Predictive Value of Coronary Calcifications for Future Cardiac Events in Asymptomatic Patients with Severe Chronic Kidney Disease.

Background: Coronary calcification is a well-established risk factor for cardiovascular events. This retrospective study sought to determine the predictive value of coronary calcification in a specific group of patients with chronic kidney disease.

Methods: We included 1094 asymptomatic patients (724 males, 370 females, age 62 ± 9.

Increased Pericardial Adipose Tissue in Smokers.

Background: Pericardial adipose tissue (PAT), a visceral fat depot directly located to the heart, is associated with atherosclerotic and inflammatory processes. The extent of PAT is related to the prevalence of coronary heart disease and might be used for cardiovascular risk prediction. This study aimed to determine the effect of smoking on the extent of PAT.

Sitagliptin plus granulocyte colony-stimulating factor in patients suffering from acute myocardial infarction: A double-blind, randomized placebo-controlled trial of efficacy and safety (SITAGRAMI trial).

Objective: In animal models, G-CSF based progenitor cell mobilization combined with a DPP4 inhibitor leads to increased homing of bone marrow derived progenitor cells to the injured myocardium via the SDF1/CXCR4 axis resulting in improved ejection fraction and survival after acute myocardial infarction (AMI).

Research Design And Methods: After successful revascularization in AMI, 174 patients were randomized 1:1 in a multi-centre, prospective, placebo-controlled, parallel group, double blind, phase III efficacy and safety trial to treatment with G-CSF and Sitagliptin (GS) or placebo. Diabetic and non-diabetic patients were included in our trial.

De novo sirolimus with low-dose tacrolimus versus full-dose tacrolimus with mycophenolate mofetil after heart transplantation--8-year results.

Background: Although acute cellular rejection after heart transplantation (HTX) can be controlled by full-dose calcineurin inhibitor (CNI)-based immunosuppressive regimens, cardiac allograft vasculopathy (CAV), nephrotoxicity, and malignancy remain ongoing problems. To evaluate the potential beneficial effects of sirolimus and CNI reduction, we compared de novo low-dose tacrolimus and sirolimus with standard tacrolimus and mycophenolate mofetil (MMF)-based immunosuppression after HTX.

Methods: We analyzed a long-term follow-up cohort of 126 patients who underwent HTX during the period 1998-2005 and received either de novo low-dose tacrolimus/sirolimus (lowTAC/SIR; n = 61) or full-dose tacrolimus/MMF (TAC/MMF; n = 64).

Immediate and 12 months follow up of function and lead integrity after cranial MRI in 356 patients with conventional cardiac pacemakers.

Background: Conventional cardiac pacemakers are still often regarded as a contraindication to magnetic resonance imaging (MRI). We conducted this study to support the hypothesis that it is safe to scan patients with cardiac pacemakers in a 1.5 Tesla MRI, if close supervision and monitoring as well as adequate pre- and postscan programming is provided.

Distribution of coronary calcifications in patients with suspected coronary heart disease.

Background: Coronary calcifications are a marker of coronary atherosclerosis. The role of coronary calcium scoring (CS) as part of the initial evaluation of patients with suspected coronary heart disease (CHD) is controversially discussed. The primary goal of this study was to characterize the coronary calcium distribution in this particular patient population.

Dynamic myocardial CT perfusion imaging for evaluation of myocardial ischemia as determined by MR imaging.

Objectives: The aim of this study was to determine the feasibility of computed tomography (CT)-based dynamic myocardial perfusion imaging for the assessment of myocardial ischemia and infarction compared with cardiac magnetic resonance (CMR).

Background: Sequential myocardial CT perfusion imaging has emerged as a novel imaging technique for the assessment of myocardial hypoperfusion.

Methods: We prospectively enrolled subjects with known coronary artery disease who underwent adenosine-mediated stress dynamic dual-source CT (100 kV, 320 mAs/rot) and CMR (3-T).

Use of multi-slice computed tomography in patients with chest-pain submitted to the emergency department.

This study evaluates calcium scoring (CS) and computed tomography angiography (MSCTA) in patients >50 years with chest-pain submitted to the emergency department utilising CS as a "diagnostic filter" upfront. Results of CS and MSCTA performed by a 64-slice CT scanner were compared to invasive coronary angiography (ICA). 289 consecutive symptomatic patients (185 men, mean age 71.

Norepinephrine versus dopamine pretreatment of potential heart donors - impact on long-term outcome.

Background: Current guidelines advocate administration of inotropic agents to stabilize potential deceased heart-beating donors. A consensus on the specific agent or combination therapy is lacking. We thus initiated a retrospective analysis of patients being transplanted at our center in a matched-pair study design focusing on survival after donor pre-treatment either with norepinephrine or dopamine.

CT stress perfusion imaging for detection of haemodynamically relevant coronary stenosis as defined by FFR.

Objectives: To evaluate the diagnostic accuracy (DA) of CT-myocardial perfusion imaging (CT-MPI) and a combined approach with CT angiography (CTA) for the detection of haemodynamically relevant coronary stenoses in patients with both suspected and known coronary artery disease.

Design: Prospective, non-randomised, diagnostic study.

Setting: Academic hospital-based study.

Increased pericardial adipose tissue is correlated with atrial fibrillation and left atrial dilatation.

Introduction: Pericardial adipose tissue (PAT), a visceral fat depot surrounding the heart, serves as an endocrine active organ and is associated with inflammation. There is growing evidence that atrial fibrillation (AF) is linked with inflammation, which in turn can be a promoter of left atrial remodeling. The aim of this study was to evaluate a potential correlation of PAT to AF and left atrial structural remodeling represented by LA size.

SPECT myocardial perfusion imaging as an adjunct to coronary calcium score for the detection of hemodynamically significant coronary artery stenosis.

Background: Coronary artery calcifications (CAC) are markers of coronary atherosclerosis, but do not correlate well with stenosis severity. This study intended to evaluate clinical situations where a combined approach of coronary calcium scoring (CS) and nuclear stress test (SPECT-MPI) is useful for the detection of relevant CAD.

Methods: Patients with clinical indication for invasive coronary angiography (ICA) were included into our study during 08/2005-09/2008.

Lipoprotein (a) is independently correlated with coronary artery calcification.

Introduction: Lipoprotein a (Lp(a)) has been recognized as a risk factor for both coronary heart diseases and for cardiovascular events. Coronary artery calcification (CAC) is a well proven marker for coronary artery disease and risk factor for cardiovascular events. Still there are conflicting data regarding the relationship of Lp(a) and CAC.

Detection of significant coronary artery stenosis with cardiac dual-source computed tomography angiography in heart transplant recipients.

Present study evaluates clinical feasibility of cardiac dual-source computed tomography angiography (DSCTA) to detect significant coronary stenosis because of chronic allograft vasculopathy (CAV) after heart transplantation (HTX). An overall of 51 consecutive heart transplant recipients (43 men, 8 women, mean age: 52.3 ± 13.

Determination of pericardial adipose tissue increases the prognostic accuracy of coronary artery calcification for future cardiovascular events.

Objectives: Pericardial adipose tissue (PAT) is associated with coronary artery plaque accumulation and the incidence of coronary heart disease. We evaluated the possible incremental prognostic value of PAT for future cardiovascular events.

Methods: 145 patients (94 males, age 60 ± 10 years) with stable coronary artery disease underwent coronary artery calcification (CAC) scanning in a multislice CT scanner, and the volume of pericardial fat was measured.

Donor transmitted left atrial myxoma 13 years after heart transplantation.

Background: Left atrial cardiac myxomas are among the most common cardiac masses. However, occurrence of left atrial myxomas in post-transplant patients is very rare and often misdiagnosed as left atrial thrombus formation.

Case Report: We report the case of a 67-year old female, who was referred due to suspected left atrial thrombus but was found to have a pediculated mass at the suture line of the left atrium on cardiac MRI.

Detection of hemodynamically significant coronary artery stenosis: incremental diagnostic value of dynamic CT-based myocardial perfusion imaging.

Purpose: To determine the feasibility of computed tomography (CT)-based dynamic myocardial perfusion imaging for the detection of hemodynamically significant coronary artery stenosis, as defined with fractional flow reserve (FFR).

Materials And Methods: Institutional review board approval and informed patient consent were obtained before patient enrollment in the study. The study was HIPAA compliant.

Cardiac arrest associated with sildenafil ingestion in a patient with an abnormal origin of the left coronary artery: case report.

Background: Left coronary artery arising from the right sinus of Valsalva is an uncommon congenital coronary anomaly that seems to be associated with sudden death in young patients.

Case Presentation: We report a case of cardiac arrest in a 59-year-old patient after sexual intercourse and Sildenafil ingestion. A coronary arteriography and an angiographic computed tomography scan subsequently revealed a LCA origin from the right aortic sinus along with an intramural course of the left main stem.

Coronary dilatation after heart transplantation.

Background: The angiographic incidence of coronary dilatation (CD) in the nontransplant population is approximately 0.2% to 5%. The endothelial-dependent and -independent causes for CD are postulated.

Coronary calcifications detected by computed tomography are not markers of cardiac allograft vasculopathy.

Background: Cardiac allograft vasculopathy (CAV) still limits survival after heart transplantation. Currently available noninvasive tests are of inferior value to detect CAV, and thus invasive coronary angiography (ICA) is frequently performed. Cardiac dual-source computed tomography calcium scoring (DSCTCS) offers the possibility to detect coronary calcifications, which might serve as a noninvasive marker of CAV.

Visualization of anomalous origin and course of coronary arteries in 748 consecutive symptomatic patients by 64-slice computed tomography angiography.

Background: Coronary artery anomalies (CAAs) are currently undergoing profound changes in understanding potentially pathophysiological mechanisms of disease. Aim of this study was to investigate the prevalence of anomalous origin and course of coronary arteries in consecutive symptomatic patients, who underwent cardiac 64-slice multidetector-row computed tomography angiography (MDCTA).

Methods: Imaging datasets of 748 consecutive symptomatic patients referred for cardiac MDCTA were analyzed and CAAs of origin and further vessel course were grouped according to a recently suggested classification scheme by Angelini et al.

MMP-1 serum levels predict coronary atherosclerosis in humans.

Background: Myocardial infarction results as a consequence of atherosclerotic plaque rupture, with plaque stability largely depending on the lesion forming extracellular matrix components. Lipid enriched non-calcified lesions are considered more instable and rupture prone than calcified lesions. Matrix metalloproteinases (MMPs) are extracellular matrix degrading enzymes with plaque destabilisating characteristics which have been implicated in atherogenesis.

Chemerin is associated with markers of inflammation and components of the metabolic syndrome but does not predict coronary atherosclerosis.

Objectives: Chemerin is a recently discovered adipokine that regulates adipocyte differentiation and modulates chemotaxis and activation of dendritic cells and macrophages. Given the convergence of adipocyte and macrophage function, chemerin may provide an interesting link between obesity, inflammation and atherosclerosis in humans. We sought to examine the relationship of i) chemerin and markers of inflammation, ii) chemerin and components of the metabolic syndrome, and iii) chemerin and coronary atherosclerotic plaque burden and morphology.

Low adiponectin levels are an independent predictor of mixed and non-calcified coronary atherosclerotic plaques.

Background: Atherosclerosis is the primary cause of coronary artery disease (CAD). There is increasing recognition that lesion composition rather than size determines the acute complications of atherosclerotic disease. Low serum adiponectin levels were reported to be associated with coronary artery disease and future incidence of acute coronary syndrome (ACS).

Pericardial adipose tissue determined by dual source CT is a risk factor for coronary atherosclerosis.

Objectives: Pericardial fat as a visceral fat depot may be involved in the pathogenesis of coronary atherosclerosis. To gain evidence for that concept we sought to investigate the relation of pericardial fat volumes to risk factors, serum adiponectin levels, inflammatory biomarkers, and the quantity and morphology of coronary atherosclerosis.

Methods And Results: Using Dual source CT angiography pericardial fat volume and coronary atherosclerosis were assessed simultaneously.