Cardiac Imaging News

MRI Could Help Guide Acute Stroke Therapy
 …

According to a retrospective study, patients who suffer from acute strokes and undergo endovascular therapy, may greatly benefit if an MRI is used to navigate the therapy. According to M. Shazam Hussain, MD, of the Cleveland Clinic, and co-workers, a procedure that added MRI to the traditional CT-based evaluation was linked with a lower percentage of patients who received endovascular therapy (51.7% versus 96.6%, ... Read more

MI Risks in Women Not So Different…

Researchers have reported that although some studies show that women may have a higher risk of a myocardial infarction (MI) or death due to unusual symptoms, a study using coronary computed tomography angiography reveals that adverse results are not determined by gender. “Major adverse cardiovascular events, heart attacks or death, occurred in 0.3% of women who were found to be free of coronary artery disease and in 1.2% of women who had mild, but non-obstructive coronary artery disease, compared with 0.3% of men (P=0.87) with no heart disease observed with the imaging technology and 1.1% of men with some non-obstructive heart disease (P=0.95),” said director of medical imaging at St. Paul's Hospital, Vancouver, British Columbia, Jonathon Leipsic, M.D. “There is a tendency to think women's heart disease is very different from men's heart disease. Our data show that once plaque accumulates in the coronary arteries, the prognosis is very similar between men and women. Men and women behave quite similarly,” Leipsic said in a press conference at the annual meeting of the Radiological Society of North America (RSNA). Leipsci noted that overall having mild coronary artery disease is worse than not having coronary artery disease, but that it is just as bad for men as it is for women. For this study, 6,759 people with coronary plaque were observed during CT angiography, the 3-year mortality was 0.3%, while the 3-year mortality for the 4,703 patients observed to have mild coronary artery disease was 1.1%, a difference that was statistically important with a hazard ratio of 1.84 (95% CI 1.28-2.63; P=0.001). To conduct the study, Leipsic and his team examined the Coronary CT Angiography Evaluation for Clinical Outcomes (CONFIRM) Registry, an international partnership that involved performing CT angiography among 27,725 individuals in 6 different countries. From that population, the research team pulled 18,158 individuals whose scans showed either no obstruction or coronary arteries that had less than a 50% obstruction. The patients included 8,808 women and 9,350 men. "We then matched men and women for their pretest likelihood for their risk factors and their type of chest pain," said Leipsci. The patients were then assessed on the basis of heart attacks or death. The proclivity matching left the researchers with a study population of 11,462 subjects. They recorded 37 heart attacks and 120 of the group died, seven of whom also had heart attacks. The yearly event rate in the study was 0.6%. "We found that having mild coronary disease is not just incidental but identifies people who are at an increased risk of having a heart attack or dying. We also analyzed out data on the basis of the presence or absence of symptoms or of the type of symptoms, and it does not appear that symptomatology matters," said Leipsic. For those patients with normal scans, events took place in 0.3% of asymptomatic men and in 0.4% of asymptomatic women (P=0.62). For asymptomatic individuals were non-obstructive coronary plaques, the event rate was 1.2% in men and 1.2% in women (P=0.94). Similar and non-significant findings were seen when Leipsic's team analyzed the outcomes for patients who reported to the clinic for non-anginal chest pain, for those with atypical angina, and for those with typical angina. Leipsic said his study shows that coronary "CT angiography in patients with low or intermediate risk with atypical or somewhat typical symptoms is a powerful tool not only for diagnosis but also a very good prognostic tool even in the setting of mild coronary narrowing. And we see that the use of this tool is consistent across both men and women." He also said that his study is good news for women. "Women have been told that if they are having atypical pain they can't rely on tests the way men can. They should not ignore the chest pain but they don't have to worry that they are going to die at a higher rate than ... Read more

Heart Disease Comparable in Men and Women, …

Based on a study recently presented at the annual meeting of the Radiological Society of North America (RSNA), an examination of data from an international multicenter study of coronary computed tomography angiography (CCTA) shows that men and women with mild coronary artery disease and similar cardiovascular risk profiles share similar diagnoses. “We conducted this study because we wanted to understand whether men and women with the same extent of coronary artery disease and similar risk profiles have similar or dissimilar prognoses. There is a tendency to think women's heart disease is very different than men's heart disease. Our data show that once plaque accumulates in the coronary arteries, the prognosis is very similar between men and women,” said director of medical imaging at St. Paul's Hospital in Vancouver, British Columbia, Jonathon Leipsic, M.D., FRCPC. Coronary artery disease takes place when the coronary arteries, the key blood vessels that provide the oxygen-rich blood to the heart muscle, start to amass a buildup of fatty deposits called plaque. Over time, plaque may damage or narrow the arteries. CCTA is a noninvasive imaging test that employs computed tomography (CT) to image the quantity of plaque existing in the coronary arteries. For the study, Leipsic and a team of researchers used data from the Coronary CT Angiography Evaluation For Clinical Outcomes: An InteRnational Multicenter (CONFIRM) Registry, which composed information on 27,725 individuals in six countries who received CCTA. The registry also included participants' traditional risk factors, allowing for the derivation of Framingham scores, which are used to gauge an individual's risk of developing cardiovascular disease. From the registry, the researchers found 18,158 patients without known coronary artery disease, whose CCTA results were normal or indicated nonobstructive disease, in which coronary arteries were less than 50 percent blocked. These patients, including 8,808 women and 9,350 men, were then paired on the account of pre-existing cardiovascular risk factors and the degree of their coronary artery disease as assessed by CCTA, resulting in a one-to-one group of 11,462 patients. A statistical analysis of the paired group showed that, controlling for all cardiovascular risk factors, nonobstructive coronary artery disease presented a similar adverse risk of death or heart attack in both men and women. On the other hand, the absence of plaque on CCTA presented a good diagnosis for both men and women. Of the patients in the group, only 251 experienced a heart attack or cardiac-related death during a median follow-up period of 2.3 years. "This analysis is exciting, because this has never been shown before. There's a prevailing belief that mild CAD puts women at greater risk for a major cardiac event compared to men with mild CAD. Our findings show this is just not true,” said ... Read more

Energy Drinks Can Harm Heart Function According to …

Based on a study presented at the annual meeting of the Radiological Society of North America (RSNA), healthy people who drink energy drinks that are high in caffeine and taurine had considerably higher heart contraction rates only one hour later. "Until now, we haven't known exactly what effect these energy drinks have on the function of the heart. There are concerns about the products' potential adverse side effects on heart function, especially in adolescents and young adults, but there is little or no regulation of energy drink sales,” said radiology resident Jonas Dörner, M.D., of the cardiovascular imaging section at the University of Bonn, Germany, which is led by the study's principal investigator, Daniel K. Thomas, M.D. Energy drinks are part of a multi-billion dollar industry that is widening its reach; for as research shows that while teenagers and young adults have been the majority consumers, in recent years more people from different demographics have begun to consumer energy drinks. A 2013 report from the Substance Abuse and Mental Health Services Administration stated that in the U.S. from 2007 to 2011, the number of emergency department visits related to energy drink consumption nearly doubled, increasing from 10,068 to 20,783. Most of the cases were categorized among patients aged 18 to 25, followed by those aged 26 to 39. "Usually energy drinks contain taurine and caffeine as their main pharmacological ingredients. The amount of caffeine is up to three times higher than in other caffeinated beverages like coffee or cola. There are many side effects known to be associated with a high intake of caffeine, including rapid heart rate, palpitations, rise in blood pressure and, in the most severe cases, seizures or sudden death,” said Dörner. For this ongoing study, Dörner and his team utilized cardiac magnetic resonance imaging (MRI) to measure the impact of energy drink consumption on heart function in 18 healthy volunteers, including 15 men and three women with an average age of 27.5 years. Each of the volunteers received cardiac MRI before and one hour after consuming an energy drink containing taurine (400 mg/100 ml) and caffeine (32 mg/100 ml). When compared to the baseline images, results of cardiac MRI performed one hour after the study participants consumed the energy drink showed notably increased peak strain and peak systolic strain rates (measurements for contractility) in the left ventricle of the heart. The heart's left ventricle takes in oxygenated blood from the lungs and pumps it to the aorta, which then delivers it throughout the rest of the body. "We don't know exactly how or if this greater contractility of the heart impacts daily activities or athletic performance. We need additional studies to understand this mechanism and to determine how long the effect of the energy drink lasts,” said Dörner. Additionally, the researchers found no major differences in heart rate, blood pressure, or the amount of blood ejected from the left ventricle of the heart between the volunteers' baseline and second MRI exams. "We've shown that energy drink consumption has a short-term impact on cardiac contractility. Further studies are needed to evaluate the impact of long-term energy drink consumption and the effect of such drinks on individuals with heart disease,” said Dörner. Dörner admits that while long-term risks to the heart from drinking energy drinks remain unknown, he advises that children, as well as people with known cardiac arrhythmias, should pass up energy drinks, because changes in contractility could prompt arrhythmias. He also suggets that additional study is required to address risks caused by the consumption of energy drinks in conjunction with ... Read more

New Rehabilitation Tool Improves Motor Skills …

A recent study shows that by utilizing a new stroke rehabilitation device that adapts a patient's thoughts to electrical impulses to move upper extremities, stroke patients reported improvements in their motor skills and capability to perform daily ... Read more

Advanced CT Imaging Proves Just as Precise as Invasive …

Based on an international study, an ultrafast, 320-detector computed tomography (CT) scanner that displays both anatomy within coronary arteries and blood flow can accurately pick out which people require, or don’t require, an invasive procedure to classify coronary blockages. The researchers suggest that their discoveries may be able to save millions of people worldwide from undergoing unnecessary cardiac catheterization. The study, referred to as CORE 320, included 381 patients at 16 hospitals in eight different countries. An article on the results was published online by the European Heart Journal on Nov. 19, 2013. In the study, participants were assessed with a 320-detector CT and standard tests that are widely applied today. The researchers say 91 percent of those in whom the CT scan ruled out blockages would not have needed invasive treatment such as stenting or bypass surgery. Therefore, those patients, none of whom had a history of coronary artery disease, could have circumvented invasive tests because for them the CT scan was just as precise in determining who would be an eligible candidate for revascularization as the standard tests. "Ours is the first prospective, multicenter study to examine the diagnostic accuracy of CT for assessing blockages in blood vessels and determining which of those blockages may be preventing the heart from getting adequate blood flow. We found an excellent correlation in results when we compared the 320-detector CT testing with the traditional means of assessment using a stress test with imaging and cardiac catheterization,” said senior author of the study and a professor of medicine and radiology at the Johns Hopkins University School of Medicine, Joao A. C. Lima, M.D. The study discoveries, noted Lima, would apply to people who have chest pain but not a heart attack based on EKG and other supplemental evidence. Many people in those circumstances are sent to a cardiac catheterization laboratory for further observation with angiography, an invasive test that searches for blockages in the coronary arteries using dye and special X-rays. “About 30 percent of people who have such catheterization are found to have minimal disease or no blockage requiring an intervention to open the vessel with a stent or bypass the vessel through surgery,” said Lima. The 381 patients who underwent the study had conventional single-photon emission computed tomorgraphy (SPECT) tests and invasive angiography. According to Lima SPECT, a stress test with imaging, demonstrates reduced blood flow to the heart without signifying the number or specific location of blockages. Study participants also had two types of tests with a noninvasive 320-detector CT scanner. For the first CT test, the scanner was utilized to view the anatomy of vessels to determine whether and where there were blockages. This test is known as CTA, in which the "A" stands for angiography. For the second CT test with the same system, patients were provided a drug that dilates blood vessels and increases blood flow to the heart in ways similar to what occurs during a stress test. This second test is called CTP, with the "P" standing for perfusion. "We found that the 320-detector CT scanner allowed us to see the anatomy of the blockages and determine whether the blockages were causing a lack of perfusion to the heart. We were therefore able to correctly identify the patients who needed revascularization within 30 days of their evaluation,” said cardiologist at the Heart Institute (InCor), University of São Paulo Medical School, in Brazil and lead author of the study, Carlos E. Rochitte, M.D. "Many patients are sent for an angioplasty when they may not need it. Our ultimate goal is to have more certainty about which patients having chest pain, without evidence of a heart attack, need an invasive procedure to open an arterial blockage,” said cardiologist and associate professor of medicine at the Johns Hopkins University School of Medicine and a co-author of the study, Richard George, M.D. "The CTP test added significant information about the patients'conditions and boosted our ability to identify those whose blockages were severe enough to reduce blood flow to the heart," added George, who helped develop the CTP testing method with Lima. The 320-detector CT offers a fully-rounded image of the heart by making just one circular movement around the body. The researchers say the two tests combined, CTA and CTP, still generate less radiation than a scan with the 64-detector CT scanner in frequent use today. "In our study, the amount of radiation exposure to patients from the two 320-detector CT tests was half the amount they received as a result of the traditional evaluation methods, the angiogram and nuclear medicine stress test combined," said Lima. As of now the researchers say they will continue to follow the patients in the study for a five year period, looking for any adverse heart-related events such as heart attacks, as well as hospital admissions, procedures or ... Read more

Clot-Buster Improved by Ultrasound in Stoke Patients…

A new study showcased that a hands-free ultrasound device in conjunction with a clot-busting drug was quite safe and effective for ischemic stroke patients. The phase II pilot-study results were published online in the American Heart Association journal Stroke.  Lead author of the study, Andrew D. Barreto, MD, is an assistant professor of neurology in the Stroke Program at the University of Texas (UT) Health Medical School (Houston, USA). The appliance, which utilizes UTHealth technology accredited to Cerevast Therapeutics, Inc. (Redmond, WA, USA), is situated on the stroke patient’s head and delivers ultrasound to maximize the effectiveness of the clot-busting drug tissue plasminogen activator (tPA). Unlike to the standard hand-held ultrasound probe that is directed at a blood clot, the hands-free device used 18 separate probes and floods the deep areas of the brain where large blood clots cause severe strokes.  “Our goal is to open up more arteries in the brain and help stroke patients recover. This technology would have a significant impact on patients, families, and society if we could improve outcomes by another 10% or more by adding ultrasound to patients who’ve already received tPA,” said Barreto. Being the first study of its kind, in which 20 more or less severe ischemic stroke patients (12 men and eight women, median age of 63 years) were administered intravenous tPA for up to 4.5 hours following symptoms exhibited and two hours exposure to 2-MHz pulsed wave transcranial ultrasound.  Researchers reported that 13 (or 65%) patients either returned home or to rehabilitation 90 days following the combination treatment. Five of the 20 patients, after three months, had no apparent disability from the stroke, while one had a slight disability. Cerevast Therapeutics has recently introduced an 830-patient international, randomized efficiency study of the ultrasound device in accordance with the clot buster in ischemic stroke.  Barreto is the North American lead investigator for that phase III study called Combined Lysis of Thrombus with Ultrasound and Systemic Tissue Plasminogen Activator (tPA) for Emergent Revascularization in Acute Ischemic Stroke ... Read more

Seemingly Harmless Lesions May Not Require PCI …

Recent results of a randomized trial showed that taking a more conventional appraoch in determining which coronary lesions would require percutaneous intervention did not harm or derail patient outcomes in any way. According to Hyeon-Cheol Gwon, MD, PhD, of Samsung Medical Center in Seoul, South Korea, the 1-year rate of all-cause of death,myocardial infarction, and any revascularization was 7.3% when stenosis of more than 70% was used as the starting point and 6.8% when stenosis of more than 50% was used (HR 1.05, 95% CI 0.63-1.74). The differentiation matched criteria for noninferiority (P=0.0055), Gwon reported at the Transcatheter Cardiovascular Therapeutics meeting. "The revascularization of an angiographically intermediate lesion can be deferred safely," he said. Other cardiologists who looked at and commented on the results agreed that using an angiographic cutoff of 50% stenosis was not helpful in determining which lesions to revascularize. However, they argued for the need for more accurate information on lesions in the intermediate range of 50% to 70% stenosis using fractional flow reserve (FFR). "Revascularization of all 50% lesions is not necessary but I still think that there's a place for physiologic assessment of the intermediate lesion," said Philippe Genereux, MD, of the Hopital du Sacre-Coeur de Montreal. Genereux’s comments were met in agreement by Bernard Gersh, MBChB, DPhil, of the Mayo Clinic in Rochester, Minn. "What FFR measurements have taught us is if you look at the 50% to 70% stenoses, intermediate stenoses, there is a wide range of FFR in that group and it seems to correlate with clinical events. We've gone beyond visual assessment,” said Gersh. However, Gwon contested that there should be a comparison between the outcomes when using the more aggressive angiographic cutoff of 50% stenosis for PCI, as specified in U.S. guidelines, or when using the more conventional cutoff of 70% stenosis, as specified in the European guidelines, because FFR is employed in only a minority of cases. “Most center, still rely on angiographic assessment,” said Gwon. He and his peers examined the matter in the SMART-CASE trial, an open-label, randomized study performed at 16 centers in South Korea. The trial included 899 patients (average age about 65) who had a target lesion resulting in 50% to 70% stenosis, as calculated by quantitative coronary angiography, in a native coronary artery eligible for PCI. They were randomized as a means to have only those lesions greater than 70% stenosis stented or to have lesions greater than 50% stented. The Xience V everolimus-eluting stent was used whenever PCI was pronounced. Using the more traditional 70% cutoff, nearly half (47.4%) of the patients were not administered any stents at all. Through the first year, clinical outcomes were comparable between the two groups. The rate of mortality or MI (leaving out the revascularization part of the main endpoint) was numerically lower in the conventional group, but the difference did not achieve statistical significance (1.4% versus 2.7%; HR 0.50, 95% CI 0.19-1.33). There was also no real difference in the rate of any revascularization (6.8% with conservative versus 4.8% with aggressive; HR 1.42, 95% CI 0.80-2.52), albeit the rate of revascularization of the target lesion only was higher in the conservative group (4.1% versus 1.7%; HR 2.47, 95% CI 1.02-5.95). “The absolute rate was still low in both groups,” said Gwon. In a subgroup analysis, there was a considerable interaction with age (P=0.02), such that patients who were 65 and older tended to do better with the conservative strategy and younger patients tended to do better with the aggressive strategy. Gwon recognized that the study was limited due to the wide noninferiority margin used, the lack of statistical power for hard clinical endpoints, the short duration of follow-up, and the lack of FFR ... Read more

Imaging May Detect Suspicious Coronary Plaque Early…

Researchers from the University of Edinburgh  have discovered that using a noninvasive imaging system may be able to spot coronary atherosclerotic plaques that are at high risk for rupture, potentially allowing for earlier involvement in order to prevent any adverse clinical events. According to Nikhil Joshi, MD, of the University of Edinburgh in Scotland, and peers, on positron emission tomography (PET) and CT images, there was an increased uptake of the radioactive tracer 18F-sodium fluoride (18F-NaF) in ruptured plaques amongst patients with severe myocardial infarction and in plaques with high-risk features, such as more positive remodeling, increased microcalcification, and larger necrotic cores; among patients with stable angina. Additionally, in a small sample of ruptured carotid plaques, all displayed increased uptake of18F-NaF, which "was associated with histological evidence of active calcification, macrophage infiltration, apoptosis, and necrosis," they reported online in the journal, The Lancet. "18F-NaF PET-CT is the first noninvasive imaging method to identify and localize ruptured and high-risk coronary plaque," they wrote, citing that the next phase is to reveal that increased 18F-NaF has the ability to predict adverse clinical events. "If the results prove confirmatory then this technique has the potential to fundamentally alter the way we treat coronary artery disease: moving us away from the current framework based on lesion severity and ischemia to one focused on plaque metabolism and inflammation. It could, for example, permit the identification of the vulnerable patient with single or multiple high-risk or silently ruptured plaques, providing an opportunity to treat and modify their risk to prevent future adverse cardiovascular events,”the researchers note. Determining which plaques are at risk for rupture has proven to be a difficult task, and as of today no noninvasive imaging techniques have been  able to circumvent this issue. In this recent study, Joshi and colleagues assessed atherosclerotic plaques using PET-CT with two different radioactive tracers: 18F-NaF, which has been utilized for the past 3 decades for bone imaging, and 18F-fluorodeoxyglucose (18F-FDG), the current noninvasive gold standard. The study involved 40 patients with acute MI and 40 with stable angina who received elective invasive coronary angiography. All patients received PET-CT, invasive coronary angiography, CT coronary angiography, and CT calcium scoring. Moreover, the researchers also examined carotid plaque samples from nine patients undergoing carotid endarterectomy for symptomatic carotid artery disease. Of the patients with acute MI, 18F-NaF uptake was 34% higher in the culprit ruptured plaque as opposed to nonculprit plaques ... Read more

Ultrasound Catheter, CT Software Developed for …

A new ultrasound catheter has been developed for use with real-time volumetric intracardiac echocardiography (ICE). Real-time ICE provides great quality, dose-free imaging during interventional procedures, and the Acuson AcuNav V catheter, developed by Siemens Healthcare (Erlangen, Germany) is particularly useful during transcatheter aortic valve implantation (TAVI) surgery. By employing the volumetric ICE catheter, physicians can perform TAVI procedures while the patient is under conscious sedation as opposed to a general form of anesthesia. The catheter is also useful during electrophysiology (EP) ablation procedures. Computed tomography (CT) systems also offer support for minimally invasive TAVI practices. Siemens Healthcare has developed novel software that assists physicians in figuring and selecting the right valve size for the patient and determine the exact angle at which the new valve must be implanted even before the intervention in the cardiac catheterization laboratory. This saves time and lessens the contrast agent dose needed for the patient during intervention.  In order to select a suitable artificial heart valve, clinicians must determine the precise dimensions of the aortic annulus. The syngo CT cardiac function, valve pilot application, in conjunction with three-dimensional (3D) CT imaging, automatically detects the annulus plane and calculates the exact measurements of the annulus as the case is ... Read more

Live 3D Hologrpahic Imaging for Use in in …

A clinical study, conducted by Philips (Best, The Netherlands) and RealView Imaging, Ltd. (Yokneam, Israel) has shown the feasibility of using a special live three-dimensional (3D) holographic visualization and interaction technology to guide minimally invasive structural heart disease procedures. In the pilot study that included eight patients and was performed in cooperation with the Schneider Children’s Medical Center (Petach Tikva, Israel), RealView’s innovative visualization technology was employed to show interactive, real-time 3D holographic images obtained by Philips’ interventional X-ray and cardiac ultrasound systems. Physicians in the interventional team were able to view detailed dynamic 3D holographic images of the heart “floating in free space” during a minimally-invasive structural heart disease procedure, all the while viewing the patient’s heart on a 2D screen, without using special eyewear. The physicians were also able to influence the projected 3D heart structures by just touching the holographic volumes in front of them. The study’s findings revealed the potential of the technology to optimize the context and guidance of structural heart repairs. “The holographic projections enabled me to intuitively understand and interrogate the 3D spatial anatomy of the patient’s heart, as well as to navigate and appreciate the device-tissue interaction during the procedure,” said pediatric cardiologist and director of the Institute of Pediatric Cardiology at Schneider Children’s Medical Center, Dr. Einat Birk. “The ability to reach into the image and apply markings on the soft tissue anatomy in the X-ray and 3D ultrasound images would be extremely useful for guidance of these complex procedures,” added pediatric cardiologist and director of the Cardiac Catheterization Laboratories at Schneider Children’s Medical Center, Dr. Elchanan Bruckheimer. The findings of this one of a kind pilot study was presented by Bruckheimer at the 25th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, held October 27-November 1, 2013, in San Francisco (CA, USA), and sponsored by the Cardiovascular Research Foundation. “Our ultimate goal is to create the future of healthcare by delivering innovative solutions that enhance clinical capabilities and improve patient outcomes. By teaming up with partners that share our passion for innovation, we have been able to demonstrate the feasibility and potential value of the world’s first holographic visualization technology targeted at guiding minimally invasive cardiac procedures, said general manager of integrated clinical solutions and marketing for imaging systems at Philips Healthcare, Bert van Meurs. Progress in image-guided treatment therapies for heart disease, from the opening of blocked coronary arteries to catheter ablation therapy for heart arrhythmias and catheter-based structural heart procedures (for example, heart valve replacements), have considerably raised the need for live 3D image guidance, to enhance present live 2D image guidance. Live X-ray and live 3D cardiac ultrasound imaging are usually used concurrently to guide minimally invasive structural heart repair procedures, with the ultrasound images supplying detailed insights into the heart’s soft tissue anatomy, and the X-ray imaging supplying visualization of catheters and heart implants. “I see clear indications that 3D medical holography will play an important role in medical imaging in the near future. With the advancement of live 3D imaging and increasing clinical evidence of its value for a variety of procedures, we are convinced that our holographic technology will further enhance 3D imaging and, most importantly, improve patient care,” said CEO of RealView Imaging, Aviad Kaufman. The technologic developments in the acquisition of live 3D images to guide minimally invasive procedures have also sparked the development of new ways to visualize the data. Following the promising findings produced by this pilot study, Philips and RealView Imaging will continue to examine the clinical benefits of incorporating live 3D imaging and medical holography, both in interventional cardiology and in other clinical ... Read more

Regular use of FFR Linked with Improved PCI Results…

Based on the results of a Korean study, regular measurement of fractional flow reserve (FFR) was associated to improved clinical outcomes and decreased use of stents in patients undergoing percutaneous coronary intervention (PCI). According to the study findings, the rate of FFR use over the course of study's site rose from  1.9% in January 2008 to 50.7% in December 2011 ... Read more

T1 Mapping with Cardiac MRI Detects Fabry Disease…

Based on a new study, T1 mapping with cardiac MRI was a highly sensitive and particular parameter for the detection of Fabry disease. “Current imaging evaluations of the heart [for Fabry disease] are suboptimal. The goal of the current study [was] to evaluate the potential of quantitative T1 mapping with cardiovascular MRI as a disease-specific imaging biomarker,” Richard B. Thompson, PhD, from the University of Alberta, Canada, and colleagues wrote. The study involved 31 patients with Fabry disease, 23 healthy participants and 21 participants with concentric remodeling or hypertrophy. All patients received cardiac MRI so the researchers could calculate and measure left ventricular morphology, function, delayed enhancement, myocardial T1 values and derived parameters. Based on the results, average noncontrast myocardial T1 values were lower in patients with Fabry disease (1,070 ms) as opposed to controls (1,177 ms) and those with concentric remodeling or hypertrophy (1,207 ms; P.05). The researchers conducted single-voxel nuclear MR spectroscopy on four patients with Fabry disease and on four healthy patients. Those set of results revealed a negative linear connection between lipid content and noncontrast T1values (r=–0.9; P=.002). Women in all groups had lower LV mass and wall thickness longer myocardial T1 values and larger extracellular volume as opposed to the men. “These results illustrate the ability of cardiac MRI coupled with [nuclear] MR spectroscopy to further characterize substrate for cardiomyopathy and serve as an imaging-based biomarker,” Thompson and colleagues ... Read more

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