAIDE, Shetye, A, Razvi, NA, Nazir, SA, Price, N, Khan, JN, Kanagala, P, Singh, A, Squire, I, Mccann, GP, Stoebe, S, Langel, M, Pfeiffer, D, Hagendorff, A, Lisowska, A, Ptaszynska-Kopczynska, K, Marcinkiewicz-Siemion, M, Knapp, M, Witkowski, M, Musial, WJ, Kaminski, K, Chinali, M, Natali, B, D' Anna, C, Leonardi, B, Secinaro, A, Pongiglione, G, Rinelli, G, Orabona, M, Renard, S, Michel, N, Mancini, J, Haentjens, J, Sitbon, O, Habib, G, Contaldi, C, Imbriaco, M, Alcidi, G, Santoro, C, Buonauro, A, Lo Iudice, F, Lembo, M, Cuocolo, A, Trimarco, B, Galderisi, M, De La Chica, JA, Mora Robles, J, Roldan Jimenez, MA, Mancisidor, MA, De Mora, MA, Codolosa, JN, Alnabelsi, T, Goykhman, I, Koshkelashvili, N, Romero-Corral, A, Pressman, GS, Trzcinski, P, Michalski, BW, Kupczynska, K, Miskowiec, D, Lipiec, P, Kasprzak, JD, Prado Diaz, S, Montoro Lopez, N, Refoyo Salicio, E, Valbuena Lopez, SC, Gonzalez, O, Alvarez, C, Moreno Yanguela, M, Bartha Rasero, JL, De La Calle, M, Guzman Martinez, G, Morales Portano, J D, Suarez-Cuenca, JA, Merino, JA, Gomez Alvarez, E B, Delgado, LG, Ha, SJ, Woo, YM, Bang, WD, Sohn, GH, Cheong, SS, Yoo, SY, Valente, F, Rodriguez Palomares, JF, Gutierrez, L, Maldonado, G, Pineda, V, Galian, L, Teixido, G, Gonzalez Allujas, MT, Evangelista, A, Garcia Dorado, D, Joseph, G, Zaremba, T, Ekeloef, S, Heiberg, E, Engblom, H, Jensen, SE, Sogaard, P, Valente, F, Rodriguez Palomares, JF, Gutierrez, L, Garcia, G, Pineda, V, Galian, L, Teixido, G, Gonzalez Allujas, MT, Evangelista, A, Garcia Dorado, D, Scali, MC, Dini, FL, Galli, F, Lattanzi, F, Picano, E, Marzilli, M, Cordeiro, F, Leao, S, Moz, M, Magalhaes, P, Trigo, J, Mateus, PS, Ferreira, A, Moreira, JI, Duchateau, N, De Craene, M, Legallois, D, Labombarda, F, Pellissier, A, Sermesant, M, Saloux, E, Fabris, E, Merlo, M, Moretti, M, Barbati, G, Stolfo, D, Gigli, M, Pinamonti, B, Sinagra, G, Costantino, MF, Dores, E, Matera, A, Innelli, P, Innelli, P, Lopizzo, A, Violini, R, Fiorilli, R, Cappabianca, G, Picano, E, Tarsia, G, Cho, I J, Seo, J, Chang, HJ, Heo, R, Kim, IC, Shim, CY, Hong, GR, Chung, N, Goublaire, C, Melissopoulou, MM, Nguyen, V, Brochet, E, Cimadevilla, C, Codogno, I, Vahanian, A, Messika-Zeitoun, D, Lam, W, Pontana, F, Vassiliou, V, Prasad, S, Galli, E, Leclercq, C, Samset, E, Donal, E, Kim, KH, Lim, DS, Mariani, M, Bianchi, G, Rossi, F, Gianetti, J, Marchi, F, Cerone, E, Nardelli, A, Terrazzi, M, Solinas, M, Maffei, S, Malev, E, Pshepiy, A, Vasina, L, Timofeev, E, Reeva, S, Zemtsovsky, E, Zuercher, F, Brugger, N, Jahren, S, De Marchi, SF, Seiler, C, Tang, Z, Jin, CN, Tang, H, Fan, K, Kam, K, Yan, BP, Yu, CM, Lee, PW, Cimino, S, Reali, M, Silvetti, E, Salatino, T, Mancone, M, Pennacchi, M, Giordano, A, Sardella, G, Agati, L, Mahia, P, Tirado, G, Nogales-Romo, MT, Marcos-Alberca, P, De Agustin, A, Almeria, C, Rodrigo, JL, Garcia Fernandez, MA, Macaya, C, Perez De Isla, L, De La Chica, JA, Mancisidor, M, Lara Garcia, C, Vivancos, R, De Mora, M, Petrovic, J, Petrovic, M, Vujisic-Tesic, B, Trifunovic, D, Boricic-Kostic, M, Petrovic, I, Draganic, G, Petrovic, O, Tomic-Dragovic, M, Ciobotaru, V, Remsey- Semmelweiss, E, Kogoj, P, Furlan, T, Ambrozic, J, Mohorko Pleskovic, PN, Bunc, M, Guerreiro, S, Ribeiras, R, Abecasis, J, Andrade, MJ, Mendes, M, Saxena, A, Ramakrishnan, S, Gupta, SK, Juneja, R, Kothari, SS, Mozenska, O, Zaleska, M, Segiet, A, Chwesiuk, S, Kroc, A, Kosior, DA, Pontone, G, Andreini, D, Solbiati, A, Guglielmo, M, Mushtaq, S, Baggiano, A, Beltrama, V, Rota, C, Guaricci, AI, Pepi, M, Macaya Ten, F, Pons Llinares, J, Asmarats Serra, L, Pericas Ramis, P, Caldes Llull, O, Grau Sepulveda, A, Frontera, G, Vaquer Segui, A, Noris, M, Bethencourt Gonzalez, A, Caballero, L, Climent Paya, V, Martinez Moreno, M, Saura, D, Oliva, MJ, Sanchez Quinones, J, Garcia Honrubia, A, Valdes, M, De La Morena, G, Avegliano, G, Terricabras, M, Costabel, JP, Ronderos, R, Evangelista, A, Venturini, C, Galve, E, Halmai, L, Nemes, A, Neubauer, S, Rahman Haley, S, Banner, N, Reis, L, Teixeira, R, Caetano, F, Almeida, I, Trigo, J, Botelho, A, Silva, J, Nascimento, J, Goncalves, L, Trifunovic, D, Tesic, M, Jovanovic, I, Petrovic, O, Boricic-Kostic, M, Dragovic, M, Petrovic, M, Stepanovic, J, Banovic, M, Vujisic-Tesic, B, Gospodinova, M, Guergelcheva, V, Chamova, T, Sarafov, S, Tournev, I, Denchev, S, Makavos, G, Ikonomidis, I, Psarogiannakopoulos, P, Tsirigotis, P, Paraskevaidis, I, Lekakis, J, D'ascenzi, F, Pelliccia, A, Natali, BM, Cameli, M, Focardi, M, Bonifazi, M, Mondillo, S, Dantas Tavares De Melo, M, Lima, C, Assed, L, Kalil Filho, R, Mady, C, Bochi, E A, Salemi, V M C, Bonapace, S, Targher, G, Valbusa, F, Rossi, A, Lanzoni, L, Lipari, P, Zenari, L, Molon, G, Canali, G, Barbieri, E, Kulkarni, A, Li, L, Craft, M, Nanda, M, Lorenzo, JM, Kutty, S, Cameli, M, Bombardini, T, Sparla, S, Di Tommaso, C, Losito, M, Incampo, E, Maccherini, M, Mondillo, S, Ingvarsson, A, Werther Evaldsson, A, Radegran, G, Stagmo, M, Waktare, J, Roijer, A, Meurling, CJ, Driessen, MMP, Hui, W, Meijboom, FJ, Bijnens, B, Dragulescu, A, Mertens, L, Friedberg, MK, Tufekcioglu, O, Sensoy, B, Suleymanoglu, M, Akin, Y, Sahan, E, Sasmaz, H, Radulescu, D, Pasca, L, Buzdugan, E, Chis, B, Stoicescu, L, Barac, A, Lynce, FC, Smith, KL, Mete, M, Isaacs, C, Cioffi, G, Viapiana, O, Di Nora, C, Ognibeni, F, Fracassi, E, Giollo, A, Mazzone, C, Faganello, G, Di Lenarda, A, Rossini, M, Almeida Morais, L, Galrinho, A, Branco, L, Timoteo, A T, Rodrigues, I, Daniel, P, Rosa, S, Ferreira, L, Ferreira, R, Ledakowicz-Polak, A, Polak, L, Krauza, G, Stokfisz, K, Zielinska, M, Portugal, G, Branco, L M, Galrinho, A, Mota Carmo, M, Teresa Timoteo, A, Aguiar Rosa, S, Abreu, J, Pinto Teixeira, P, Viveiros Monteiro, A, Cruz Ferreira, R, Naksuk, N, Peeraphatdit, T, Chaiteerakij, R, Klarich, KW, Parato, V M, Masia, S, Kovalova, S, Necas, J, Cherubini, A, Nistri, S, Negri, F, Barbati, G, Cioffi, G, Russo, G, Mazzone, C, Faganello, G, Pandullo, C, Di Lenarda, A, Corrado, G, Durante, A, Rovelli, E, Genchi, V, Trabattoni, L, Zerboni, SC, Cattaneo, L, Butti, E, Ferrari, G, Malev, E, Luneva, E, Mitrofanova, L, Uspensky, V, Zemtsovsky, E, Wierzbowska-Drabik, K, Kasprzak, JD, Lesevic, H, Rosner, S, Karl, M, Ott, I, Sonne, C, Laredj, N, Ali Lahmar, HM, Hammou, L, Pieles, G E, Forsey, J, Gowing, L, Miller, F, Ramanujam, P, Stuart, AG, Williams, CA, Generati, G, Bandera, F, Pellegrino, M, Carbone, F, Labate, V, Alfonzetti, E, Guazzi, M, Van Zalen, JJ, Patel, NR, Raju, P, Beale, L, Brickley, G, Lloyd, GW, Aquila, I, Fernandez-Golfin, C, Gonzalez, A, Rincon, LM, Hinojar, R, Garcia, A, Megias, A, Jimenez-Nacher, JJ, Moya, JL, Zamorano, JL, Cheng, H-L, Lanzoni, L, Molon, G, Canali, G, Bonapace, S, Chiampan, A, Albrigi, L, Barbieri, E, Asmarats Serra, L, Noris Mora, M, Rodriguez Fernandez, A, Exposito Pineda, C, Grande, C, Gonzalez Colino, R, Macaya Ten, F, Fernandez Vazquez, X, Fortuny Frau, E, Bethencourt Gonzalez, A, Kadrabulatova, S, Ranjbar, S, Karvandi, M, Szczesniak-Stanczyk, D, Blaszczyk, R, Zarczuk, R, Brzozowski, W, Janowski, M, Wysokinski, A, Stanczyk, B, Consortium, ReMeDi, Sharka, I, Myftiu, S, Teferici, D, Quka, A, Dado, E, Djamandi, J, Kresto, L, Duka, A, Kristo, A, Balla, I, Di Salvo, G, Issa, Z, Moiduddin, N, Siblini, G, Bulbul, Z, Ben Kahla, S, Abid, L, Abid, D, Kammoun, S, Li, L, Rush, E, Craft, M, Goodwin, J, Kreikemeier, R, Cantinotti, M, Kutty, S, Hadeed, HA, Zolaly, M A, Khoshhal, SQ, El-Harbi, K, Tarawah, A, Al-Hawsawi, Z, Al-Mozainy, I, Habeeb, H A, Bakhoum, S W G, Nabil, M N, Elebrashy, I N, Toscano, A, Chinali, M, Albanese, S, Carotti, A, Iacobelli, R, Esposito, C, Secinaro, A, Moscogiuri, G, Pasquini, L, Granata, F, Malvezzi Caracciolo, M, Bianchi, RM, Caso, P, Arenga, F, Riegler, L, Scarafile, R, D'andrea, A, Russo, MG, Calabro', P, Djikic, D, Simic, DS, Peric, VP, Mujovic, NM, Marinkovic, MM, Jankovic, NJ, Wdowiak-Okrojek, K, Shim, A, Wejner-Mik, P, Kasprzak, JD, Lipiec, P, Girgis, H Y A, Sharma, A, Jain, N, Kharwar, R, Saran, RK, Narain, VS, Dwivedi, SK, Sethi, R, Chandra, S, Pradhan, A, Safal, S, Soro, C, Marchetti, MF, Cacace, C, Congia, M, Nissardi, V, Ruscazio, M, Meloni, L, Montisci, R, Gallego Page, J C, Gallego Sanchez, G, Calero, S, Portero, JJ, Tercero, A, Garcia, JC, Barambio, M, Martinez Lazaro, R, Corneli, M, Meretta, AH, Perea, GO, Belcastro, F, Aguirre, E, De Luca, I, Henquin, R, and Masoli, O

Abstract

Introduction: The relationship between the appropriateness of the transthoracic echocardiography (TTE) and its clinical impact is still a matter of debate. Objective: The aim of this study was to assess the degree of adherence to the appropriate use criteria for echocardiography, in a tertiary public hospital in the United Kingdom, as well as the clinical impact of the exam on patient management. Methods: 859 TTE’s performed consecutively during January 2014 were reviewed to assess its appropriateness, and were classified as appropriate, uncertain or inappropriate using the 2011 guidelines. Subsequently, patient’s files were examined to determine the clinical impact of the TTE which was assigned to one of the following three categories: (1) active change in care, (2) continuation of current care, or (3) no change in care. Patients which files were not available were excluded (259). All classifications were evaluated by two independent cardiologists, with no direct relation to the study. Results: Our sample had a mean age of 63 ± 17 years with a gender balance. The majority of the exams were requested at the outpatient (81.4%) clinic, by cardiologists (50.3%) and general practitioners (13.4%). Regarding the main findings, in 7.6% of the studies there were moderate to severe systolic dysfunction; 4.0% showed severe valvular heart disease and 5.1% had significant pulmonary hypertension. Relatively to the appropriateness of the TTE requests, 76.5% were considered appropriate, 7.1% inappropriate and 12.6% uncertain. With respect to the clinical impact of the TTE’s, 42.7% of the exams led to an active change in care, 15.6% to a continuation of the care and 11.5% revealed no change in care. Age (β0.90, P=0.05) and outpatient setting (β4.4, P<0.01) were the most important predictors of an active change of care exam. On the contrary, the appropriateness of the TTE’s requests (β1.1, P=0.56) and the specialist ordering the exams (β0.81, P=0.26) were not independently associated. Conclusion: Our data showed that almost 8 out of 10 TTE were considered appropriate, and 4 out of 10 exams had an active clinical impact.

Published
2015
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45. Poster session 5

Author

Colunga Blanco, S, Garcia Campos, A, Capin Sampedro, E, Corros Vicente, C, Martin Fernandez, M, Leon Arguero, V, Fidalgo Arguelles, A, Velasco Alonso, E, Lopez Iglesias, F, De La Hera Galarza, JM, Gonzalez Matos, C, Chaparro-Munoz, M, Recio-Mayoral, A, Angelis, A, Vlachopoulos, C, Ioakeimidis, N, Felekos, I, Abdelrasoul, M, Aznaouridis, K, Chrysohoou, C, Rousakis, G, Aggeli, K, Tousoulis, D, Dinis, P G, Faustino, AC, Paiva, L, Fernandes, A, Costa, M, Cachulo, MC, Goncalves, L, Chinali, M, Emma, F, Rinelli, G, Esposito, C, Franceschini, A, Doyon, A, Raimondi, F, Schaefer, F, Pongiglione, G, Mateucci, MC, Toth, A, Vago, H, Juhasz, C, Janosa, C, Oprea, V, Balint, OH, Temesvari, A, Simor, T, Kadar, K, Merkely, B, Andreassi, M G, Bruno, R M, Borghini, A, Stea, F, Gargani, L, Mercuri, A, Sicari, R, Picano, E, Rodriguez Munoz, D, Lozano Granero, C, Carbonell San Roman, A, Moya Mur, JL, Fernandez-Golfin, C, Moreno Planas, J, Fernandez Santos, S, Casas Rojo, E, Hernandez-Madrid, A, Zamorano Gomez, JL, Reid, A B, Pearce, K, Gamlin, W, Miller, C, Schmitt, M, Park, JH, Seong, IW, Kim, KH, Kim, MJ, Jung, HO, Sohn, IS, Park, SM, Cho, GY, Choi, JO, Park, SW, study, NORMAL, Shetye, A, Nazir, SA, Khan, JN, Singh, A, Kanagala, P, Squire, I, Mccann, GP, Novo, G, Di Lisi, D, Meschisi, MC, Brunco, V, Badalamenti, G, Bronte, E, Russo, A, Novo, S, De Marchi, S F, Von Tscharner, M, Urheim, S, Aakhus, S, Seiler, C, Schmalholz, S, Cikes, M, Biering-Sorensen, T, Cheng, S, Oparil, S, Izzo, J, Pitt, B, Solomon, SD, Smarz, K, Zaborska, B, Jaxa-Chamiec, T, Tysarowski, M, Budaj, A, Illatopa, V, Cordova, F, Aguirre, O, Sanabria, S, Ortega, J, Peluso, D, Romeo, G, Perazzolo Marra, M, Tona, F, Famoso, G, Pigatto, E, Cozzi, F, Iliceto, S, Badano, LP, Wellnhofer, E, Kriatselis, C, Gerds-Li, JH, Kropf, M, Pieske, B, Graefe, M, De La Rosa Riestra, A, Martinez Santos, P, Batlle Lopez, E, Vilacosta, I, Sanchez Sauce, B, Espana Barrio, E, Jimenez Valtierra, J, Campuzano Ruiz, R, Alonso Bello, J, Martin Rios, MD, Sattarzadeh Badkoubeh, R, Farrashi, M, Abtahi, H, Sadeghi, H, Sadeghipour, P, Tavoosi, A, Mandour Ali, M, Abdel Rahman, TA, Mohamed, LA, Maghraby, HM, Kora, IM, Abdel Hameed, FR, Ali, MN, Azoz, A, Al Shehri, A, Youssef, A, Gad, A, Alsharqi, M, Alsaikhan, L, Pontone, G, Andreini, D, Rota, C, Guglielmo, M, Mushtaq, S, Baggiano, A, Beltrama, V, Solbiati, A, Guaricci, AI, Pepi, M, Krljanac, G, Trifunovic, D, Sobic Saranovic, D, Savic, L, Grozdic Milojevic, I, Asanin, M, Srdic, M, Petrovic, M, Zlaic, N, Mrdovic, I, Acar, R, Dogan, C, Izci, S, Gecmen, C, Unkun, T, Cap, M, Erdogan, E, Onal, C, Yilmaz, F, Ozdemir, N, Nucifora, G, Muser, D, Tioni, C, Zanuttini, D, Morocutti, G, Spedicato, L, Bernardi, G, Proclemer, A, Sirtautas, A, Pranevicius, R, Zapustas, N, Briedis, K, Valuckiene, Z, Jurkevicius, R, Roos, S T, Juffermans, LJM, Enait, V, Van Royen, N, Van Rossum, AC, Kamp, O, Qasem, M S, Khalaf, HASSEN, Hitham, SAKER, Osama, AS, Abazid, RAMI, Guall, RAHIM, Durdan, SHAFAT, Mohammed, ZYAD, Marini, C, Stella, S, Rosa, I, Ancona, F, Spartera, M, Italia, L, Latib, A, Colombo, A, Margonato, A, Agricola, E, Fabiani, I, Scatena, C, Mazzanti, C, Conte, L, Pugliese, N, Barletta, V, Bortolotti, U, Naccarato, AG, Di Bello, V, Gillis, K, Bala, G, Roosens, B, Hernot, S, Remory, I, Droogmans, S, Cosyns, B, Bandera, F, Generati, G, Labate, V, Donghi, V, Pellegrino, M, Carbone, F, Alfonzetti, E, Guazzi, M, Borowiec, A, Dabrowski, R, Kowalik, I, Firek, B, Chwyczko, T, Szwed, H, Lim, YJ, Kawamura, A, Kawano, S, Chalbia, T E, Zaroui, A, Ben Said, R, Ben Halima, M, Kheder, N, Farhati, A, Mourali, S, Mechmech, R, Santos, M, Leite, L, Martins, R, Baptista, R, Barbosa, A, Ribeiro, N, Oliveira, A, Castro, G, Pego, M, Gao, S A, Polte, C L, Lagerstrand, K, Johnsson, A A, Janulewicz, M, Bech-Hanssen, O, Zilberszac, R, Gabriel, H, Wisser, W, Maurer, G, Rosenhek, R, Farrag, AAM, El Aroussy, W, Abdel Ghany, M, Al Adeeb, K, Palmiero, G, Ascione, L, Carlomagno, G, Sordelli, C, Ferro, A, Ascione, 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CLM, Timmermans, J, Brouwer, MA, Kofflard, MJM, Godinho, A R, Vasconcelos, M, Araujo, V, Almeida, P, Sousa, C, Macedo, F, Cardoso, JS, Maciel, MJ, Mielczarek, M, Voilliot, D, Huttin, O, Venner, C, Olivier, A, Villemin, T, Deballon, R, Manenti, V, Juilliere, Y, Selton-Suty, C, Bandera, F, Generati, G, Pellegrino, M, Labate, V, Carbone, F, Alfonzetti, E, Guazzi, M, Kubik, M, Dabrowska-Kugacka, A, Dorniak, K, Lewicka, E, Szalewska, D, Kutniewska-Kubik, M, Raczak, G, Cho, J Y, Kim, K H, Yoon, H J, Park, H J, Ahn, Y, Jeong, M H, Cho, J G, Park, J C, Kim, J H, Tarando, F, Galli, E, Habib, G, Schnell, F, Lederlin, M, Daubert, JC, Mabo, P, Donal, E, Lourenco Marmelo, B F, Faria, R, Magalhaes, P, Marques, N, Domingues, K, Lourenco, C, Almeida, AR, Teles, L, Picarra, B, Azevedo, O, SUNSHINE, Grupo, Reis, L, Lourenco, C, Oliveira, M, Magalhaes, P, Domingues, K, Marmelo, B, Almeida, A, Picarra, B, Faria, R, Marques, N, Sunshine, Domingues, K, Bento, D, Lourenco, C, Magalhaes, P, Cruz, I, Marmelo, B, Reis, L, Picarra, B, Faria, R, Azevedo, O, group, Sunshine, Krestjyaninov, MV, Gimaev, RH, Melnikova, MA, Olezov, NV, Ruzov, VI, Mesquita, J, Goncalves, P, Almeida, M S, Branco, P, Carvalho, M S, Dores, H, Gaspar, M A, Sousa, H, Andrade, M J, Mendes, M, Ikonomidis, I, Makavos, G, Varoudi, M, Papadavid, E, Andreadou, I, Gravanis, K, Liarakos, N, Pavlidis, G, Rigopoulos, D, Lekakis, J, Ferferieva, V, Deluyker, D, Bito, V, Peluso, D, Pigatto, E, Romeo, G, Muraru, D, Cozzi, F, Punzi, L, Iliceto, S, Badano, LP, Peluso, D, Pigatto, E, Romeo, G, Muraru, D, Cozzi, F, Iliceto, S, Badano, LP, King, GJ, Neilan, T, Coen, K, Gannon, S, Bennet, K, Clarke, JG, D'ascenzi, F, Solari, M, Cameli, M, Focardi, M, Corrado, D, Bonifazi, M, Henein, M, Mondillo, S, Ferrera Duran, C, Gomez-Escalonilla, C, De Agustin, A, Egido, J, Islas, F, Simal, P, Gomez De Diego, JJ, Luaces, M, Macaya, C, Perez De Isla, L, Sormani, P, Zancanella, M, Rusconi, C, Musca, F, Santambrogio, G, De Chiara, B, Vallerio, P, Cairoli, R, Giannattasio, G, Moreo, A, Gonzalez Fernandez, O, Alvarez Ortega, C, Mori Junco, R, Caro Codon, J, Meras Colunga, P, Ponz De Antonio, I, Lopez Fernandez, T, Valbuena Lopez, S, Moreno Yanguela, M, Lopez-Sendon, JL, Tereshina, O, Surkova, E, Cambronero Cortinas, E, Bonanad-Lozano, C, Lopez-Lereu, MP, Monmeneu-Menadas, JV, Gavara, J, De Dios, E, Paya-Chaume, A, Escribano-Alarcon, D, Chorro-Gasco, FJ, Bodi-Peris, V, Kupczynska, K, Michalski, BW, Miskowiec, D, Kasprzak, JD, Lipiec, P, Carvalho, J F, Morgado, G, Caldeira, D, Cruz, I, Joao, I, Almeida, A R, Lopes, L, Fazendas, P, Cotrim, C, Pereira, H, Shivalkar, B, De Block, C, Buys, D, Salgado, R, Vrints, C, Van Gaal, L, Aghamohammadzadeh, R, Mctear, C, Irwin, RB, Cifra, B, Dragulescu, A, Friedberg, M, Mertens, L, Cifra, B, Dragulescu, A, Friedberg, M, Mertens, L, Bandera, F, Carbone, F, Generati, G, Pellegrino, M, Labate, V, Alfonzetti, E, Guazzi, M, Kuznetsov, VA, Krinochkin, DV, Yaroslavskaya, EI, Zaharova, EH, Pushkarev, GS, Van Zalen, JJ, Sugihara, C, Patel, NR, Sulke, AN, Lloyd, GW, Kochanowski, J, Piatkowski, R, Scislo, P, Grabowski, M, Marchel, M, Opolski, G, Goebel, B, Roland, H, Hamadanchi, A, Otto, S, Jung, C, Lauten, A, Figulla, HC, Poerner, TC, Ladeiras-Lopes, R, Sampaio, F, Fonseca, P, Fontes-Carvalho, R, Pinho, M, Campos, AS, Castro, P, Fonseca, C, Ribeiro, J, Gama, V, Goebel, B, Heck, R, Hamdanchi, A, Otto, S, Jung, C, Lauten, A, Figulla, HR, Poerner, TC, Karvandi, M, Ranjbar, S, Ghaffaripour Jahromi, M, Karvandi, M, Ranjbar, S, Alonso Salinas, G, Hinojar, R, Fernandez Golfin, C, Esteban, A, Pascual-Izco, M, Garcia-Martin, A, Casas Rojo, E, Jimenez-Nacher, JJ, Zamorano, JL, Unkun, T, Gecmen, C, Cap, M, Izci, S, Erdogan, E, Onal, C, Acar, R, Bakal, RB, Kaymaz, C, Ozdemir, N, Ranjbar, S, Karvandi, M, Ghaffaripour Jahromi, M, Hubert, A, Galand, V, Schnell, F, Matelot, D, Martins, R, Leclercq, C, Carre, F, Enescu, OA, Suran, BC, Margulescu, AD, Rimbas, RC, Siliste, C, Vinereanu, D, Liccardo, M, Nocerino, P, Urso, AC, Borrino, A, Carbone, C, Follero, P, Ciardiello, C, Prato, L, Salzano, G, Cameli, M, Marino, F, Ruspetti, A, Sparla, S, Di Tommaso, C, Loiacono, F, Focardi, M, D'ascenzi, F, Henein, M, Mondillo, S, Ako, E, Porter, J, Walker, M, Lembo, M, Lo Iudice, F, Esposito, R, Santoro, C, Cocozza, S, Izzo, R, De Luca, N, De Simone, G, Trimarco, B, Galderisi, M, Goffredo, C, Gervasi, F, Patti, G, Mega, S, Bono, M, Di Sciascio, G, Enache, R, Buture, A, Badea, R, Platon, P, Ghiorghiu, I, Jurcut, R, Coman, IM, Popescu, BA, Ginghina, C, Novo, G, Lunetta, M, Spoto, MS, Lo Vi, AM, Pensabene, G, Meschisi, MC, Carita, P, Coppola, G, Novo, S, Assennato, P, Wdowiak-Okrojek, K, Shim, A, Wejner-Mik, P, Kasprzak, JD, Lipiec, P, Nemes, A, Havasi, K, Domsik, P, Kalapos, A, Forster, T, Nemes, A, Piros, GA, Domsik, P, Kalapos, A, Lengyel, C, Orosz, A, Forster, T, Di Salvo, G, Bulbul, Z, Issa, Z, Al Sehly, A, Pergola, V, Oufi, S, Capotosto, L, Conde, Y, Cimino, E, Rinaldi, E, Ashurov, R, Ricci, S, Pergolini, M, Vitarelli, A, Caravaca, P, Lujan Valencia, JE, Chaparro, M, Garcia-Guerrero, A, Cristo Ropero, MJ, Izquierdo Bajo, A, Madrona, L, Recio-Mayoral, A, Maceira Gonzalez, A M, Monmeneu, JV, Igual, B, Lopez Lereu, P, Garcia, MP, Iriart, X, Selmi, W, Jalal, Z, Thambo, JB, Jug, B, Kosuta, D, and Fras, Z

Abstract

Background: Handheld ultrasound devices allow for a bedside screening although quantitative parameters are not easily obtained. We aim to assess the reliability of visual qualitative evaluation of left ventricle (LV) compared with standard quantitative evaluation with 2D transthoracic echocardiography (TTE). Methods: Two cardiologists have reviewed 135 consecutive standard TTE examinations. Both observers visually assessed LV size, hypertrophy (LVH) and ejection fraction (EF). LV diameter, volume, wall thickness and EF (Teichholz and Simpson) were also measured by both observers. Visual and quantitative agreement and inter and intraobserver variability were calculated. Results: Image quality allowed for evaluation of 130 examinations. Visually assessed EF compared with Simpson had better consistency (Intraclass correlation coefficient [ICC] 0,91 IC95% 0,88-0,94) than with Teichholz (ICC 0,75 IC95% 0,66-0,82). We have also observed good interobserver agreement regarding visually assessed EF (ICC 0,81 IC95% 0,71-0,87) and Simpson EF (ICC 0,80 IC95% 0,70-0,89) as well as good intraobserver agreement (visual EF: ICC 0,81 IC95% 0,74-0,86; Simpson: ICC 0,89 IC95% 0,84-0,93). Regarding LVH we found moderate agreement between visual and quantitative assessment (weighted Kappa [wK] 0,44 (IC95% 0,32-0,56)), moderate interobserver agreement for quantitative assessment (ICC 0,59 IC95% 0,44-0,71) and poor interobserver agreement for visual assessment (wK 0,19 IC95% 0,08-0,30). Intraobserver variability regarding LVH visual estimation was moderate (wK 0,40 IC95% 0,29-0,52) and regarding LVH quantification was good (ICC 0,78 IC95% 0,70-0,84). LVH was visually overestimated in 25% of examinations. Regarding LV size, we found poor agreement between visual assessment and its quantification with end-diastolic diameter (wK 0,22 IC95% 0,06-0,39) and moderate agreement between visual assessment and end-systolic LV volume (wK 0,62 IC95% 0,47-0,77). Interobserver agreement regarding quantitative volume assessment was good (ICC 0,90 IC95% 0,85-0,94) and regarding visual assessment was moderate (wK 0,43 IC95% 0,26-0,70). We found good intraobserver variability of volume measurement (wK 0,64 IC95% 0,50-0,78) and of visual size assessment (ICC 0,96 IC95% 0,94-0,97). Conclusions: Visual LVEF assessment is consistent with quantitative assessment and should be regarded as a reliable parameter that can be obtained from bedside examination with a handheld device. Visual assessment of LV size and wall thickness is less reliable than its quantification and should be confirmed with standard measurements.

Published
2015
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47. AI Cardiac MRI Scar Analysis Aids Prediction of Major Arrhythmic Events in the Multicenter DERIVATE Registry

Author

Fahime Ghanbari, Thomas Joyce, Valentina Lorenzoni, Andrea I. Guaricci, Anna-Giulia Pavon, Laura Fusini, Daniele Andreini, Mark G. Rabbat, Giovanni Donato Aquaro, Raffaele Abete, Jan Bogaert, Giovanni Camastra, Samuela Carigi, Nazario Carrabba, Grazia Casavecchia, Stefano Censi, Gloria Cicala, Carlo N. De Cecco, Manuel De Lazzari, Gabriella Di Giovine, Mauro Di Roma, Marta Focardi, Nicola Gaibazzi, Annalaura Gismondi, Matteo Gravina, Chiara Lanzillo, Massimo Lombardi, Jordi Lozano-Torres, Ambra Masi, Claudio Moro, Giuseppe Muscogiuri, Alberto Nese, Silvia Pradella, Stefano Sbarbati, U. Joseph Schoepf, Adele Valentini, Gérard Crelier, Pier Giorgio Masci, Gianluca Pontone, Sebastian Kozerke, Juerg Schwitter, Institut Català de la Salut, [Ghanbari F] Cardiovascular Department, CMR Center, University Hospital Lausanne–CHUV, Lausanne, Switzerland. Faculty of Biology and Medicine, Lausanne University, UniL, Lausanne, Switzerland. [Joyce T] Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland. [Lorenzoni V] Institute of Management, Scuola Superiore Sant’Anna, Pisa, Italy. [Guaricci AI] Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy. [Pavon AG] Cardiovascular Department, CMR Center, University Hospital Lausanne–CHUV, Lausanne, Switzerland. [Fusini L] Centro Cardiologico Monzino IRCCS, Milan, Italy. Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy. [Lozano-Torres J] Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. Centro de Investigación Biomédica en Red-CV, CIBER CV, Madrid, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
conceptos matemáticos::algoritmos::inteligencia artificial [FENÓMENOS Y PROCESOS], Male, Intel·ligència artificial, enfermedades cardiovasculares::enfermedades cardíacas::arritmias cardíacas [ENFERMEDADES], Mathematical Concepts::Algorithms::Artificial Intelligence [PHENOMENA AND PROCESSES], Arrítmia, Contrast Media, Magnetic Resonance Imaging, Cine, Stroke Volume, Gadolinium, Magnetic Resonance Imaging, Ventricular Function, Left, Cicatrix, Artificial Intelligence, Predictive Value of Tests, Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Tomography::Magnetic Resonance Imaging [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Imatgeria per ressonància magnètica, Humans, diagnóstico::técnicas y procedimientos diagnósticos::diagnóstico por imagen::tomografía::imagen por resonancia magnética [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Radiology, Nuclear Medicine and imaging, Registries, Cardiovascular Diseases::Heart Diseases::Arrhythmias, Cardiac [DISEASES], Aged, Retrospective Studies
Abstract

Background Scar burden with late gadolinium enhancement (LGE) cardiac MRI (CMR) predicts arrhythmic events in patients with postinfarction in single-center studies. However, LGE analysis requires experienced human observers, is time consuming, and introduces variability. Purpose To test whether postinfarct scar with LGE CMR can be quantified fully automatically by machines and to compare the ability of LGE CMR scar analyzed by humans and machines to predict arrhythmic events. Materials and Methods This study is a retrospective analysis of the multicenter, multivendor CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DebrillAtor ThErapy (DERIVATE) registry. Patients with chronic heart failure, echocardiographic left ventricular ejection fraction (LVEF) of less than 50%, and LGE CMR were recruited (from January 2015 through December 2020). In the current study, only patients with ischemic cardiomyopathy were included. Quantification of total, dense, and nondense scars was carried out by two experienced readers or a Ternaus network, trained and tested with LGE images of 515 and 246 patients, respectively. Univariable and multivariable Cox analyses were used to assess patient and cardiac characteristics associated with a major adverse cardiac event (MACE). Area under the receiver operating characteristic curve (AUC) was used to compare model performances. Results In 761 patients (mean age, 65 years ± 11, 671 men), 83 MACEs occurred. With use of the testing group, univariable Cox-analysis found New York Heart Association class, left ventricle volume and/or function parameters (by echocardiography or CMR), guideline criterion (LVEF of ≤35% and New York Heart Association class II or III), and LGE scar analyzed by humans or the machine-learning algorithm as predictors of MACE. Machine-based dense or total scar conferred incremental value over the guideline criterion for the association with MACE (AUC: 0.68 vs 0.63, P = .02 and AUC: 0.67 vs 0.63, P = .01, respectively). Modeling with competing risks yielded for dense and total scar (AUC: 0.67 vs 0.61, P = .01 and AUC: 0.66 vs 0.61, P = .005, respectively). Conclusion In this analysis of the multicenter CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DebrillAtor ThErapy (DERIVATE) registry, fully automatic machine learning-based late gadolinium enhancement analysis reliably quantifies myocardial scar mass and improves the current prediction model that uses guideline-based risk criteria for implantable cardioverter defibrillator implantation. ClinicalTrials.gov registration no.: NCT03352648 Published under a CC BY 4.0 license. Supplemental material is available for this article. ispartof: Radiology vol:307 issue:3 pages:e222239- ispartof: location:United States status: published

Published
2023

48. Rationale, design and methods of CTCA-PRORECAD (Computed Tomography Coronary Angiography Prognostic Registry for Coronary Artery Disease): a multicentre and multivendor registry

Author

Teresa Arcadi, Nazario Carrabba, Filippo Cademartiri, Onofrio A. Catalano, Marco Francone, Massimo Midiri, Carlo Tedeschi, Alberto Cuocolo, Andrea Igoren Guaricci, Roberto Malago, Erica Maffei, Paolo Spagnolo, Marco Rengo, Vincenzo Russo, Sara Seitun, Maffei, E, Midiri, M, Russo, V, Rengo, M, Tedeschi, C, Spagnolo, P, Seitun, S, Francone, M, Guaricci, Ai, Carrabba, N, Malagò, R, Cuocolo, Alberto, Arcadi, T, Catalano, Oa, Cademartiri, F., Guaricci, A, Cuocolo, A, Catalano, O, and Cademartiri, F

Subjects
Coronary angiography, Male, Contrast Media, Computed tomography, Coronary Disease, Coronary Angiography, Coronary artery disease, Computed tomography coronary angiography, Computer-Assisted, Risk Factors, Registries, Tomography, Neuroradiology, education.field_of_study, medicine.diagnostic_test, computed tomography coronary angiography, coronary artery disease, prevalence of disease, prognosis, registry, risk stratification, Radiographic Image Interpretation, Interventional radiology, General Medicine, Middle Aged, Prognosis, X-Ray Computed, Research Design, Risk stratification, Cardiology, Prevalence of disease, Radiographic Image Interpretation, Computer-Assisted, Female, Radiology, medicine.medical_specialty, Registry, Prognosi, Endpoint Determination, Population, Risk Assessment, Analysis of Variance, Humans, Proportional Hazards Models, Retrospective Studies, Tomography, X-Ray Computed, Internal medicine, medicine, Radiology, Nuclear Medicine and imaging, education, business.industry, medicine.disease, business
Abstract

PURPOSE: This study was done to assess the prognostic value of computed tomography coronary angiography (CTCA) in a large multicentre population of patients with suspected coronary artery disease (CAD) and, in particular, its incremental value compared with traditional methods for risk stratification. MATERIALS AND METHODS: This is a retrospective observational study that began in January 2003 conducted on patients with suspected CAD assessed with CTCA on the basis of symptoms (chest pain, dyspnoea) and/or abnormal or equivocal stress test and/or a high cardiovascular risk profile. The participating centres will provide data obtained with CTCA performed with 16-slice or higher equipment. Exclusion criteria are renal insufficiency, allergy to iodinated contrast material, pregnancy and previous myocardial infarction or revascularisation (percutaneous coronary intervention and/or coronary artery bypass graft). All patients are stratified by means of clinical assessment and/or data retrieved from a clinical database. Risk factors considered are hypertension, dyslipidaemia, diabetes mellitus, smoking, family history and obesity. Symptoms are classified as absent, typical chest pain, atypical chest pain and dyspnoea. Primary endpoints are death, major adverse cardiovascular events (cardiac death, unstable angina requiring hospitalisation, acute myocardial infarction) and shifting of cardiovascular risk category on the basis of coronary plaque burden. The secondary endpoint is coronary revascularisation. Telephone interviews and/or clinical databases are used for the follow-up. The study will be conducted on a population >1,000 patients. CONCLUSIONS: The information collected from the Prognostic Registry for Coronary Artery Disease (PRORECAD) will provide insight into the prognostic value of CTCA in addition to demographic and clinical features. The results will allow for better use and interpretation of CTCA for prognostic purposes.

Published
2011

49. Coronary artery calcium score on low-dose computed tomography for lung cancer screening

Author

Erica Maffei, Teresa Arcadi, Carlo Tedeschi, Chiara Martini, Nicola Sverzellati, Cesare Mantini, Filippo Cademartiri, Andrea Igoren Guaricci, Ludovico La Grutta, Arcadi, T, Maffei, E, Sverzellati, N, Mantini, C, Guaricci, AI, Tedeschi, C, Martini, C, La Grutta, L, and Cademartiri F

Subjects
High-resolution computed tomography, medicine.medical_specialty, Coronary artery calcium score, unenhanced chest computed tomography, medicine.diagnostic_test, business.industry, cardiovascular risk stratification, Low dose, nutritional and metabolic diseases, Computed tomography, Lower risk, Effective dose (radiation), Surgery, Lung cancer screening, cardiovascular system, medicine, Prospective Study, cardiovascular diseases, Settore MED/36 - Diagnostica Per Immagini E Radioterapia, Agatston score, Nuclear medicine, business
Abstract

Aim: To evaluate the feasibility of coronary artery calcium score (CACS) on low-dose non-gated chest CT (ngCCT). Methods: Sixty consecutive individuals (30 males; 73 ± 7 years) scheduled for risk stratification by means of unenhanced ECG-triggered cardiac computed tomography (gCCT) underwent additional unenhanced ngCCT. All CT scans were performed on a 64-slice CT scanner (Somatom Sensation 64 Cardiac, Siemens, Germany). CACS was calculated using conventional methods/scores (Volume, Mass, Agatston) as previously described in literature. The CACS value obtained were compared. The Mayo Clinic classification was used to stratify cardiovascular risk based on Agatston CACS. Differences and correlations between the two methods were compared. A P-value < 0.05 was considered significant. Results: Mean CACS values were significantly higher for gCCT as compared to ngCCT (Volume: 418 ± 747 vs 332 ± 597; Mass: 89 ± 151 vs 78 ± 141; Agatston: 481 ± 854 vs 428 ± 776; P < 0.05). The correlation between the two values was always very high (Volume: r = 0.95; Mass: r = 0.97; Agatston: r = 0.98). Of the 6 patients with 0 Agatston score on gCCT, 2 (33%) showed an Agatston score > 0 in the ngCCT. Of the 3 patients with 1-10 Agatston score on gCCT, 1 (33%) showed an Agatston score of 0 in the ngCCT. Overall, 23 (38%) patients were reclassified in a different cardiovascular risk category, mostly (18/23; 78%) shifting to a lower risk in the ngCCT. The estimated radiation dose was significantly higher for gCCT (DLP 115.8 ± 50.7 vs 83.8 ± 16.3; Effective dose 1.6 ± 0.7 mSv vs 1.2 ± 0.2 mSv; P < 0.01). Conclusion: CACS assessment is feasible on ngCCT; the variability of CACS values and the associated re-stratification of patients in cardiovascular risk groups should be taken into account.

Published
2014
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50. Clinical parameters of death and heart failure hospitalization in biventricular systolic dysfunction assessed via cardiac magnetic resonance.

Author

Al'Aref SJ, Gautam N, Mansour M, Alqaisi O, Tarun T, Devabhaktuni S, Atreya A, Abete R, Aquaro GD, Baggiano A, Barison A, Bogaert J, Camastra G, Carigi S, Carrabba N, Casavecchia G, Censi S, Cicala G, De Cecco CN, De Lazzari M, Di Giovine G, Calo L, Dobrovie M, Focardi M, Fusini L, Gaibazzi N, Gismondi A, Gravina M, Guglielmo M, Lanzillo C, Lombardi M, Lorenzoni V, Lozano-Torres J, Margonato D, Martini C, Marzo F, Masci PG, Masi A, Moro C, Muscogiuri G, Mushtaq S, Nese A, Palumbo A, Pavon AG, Pedrotti P, Marra MP, Pradella S, Presicci C, Rabbat MG, Raineri C, Rodriguez-Palomares JF, Sbarbati S, Schoepf UJ, Squeri A, Sverzellati N, Symons R, Tat E, Timpani M, Todiere G, Valentini A, Varga-Szemes A, Volpe A, Guaricci AI, Schwitter J, and Pontone G

Abstract

Aims: While factors associated with adverse events are well elucidated in setting of isolated left ventricular dysfunction, clinical and imaging-based prognosticators of adverse outcomes are lacking in context of biventricular dysfunction. The purpose of this study was to establish role of clinical variables in prognosis of biventricular heart failure (HF), as assessed by cardiac magnetic resonance imaging., Methods: Study cohort consisted of 840 patients enrolled in DERIVATE registry with coexisting CMR-derived right ventricular (RV) and left ventricular (LV) dysfunction, as defined by RV and LV ejection fractions ≤45 % and ≤ 50 %, respectively. The primary objective was to identify factors associated with adverse long-term outcomes, defined as composite of all-cause death and HF hospitalizations (DHFH). Kaplan-Meir curves were plotted for survival analysis. Cox proportional hazard models were constructed to estimate adjusted hazard ratios (aHRs) and associated 95 % confidence intervals for clinical variables and their correlation with adverse events., Results: Mean age was 61.0 years; 83.1 % were male, 26.6 % had diabetes mellitus (DM), and 45.9 % had non-ischemic cardiomyopathy. At median follow-up of 2 years, DHFH occurred in 32.5 % of the cohort. Kaplan-Meir analysis showed higher rate of DHFH in patients with DM (35.2 % vs. 22.6 %, p < 0.001). Multivariate Cox regression analysis showed that DM was independently associated with DHFH (aHR 1.61 [95 % CI: 1.15-2.25]; p = 0.003). Importantly, ACE-inhibitor/ARB usage in patients with DM was associated with significant reduction in DHFH (aHR 0.53 [95 % CI: 0.31-0.90]; p = 0.02)., Conclusion: In patients with biventricular HF, DM was a strong predictor of DHFH, with ACE-inhibitor/ARB usage having cardioprotective effect., Competing Interests: Declaration of competing interest Subhi J. Al’Aref is supported by NIH: National Institutes of Health, USA 2R01 HL12766105 & 1R21 EB030654 and receives royalty fees from Elsevier. Carlo De Cecco received grant from Siemens. Gianluca Pontone received institutional fees by General Electric, Bracco, Heartflow, Medtronic, Bayer, Bhoeringher. Juerg Schwitter received research support by Bayer Healthcare Switzerland. U. Joseph Schoepf received grant by Astellas, Bayer, General Electric, and Siemens Healthcare, personal fees by Guerbet, speaking honorarium by Heartflow. Akos Varga-Szemes received grant from Siemens Healthcare and personal fees from Elucid Bioimaging. The other authors have no conficts of interestes relevant to this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Published
2024
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