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Clinical Application of Cardiac Imaging
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Clinical Application of Cardiac Imaging

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: 15 October 2024 | Viewed by 3221

Special Issue Editors

Dr. Maria Concetta Pastore

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Guest Editor
Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy
Interests: heart failure; acute heart failure; valvular heart disease; echocardiography; advanced echocardiography; clinical cardiology; cardiovascular medicine
Dr. Marco Guglielmo

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Guest Editor
1. Department of Cardiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
2. Department of Cardiology, Haga Teaching Hospital, 2545 GM The Hague, The Netherlands
Interests: echocardiography; cardiac imaging; cardiac MRI; cardiac CT; cardiovascular imaging; transesophageal echocardiography; transthoracic echocardiography
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cardiac imaging is a pivotal tool in the diagnosis, management, and treatment of cardiovascular diseases. Its non-invasive or minimally invasive nature makes it a safe and effective option for patients, possessing considerable accuracy compared to invasive techniques. Clinicians should consider cardiac imaging in their diagnostic and treatment pathways for patients with suspected or confirmed cardiovascular disease.

The Special Issue, entitled “Clinical Application of Cardiac Imaging", explores various imaging techniques and their application in the diagnostic and prognostic assessment of cardiovascular diseases. It further discusses the role of multimodality imaging in guiding therapeutic management and interventions, such as cardiac catheterization, electrophysiology studies, and heart surgery, addressing topics such as echocardiography, cardiac magnetic resonance imaging, computed tomography, and nuclear imaging.

Overall, this Special Issue aims to provide a platform for researchers to share their latest findings related to the current state of cardiac imaging and its clinical applications. It will demonstrate the significance of various imaging modalities in the diagnosis and management of cardiac disease, discuss the recent advances in scientific knowledge and highlight the need for continued research and innovation in this field, and address the challenges and limitations of cardiac imaging.

Dr. Maria Concetta Pastore
Dr. Marco Guglielmo
Guest Editors

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. Journal of Clinical Medicine 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

  • cardiac imaging
  • echocardiography
  • magnetic resonance imaging
  • computed tomography
  • nuclear imaging
  • heart failure
  • valvular heart disease
  • congenital heart disease

Published Papers (4 papers)

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Research

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38 pages, 7060 KiB  
Article
Patients with a Bicuspid Aortic Valve (BAV) Diagnosed with ECG-Gated Cardiac Multislice Computed Tomography—Analysis of the Reasons for Referral, Classification of Morphological Phenotypes, Co-Occurring Cardiovascular Abnormalities, and Coronary Artery Stenosis
by Piotr Machowiec, Piotr Przybylski, Elżbieta Czekajska-Chehab and Andrzej Drop
J. Clin. Med. 2024, 13(13), 3790; https://doi.org/10.3390/jcm13133790 - 27 Jun 2024
Viewed by 369
Abstract
Background/Objectives: The aim of this study was to analyze a group of patients with a bicuspid aortic valve (BAV) examined with ECG-gated cardiac CT (ECG-CT), focusing on the assessment of the clinical reasons for cardiac CT, cardiovascular abnormalities coexisting with their BAV, [...] Read more.
Background/Objectives: The aim of this study was to analyze a group of patients with a bicuspid aortic valve (BAV) examined with ECG-gated cardiac CT (ECG-CT), focusing on the assessment of the clinical reasons for cardiac CT, cardiovascular abnormalities coexisting with their BAV, and coronary artery stenosis. Methods: A detailed statistical analysis was conducted on 700 patients with a BAV from a group of 15,670 patients examined with ECG-CT. Results: The incidence of a BAV in ECG-CT was 4.6%. The most common reason for examination was suspicion of coronary heart disease—31.1%. Cardiovascular defects most frequently associated with a BAV were a VSD (4.3%) and coarctation of the aorta (3.6%), while among coronary anomalies, they were high-take-off coronary arteries (6.4%) and paracommissural orifice of coronary arteries (4.4%). The analysis of the coronary artery calcium index showed significantly lower values for type 2 BAV compared to other valve types (p < 0.001), with the lowest average age in this group of patients. Moreover, the presence of a raphe between the coronary and non-coronary cusps was associated with a higher rate of significant coronary stenosis compared to other types of BAVs (p < 0.001). Conclusions: The most common reason for referral for cardiac ECG-CT in the group ≤ 40-year-olds with a BAV was the suspicion of congenital cardiovascular defects, while in the group of over 40-year-olds, it was the suspicion of coronary artery disease. The incidence of cardiovascular abnormalities co-occurring with BAV and diagnosed with ECG-CT differs among specific patient subgroups. The presence of a raphe between the coronary and non-coronary cusps appears to be a potential risk factor for significant coronary stenosis in patients with BAVs. Full article
(This article belongs to the Special Issue Clinical Application of Cardiac Imaging)
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12 pages, 2002 KiB  
Article
Diagnostic Ability of Manual Calcification Length Assessment on Non-Electrocardiographically Gated Computed Tomography for Estimating the Presence of Coronary Artery Disease
by Ryota Watanabe, Yuichi Saito, Satoshi Tokimasa, Hiroyuki Takaoka, Hideki Kitahara, Masato Yamanouchi and Yoshio Kobayashi
J. Clin. Med. 2024, 13(8), 2255; https://doi.org/10.3390/jcm13082255 - 12 Apr 2024
Viewed by 697
Abstract
Background: Coronary artery calcification score (CACS) on electrocardiography (ECG)-gated computed tomography (CT) is used for risk stratification of atherosclerotic cardiovascular disease, which requires dedicated analytic software. In this study, we evaluated the diagnostic ability of manual calcification length assessment on non-ECG-gated CT for [...] Read more.
Background: Coronary artery calcification score (CACS) on electrocardiography (ECG)-gated computed tomography (CT) is used for risk stratification of atherosclerotic cardiovascular disease, which requires dedicated analytic software. In this study, we evaluated the diagnostic ability of manual calcification length assessment on non-ECG-gated CT for epicardial coronary artery disease (CAD). Methods: A total of 100 patients undergoing both non-ECG-gated plain CT scans with a slice interval of 1.25 mm and invasive coronary angiography were retrospectively included. We manually measured the length of the longest calcified lesions of coronary arteries on each branch. The relationship between the number of coronary arteries with the length of coronary calcium > 5, 10, or 15 mm and the presence of epicardial CAD on invasive angiography was evaluated. Standard CACS was also evaluated using established software. Results: Of 100 patients, 49 (49.0%) had significant epicardial CAD on angiography. The median standard CACS was 346 [7, 1965]. In both manual calcium assessment and standard CACS, the increase in calcium burden was progressively associated with the presence of epicardial CAD on angiography. The receiver operating characteristic curve analysis showed similar diagnostic abilities of the two diagnostic methods. The best cut-off values for CAD were 2, 1, and 1 for the number of vessels with calcium > 5, 10, and 15 mm, respectively. Overall, the diagnostic ability of manual calcium assessment was similar to that of standard CACS > 400. Conclusions: Manual assessment of coronary calcium length on non-ECG-gated plain CT provided similar diagnostic ability for the presence of significant epicardial CAD on invasive angiography, as compared to standard CACS. Full article
(This article belongs to the Special Issue Clinical Application of Cardiac Imaging)
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Review

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19 pages, 641 KiB  
Review
Atrial Fibrillation, Atrial Myopathy, and Thromboembolism: The Additive Value of Echocardiography and Possible New Horizons for Risk Stratification
by Alessandro Campora, Matteo Lisi, Maria Concetta Pastore, Giulia Elena Mandoli, Yu Fu Ferrari Chen, Annalisa Pasquini, Andrea Rubboli, Michael Y. Henein and Matteo Cameli
J. Clin. Med. 2024, 13(13), 3921; https://doi.org/10.3390/jcm13133921 - 4 Jul 2024
Viewed by 531
Abstract
Atrial fibrillation (AF) is the most common cardiac sustained arrhythmia, and it is associated with increased stroke and dementia risk. While the established paradigm attributes these complications to blood stasis within the atria and subsequent thrombus formation with cerebral embolization, recent evidence suggests [...] Read more.
Atrial fibrillation (AF) is the most common cardiac sustained arrhythmia, and it is associated with increased stroke and dementia risk. While the established paradigm attributes these complications to blood stasis within the atria and subsequent thrombus formation with cerebral embolization, recent evidence suggests that atrial myopathy (AM) may play a key role. AM is characterized by structural and functional abnormalities of the atria, and can occur with or without AF. Moving beyond classifications based solely on episode duration, the 4S-AF characterization has offered a more comprehensive approach, incorporating patient’s stroke risk, symptom severity, AF burden, and substrate assessment (including AM) for tailored treatment decisions. The “ABC” pathway emphasizes anticoagulation, symptom control, and cardiovascular risk modification and emerging evidence suggests broader benefits of early rhythm control strategies, potentially reducing stroke and dementia risk and improving clinical outcomes. However, a better integration of AM assessment into the current framework holds promise for further personalizing AF management and optimizing patient outcomes. This review explores the emerging concept of AM and its potential role as a risk factor for stroke and dementia and in AF patients’ management strategies, highlighting the limitations of current risk stratification methods, like the CHA2DS2-VASc score. Echocardiography, particularly left atrial (LA) strain analysis, has shown to be a promising non-invasive tool for AM evaluation and recent studies suggest that LA strain analysis may be a more sensitive risk stratifier for thromboembolic events than AF itself, with some studies showing a stronger association between LA strain and thromboembolic events compared to traditional risk factors. Integrating it into routine clinical practice could improve patient management and targeted therapies for AF and potentially other thromboembolic events. Future studies are needed to explore the efficacy and safety of anticoagulation in AM patients with and without AF and to refine the diagnostic criteria for AM. Full article
(This article belongs to the Special Issue Clinical Application of Cardiac Imaging)
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14 pages, 1219 KiB  
Review
Dynamic CT Myocardial Perfusion: The Role of Functional Evaluation in the Diagnosis of Coronary Artery Disease
by Agata Zdanowicz, Maciej Guzinski, Michal Pula, Agnieszka Witkowska and Krzysztof Reczuch
J. Clin. Med. 2023, 12(22), 7062; https://doi.org/10.3390/jcm12227062 - 13 Nov 2023
Viewed by 1272
Abstract
Coronary computed tomography angiography (CTA) is a widely accepted, non-invasive diagnostic modality for the evaluation of patients with suspected coronary artery disease (CAD). However, a limitation of CTA is its inability to provide information on the hemodynamic significance of the coronary lesion. The [...] Read more.
Coronary computed tomography angiography (CTA) is a widely accepted, non-invasive diagnostic modality for the evaluation of patients with suspected coronary artery disease (CAD). However, a limitation of CTA is its inability to provide information on the hemodynamic significance of the coronary lesion. The recently developed stress dynamic CT perfusion technique has emerged as a potential solution to this diagnostic challenge. Dynamic CT myocardial perfusion provides information on the hemodynamic consequences of coronary stenosis and is used to detect myocardial ischemia. The combination of stress dynamic CT myocardial perfusion with CTA provides a comprehensive assessment that integrates anatomical and functional information. CT myocardial perfusion has been validated in several clinical studies and has shown comparable accuracy to Positron Emission Tomography (PET) and stress magnetic resonance imaging (MRI) in the diagnosis of hemodynamically significant coronary stenosis and superior performance to Single Photon Emission Computed Tomography (SPECT). More importantly, CTP-derived myocardial perfusion has been shown to have a strong correlation with FFR, and the use of CTP results in a reduction of negative catheterizations. In the context of suspected stable coronary artery disease, the CT protocol with dynamic perfusion imaging combined with CTA eliminates the need for additional testing, making it a convenient “one-stop-shop” method and an effective gatekeeper to an invasive approach. Full article
(This article belongs to the Special Issue Clinical Application of Cardiac Imaging)
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