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Diagnostics
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Advances in Cardiovascular Imaging
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Advances in Cardiovascular Imaging

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

Deadline for manuscript submissions: closed (30 May 2023) | Viewed by 7895

Special Issue Editor

Prof. Dr. Michael Henein

E-Mail Website
Guest Editor
Department of Public Health and Clinical Medical and Heart Center, Umea University, Umea, Sweden
Interests: non-invasive cardiology including valve disease; coronary artery disease; heart failure; cardiovascular imaging
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

Optimum twenty-first century cardiology practice is based, in most cases, on cardiovascular imaging. Various non-invasive imaging techniques, including echocardiography with its multiple modalities, cardiac magnetic resonance, myocardial perfusion tomography and CT coronary artery scanning, have become the cornerstone for accurate diagnosis. In addition, Doppler vascular scanning has also become essential for various arterial syndromes, as well as an aid in routine atherosclerosis prevention clinics. This Special Issue of the Diagnostics journal aims to attract high-quality articles, both original and review, in the field of cardiovascular imaging. Combining such a wealth of knowledge in one Issue will be a great educational tool, particularly in broadcasting recent imaging advances.

Prof. Dr. Michael Henein
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiovascular imaging including echocardiography and CTCA
  • cardiovascular imaging
  • echocardiography
  • cardiac magnetic resonance
  • myocardial perfusion imaging

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Published Papers (4 papers)

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Research

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14 pages, 1259 KiB  
Article
Left Ventricle Segmentation in Echocardiography with Transformer
by Minqi Liao, Yifan Lian, Yongzhao Yao, Lihua Chen, Fei Gao, Long Xu, Xin Huang, Xinxing Feng and Suxia Guo
Diagnostics 2023, 13(14), 2365; https://doi.org/10.3390/diagnostics13142365 - 13 Jul 2023
Cited by 7 | Viewed by 2753
Abstract
Left ventricular ejection fraction (LVEF) plays as an essential role in the assessment of cardiac function, providing quantitative data support for the medical diagnosis of heart disease. Robust evaluation of the ejection fraction relies on accurate left ventricular (LV) segmentation of echocardiograms. Because [...] Read more.
Left ventricular ejection fraction (LVEF) plays as an essential role in the assessment of cardiac function, providing quantitative data support for the medical diagnosis of heart disease. Robust evaluation of the ejection fraction relies on accurate left ventricular (LV) segmentation of echocardiograms. Because human bias and expensive labor cost exist in manual echocardiographic analysis, computer algorithms of deep-learning have been developed to help human experts in segmentation tasks. Most of the previous work is based on the convolutional neural networks (CNN) structure and has achieved good results. However, the region occupied by the left ventricle is large for echocardiography. Therefore, the limited receptive field of CNN leaves much room for improvement in the effectiveness of LV segmentation. In recent years, Vision Transformer models have demonstrated their effectiveness and universality in traditional semantic segmentation tasks. Inspired by this, we propose two models that use two different pure Transformers as the basic framework for LV segmentation in echocardiography: one combines Swin Transformer and K-Net, and the other uses Segformer. We evaluate these two models on the EchoNet-Dynamic dataset of LV segmentation and compare the quantitative metrics with other models for LV segmentation. The experimental results show that the mean Dice similarity of the two models scores are 92.92% and 92.79%, respectively, which outperform most of the previous mainstream CNN models. In addition, we found that for some samples that were not easily segmented, whereas both our models successfully recognized the valve region and separated left ventricle and left atrium, the CNN model segmented them together as a single part. Therefore, it becomes possible for us to obtain accurate segmentation results through simple post-processing, by filtering out the parts with the largest circumference or pixel square. These promising results prove the effectiveness of the two models and reveal the potential of Transformer structure in echocardiographic segmentation. Full article
(This article belongs to the Special Issue Advances in Cardiovascular Imaging)
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12 pages, 2587 KiB  
Article
Strain Rate Changes during Stress Echocardiography Are the Most Accurate Predictors of Significant Coronary Artery Disease in Patients with Previously Treated Acute Coronary Syndrome
by Rafik Shenouda, Ibadete Bytyçi, Eman El Sharkawy, Noha Hisham, Mohamed Sobhy and Michael Y. Henein
Diagnostics 2023, 13(10), 1796; https://doi.org/10.3390/diagnostics13101796 - 19 May 2023
Viewed by 1521
Abstract
Background and Aims. Dobutamine stress echocardiography (DSE) is a well-established non-invasive investigation for the detection of ischemic myocardial dysfunction. The aim of this study was to evaluate the accuracy of myocardial deformation parameters measured by speckle tracking echocardiography (STE) in predicting culprit coronary [...] Read more.
Background and Aims. Dobutamine stress echocardiography (DSE) is a well-established non-invasive investigation for the detection of ischemic myocardial dysfunction. The aim of this study was to evaluate the accuracy of myocardial deformation parameters measured by speckle tracking echocardiography (STE) in predicting culprit coronary artery lesions in patients with prior revascularization and acute coronary syndrome (ACS). Methods. We prospectively studied 33 patients with ischemic heart disease, a history of at least one episode of ACS and prior revascularization. All patients underwent a complete stress Doppler echocardiographic examination, including the myocardial deformation parameters of peak systolic strain (PSS), peak systolic strain rate (SR) and wall motion score index (WMSI). The regional PSS and SR were analyzed for different culprit lesions. Results. The mean age of patients was 59 ± 11 years and 72.7% were males. At peak dobutamine stress, the change in regional PSS and SR in territories supplied by the LAD showed smaller increases compared to those in patients without culprit LAD lesions (p < 0.05 for all). Likewise, the regional parameters of myocardial deformation were reduced in patients with culprit LCx lesions compared to those with non-culprit LCx lesions and in patients with culprit RCA legions compared to those with non-culprit RCA lesions (p < 0.05 for all). In the multivariate analysis, the △ regional PSS (1.134 (CI = 1.059–3.315, p = 0.02)) and the △ regional SR (1.566 (CI = 1.191–9.013, p = 0.001)) for LAD territories predicted the presence of LAD lesions. Similarly, in a multivariable analysis, the △ regional PSS and the △SR predicted LCx culprit lesions and RCA culprit lesions (p < 0.05 for all). In an ROC analysis, the PSS and SR had higher accuracies compared to the regional WMSI in predicting culprit lesions. A △ regional SR of −0.24 for the LAD territories was 88% sensitive and 76% specific (AUC = 0.75; p < 0.001), a △ regional PSS of −1.20 was 78% sensitive and 71% specific (AUC = 0.76, p < 0.001) and a △ WMSI of −0.35 was 67% sensitive and 68% specific (AUC = 0.68, p = 0.02) in predicting LAD culprit lesions. Similarly, the △ SR for LCx and RCA territories had higher accuracies in predicting LCx and RCA culprit lesions. Conclusions. The myocardial deformation parameters, particularly the change in regional strain rate, are the most powerful predictors of culprit lesions. These findings strengthen the role of myocardial deformation in increasing the accuracy of DSE analyses in patients with prior cardiac events and revascularization. Full article
(This article belongs to the Special Issue Advances in Cardiovascular Imaging)
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Other

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10 pages, 2104 KiB  
Case Report
Myocardial Work Evaluation—A Useful Non-Invasive Method to Predict Coronary Artery Sub-Occlusion in a Patient with Unstable Angina and Multiple Myocardial Revascularization Interventions
by Alexandru Gheorghiu, Sergiu-Florin Arnautu, Milena Slovenski, Claudiu-Daniel Malița, Mirela-Cleopatra Tomescu and Diana-Aurora Arnautu
Diagnostics 2023, 13(8), 1459; https://doi.org/10.3390/diagnostics13081459 - 18 Apr 2023
Cited by 2 | Viewed by 1366
Abstract
Background: While lifestyle changes, management of coronary artery disease (CAD) risk factors, myocardial revascularization procedures, and medication can improve a patient’s prognosis, de novo native coronary lesions and in-stent restenosis (ISR) remain significant clinical concerns. ISR is more frequent with a bare-metal stent [...] Read more.
Background: While lifestyle changes, management of coronary artery disease (CAD) risk factors, myocardial revascularization procedures, and medication can improve a patient’s prognosis, de novo native coronary lesions and in-stent restenosis (ISR) remain significant clinical concerns. ISR is more frequent with a bare-metal stent than with a drug-eluting stent and has been documented in around 12% of DES patients. Acute coronary syndrome (ACS) manifests as unstable angina in about 30% to 60% of ISR patients. Myocardial work imaging is a modern, non-invasive technique able to identify individuals with critical coronary artery lesions with high sensitivity and specificity. Case report: We present the case of a 72-year-old Caucasian gentleman with multiple cardiovascular risk factors, admitted to the Cardiology Clinic of Timișoara Municipal Hospital with unstable angina. From 1999 to 2021, the patient experienced two myocardial infarctions, a double aortocoronary bypass graft, and multiple percutaneous coronary interventions with 11 stent implantations, including 6 for ISR. Using two-dimensional speckle-tracking echocardiography and myocardial work assessment, we detected that the lateral wall of the left ventricle had a severely impaired deformation pattern. Angio-coronarography was performed, and sub-occlusion of the posterolateral branch of the right coronary artery was found. Angioplasty was performed and a DES was inserted, with a good final angiographic result and complete release of symptoms. Conclusion: In patients with a history of multiple myocardial revascularization interventions and ISR, it is challenging to identify the critical ischemia region by non-invasive methods. Myocardial work imaging was beneficial in the detection of the altered deformation patterns indicating significant ischemia, its accuracy being superior to that of LV strain, as proven by coronary angiography. Urgent coronary angiography followed by angioplasty and stent implantation resolved the issue. Full article
(This article belongs to the Special Issue Advances in Cardiovascular Imaging)
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10 pages, 2041 KiB  
Case Report
Surgical Atrial Septal Patch Endocarditis in a Patient with a Complete Corrected Atrioventricular Canal Defect: A Case Report and Review of the Literature
by Adela Serban, Alexandru Achim, Dana Elena Gavan, Raluca Tomoaia, Adrian Molnar, Mihai Suceveanu, Dan Damian Axente, Stefan Mot and Alexandra Dadarlat-Pop
Diagnostics 2023, 13(5), 856; https://doi.org/10.3390/diagnostics13050856 - 23 Feb 2023
Viewed by 1670
Abstract
Infective endocarditis (IE) is common in patients with corrected congenital heart disease (CHD) with a residual lesion, but is rarely found on surgical patches used to close atrial septal defects (ASDs). This is also reflected in the current guidelines that do not recommend [...] Read more.
Infective endocarditis (IE) is common in patients with corrected congenital heart disease (CHD) with a residual lesion, but is rarely found on surgical patches used to close atrial septal defects (ASDs). This is also reflected in the current guidelines that do not recommend antibiotic therapy for patients with a repaired ASD with no residual shunt six months after closure (percutaneous or surgical). However, the situation could be different in the case of mitral valve endocarditis, which causes leaflet disruption with severe mitral insufficiency and could seed the surgical patch. We present herein a 40-year-old male patient with a past medical history of a complete surgically corrected atrioventricular canal defect performed in childhood who presented with fever, dyspnea and severe abdominal pain. Transthoracic and transesophageal echocardiography (TTE and TEE) revealed vegetation at the level of the mitral valve and the interatrial septum. The CT scan confirmed ASD patch endocarditis and multiple septic emboli, guiding the therapeutic management. An accurate evaluation of cardiac structures should be mandatory when a systemic infection is detected in CHD patients, even if the defects were surgically corrected, because the detection and eradication of such infectious foci as well as a surgical reintervention are particularly difficult to achieve in this subpopulation. Full article
(This article belongs to the Special Issue Advances in Cardiovascular Imaging)
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