Computed tomography angiography-derived extracellular volume fraction predicts early recovery of left ventricular systolic function after transcatheter aortic valve replacement.

Aims: Recovery of left ventricular ejection fraction (LVEF) after aortic valve replacement has prognostic importance in patients with aortic stenosis (AS). The mechanism by which myocardial fibrosis impacts LVEF recovery in AS is not well characterized. We sought to evaluate the predictive value of extracellular volume fraction (ECV) quantified by cardiac CT angiography (CTA) for LVEF recovery in patients with AS after transcatheter aortic valve replacement (TAVR).

Prognostic Value of Computed Tomography-Derived Extracellular Volume in TAVR Patients With Low-Flow Low-Gradient Aortic Stenosis.

Objectives: The association between extracellular volume (ECV) measured by computed tomography angiography (CTA) and clinical outcomes was evaluated in low-flow low-gradient (LFLG) aortic stenosis (AS) patients undergoing transcatheter aortic valve replacement (TAVR).

Background: Patients with LFLG AS comprise a high-risk group with respect to clinical outcomes. Although ECV, a marker of myocardial fibrosis, is traditionally measured with cardiac magnetic resonance, it can also be measured using cardiac CTA.

Prediction of revascularization by coronary CT angiography using a machine learning ischemia risk score.

Objectives: The machine learning ischemia risk score (ML-IRS) is a machine learning-based algorithm designed to identify hemodynamically significant coronary disease using quantitative coronary computed tomography angiography (CCTA). The purpose of this study was to examine whether the ML-IRS can predict revascularization in patients referred for invasive coronary angiography (ICA) after CCTA.

Methods: This study was a post hoc analysis of a prospective dual-center registry of sequential patients undergoing CCTA followed by ICA within 3 months, referred from inpatient, outpatient, and emergency department settings (n = 352, age 63 ± 10 years, 68% male).

3D PET/CT Rb PET myocardial blood flow quantification: comparison of half-dose and full-dose protocols.

Purpose: Quantification of myocardial blood flow (MBF) has become central in the clinical application of Rubidium-82 (Rb) PET myocardial perfusion scans. Current recommendations suggest injections of 1100-1500 MBq of Rb in bolus form, which poses a potential risk of PET system saturation on most 3D PET/CT systems currently being used. We aimed to evaluate the frequency and impact of PET system saturation and to test the potential use of a half-dose acquisition protocol.

Improved Evaluation of Lipid-Rich Plaque at Coronary CT Angiography: Head-to-Head Comparison with Intravascular US.

Purpose: To improve the evaluation of low-attenuation plaque (LAP) by using semiautomated software and to assess whether the use of a proposed automated function (LAP editor) that excludes voxels adjacent to the outer vessel wall improves the relationship between LAP and the presence and size of the lipid-rich component (LRC) verified at intravascular US. At coronary CT angiography, quantification of LAP can improve risk stratification. defined as the area between the vessel and the lumen wall, is prone to partial volume effects from the surrounding pericoronary adipose tissue.

Deep Learning-Based Quantification of Epicardial Adipose Tissue Volume and Attenuation Predicts Major Adverse Cardiovascular Events in Asymptomatic Subjects.

Background: Epicardial adipose tissue (EAT) volume (cm) and attenuation (Hounsfield units) may predict major adverse cardiovascular events (MACE). We aimed to evaluate the prognostic value of fully automated deep learning-based EAT volume and attenuation measurements quantified from noncontrast cardiac computed tomography.

Methods: Our study included 2068 asymptomatic subjects (56±9 years, 59% male) from the EISNER trial (Early Identification of Subclinical Atherosclerosis by Noninvasive Imaging Research) with long-term follow-up after coronary artery calcium measurement.

Coronary computed tomography-angiography quantitative plaque analysis improves detection of early cardiac allograft vasculopathy: A pilot study.

Cardiac allograft vasculopathy (CAV) is an increasingly important complication after cardiac transplant. We assessed the additive diagnostic benefit of quantitative plaque analysis in patients undergoing coronary computed tomography-angiography (CCTA). Consecutive patients undergoing CCTA for CAV surveillance were identified.

Short-term repeatability of myocardial blood flow using Rb PET/CT: The effect of arterial input function position and motion correction.

Background: We tested the repeatability of myocardial blood flow (MBF) quantified using Rb with and without motion correction (MC) and with arterial input functions estimated from left ventricle (LV) and atrium (LA).

Methods: Twenty-one patients referred for clinical Rb PET/CT underwent repeated rest scans in a single imaging session. Global MBF was quantified using three different assessments by two operators: (1) automatic processing without MC and LV arterial input function (AIF), (2) with MC and LV-AIF, and (3) with MC and LA-AIF.

Impact of heart rate on coronary computed tomographic angiography interpretability with a third-generation dual-source scanner.

Background: Guidelines suggest coronary computed tomography angiography (CCTA) should be performed with a heart rate (HR) below 60. Third-generation dual-source CT (DSCT) scanners, with improved temporal resolution, and end-systolic acquisition may facilitate imaging at higher HRs. We determined the influence of HR and end-systolic acquisition on image interpretability and quality with a third-generation DSCT.

Transient ischaemic dilation and post-stress wall motion abnormality increase risk in patients with less than moderate ischaemia: analysis of the REFINE SPECT registry.

Aims: Ischaemia on single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) is strongly associated with cardiovascular risk. Transient ischaemic dilation (TID) and post-stress wall motion abnormalities (WMA) are non-perfusion markers of ischaemia with incremental prognostic utility. Using a large, multicentre SPECT MPI registry, we assessed the degree to which these features increased the risk of major adverse cardiovascular events (MACE) in patients with less than moderate ischaemia.

Peri-Coronary Adipose Tissue Density Is Associated With F-Sodium Fluoride Coronary Uptake in Stable Patients With High-Risk Plaques.

Objectives: This study aimed to assess the association between increased lesion peri-coronary adipose tissue (PCAT) density and coronary F-sodium fluoride (F-NaF) uptake on positron emission tomography (PET) in stable patients with high-risk coronary plaques (HRPs) shown on coronary computed tomography angiography (CTA).

Background: Coronary F-NaF uptake reflects the rate of calcification of coronary atherosclerotic plaque. Increased PCAT density is associated with vascular inflammation.

Sex differences in heart failure.

Heart failure (HF) numbers continue to grow in the United States and approximately 50% of patients living with HF are women. For the provider, it is critical to understand the role that gender plays in recognition, diagnosis, and management. The purpose of this literature review is to highlight the prevalence of heart failure in women and discuss gender variations in epidemiology, symptoms, pharmacology, and treatment as well as examine the representation of women in clinical trials.