Inflammatory risk and cardiovascular events in patients without obstructive coronary artery disease: the ORFAN multicentre, longitudinal cohort study.

Background: Coronary computed tomography angiography (CCTA) is the first line investigation for chest pain, and it is used to guide revascularisation. However, the widespread adoption of CCTA has revealed a large group of individuals without obstructive coronary artery disease (CAD), with unclear prognosis and management. Measurement of coronary inflammation from CCTA using the perivascular fat attenuation index (FAI) Score could enable cardiovascular risk prediction and guide the management of individuals without obstructive CAD.

The Use and Efficacy of FFR-CT: Real-World Multicenter Audit of Clinical Data With Cost Analysis.

Background: Fractional flow reserve-computed tomography (FFR-CT) is endorsed by UK and U.S. chest pain guidelines, but its clinical effectiveness and cost benefit in real-world practice are unknown.

Cardiovascular disease in women: insights from magnetic resonance imaging.

The presentation and identification of cardiovascular disease in women pose unique diagnostic challenges compared to men, and underrecognized conditions in this patient population may lead to clinical mismanagement.This article reviews the sex differences in cardiovascular disease, explores the diagnostic and prognostic role of cardiovascular magnetic resonance (CMR) in the spectrum of cardiovascular disorders in women, and proposes the added value of CMR compared to other imaging modalities. In addition, this article specifically reviews the role of CMR in cardiovascular diseases occurring more frequently or exclusively in female patients, including Takotsubo cardiomyopathy, connective tissue disorders, primary pulmonary arterial hypertension and peripartum cardiomyopathy.

Low-Dose Alteplase During Primary Percutaneous Coronary Intervention According to Ischemic Time.

Background: Microvascular obstruction affects one-half of patients with ST-segment elevation myocardial infarction and confers an adverse prognosis.

Objectives: This study aimed to determine whether the efficacy and safety of a therapeutic strategy involving low-dose intracoronary alteplase infused early after coronary reperfusion associates with ischemic time.

Methods: This study was conducted in a prospective, multicenter, parallel group, 1:1:1 randomized, dose-ranging trial in patients undergoing primary percutaneous coronary intervention.

A Multicenter, Scan-Rescan, Human and Machine Learning CMR Study to Test Generalizability and Precision in Imaging Biomarker Analysis.

Background: Automated analysis of cardiac structure and function using machine learning (ML) has great potential, but is currently hindered by poor generalizability. Comparison is traditionally against clinicians as a reference, ignoring inherent human inter- and intraobserver error, and ensuring that ML cannot demonstrate superiority. Measuring precision (scan:rescan reproducibility) addresses this.

Cangrelor versus Ticagrelor in Patients Treated with Primary Percutaneous Coronary Intervention: Impact on Platelet Activity, Myocardial Microvascular Function and Infarct Size: A Randomized Controlled Trial.

Background:  Oral P2Y12 inhibitors take more than 2 hours to achieve full effect in healthy subjects and this action is further delayed in patients with acute myocardial infarction. Intravenous P2Y12 inhibition might lead to more timely and potent anti-platelet effect in the context of emergency primary angioplasty, improving myocardial recovery.

Objectives:  This article compares the efficacy of intravenous cangrelor versus ticagrelor in a ST-elevation myocardial infarction (STEMI) population treated with primary percutaneous coronary intervention (PPCI).

Microvascular dysfunction determines infarct characteristics in patients with reperfused ST-segment elevation myocardial infarction: The MICROcirculation in Acute Myocardial Infarction (MICRO-AMI) study.

Background: In patients with reperfused ST-elevation myocardial infarction (STEMI) both invasive and non-invasive assessments of microvascular dysfunction, the index of microcirculatory resistance (IMR), and microvascular obstruction (MVO) by cardiovascular magnetic resonance (CMR), independently predict poor long-term outcomes.

Aims: The aims of this study were to investigate whether an invasive parameter (IMR), assessed at the time of primary percutaneous intervention (PPCI), could predict the extent of MVO in proportion to infarct size (MVO index).

Methods: 50 patients presenting with STEMI and TIMI flow ≤ I in the infarct related artery were prospectively recruited to the study, before undergoing PPCI.

Native T1 mapping to detect extent of acute and chronic myocardial infarction: comparison with late gadolinium enhancement technique.

Investigate whether native-T1 mapping can assess the transmural extent of myocardial infarction (TEI) thereby differentiating viable from non-viable myocardium without the use of gadolinium-contrast in both acute and chronic myocardial infarction (aMI and cMI). Sixty patients (30 cMI > 1 year and 30 aMI day 2 STEMI) and 20 healthy-controls underwent 1.5 T CMR to assess left ventricular function (cine), native-T1 mapping (MOLLI sequence 5(3)3, motion-corrected) and the presence and TEI from late gadolinium enhancement (LGE) images.

Formal consensus to identify clinically important changes in management resulting from the use of cardiovascular magnetic resonance (CMR) in patients who activate the primary percutaneous coronary intervention (PPCI) pathway.

Objective: To define important changes in management arising from the use of cardiovascular magnetic resonance (CMR) in patients who activate the primary percutaneous coronary intervention (PPCI) pathway.

Design: Formal consensus study using literature review and cardiologist expert opinion to formulate consensus statements and setting up a consensus panel to review the statements (by completing a web-based survey, attending a face-to-face meeting to discuss survey results and modify the survey to reflect group discussion and completing the modified survey to determine which statements were in consensus).

Participants: Formulation of consensus statements: four cardiologists (two CMR and two interventional) and six non-clinical researchers.

The effect of reducing spatial resolution by in-plane partial volume averaging on peak velocity measurements in phase contrast magnetic resonance angiography.

Background: The aim of this study was to quantify the degree of the effect of in-plane partial volume averaging on recorded peak velocity in phase contrast magnetic resonance angiography (PCMRA).

Methods: Using cardiac optimized 1.5 Tesla MRI scanners (Siemens Symphony and Avanto), 145 flow measurements (14 anatomical locations; ventricular outlets, aortic valve (AorV), aorta (5 sites), pulmonary arteries (3 sites), pulmonary veins, superior and inferior vena cava)- in 37 subjects (consisting of healthy volunteers, congenital and acquired heart disease patients) were analyzed by Siemens Argus default voxel averaging technique (where peak velocity = mean of highest velocity voxel and four neighbouring voxels) and by single voxel technique (1.

A Novel Cause of Acute Coronary Syndrome Due to Dynamic Extrinsic Coronary Artery Compression by a Rib Exostosis: Multimodality Imaging Diagnosis.

We report a case of acute coronary syndrome secondary to intermittent extrinsic compression of the left anterior descending coronary artery by inward-pointing rib exostosis in an 18-year-old woman during forceful repeated expiration in labour. The diagnosis was achieved using multimodality noninvasive cardiac imaging. In particular, we demonstrated the novel role of expiratory-phase cardiac computed tomography in confirming the anatomical relationship of the bony exostosis to the left anterior descending coronary artery.

Optimising the imaging plane for right ventricular magnetic resonance volume analysis in adult patients referred for assessment of right ventricular structure and function.

Introduction: Our aim was to evaluate the reproducibility and accuracy of using short-axis and axial (transaxial) plane for magnetic resonance imaging analysis in adult patients referred for assessment of right ventricular (RV) structure and function.

Methods: Twenty consecutive subjects (10 male, 10 female, mean age 32.2 ± 14.

The impact of infarct size on regional and global left ventricular systolic function: a cardiac magnetic resonance imaging study.

Myocardial infarction (MI) results in myocardial scarring which can have an impact on left ventricular (LV) stiffness and contractile function, ultimately leading to reduced LV systolic function and LV remodelling, However some concerns about the relation between scar extension and segmental wall motion contractility is not enough clear. Thus, the association between myocardial scar, LV regional and global function and LV remodeling should be investigated. We studied the relationship between scar extension, wall motion score index (WMSI), LV dimensions and systolic function in a group of patients with previous MI by cardiac magnetic resonance (CMR).

Quantification of infarct size and myocardium at risk: evaluation of different techniques and its implications.

Aims: The aim of this study was to evaluate seven methods for quantifying myocardial oedema [2 standard deviation (SD), 3 SD, 5 SD, full width at half maximum (FWHM), Otsu method, manual thresholding, and manual contouring] from T2-weighted short tau inversion recovery (T2w STIR) and also to reassess these same seven methods for quantifying acute infarct size following ST-segment myocardial infarction (STEMI). This study focuses on test-retest repeatability while assessing inter- and intraobserver variability. T2w STIR and late gadolinium enhancement (LGE) are the most widely used cardiovascular magnetic resonance (CMR) techniques to image oedema and infarction, respectively.

Measurement of myocardium at risk with cardiovascular MR: comparison of techniques for edema imaging.

Purpose: To determine variability and agreement for detecting myocardial edema with T2-weighted short-tau inversion recovery (STIR), acquisition for cardiac unified T2 edema (ACUT2E), T2 mapping, and early gadolinium enhancement (EGE) after successfully reperfused ST-segment-elevation myocardial infarction (STEMI) and diagnostic accuracy of each sequence to predict infarct-related artery (IRA).

Materials And Methods: Local ethics committee approved the study, with patient informed written consent. On day 2 after successful primary angioplasty for STEMI, 53 patients were prospectively enrolled; 40 patients (mean age, 60 years) completed study.

Diagnosing cardiac involvement in the hypereosinophilic syndrome by cardiac magnetic resonance.

Hypereosinophilic syndrome is characterized by unexplained hypereosinophilia involving different organ systems. The investigators present a patient diagnosed with hypereosinophilic syndrome in which cardiac magnetic resonance was pivotal in establishing the presence of cardiac involvement.

Impact of gender differences on myocardial salvage and post-ischaemic left ventricular remodelling after primary coronary angioplasty: new insights from cardiovascular magnetic resonance.

Aims: There is conflicting evidence on the impact of gender on reperfusion after primary coronary angioplasty (PPCI), and on left ventricular (LV) remodelling (LVR). In a cohort of patients with reperfused ST elevation myocardial infarction (STEMI), gender-related differences on myocardial reperfusion, and sex-related differences on LVR were assessed by using a comprehensive cardiac magnetic resonance (CMR) approach.

Methods And Results: In four tertiary referral centres, 283 (238 males and 45 females) consecutive STEMI patients, treated with PPCI within 12 h from symptoms onset underwent CMR 3 ± 2 days after STEMI and at 4-month follow-up.