Four-Dimensional Flow MRI for Cardiovascular Evaluation (4DCarE): A Prospective Non-Inferiority Study of a Rapid Cardiac MRI Exam: Study Protocol and Pilot Analysis.

Background: Accurate measurements of flow and ventricular volume and function are critical for clinical decision-making in cardiovascular medicine. Cardiac magnetic resonance (CMR) is the current gold standard for ventricular functional evaluation but is relatively expensive and time-consuming, thus limiting the scale of clinical applications. New volumetric acquisition techniques, such as four-dimensional flow (4D-flow) and three-dimensional volumetric cine (3D-cine) MRI, could potentially reduce acquisition time without loss in accuracy; however, this has not been formally tested on a large scale.

Guideline-based audit of the hospital management of heart failure with reduced ejection fraction.

Background: Heart failure is a major burden in Australia in terms of morbidity, mortality and healthcare expenditure. Multiple evidence-based therapies are recommended for heart failure with reduced ejection fraction (HFrEF), but data on physician adherence to therapy guidelines are limited.

Aim: To compare use of HFrEF therapies against current evidence-based guidelines in an Australian hospital inpatient population.

Hypertrophic Cardiomyopathy (HCM): New insights into Coronary artery remodelling and ischemia from FFR.

Introduction: Angina, myocardial ischemia, and coronary artery physiology in hypertrophic cardiomyopathy (HCM) are poorly understood. However, coronary computed tomography angiography (CCTA) with fractional flow reserve from CT (FFR) analysis offers a non-invasive method for evaluation of coronary artery volume to myocardial mass ratio (V/M) that may provide insight into such mechanisms. Thus, we sought to investigate changes in V/M in HCM.

Prevalence and impact of scan-related anxiety during coronary CT angiography: A prospective cohort study of 366 patients.

Background: Scanxiety, the anxiety/stress associated with an imaging test, has never been evaluated in relation to coronary CT angiography (Coronary CTA). As it could impact heart rate and thereby affect image quality of Coronary CTA, we aimed to evaluate the prevalence, severity, and impact of scanxiety on quality and interpretability of Coronary CTA.

Methods: 366 consecutive patients were prospectively presented with a clinical questionnaire comprising two tests to evaluate their scan-related anxiety: the Impact of Event IES-6 (6 questions, final score 0-24) and a visual stress-scale (1 question, score 1-10).

Role of MDCT Imaging in Planning Mitral Valve Intervention.

Purpose Of Review: Recent advancements in transcatheter valvular interventions have resulted in a growing demand for advanced cardiac imaging to help guide these procedures.

Recent Findings: Both echocardiography and multi-detector computed tomography have played essential roles in the maturation of transcatheter aortic valve replacement and are now building on these experiences and helping inform the nascent field of transcatheter mitral interventions. Advanced imaging is essential to aid in the diagnosis and determination of the mechanism of mitral regurgitation.

Coronary lumen volume to myocardial mass ratio in primary microvascular angina.

Background: Microvascular angina (MVA) is an incompletely understood clinical entity. Computational analysis of coronary Computed Tomography Angiography (CTA) has shown an association between low coronary lumen volume to myocardial mass (V/M) ratio and lower Fractional Flow Reserve values, independent of plaque measures. We hypothesized that low V/M ratio may be present in patients with MVA.

Fractional flow reserve derived from coronary computed tomography angiography reclassification rate using value distal to lesion compared to lowest value.

Introduction: A standardised approach to the interpretation of FFRCT data is currently lacking. We evaluated the rate of reclassification of FFRCT positivity using the FFRCT value distal to an anatomical stenoses compared to the lowest FFRCT value.

Method: Patients who underwent coronary CTA and FFRCT analysis were eligible.

Imaging for structural heart procedures: focus on computed tomography.

The success and continued rapid clinical integration of transcatheter valve technologies relies on imaging modalities to guide safe and effective device deployment. In particular, cardiac imaging, using both echocardiography and CT, is an integral resource for the multidisciplinary team. These modalities can provide valuable insight for the proceduralist at each stage of transcatheter-based valve insertion, as they can be used reliably to define the anatomy of interest and its relationship to surrounding structures, determine accurate device sizing, assess patients for valve-in-valve procedures, and screen for adverse features or procedural contraindications.