Coronary Plaque Morphology and the Anti-Inflammatory Impact of Atorvastatin: A Multicenter 18F-Fluorodeoxyglucose Positron Emission Tomographic/Computed Tomographic Study.

Background: Nonobstructive coronary plaques manifesting high-risk morphology (HRM) associate with an increased risk of adverse clinical cardiovascular events. We sought to test the hypothesis that statins have a greater anti-inflammatory effect within coronary plaques containing HRM.

Methods And Results: In this prospective multicenter study, 55 subjects with or at high risk for atherosclerosis underwent F-fluorodeoxyglucose positron emission tomographic/computed tomographic imaging at baseline and after 12 weeks of treatment with atorvastatin.

Computed tomography versus invasive coronary angiography: design and methods of the pragmatic randomised multicentre DISCHARGE trial.

Objectives: More than 3.5 million invasive coronary angiographies (ICA) are performed in Europe annually. Approximately 2 million of these invasive procedures might be reduced by noninvasive tests because no coronary intervention is performed.

Aortic root dimensions are predominantly determined by genetic factors: a classical twin study.

Objectives: Previous studies using transthoracic echocardiography (TTE) observed moderate heritability of aortic root dimensions. Computed tomography angiography (CTA) might provide more accurate heritability estimates. Our primary aim was to assess the heritability of the aortic root with CTA.

Non-diagnostic coronary artery calcification and stenosis: a correlation of coronary computed tomography angiography and invasive coronary angiography.

Background Heavy coronary artery calcification (CAC) impairs diagnostic accuracy of coronary computed tomography angiography (cCTA) and is considered to be a major limitation. Purpose To investigate the effect of non-evaluable CAC seen on cCTA on clinical decision-making by determining the degree of subsequent invasive testing and to assess the relationship between non-evaluable segments containing CAC and significant stenosis as seen in invasive coronary angiography (ICA). Material and Methods The study comprised of 356 patients who underwent cCTA and subsequent ICA within 2 months between 2005 and 2009.

Coronary Artery Manifestation of Ormond Disease: The "Mistletoe Sign".

A 69-year-old woman presented with symptoms of presumed cardiac involvement of idiopathic retroperitoneal fibrosis, otherwise known as Ormond disease. Distinct pericoronary tissue proliferations were depicted at cardiac magnetic resonance (MR) imaging and coronary computed tomographic (CT) angiography. On images, the coronary manifestation was termed the "mistletoe sign.

Thoracic Aortic Strain is Irrelevant Regarding Endograft Sizing in Most Young Patients.

Background: The introduction of electrocardiogram gating in computed tomography (CT) angiography imaging of aortic disease raised questions whether diameters measured on diastolic images can lead to the undersizing of aortic endografts. As previous studies suggested that young patients may have the highest risk of an unintended undersize, the aim of our study was to analyze the strain of the thoracic aorta in a young patient cohort.

Methods: We assessed the descending aorta of 52 patients (35 men, mean age 41.

Quantifying the effect of side branches in endothelial shear stress estimates.

Background And Aims: Low and high endothelial shear stress (ESS) is associated with coronary atherosclerosis progression and high-risk plaque features. Coronary ESS is currently assessed via computational fluid dynamic (CFD) simulation of coronary blood flow in the lumen geometry determined from invasive imaging such as intravascular ultrasound and optical coherence tomography. This process typically omits side branches of the target vessel in the CFD model as invasive imaging of those vessels is not usually clinically-indicated.

Prognostic Value of Coronary Computed Tomography Angiography in Patients With Diabetes: A Meta-analysis.

Objective: The usefulness of coronary computed tomography angiography (CTA) for the evaluation of coronary artery disease (CAD) in patients with diabetes is ambiguous. We therefore performed a meta-analysis of studies reporting event rates and hazard ratios (HR) to determine the prognostic value of CTA in this patient population.

Research Design And Methods: We searched PubMed and Embase up to November 2015.

Comparison of Quantity of Coronary Atherosclerotic Plaques Detected by Computed Tomography Versus Angiography.

Numerous clinical studies using coronary computed tomography angiography (CTA) and conventional invasive coronary angiography (ICA) confirmed the strong relation between atherosclerotic disease burden and risk of adverse events. Few studies have compared coronary CTA and ICA regarding semiquantitative plaque burden measurements, reproducibility, and cardiovascular risk assessment. We enrolled 71 consecutive patients (mean age 62 ± 9 years, 37% women) from the Genetic Loci and the Burden of Atherosclerotic Lesions study (NCT01738828), who underwent 256-slice multidetector row coronary CTA and ICA at a single site.

Non-invasive and invasive imaging of vulnerable coronary plaque.

Vulnerable plaque is characterized by a large necrotic core and an overlying thin fibrous cap. Non-invasive imaging modalities such as computed tomography angiography (CTA) and magnetic resonance imaging (MRI) allow for the assessment of morphological plaque characteristics, while positron emission tomography (PET) enables the detection of metabolic activity within the atherosclerotic lesions. Invasive imaging modalities such as intravascular ultrasound (IVUS), optical-coherence tomography (OCT), and intravascular MRI (IV-MRI) display plaques at a high spatial resolution.

Cardiac CT Imaging of Plaque Vulnerability: Hype or Hope?

Advances in cardiovascular computed tomography (CT) have resulted in an excellent ability to exclude coronary heart disease (CHD). Anatomical information, functional information, and spectral information can already be obtained with current CT technologies. Moreover, novel developments such as targeted nanoparticle contrast agents, photon-counting CT, and phase contrast CT will further enhance the diagnostic value of cardiovascular CT.

Ultra low-dose chest ct with iterative reconstructions as an alternative to conventional chest x-ray prior to heart surgery (CRICKET study): Rationale and design of a multicenter randomized trial.

Background: Stroke after cardiac surgery is a severe complication with a persistently high incidence of 1.4 - 9.7%.

Respiratory gating algorithm helps to reconstruct more accurate electroanatomical maps during atrial fibrillation ablation performed under spontaneous respiration.

Purpose: Electroanatomical mapping is a useful tool during the ablation of atrial fibrillation. Respiratory movement might influence the mapping accuracy and merging. This study aims to investigate the effect of respiratory gating on the accuracy of magnetic-field-based electroanatomical mapping under spontaneous respiration.

Bentall procedure: quarter century of clinical experiences of a single surgeon.

Background: We retrospectively analyzed 25 years of experiences with the button Bentall procedure in patients with aortic root pathologies. Even though this procedure has become widespread, there are only a few very long term follow-ups available in the clinical literature, especially regarding single surgeon results.

Methods: Between 1988 and 2013, a total of 147 patients underwent the Bentall procedure by the same surgeon.

Right Ventricular Adaptation Is Associated with the Glu298Asp Variant of the NOS3 Gene in Elite Athletes.

Nitric oxide (NO), an important endogenous pulmonary vasodilator is synthetized by the endothelial NO synthase (NOS3). Reduced NO bioavailability and thus the Glu298Asp polymorphism of NOS3 may enhance right ventricular (RV) afterload and hypertrophic remodeling and influence athletic performance. To test this hypothesis world class level athletes (water polo players, kayakers, canoeists, rowers, swimmers, n = 126) with a VO2 maximum greater than 50ml/kg/min were compared with non-athletic volunteers (n = 155).

Rationale, Design, and Methodological Aspects of the BUDAPEST-GLOBAL Study (Burden of Atherosclerotic Plaques Study in Twins-Genetic Loci and the Burden of Atherosclerotic Lesions).

The heritability of coronary atherosclerotic plaque burden, coronary geometry, and phenotypes associated with increased cardiometabolic risk are largely unknown. The primary aim of the Burden of Atherosclerotic Plaques Study in Twins-Genetic Loci and the Burden of Atherosclerotic Lesions (BUDAPEST-GLOBAL) study is to evaluate the influence of genetic and environmental factors on the burden of coronary artery disease. By design this is a prospective, single-center, classical twin study.

hs-Troponin I Followed by CT Angiography Improves Acute Coronary Syndrome Risk Stratification Accuracy and Work-Up in Acute Chest Pain Patients: Results From ROMICAT II Trial.

Objectives: This study compared diagnostic accuracy of conventional troponin/traditional coronary artery disease (CAD) assessment and highly sensitive troponin (hsTn) I/advanced CAD assessment for acute coronary syndrome (ACS) during the index hospitalization.

Background: hsTnI and advanced assessment of CAD using coronary computed tomography angiography (CTA) are promising candidates to improve the accuracy of emergency department evaluation of patients with suspected ACS.

Methods: We performed an observational cohort study in patients with suspected ACS enrolled in the ROMICAT II (Rule Out Myocardial Infarction/Ischemia using Computer Assisted Tomography) trial and randomized to coronary CTA who also had hsTnI measurement at the time of the emergency department presentation.

Thoracic aortic strain can affect endograft sizing in young patients.

Objective: Aortic computed tomography angiography (CTA) examination with electrocardiography gating is becoming the clinical routine image acquisition protocol for diagnosis and intervention planning. To minimize motion artifact, the images are reconstructed in the diastolic phase of the cardiac cycle. The aim of our study was to quantify aortic strain in an elderly nonaneurysmatic patient cohort and to identify the phases of the R-R cycle that correspond to the minimal and maximal aortic diameters.

Defining the optimal systolic phase targets using absolute delay time for reconstructions in dual-source coronary CT angiography.

To define the optimal systolic phase for dual-source computed tomography angiography using an absolute reconstruction delay time after the R-R interval based on the coronary artery motion, we analyzed images reconstructed between 200 and 420 miliseconds (ms) after the R wave at 20 ms increments in 21 patients. Based on the American Heart Association coronary segmentation guidelines, the origin of six coronary artery landmarks (RCA, AM1, PDA, LM, OM1, and D2) were selected to calculate the coronary artery motion velocity. The velocity of the given landmark was defined as the quotient of the route and the length of the time interval.

The effect of iterative model reconstruction on coronary artery calcium quantification.

Coronary artery calcium (CAC) scoring with computed tomography (CT) is an established tool for quantifying calcified atherosclerotic plaque burden. Despite the widespread use of novel image reconstruction techniques in CT, the effect of iterative model reconstruction on CAC score remains unclear. We sought to assess the impact of iterative model based reconstruction (IMR) on coronary artery calcium quantification as compared to the standard filtered back projection (FBP) algorithm and hybrid iterative reconstruction (HIR).

Plaque assessment by coronary CT.

Coronary CT angiography (CTA) has emerged as a highly reliable and non-invasive modality for the exclusion of coronary artery disease. Recent technological advancements in coronary CTA imaging allow for robust qualitative and quantitative assessment of atherosclerotic plaques. Furthermore, CTA is a promising modality for functional evaluation of coronary lesions.

Computed tomography-based high-risk coronary plaque score to predict acute coronary syndrome among patients with acute chest pain--Results from the ROMICAT II trial.

Background: Coronary computed tomography angiography (CTA) can be used to detect and quantitatively assess high-risk plaque features.

Objective: To validate the ROMICAT score, which was derived using semi-automated quantitative measurements of high-risk plaque features, for the prediction of ACS.

Material And Methods: We performed quantitative plaque analysis in 260 patients who presented to the emergency department with suspected ACS in the ROMICAT II trial.