Large core trial: State of Practice.

Background: This review critically analyzed recent publications on large-core Randomized Controlled Trials (RCTs). Six RCTs demonstrated the superiority of mechanical thrombectomy over the best medical treatment in patients with low ASPECTs. However, the use of ASPECTs to define the ischemic core has limitations in detecting ischemic changes beyond the middle cerebral artery (MCA) territory.

Advancements in Computed Tomography Angiography for Pulmonary Embolism Assessment.

Pulmonary embolism (PE) is a critical condition stemming from venous thromboembolism, with potentially fatal outcomes. Computed tomography pulmonary angiography (CTPA) serves as the gold standard for diagnosing PE, offering unparalleled diagnostic accuracy, accessibility, and speed. Recent innovations, such as spectral CT systems and artificial intelligence (AI)-driven algorithms, have enhanced the diagnostic and prognostic capabilities of CTPA, enabling precise anatomical and functional assessments.

Vulnerable or High-Risk Plaque: A JACC: Cardiovascular Imaging Position Statement.

The concept of high-risk plaque emerged from pathologic and epidemiologic studies 3 decades ago that demonstrated plaque rupture with thrombosis as the predominant mechanism of acute coronary syndrome and sudden cardiac death. Thin-cap fibroatheroma, a plaque with a large lipidic core covered by a thin fibrous cap, is the prototype of the rupture-prone plaque and has been traditionally defined as "vulnerable plaque." Although knowledge on the pathophysiology of plaque instability continues to grow, the risk profile of our patients has shifted and the character of atherosclerotic disease has evolved, partly because of widespread use of lipid-lowering therapies and other preventive measures.

Left ventricular diastolic and systolic functions by cardiac magnetic resonance in beta-thalassemia major: correlation with clinical findings and cardiac complications.

This cross-sectional study explored the association of left ventricular (LV) fractional area change (FAC) with demographic characteristics, clinical data, cardiovascular magnetic resonance (CMR) findings, and cardiac complications (heart failure and arrythmias) in patients with beta-thalassemia major (β-TM). We included 292 β-TM patients (151 females, 36.72 ± 11.

The Digital Health Competencies in Medical Education Framework: An International Consensus Statement Based on a Delphi Study.

Importance: Rapid digitalization of health care and a dearth of digital health education for medical students and junior physicians worldwide means there is an imperative for more training in this dynamic and evolving field.

Objective: To develop an evidence-informed, consensus-guided, adaptable digital health competencies framework for the design and development of digital health curricula in medical institutions globally.

Evidence Review: A core group was assembled to oversee the development of the Digital Health Competencies in Medical Education (DECODE) framework.

Use of AI in Cardiac CT and MRI: A Scientific Statement from the ESCR, EuSoMII, NASCI, SCCT, SCMR, SIIM, and RSNA.

Artificial intelligence (AI) offers promising solutions for many steps of the cardiac imaging workflow, from patient and test selection through image acquisition, reconstruction, and interpretation, extending to prognostication and reporting. Despite the development of many cardiac imaging AI algorithms, AI tools are at various stages of development and face challenges for clinical implementation. This scientific statement, endorsed by several societies in the field, provides an overview of the current landscape and challenges of AI applications in cardiac CT and MRI.

Cracking the Code of Calcification: How Presence and Burden among Intracranial Arteries Influence Stroke Incidence and Recurrence.

Background: Intracranial atherosclerosis accounts for about 8% of all strokes in Western societies but the influence of arterial calcification on plaque instability is a topic on ongoing debate.

Purpose: Explore the association between the presence and burden of calcium in atherosclerotic plaques among intracranial arteries with the risk of clinical or silent stroke events through a systematic review and meta-analysis.

Data Sources: Adhering to PRISMA guidelines, studies from PubMed and Embase were analyzed up to May 2024.

Prevalence of High-Risk CTA-Based Carotid Plaque-RADS Subtypes in Patients With Embolic Stroke of Undetermined Source.

Background: A modified computed tomography angiography (CTA)-based Carotid Plaque Reporting and Data System (Plaque-RADS) classification was applied to a cohort of patients with embolic stroke of undetermined source to test whether high-risk Plaque-RADS subtypes are more prevalent on the ipsilateral side of stroke. With the widespread use of CTA for stroke evaluation, a CTA-based Plaque-RADS would be valuable for generalizability.

Methods: A retrospective observational cross-sectional study was conducted at a single integrated health system comprised of 3 hospitals with a comprehensive stroke center between October 1, 2015, and April 1, 2017.

Assessment of Attenuation in Pericarotid Fat among Patients with Carotid Plaque and Spontaneous Carotid Dissection.

Background And Purpose: Changes in perivascular fat density (PFD) and its association with inflammation have been topics of interest in both atherosclerotic and nonatherosclerotic vasculopathies. The objective of this study was to assess the PFD in patients with spontaneous internal carotid artery dissection (SICAD) or carotid atherosclerotic plaque, with and without intraplaque hemorrhage (IPH).

Materials And Methods: A cross-sectional retrospective bicentric analysis of 130 patients (30 with SICAD and 100 with carotid atherosclerotic plaque) who underwent CT angiography was performed.

Myocardial microvascular function assessed by cardiovascular magnetic resonance first-pass perfusion in patients with Takotsubo syndrome.

Objective: The purpose of this study was to explore microvascular function impairment using first-pass cardiovascular magnetic resonance (CMR) in patients with Takotsubo syndrome (TS). Moreover, we explored myocardial microcirculation in patients with TS and related this to demographic data, cardiovascular risk factors, clinical parameters, cardiac biomarkers, and cardiac function.

Methods: This retrospective study performed CMR first-pass perfusion scans in 42 consecutive patients with TS (37 females, 70.

Current applications and challenges in large language models for patient care: a systematic review.

Background: The introduction of large language models (LLMs) into clinical practice promises to improve patient education and empowerment, thereby personalizing medical care and broadening access to medical knowledge. Despite the popularity of LLMs, there is a significant gap in systematized information on their use in patient care. Therefore, this systematic review aims to synthesize current applications and limitations of LLMs in patient care.

Impact of papillary muscle infarction on atrial and ventricular myocardial deformation in non-anterior STEMI patients.

The purpose of this study was to explore the impact of papillary muscle (PPM) infarction on left atrial and ventricular strain parameters in patients with non-anterior ST-segment elevation myocardial infarction (NA-STEMI) using cardiovascular magnetic resonance (CMR). This retrospective study performed CMR scans on 88 consecutive patients with NA-STEMI (68 males, 65 ± 10.05 years).

Current Status of CT Imaging Before Common Transcatheter Interventions for Structural Heart Disease.

Over the past decade, several trials and observational studies have validated the use of minimally invasive cardiac interventions as viable treatment options for various cardiac diseases. Transcatheter techniques for severe aortic valve stenosis have rapidly emerged as alternatives to surgical aortic valve replacement in certain patient populations. Additionally, non-surgical treatment options have expanded for conditions affecting other cardiac valves, such as the mitral valve.

Carotid artery atherosclerosis: mechanisms of instability and clinical implications.

Cardiovascular disease remains a prominent cause of disability and premature death worldwide. Within this spectrum, carotid artery atherosclerosis is a complex and multifaceted condition, and a prominent precursor of acute ischaemic stroke and other cardiovascular events. The intricate interplay among inflammation, oxidative stress, endothelial dysfunction, lipid metabolism, and immune responses participates in the development of lesions, leading to luminal stenosis and potential plaque instability.

Interlinking pathways: a narrative review on the role of IL-6 in cancer and atherosclerosis.

Background And Objective: Interleukin-6 (IL-6) plays multifaceted roles in cancer and atherosclerosis. Initially recognized for its role in immune response and inflammation, IL-6 promotes tumor progression via the JAK-STAT and MAP kinase pathways and is associated with poor cancer prognoses. In atherosclerosis, IL-6 contributes to endothelial dysfunction and plaque formation.

Artificial intelligence-based cardiovascular/stroke risk stratification in women affected by autoimmune disorders: a narrative survey.

Women are disproportionately affected by chronic autoimmune diseases (AD) like systemic lupus erythematosus (SLE), scleroderma, rheumatoid arthritis (RA), and Sjögren's syndrome. Traditional evaluations often underestimate the associated cardiovascular disease (CVD) and stroke risk in women having AD. Vitamin D deficiency increases susceptibility to these conditions.

An Artificial Intelligence-Based Non-Invasive Approach for Cardiovascular Disease Risk Stratification in Obstructive Sleep Apnea Patients: A Narrative Review.

Background: Obstructive sleep apnea (OSA) is a severe condition associated with numerous cardiovascular complications, including heart failure. The complex biological and morphological relationship between OSA and atherosclerotic cardiovascular disease (ASCVD) poses challenges in predicting adverse cardiovascular outcomes. While artificial intelligence (AI) has shown potential for predicting cardiovascular disease (CVD) and stroke risks in other conditions, there is a lack of detailed, bias-free, and compressed AI models for ASCVD and stroke risk stratification in OSA patients.

Assessing Acute Pericarditis with T1 Mapping: A Supportive Contrast-Free CMR Marker.

Objective: The purpose of this study was to explore the impact of pericardial T1 mapping as a potential supportive non-contrast cardiovascular magnetic resonance (CMR) parameter in the diagnosis of acute pericarditis. Additionally, we investigated the relationship between T1 mapping values in acute pericarditis patients and their demographic data, cardiovascular risk factors, clinical parameters, cardiac biomarkers, and cardiac function.

Method: This retrospective study included CMR scans in 35 consecutive patients with acute pericarditis (26 males, 45.

State of the art of CT myocardial perfusion.

Coronary computed tomography angiography (CCTA) is a powerful tool to rule out coronary artery disease (CAD). In the last decade, myocardial perfusion CT (CTP) technique has been developed for the evaluation of myocardial ischemia, thereby increasing positive predictive value for diagnosis of obstructive CAD. A diagnostic strategy combining CCTA and perfusion acquisitions provides both anatomical coronary evaluation and functional evaluation of the stenosis, increasing the specificity and the positive predictive value of cardiac CT.

Prevalence of Mitral Annular Disjunction at Cardiac MRI: Results from a Multicenter Registry.

Purpose To determine the prevalence of mitral annular disjunction (MAD) in patients undergoing cardiac MRI for various clinical indications and to assess the association of MAD with arrhythmia, mitral valve prolapse (MVP), and myocardial alteration. Materials and Methods This study analyzed data from a retrospective observational registry of consecutive patients undergoing cardiac MRI for different clinical indications. Cardiac MRI examinations were performed from January 2019 to June 2019 at 13 Italian hospitals.

Addressing hidden risks: Systematic review of artificial intelligence biases across racial and ethnic groups in cardiovascular diseases.

Background: Artificial intelligence (AI)-based models are increasingly being integrated into cardiovascular medicine. Despite promising potential, racial and ethnic biases remain a key concern regarding the development and implementation of AI models in clinical settings.

Objective: This systematic review offers an overview of the accuracy and clinical applicability of AI models for cardiovascular diagnosis and prognosis across diverse racial and ethnic groups.

"Artificial histology" in colonic Neoplasia: A critical approach.

Background: The histological assessment of colorectal precancer and cancer lesions is challenging and primarily impacts the clinical strategies of secondary colon cancer prevention. Artificial intelligence (AI) models may potentially assist in the histological diagnosis of this spectrum of phenotypical changes.

Objectives: To provide a current overview of the evidence on AI-based methods for histologically assessing colonic precancer and cancer lesions.

The Detection Rate of Late Gadolinium Enhancement in Takotsubo Syndrome: A Systematic Review and Meta-Analysis.

The absence of late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) is commonly used to distinguish takotsubo syndrome (TTS) from other myocardial diseases. However, case series have reported the presence of LGE in TTS. This study aimed to summarize the evidence on the frequency of LGE in TTS and identify potential variables that may influence the detection of LGE.

Explainable machine-learning model to classify culprit calcified carotid plaque in embolic stroke of undetermined source.

Background: Embolic stroke of undetermined source (ESUS) may be associated with carotid artery plaques with <50% stenosis. Plaque vulnerability is multifactorial, possibly related to intraplaque hemorrhage (IPH), lipid-rich-necrotic-core (LRNC), perivascular adipose tissue (PVAT), and calcification morphology. Machine-learning (ML) approaches in plaque classification are increasingly popular but often limited in clinical interpretability by black-box nature.