Regional variability of cardiovascular magnetic resonance access and utilization in the United States.

Background: Clinical guidelines and scientific data increasingly support the appropriate use of cardiovascular magnetic resonance (CMR) . The extent of CMR adoption across the United States (US) remains unclear. This observational analysis aims to capture CMR practice patterns in the US.

Outcome of MRI in Patients with Nonconditional Devices with Mismatch between Manufacturer of Leads and Generator.

In a series of 35 MRI examinations with non-MRI-conditional devices with a mismatch between the manufacturer of the device generators and leads, there were no adverse events.

Relationship Between Myocardial Perfusion Imaging Abnormalities on Positron Emission Tomography and Anginal Symptoms, Functional Status, and Quality of Life.

Background: Myocardial perfusion imaging (MPI) identifies abnormalities that occur early in the ischemic cascade leading to angina. Our aim was to study the association between ischemic measures on positron emission tomography MPI and patients' health status; their symptoms, function, and quality of life.

Methods: Health status was collected using the Seattle Angina Questionnaire (SAQ-7, 0-100, higher=better) and Rose Dyspnea Score (RDS) on 1515 outpatients with known or suspected coronary artery disease presenting for clinically indicated pharmacological Rb positron emission tomography MPI from July 2018 to July 2019.

Relative Prognostic Significance of Positron Emission Tomography Myocardial Perfusion Imaging Markers in Cardiomyopathy.

Background: Rubidium-82 positron emission tomography myocardial perfusion imaging provides measurements of perfusion, myocardial blood flow and reserve (MBFR), and changes in left ventricular ejection fraction (LVEF) at rest and peak stress. Although all of these variables are known to provide prognostic information, they have not been well studied in patients with heart failure due to reduced LVEF.

Methods: Between 2010 and 2016, 1255 consecutive unique patients with LVEF≤40% were included in this study who underwent rubidium-82 positron emission tomography myocardial perfusion imaging and did not have subsequent revascularization within 90 days.

Correlation of Hepatic Steatosis Among Cohabitants Using Hounsfield Unit From Coronary Computed Tomography.

Background Individuals living in the same household are exposed to common risk factors. We hypothesized that living with someone who has fatty liver disease increases the risk of having the same disease. Methods This was a retrospective study that included pairs of men and women who shared the same residential addresses, underwent screening non-contrast computed tomography for coronary calcium scoring and had Hounsfield Unit density for liver and spleen in the field of view available for measurement.

Acute Heart Failure From Coronary Cameral Fistula: Diagnostic Challenge and Therapeutic Opportunity.

A 40-year-old African American woman presented with dyspnea, orthopnea, weight gain, and ankle edema. She was admitted for acute decompensated heart failure. Coronary angiography revealed coronary cameral fistula.

Evolution of Diagnostic and Treatment Patterns of Cardiac Sarcoidosis.

Cardiac sarcoidosis (CS) may impart substantial morbidity and mortality, and novel imaging modalities are now available to aid in early diagnosis of this clinically silent disease. A better understanding of the clinical experience with CS is important. Twenty-eight patients were diagnosed with the aid of multimodality imaging techniques and were treated by a multidisciplinary team.

A Pesco-Mediterranean Diet With Intermittent Fasting: JACC Review Topic of the Week.

As opportunistic omnivores, humans are evolutionarily adapted to obtain calories and nutrients from both plant and animal food sources. Today, many people overconsume animal products, often-processed meats high in saturated fats and chemical additives. Alternatively, strict veganism can cause nutritional deficiencies and predispose to osteopenia, sarcopenia, and anemia.

Technetium pyrophosphate nuclear scintigraphy for cardiac amyloidosis: Imaging at 1 vs 3 hours and planar vs SPECT/CT.

Background: Multi-societal consensus recommendations endorse both planar and single photon emission tomographic (SPECT) image acquisitions for the evaluation of cardiac amyloidosis. However, the correlation between planar and SPECT findings and the optimal timing of image acquisitions remain uncertain.

Methods: This is an analysis of 109 consecutive patients who underwent technetium pyrophosphate nuclear scintigraphy for the evaluation of cardiac amyloidosis.

Stress myocardial perfusion imaging in patients presenting with syncope: Comparison of PET vs. SPECT.

Background: The role of myocardial perfusion imaging (MPI) in patients with suspected coronary artery disease (CAD) presenting with syncope is controversial. We aimed to determine diagnostic yield of MPI for evaluation of syncope in patients without known CAD, as a function of pre-test patient risk and test modality (PET vs SPECT).

Methods: Between 1/2010 and 12/2016, 1324 consecutive patients presenting with syncope without known CAD underwent MPI with PET (n = 640) or SPECT (n = 684).

Increasing Rate of Hospital Admissions in Patients With Amyloidosis (from the National Inpatient Sample).

Cardiac amyloidosis is an increasingly recognized cause of heart failure with preserved or mildly reduced ejection fraction with emerging treatment options. We sought to analyze the temporal trends and impact of hospital admissions in patients with amyloidosis. The National Inpatient Sample was queried to identify patients from 2005 to 2014 who were hospitalized with a diagnosis of amyloidosis using ICD9 codes.

Extent of Myocardial Ischemia on Positron Emission Tomography and Survival Benefit With Early Revascularization.

Background: Prior studies with single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) have shown a survival benefit with early revascularization in patients with >10% to 12.5% ischemic myocardium. The relationship among positron emission tomography (PET)-derived extent of ischemia, early revascularization, and survival is unknown.

Stabilization of Early Duchenne Cardiomyopathy With Aldosterone Inhibition: Results of the Multicenter AIDMD Trial.

Background Duchenne muscular dystrophy incurs nearly universal dilated cardiomyopathy by the third decade of life, preceded by myocardial damage and impaired left ventricular strain by cardiac magnetic resonance. It has been shown that (1) mineralocorticoid receptor antagonist therapy with spironolactone attenuated damage while maintaining function when given early in a mouse model and (2) low-dose eplerenone stabilized left ventricular strain in boys with Duchenne muscular dystrophy and evident myocardial damage but preserved ejection fraction. We hypothesized that moderate-dose spironolactone versus eplerenone would provide similar cardioprotection in this first head-to-head randomized trial of available mineralocorticoid receptor antagonists, the AIDMD (Aldosterone Inhibition in Duchenne Muscular Dystrophy) trial.

Separating Acute Rheumatic Fever from Nonrheumatic Streptococcal Myocarditis.

Introduction: Streptococcal pharyngitis has been historically complicated with systemic involvement manifesting as acute rheumatic fever, which is a serious condition that can lead to permanent damage to heart valves. A recent association between streptococcal pharyngitis and nonrheumatic heart disease is emerging in literature. We present a case of nonrheumatic streptococcal myocarditis diagnosed using cardiac MRI.

Treatment of recurrent isolated right atrial metastatic cavitary mass from breast cancer with radiation therapy: A case report and review of literature.

The heart is a destination for metastases of various types of primary tumors, with lung, breast, melanoma, and mesothelioma being the most common types. Recurrent isolated cardiac metastasis presenting as a cavitary mass is rare. We present a case of recurrent isolated cavitary metastatic mass to the right atrium in a patient with the history of breast cancer who presented with new-onset atrial fibrillation.

Left Ventricular Thrombus in the Setting of Normal Left Ventricular Function in Patients with Crohn's Disease.

Crohn's disease results in a hypercoagulable state increasing the risk of venous or arterial thromboembolism. Cardiac involvement has not been routinely identified. Two cases are presented to illustrate that patients with Crohn's disease may represent an exception to the rule that left ventricular apical thrombus should be associated with an underlying wall motion abnormality and reduction in left ventricular ejection fraction.