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Review

The Role of Non-Invasive Multimodality Imaging in Chronic Coronary Syndrome: Anatomical and Functional Pathways

by
Luca Bergamaschi
1,†,
Anna Giulia Pavon
1,†,
Francesco Angeli
2,3,
Domenico Tuttolomondo
4,
Marta Belmonte
5,6,
Matteo Armillotta
2,3,
Angelo Sansonetti
2,3,
Alberto Foà
2,3,
Pasquale Paolisso
6,
Andrea Baggiano
7,8,
Saima Mushtaq
7,
Giulia De Zan
9,10,
Serena Carriero
11,
Maarten-Jan Cramer
9,
Arco J. Teske
9,
Lysette Broekhuizen
9,
Ivo van der Bilt
9,12,
Giuseppe Muscogiuri
13,14,
Sandro Sironi
13,15,
Laura Anna Leo
1,
Nicola Gaibazzi
4,
Luigi Lovato
16,
Gianluca Pontone
7,
Carmine Pizzi
2,3 and
Marco Guglielmo
9,12,*add Show full author list remove Hide full author list
1
Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Via Tesserete, 48, 6900 Lugano, Switzerland
2
Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy
3
Department of Medical and Surgical Sciences—DIMEC—Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
4
Department of Cardiology, Parma University Hospital, Viale Antonio Gramsci 14, 43126 Parma, Italy
5
Cardiovascular Center Aalst, OLV-Clinic, 9300 Aalst, Belgium
6
Department of Advanced Biomedical Sciences, University Federico II, 80138 Naples, Italy
7
Perioperative and Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
8
Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
9
Department of Cardiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
10
Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, 28100 Novara, Italy
11
Postgraduate School of Radiodiagnostics, Università degli Studi di Milano, 20122 Milan, Italy
12
Department of Cardiology, Haga Teaching Hospital, 2545 GM The Hague, The Netherlands
13
School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy
14
Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, 20149 Milan, Italy
15
Department of Radiology, ASST Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy
16
Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy
 
add Show full affiliation list
 
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*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Diagnostics 2023, 13(12), 2083; https://doi.org/10.3390/diagnostics13122083
Submission received: 12 May 2023 / Revised: 10 June 2023 / Accepted: 12 June 2023 / Published: 16 June 2023
(This article belongs to the Special Issue Advanced Imaging in Cardiomyopathy: Impact on Diagnosis, Clinical Management and Prognosis)
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Abstract

Coronary artery disease (CAD) is one of the major causes of mortality and morbidity worldwide, with a high socioeconomic impact. Currently, various guidelines and recommendations have been published about chronic coronary syndromes (CCS). According to the recent European Society of Cardiology guidelines on chronic coronary syndrome, a multimodal imaging approach is strongly recommended in the evaluation of patients with suspected CAD. Today, in the current practice, non-invasive imaging methods can assess coronary anatomy through coronary computed tomography angiography (CCTA) and/or inducible myocardial ischemia through functional stress testing (stress echocardiography, cardiac magnetic resonance imaging, single photon emission computed tomography—SPECT, or positron emission tomography—PET). However, recent trials (ISCHEMIA and REVIVED) have cast doubt on the previous conception of the management of patients with CCS, and nowadays it is essential to understand the limitations and strengths of each imaging method and, specifically, when to choose a functional approach focused on the ischemia versus a coronary anatomy-based one. Finally, the concept of a pathophysiology-driven treatment of these patients emerged as an important goal of multimodal imaging, integrating ‘anatomical’ and ‘functional’ information. The present review aims to provide an overview of non-invasive imaging modalities for the comprehensive management of CCS patients.
Keywords: chronic coronary syndrome; echocardiography; cardiac magnetic resonance; coronary computed tomography angiography; nuclear medicine; ischemia; CAD chronic coronary syndrome; echocardiography; cardiac magnetic resonance; coronary computed tomography angiography; nuclear medicine; ischemia; CAD

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MDPI and ACS Style

Bergamaschi, L.; Pavon, A.G.; Angeli, F.; Tuttolomondo, D.; Belmonte, M.; Armillotta, M.; Sansonetti, A.; Foà, A.; Paolisso, P.; Baggiano, A.; et al. The Role of Non-Invasive Multimodality Imaging in Chronic Coronary Syndrome: Anatomical and Functional Pathways. Diagnostics 2023, 13, 2083. https://doi.org/10.3390/diagnostics13122083

AMA Style

Bergamaschi L, Pavon AG, Angeli F, Tuttolomondo D, Belmonte M, Armillotta M, Sansonetti A, Foà A, Paolisso P, Baggiano A, et al. The Role of Non-Invasive Multimodality Imaging in Chronic Coronary Syndrome: Anatomical and Functional Pathways. Diagnostics. 2023; 13(12):2083. https://doi.org/10.3390/diagnostics13122083

Chicago/Turabian Style

Bergamaschi, Luca, Anna Giulia Pavon, Francesco Angeli, Domenico Tuttolomondo, Marta Belmonte, Matteo Armillotta, Angelo Sansonetti, Alberto Foà, Pasquale Paolisso, Andrea Baggiano, and et al. 2023. "The Role of Non-Invasive Multimodality Imaging in Chronic Coronary Syndrome: Anatomical and Functional Pathways" Diagnostics 13, no. 12: 2083. https://doi.org/10.3390/diagnostics13122083

APA Style

Bergamaschi, L., Pavon, A. G., Angeli, F., Tuttolomondo, D., Belmonte, M., Armillotta, M., Sansonetti, A., Foà, A., Paolisso, P., Baggiano, A., Mushtaq, S., De Zan, G., Carriero, S., Cramer, M.-J., Teske, A. J., Broekhuizen, L., van der Bilt, I., Muscogiuri, G., Sironi, S., ... Guglielmo, M. (2023). The Role of Non-Invasive Multimodality Imaging in Chronic Coronary Syndrome: Anatomical and Functional Pathways. Diagnostics, 13(12), 2083. https://doi.org/10.3390/diagnostics13122083

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