The Future of Cardiac Imaging in the Diagnosis

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 October 2024) | Viewed by 4013

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Special Issue Information

Dear Colleagues,

Over the years, significant progress has been made in cardiovascular imaging techniques, leading to improved diagnosis and treatment of cardiovascular diseases. This Special Issue aims to explore the cutting-edge imaging modalities, such as echocardiography, cardiac magnetic resonance imaging (MRI), computed tomography (CT), and nuclear imaging, that are being used to assess cardiac structure and function.

We hope to collect papers that delve into the latest research findings and clinical applications of these imaging techniques. To discuss the role of cardiovascular imaging in the early detection of cardiovascular diseases, risk stratification, and treatment evaluation. Furthermore, the Special Issue will address the challenges and limitations faced by cardiovascular imaging and propose potential solutions. Moreover, this Special Issue also discusses the future prospects of cardiovascular imaging, including emerging technologies and novel imaging techniques. These advancements have the potential to revolutionize cardiovascular care by providing more accurate and detailed information about the heart and blood vessels.

Overall, this Special Issue aims to provide readers with an overview of the current progress in cardiovascular imaging, highlighting its significance in the diagnosis, management, and prevention of cardiovascular diseases, while also exploring the potential of future developments in this rapidly evolving field.

Prof. Dr. Grigorios Korosoglou
Guest Editor

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Published Papers (4 papers)

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Research

9 pages, 804 KiB  
Article
Computed Tomography Confirms Increased Left Atrial Volume in Patients with Bayés Syndrome Referred for Catheter Ablation of Atrial Fibrillation
by Gabriel Cismaru, Gwendolyn Wagner, Gabriel Gusetu, Ioan-Alexandru Minciuna, Diana Irimie, Florina Fringu, Raluca Tomoaia, Horatiu Comsa, Bogdan Caloian, Dana Pop and Radu Ovidiu Rosu
Diagnostics 2024, 14(21), 2416; https://doi.org/10.3390/diagnostics14212416 - 30 Oct 2024
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Abstract
Background: Bayés syndrome is a recently identified condition that is defined by the presence of an interatrial block on a surface electrocardiogram, in addition to atrial arrhythmias such as atrial fibrillation, tachycardia, or left atrial flutter. This syndrome is linked to an increased [...] Read more.
Background: Bayés syndrome is a recently identified condition that is defined by the presence of an interatrial block on a surface electrocardiogram, in addition to atrial arrhythmias such as atrial fibrillation, tachycardia, or left atrial flutter. This syndrome is linked to an increased risk of stroke, morbidity, and mortality. An interatrial block is a conduction delay between the right atrium and left atrium and can be recognized by a P wave duration >120 ms. It is known that P wave duration can estimate the size of the left atrium measured via echocardiography, which is a marker for stratifying cardiovascular risk. Our study aims to verify whether the duration of the P wave can estimate the volume of the left atrium measured by computed tomography in patients with an interatrial block. Methods: We included 105 patients with a sinus rhythm and a partial or advanced interatrial block (IAB) who underwent contrast-enhanced cardiac computed tomography (CT). The mean age was 62.2 ± 10.1 years, and 38% of the patients were women. Results: The mean P wave duration was 122.6 ± 11.4 ms in the partial IAB group and 150 ± 8.4 ms in the advanced IAB group (p < 0.01). The mean left atrial volume was 115 ± 39 mL in the partial IAB group and 142 ± 34 mL in the advanced IAB group (p = 0.001). P wave duration was longer in patients with an advanced as opposed to partial interatrial block. Left atrial volume and LAVI were higher in patients with an advanced as opposed to partial interatrial block. Conclusions: All the patients (100%) with an advanced IAB had a dilated left atrium. P wave duration can accurately estimate LA volume in patients with an IAB using the formula: LA volume = 0.6 × P wave + 46 mL. Full article
(This article belongs to the Special Issue The Future of Cardiac Imaging in the Diagnosis)
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12 pages, 2686 KiB  
Article
Utility of Magnetocardiography and Stress Speckle Tracking in Detection of Coronary Artery Disease
by Ahmed Saleh and Johannes Brachmann
Diagnostics 2024, 14(17), 1893; https://doi.org/10.3390/diagnostics14171893 - 28 Aug 2024
Viewed by 536
Abstract
Introduction: Coronary artery disease (CAD) is a leading cause of death and disability in developed countries. While exercise testing is recommended for diagnosing stable angina pectoris, its limited sensitivity and specificity have been questioned. Myocardial strain is a promising predictor of significant CAD. [...] Read more.
Introduction: Coronary artery disease (CAD) is a leading cause of death and disability in developed countries. While exercise testing is recommended for diagnosing stable angina pectoris, its limited sensitivity and specificity have been questioned. Myocardial strain is a promising predictor of significant CAD. Aim: To evaluate the utility of myocardial strain obtained by 2D speckle tracking at rest and under stress combined with stress magnetocardiography for detecting CAD in patients with stable or low-risk unstable angina pectoris. Methods: A total of 108 patients meeting the inclusion criteria underwent coronary angiography within 48 h of admission. Myocardial strain was assessed using 2D speckle tracking at rest and during dobutamine stress alongside stress magnetocardiography. Results: Global longitudinal strain at stress showed a moderate correlation with significant CAD (r = 0.41, p <0.0001) and with coronary occlusion severity (r = 0.62, p <0.0001). Strain at stress had a sensitivity of 74.1% and specificity of 76.7% for detecting CAD at a cut-off value of −19.1. The ST fluctuation rate from magnetocardiography demonstrated the highest sensitivity for CAD detection. Conclusions: Longitudinal strain parameters and stress magnetocardiography are effective non-invasive methods for predicting CAD in patients with stable angina, potentially reducing the need for invasive assessments. Full article
(This article belongs to the Special Issue The Future of Cardiac Imaging in the Diagnosis)
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15 pages, 2559 KiB  
Article
Optimizing Arterial Vessel Contrast in Portal Venous Phase with Virtual Monoenergetic Images from Photon-Counting Detector CT Scans of the Abdomen—First Clinical Experiences
by Daniel Dillinger, Daniel Overhoff, Isabelle Ayx, Hanns L. Kaatsch, Achim Hagen, Stefan O. Schönberg and Stephan Waldeck
Diagnostics 2024, 14(6), 627; https://doi.org/10.3390/diagnostics14060627 - 15 Mar 2024
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Abstract
Background: Photon-counting detector (PCD) computed tomography (CT) allows for the reconstruction of virtual monoenergetic images (VMI) at different thresholds. Objective: The aim of our study was to evaluate the optimal arterial contrast in portal venous (pv) scans regarding objective parameters and subjective image [...] Read more.
Background: Photon-counting detector (PCD) computed tomography (CT) allows for the reconstruction of virtual monoenergetic images (VMI) at different thresholds. Objective: The aim of our study was to evaluate the optimal arterial contrast in portal venous (pv) scans regarding objective parameters and subjective image quality for different virtual keV levels. Methods: We identified 40 patients that underwent a CT scan with an arterial and pv phase on a PCD-CT (NAEOTOM alpha, Siemens Healthineers, Forchheim, Germany). The attenuation of abdominal arteries on pv phases was measured for different virtual keV levels in a monoenergetic+ application profile and for polychromatic (pc) arterial images. Two independent readers assessed subjective image quality, including vascular contrast in pv scans at different energy levels. Additionally, signal- and contrast-to-noise ratios (SNR and CNR) were measured. Results: Our results showed increasing arterial attenuation levels with decreasing energy levels in virtual monoenergetic imaging on pv scans with the highest attenuation at 40 keV, significantly higher than in the pc arterial phase (439 ± 97 HU vs. 360 ± 97, p < 0.001). Noise, SNR, and CNR were worse at this energy level (p < 0.001). Pv VMI showed less noise at energy levels above 70 keV (all p < 0.001). Subjective image quality was rated best at 70 keV, vascular contrast was best at 40 keV. Conclusions: Our research suggests that virtual monoenergetic images at 40 keV in Mono+ mode derived from a PCD-CT can be a feasible alternative to a true arterial phase for assessment of vessels with worse CNR and SNR. Full article
(This article belongs to the Special Issue The Future of Cardiac Imaging in the Diagnosis)
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12 pages, 1799 KiB  
Article
Comparison of Two Contemporary Quantitative Atherosclerotic Plaque Assessment Tools for Coronary Computed Tomography Angiography: Single-Center Analysis and Multi-Center Patient Cohort Validation
by Loris Weichsel, Alexander Giesen, Florian André, Matthias Renker, Stefan Baumann, Philipp Breitbart, Meinrad Beer, Pal Maurovitch-Horvat, Bálint Szilveszter, Borbála Vattay, Sebastian J. Buss, Mohamed Marwan, Andreas A. Giannopoulos, Sebastian Kelle, Norbert Frey and Grigorios Korosoglou
Diagnostics 2024, 14(2), 154; https://doi.org/10.3390/diagnostics14020154 - 9 Jan 2024
Cited by 1 | Viewed by 1623
Abstract
Background: Coronary computed tomography angiography (CCTA) provides non-invasive quantitative assessments of plaque burden and composition. The quantitative assessment of plaque components requires the use of analysis software that provides reproducible semi-automated plaque detection and analysis. However, commercially available plaque analysis software can vary [...] Read more.
Background: Coronary computed tomography angiography (CCTA) provides non-invasive quantitative assessments of plaque burden and composition. The quantitative assessment of plaque components requires the use of analysis software that provides reproducible semi-automated plaque detection and analysis. However, commercially available plaque analysis software can vary widely in the degree of automation, resulting in differences in terms of reproducibility and time spent. Aim: To compare the reproducibility and time spent of two CCTA analysis software tools using different algorithms for the quantitative assessment of coronary plaque volumes and composition in two independent patient cohorts. Methods: The study population included 100 patients from two different cohorts: 50 patients from a single-center (Siemens Healthineers, SOMATOM Force (DSCT)) and another 50 patients from a multi-center study (5 different > 64 slice CT scanner types). Quantitative measurements of total calcified and non-calcified plaque volume of the right coronary artery (RCA), left anterior descending (LAD), and left circumflex coronary artery (LCX) were performed on a total of 300 coronaries by two independent readers, using two different CCTA analysis software tools (Tool #1: Siemens Healthineers, syngo.via Frontier CT Coronary Plaque Analysis and Tool #2: Siemens Healthineers, successor CT Coronary Plaque Analysis prototype). In addition, the total time spent for the analysis was recorded with both programs. Results: The patients in cohorts 1 and 2 were 62.8 ± 10.2 and 70.9 ± 11.7 years old, respectively, 10 (20.0%) and 35 (70.0%) were female and 34 (68.0%) and 20 (40.0%), respectively, had hyperlipidemia. In Cohort #1, the inter- and intra-observer variabilities for the assessment of plaque volumes per patient for Tool #1 versus Tool #2 were 22.8%, 22.0%, and 26.0% versus 2.3%, 3.9%, and 2.5% and 19.7%, 21.4%, and 22.1% versus 0.2%, 0.1%, and 0.3%, respectively, for total, noncalcified, and calcified lesions (p < 0.001 for all between Tools #1 and 2 both for inter- and intra-observer). The inter- and intra-observer variabilities using Tool #2 remained low at 2.9%, 2.7%, and 3.0% and 3.8%, 3.7%, and 4.0%, respectively, for total, non-calcified, and calcified lesions in Cohort #2. For each dataset, the median processing time was higher for Tool #1 versus Tool #2 (459.5 s IQR = 348.0–627.0 versus 208.5 s; IQR = 198.0–216.0) (p < 0.001). Conclusion: The plaque analysis Tool #2 (CT-guided PCI) encompassing a higher degree of automated support required less manual editing, was more time-efficient, and showed a higher intra- and inter-observer reproducibility for the quantitative assessment of plaque volumes both in a representative single-center and in a multi-center validation cohort. Full article
(This article belongs to the Special Issue The Future of Cardiac Imaging in the Diagnosis)
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