Cardiac abnormalities in Long COVID 1-year post-SARS-CoV-2 infection.

Background: Long COVID is associated with multiple symptoms and impairment in multiple organs. Cross-sectional studies have reported cardiac impairment to varying degrees by varying methodologies. Using cardiac MR (CMR), we investigated a 12-month trajectory of abnormalities in Long COVID.

Myopericarditis and myositis in a patient with COVID-19: a case report.

Background: Concurrent myopericarditis and myositis can present in patients with pre-existing systemic inflammatory diseases. Here we present a case of myopericarditis and myositis associated with COVID-19, in the absence of respiratory symptoms.

Case Summary: We present a middle-aged female with a history of hypertension and previous myopericarditis.

The modern role of transoesophageal echocardiography in the assessment of valvular pathologies.

Despite significant advancements in the field of cardiovascular imaging, transoesophageal echocardiography remains the key imaging modality in the management of valvular pathologies. This paper provides echocardiographers with an overview of the modern role of TOE in the diagnosis and management of valvular disease. We describe how the introduction of 3D techniques has changed the detection and grading of valvular pathologies and concentrate on its role as a monitoring tool in interventional cardiology.

Improvements in ECG accuracy for diagnosis of left ventricular hypertrophy in obesity.

Objectives: The electrocardiogram (ECG) is the most commonly used tool to screen for left ventricular hypertrophy (LVH), and yet current diagnostic criteria are insensitive in modern increasingly overweight society. We propose a simple adjustment to improve diagnostic accuracy in different body weights and improve the sensitivity of this universally available technique.

Methods: Overall, 1295 participants were included-821 with a wide range of body mass index (BMI 17.

A prospective, double-blind, randomized controlled trial of the angiotensin-converting enzyme inhibitor Ramipril In Aortic Stenosis (RIAS trial).

Aims: Angiotensin-converting enzyme (ACE) inhibitors improve left ventricular (LV) remodelling and outcome in heart failure and hypertensive heart disease. They may be similarly beneficial in patients with aortic stenosis (AS), but historical safety concerns have limited their use, and no prospective clinical trials exist.

Methods And Results: We conducted a prospective, randomized, double-blind, placebo-controlled trial in 100 patients with moderate or severe asymptomatic AS to examine the physiological effects of ramipril, particularly LV mass (LVM) regression.

First experience with single-source, dual-energy CCTA for monochromatic stent imaging.

Aims: Single-source, dual-energy coronary computed tomography angiography (CCTA) with monochromatic image reconstruction allows significant noise reduction. The aim of the study was to evaluate the impact of monochromatic CCTA image reconstruction on coronary stent imaging, as the latter is known to be affected by artefacts from highly attenuating strut material resulting in artificial luminal narrowing.

Methods And Results: Twenty-one patients with 62 stents underwent invasive coronary angiography and single-source, dual-energy CCTA after stent implantation.

Accuracy of coronary CT angiography using a submillisievert fraction of radiation exposure: comparison with invasive coronary angiography.

Background: Coronary computed tomography angiography (CTA) is increasingly being used for evaluation of coronary artery disease (CAD). As a result of the widely reported potential of carcinogenic risk from x-ray based examinations, many strategies have been developed for dose reduction with CTA.

Objectives: The purpose of this study was to assess the diagnostic accuracy of CTA acquired with a submillisievert fraction of effective radiation dose reconstructed with a model-based iterative reconstruction (MBIR) using invasive coronary angiography (ICA) as a standard of reference.

Coronary artery calcium quantification from contrast enhanced CT using gemstone spectral imaging and material decomposition.

To explore the feasibility of coronary artery calcium (CAC) measurement from low-dose contrast enhanced coronary CT angiography (CCTA) as this may obviate the need for an unenhanced CT scan. 52 patients underwent unenhanced cardiac CT and prospectively ECG triggered contrast enhanced CCTA (Discovery HD 750, GE Healthcare, Milwaukee, WI, USA). The latter was acquired in single-source dual-energy mode [gemstone spectral imaging (GSI)].

Coronary computed tomography angiography with model-based iterative reconstruction using a radiation exposure similar to chest X-ray examination.

Aims: To evaluate the feasibility and image quality of coronary computed tomography angiography (CCTA) acquisition with a submillisievert fraction of effective radiation dose using model-based iterative reconstruction (MBIR) for noise reduction.

Methods And Results: In 42 patients undergoing standard low-dose (100-120 kV; 450-700 mA) and additional ultra-low-dose CCTA (80-100 kV; 150-210 mA) reconstructed with MBIR, segmental image quality was graded on a four-point scale [(i): non-evaluative, (ii): good, (iii): adequate, and (iv): excellent]. Signal-to-noise ratio (SNR) was calculated dividing left main artery (LMA) and right coronary artery (RCA) attenuation by the aortic root noise.

Impact of a new motion-correction algorithm on image quality of low-dose coronary CT angiography in patients with insufficient heart rate control.

Rationale And Objectives: Prospective electrocardiogram (ECG) triggering allows coronary computed tomography angiography (CCTA) scanning with low radiation dose but requires heart rates below 63 beats/min. We assessed the impact of a novel vendor-specific motion-correction algorithm on image quality and interpretability of low-dose CCTA acquired despite insufficient heart rate control.

Materials And Methods: In 40 patients undergoing CCTA for the assessment of known or suspected coronary artery disease who did not reach the target heart rate below 63 beats/min despite β-blockade before prospective low-dose scanning, the temporal acquisition window was increased (80 ms additional padding).

Attenuation correction maps for SPECT myocardial perfusion imaging from contrast-enhanced coronary CT angiography: gemstone spectral imaging with single-source dual energy and material decomposition.

Unlabelled: The aim of this study was to explore the feasibility of attenuation correction (AC) of myocardial perfusion imaging (MPI) with a virtual unenhanced cardiac CT scan synthesized from contrast-enhanced single-source dual-energy coronary CT angiography.

Methods: Segmental myocardial percentage uptake values obtained with AC were analyzed by use of correlation analysis and Bland-Altman limits of agreement (20-segment model), and clinical agreement was evaluated in 30 patients.

Results: The 2 methods showed an excellent correlation for segmental myocardial percentage uptake at stress (r = 0.

Myocardial steatosis and left ventricular contractile dysfunction in patients with severe aortic stenosis.

Background: Aortic stenosis (AS) leads to left ventricular (LV) hypertrophy and dysfunction. We hypothesized that cardiac steatosis is involved in the pathophysiology and also assessed whether it is reversible after aortic valve replacement.

Methods And Results: Thirty-nine patients with severe AS (symptomatic=25, asymptomatic=14) with normal LV ejection fraction and no significant coronary artery disease and 20 age- and sex-matched healthy controls underwent cardiac 1H-magnetic resonance spectroscopy and imaging for the determination of steatosis (myocardial triglyceride content) and cardiac function, including circumferential strain (measured by magnetic resonance tagging).

First in vivo head-to-head comparison of high-definition versus standard-definition stent imaging with 64-slice computed tomography.

The aim of this study was to compare image quality characteristics from 64-slice high definition (HDCT) versus 64-slice standard definition CT (SDCT) for coronary stent imaging. In twenty-five stents of 14 patients, undergoing contrast-enhanced CCTA both on 64-slice SDCT (LightSpeedVCT, GE Healthcare) and HDCT (Discovery HD750, GE Healthcare), radiation dose, contrast, noise and stent characteristics were assessed. Two blinded observers graded stent image quality (score 1 = no, 2 = mild, 3 = moderate, and 4 = severe artefacts).

Human non-contrast T1 values and correlation with histology in diffuse fibrosis.

Background: Aortic stenosis (AS) leads to diffuse fibrosis in the myocardium, which is linked to adverse outcome. Myocardial T1 values change with tissue composition.

Objective: To test the hypothesis that our recently developed non-contrast cardiac magnetic resonance (CMR) T1 mapping sequence could identify myocardial fibrosis without contrast agent.

Cardiac toxicity screening by echocardiography in healthy volunteers: a study of the effects of diurnal variation and use of a core laboratory on the reproducibility of left ventricular function measurement.

Background: In investigational medicinal products testing centers (IMP), reliable methods for monitoring early signs of cardiotoxicity of a potential new drug in healthy volunteers are essential. This study examines what levels of left ventricular ejection fraction (LVEF) variance can be achieved with two-dimensional echocardiography (2DE) in a core laboratory versus a site laboratory. Diurnal variability of LVEF and diastolic parameters were also reviewed.

Massive melanotic myocardial metastasis characterized by multiple cardiac imaging modalities.

Melanoma has a great propensity for cardiac involvement but most cases are diagnosed post-mortem. We present the case of a 67-year-old man with history of malignant melanoma who presented with increasing dyspnea, fatigue and peripheral edema. A large myocardial metastasis was identified on transthoracic echocardiography, and further characterized with cardiovascular magnetic resonance prior to surgery.

Presence Of Left Atrial Appendage Thrombus In Patients Presenting For Left Atrial Ablation Of Atrial Fibrillation Despite Pre-Operative Anticoagulation.

One of the recognised complications of left atrial ablation for atrial fibrillation (AF) is stroke. Left atrial (LA) thrombus, which may be dislodged by catheter manipulation, is an absolute contraindication to ablation. It is unclear whether imaging of the left atrial appendage (LAA) by transesophageal echo (TEE) is mandatory to exclude LA clot prior to ablation, particularly in "low-risk" patients with paroxysmal AF and normal left ventricular (LV) function.

Surgery Insight: percutaneous treatment of prosthetic paravalvular leaks.

Serious paravalvular leakage occurs in 1-5% of patients who have undergone surgical cardiac valve replacement procedures. Clinical manifestations include hemolysis, heart failure and arrhythmias. Presently, the gold standard treatment for severe paravalvular leakage is surgery; however, the outcomes remain far from optimum.