Evaluation after Orthotopic Heart Transplant: What the Radiologist Should Know.

Orthotopic heart transplant (OHT) is the treatment of choice for end-stage heart disease. As OHT use continues and postoperative survival increases, multimodality imaging evaluation of the transplanted heart will continue to increase. Although some of the imaging is performed and interpreted by cardiologists, a substantial proportion of images are read by radiologists.

Rethinking composite end points in clinical trials: insights from patients and trialists.

Background: Many clinical trials use composite end points to reduce sample size, but the relative importance of each individual end point within the composite may differ between patients and researchers.

Methods And Results: We asked 785 cardiovascular patients and 164 clinical trial authors to assign 25 "spending weights" across 5 common adverse events comprising composite end points in cardiovascular trials: death, myocardial infarction, stroke, coronary revascularization, and hospitalization for angina. We then calculated end point ratios for each participant's ratings of each nonfatal end point relative to death.

Incremental utility of iodine-123 meta-iodobenzylguanidine imaging beyond established heart failure risk models.

Background: Nuclear myocardial imaging with iodine-123 meta-iodobenzylguanidine ((123)I-mIBG) is approved for risk stratification of patients with systolic heart failure (HF). Whether (123)I-mIBG imaging provides incremental prognostic utility beyond established risk models remains unclear.

Methods And Results: In a multicenter study, 961 patients with moderate systolic HF underwent (123)I-mIBG imaging and were followed for cardiac death, progressive HF, or life-threatening arrhythmias over 2 years.

Aberrant right subclavian artery-esophageal fistula and severe gastrointestinal bleeding after surgical correction of scimitar syndrome.

Scimitar syndrome and gastrointestinal bleeding from an aberrant right subclavian artery-esophageal fistula are each extremely rare. Although scimitar syndrome and aberrant right subclavian artery are typically asymptomatic in adults, fistulous connection between the aberrant artery and the esophagus is associated with a poor prognosis. Outcomes are contingent upon timely diagnosis and prompt surgical repair.