The aim of this study was to evaluate the subclinical patterns and evolution of cardiac abnormalities via transthoracic echocardiography (TTE) in patients with mild initial COVID-19 illness. A total of 343 infected individuals (163 males; age 44 (interquartile range, IQR 35-52) years) years) underwent serial TTE assessments at a median of 109 (interquartile range (IQR), 77-177) and 327 (276-379) days after infection. Compared with those of non-COVID-19-infected controls (n = 94, male n = 49), baseline systolic (LVEF, TAPSE) and diastolic function (e', a', E/e') were significantly different in infected participants (p < 0.
View Article and Find Full Text PDFBackground: Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiovascular disease that affects approximately one in 500 people. Cardiac magnetic resonance (CMR) imaging has emerged as a powerful tool for the non-invasive assessment of HCM. CMR can accurately quantify the extent and distribution of hypertrophy, assess the presence and severity of myocardial fibrosis, and detect associated abnormalities.
View Article and Find Full Text PDFBackground: The aim of this study is to describe resources and outcomes of coronary computed tomography angiography plus Stress CT perfusion (CCTA + Stress-CTP) and stress cardiovascular magnetic resonance (Stress-CMR) in symptomatic patients with suspected or known CAD.
Methods: Six hundred and twenty-four consecutive symptomatic patients with intermediate to high-risk pretest likelihood for CAD or previous history of revascularization referred to our hospital for clinically indicated CCTA + Stress-CTP or Stress-CMR were enrolled. Stress-CTP scans were performed in 223 patients while 401 patients performed Stress-CMR.
This work proposes a convolutional neural network (CNN) that utilizes different combinations of parametric images computed from cine cardiac magnetic resonance (CMR) images, to classify each slice for possible myocardial scar tissue presence. The CNN performance comparison in respect to expert interpretation of CMR with late gadolinium enhancement (LGE) images, used as ground truth (GT), was conducted on 206 patients (158 scar, 48 control) from Centro Cardiologico Monzino (Milan, Italy) at both slice- and patient-levels. Left ventricle dynamic features were extracted in non-enhanced cine images using parametric images based on both Fourier and monogenic signal analyses.
View Article and Find Full Text PDFConstrictive pericarditis (CP) is a rare condition that can affect the pericardium after every pericardial disease process and has been described even after SARS-CoV-2 infection or vaccine. In CP, the affected pericardium, usually the inner layer, is noncompliant, constraining the heart to a fixed maximum volume and impairing the diastolic function. This leads to several clinical features, that, however, can be pleomorphic.
View Article and Find Full Text PDFBackground: Graft occlusion after coronary artery bypass grafting (CABG) has been associated with competitive flow of native coronary arteries.
Objectives: To assess with coronary computed tomography angiography (CCTA) graft occlusion and coronary artery disease (CAD) progression of native vessels after CABG and their relationship with angiography-derived vessel fractional flow reserve (vFFR) performed before surgery.
Methods: Between 2006 and 2018, serial vFFR analyses were obtained before CABG in each major native coronary vessel from two institutions.
Aims: Diagnosis of myocardial fibrosis is commonly performed with late gadolinium contrast-enhanced (CE) cardiac magnetic resonance (CMR), which might be contraindicated or unavailable. Coronary computed tomography (CCT) is emerging as an alternative to CMR. We sought to evaluate whether a deep learning (DL) model could allow identification of myocardial fibrosis from routine early CE-CCT images.
View Article and Find Full Text PDFBackground: Cardiac computed tomography (CCT) was recently validated to measure extracellular volume (ECV) in the setting of cardiac amyloidosis, showing good agreement with cardiovascular magnetic resonance (CMR). However, no evidence is available with a whole-heart single source, single energy CT scanner in the clinical context of newly diagnosed left ventricular dysfunction. Therefore, the aim of this study was to test the diagnostic accuracy of ECV in patients with a recent diagnosis of dilated cardiomyopathy, having ECV as the reference technique.
View Article and Find Full Text PDFIschaemic heart disease (IHD) is one of the world's leading causes of morbidity and mortality. Likewise, the diagnosis and risk stratification of patients with coronary artery disease (CAD) have always been based on the detection of the presence and extent of ischaemia by physical or pharmacological stress tests with or without the aid of imaging methods (e.g.
View Article and Find Full Text PDFA 22-year-old male patient with Duchenne muscular dystrophy (DMD) and chronic constipation presents to the emergency room with severe abdominal pain and hive closed to feces and gas. Contrast-enhanced computed tomography of the abdomen demonstrates mechanical ileus due to volvulus of the transverse colon: torsion of the transverse mesocolon is confirmed and subtotaly colectomy is performed, revealing multiple ischemic areas with focal perforations. DMD is frequently associated with gastrointestinal motility disorders, including chronic constipation and life-threatening conditions like intestinal pseudo-obstruction and sigmoid volvulus.
View Article and Find Full Text PDFBackground And Objective: In patients with suspected Coronary Artery Disease (CAD), the severity of stenosis needs to be assessed for precise clinical management. An automatic deep learning-based algorithm to classify coronary stenosis lesions according to the Coronary Artery Disease Reporting and Data System (CAD-RADS) in multiplanar reconstruction images acquired with Coronary Computed Tomography Angiography (CCTA) is proposed.
Methods: In this retrospective study, 288 patients with suspected CAD who underwent CCTA scans were included.
Background: Segmentation of cardiovascular magnetic resonance (CMR) images is an essential step for evaluating dimensional and functional ventricular parameters as ejection fraction (EF) but may be limited by artifacts, which represent the major challenge to automatically derive clinical information. The aim of this study is to investigate the accuracy of a deep learning (DL) approach for automatic segmentation of cardiac structures from CMR images characterized by magnetic susceptibility artifact in patient with cardiac implanted electronic devices (CIED).
Methods: In this retrospective study, 230 patients (100 with CIED) who underwent clinically indicated CMR were used to developed and test a DL model.
Immunoglobulin G4-related disease (IgG4-RD) is a systemic immune-mediated fibro-inflammatory disorder. Coronary IgG4-RD has been scarcely reported and may present as "tumor-like" lesions. These pseudo-masses may be underdiagnosed mainly due to a vague clinical picture that can vary from complete lack of symptoms to acute coronary syndrome or sudden cardiac death.
View Article and Find Full Text PDFManagement of acute type B aortic intramural haematoma (AIH) still represents a challenging issue. Although most resolve spontaneously or with conservative therapy, several cases of AIH may complicate into classic aortic dissection with subsequent risk of aortic rupture and visceral malperfusion, thus needing urgent or preemptive thoracic endovascular aneurysm repair (TEVAR). Despite the long-term aorta-related survival, TEVAR might lead to graft obstruction, migration, infection, stroke/paraplegia, visceral ischemia, endoleak and, last but not least, retrograde aortic dissection (AD), frequent in the acute phase and associated with a high mortality risk.
View Article and Find Full Text PDFPneumothorax and pneumomediastinum are life-threatening conditions especially in critically ill patients. One of the most common situations in which they occur is prolonged invasive and non-invasive mechanical ventilation with high end-expiratory pressure. Probably due to the high number of patients with SARS-CoV-2 respiratory infection being treated with mechanical ventilation, increasing number of pulmonary barotrauma cases have been reported.
View Article and Find Full Text PDFBackground: Cardiovascular magnetic resonance permits assessment of irreversible myocardial fibrosis and contractile function in patients with previous myocardial infarction. We aimed to assess the prognostic value of myocardial fibrotic tissue with preserved/restored contractile activity.
Methods: In 730 consecutive myocardial infarction patients (64 ± 11 years), we quantified left ventricular (LV) end-diastolic (EDV) and end-systolic (ESV) volumes, ejection fraction (EF), regional wall motion (WM) (1 normal, 2 hypokinetic, 3 akinetic, 4 dyskinetic), and WM score index (WMSI), and measured the transmural (1-50 and 51-100) and global extent of the infarct scar by late gadolinium enhancement (LGE).
Takotsubo syndrome is found in about 5%-6% of patients presenting with suspected ST-elevation myocardial infarction. Coronary angiography with left ventriculography is currently considered the modality of choice for the diagnosis. However, improvements of noninvasive diagnostic techniques have been allowing for definite assessment of ventricular function and anatomy.
View Article and Find Full Text PDFPortal vein thrombosis is a pathological condition characterized by the lumen occlusion of the portal vein and its intrahepatic branches, commonly associated to chronic liver diseases. Portal vein thrombosis is often asymptomatic and discovered as an incidental finding in the follow-up of chronic hepatopathy. Imaging plays a pivotal role in the detection and characterization of portal vein thrombosis in patients with hepatocellular carcinoma.
View Article and Find Full Text PDFVaccination plays an important role in the fight against SARS-CoV-2 to minimie the spread of coronavirus disease 2019 (COVID-19) and its life-threatening complications. Myocarditis has been reported as a possible and rare adverse consequence of different vaccines, and its clinical presentation can range from influenza-like symptoms to acute heart failure. We report a case of a 30-year-old man who presented progressive dyspnea and constrictive retrosternal pain after receiving SARS-CoV-2 vaccine.
View Article and Find Full Text PDFStage A and B heart failure (HF) include asymptomatic patients without and with structural cardiac disorder, respectively. Asymptomatic left ventricular (LV) dysfunction represents an early stage of HF that should be recognized to prevent overt HF development. Echocardiography plays a pivotal role in assessment of cardiac structure and function and represents the ideal imaging technique for screening in the general population, thanks to its availability, feasibility, and low cost.
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