| 1. Parshall MB, Schwartzstein RM, Adams L, et al. An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med. 2012;185(4):435-452. |
Review/Other-Dx |
N/A |
To update the 1999 ATS Consensus Statement on dyspnea. |
Progress has been made in clarifying mechanisms underlying several qualitatively and mechanistically distinct breathing sensations. Brain imaging studies have consistently shown dyspnea stimuli to be correlated with activation of cortico-limbic areas involved with interoception and nociception. Endogenous and exogenous opioids may modulate perception of dyspnea. Instruments for measuring dyspnea are often poorly characterized; a framework is proposed for more consistent identification of measurement domains. |
4 |
| 2. Budhwar N, Syed Z. Chronic Dyspnea: Diagnosis and Evaluation. Am Fam Physician 2020;101:542-48. |
Review/Other-Dx |
N/A |
To discuss the diagnosis and evaluation of chronic dyspnea. |
No results stated in the abstract. |
4 |
| 3. Viniol A, Beidatsch D, Frese T, et al. Studies of the symptom dyspnoea: a systematic review. BMC Fam Pract 2015;16:152. |
Review/Other-Dx |
6 studies |
To conduct a systematic review of symptom-evaluating studies on the prevalence, aetiology, and prognosis of dyspnoea as presented to general practitioners (GPs) in a primary care setting. |
This systematic review identified 6 symptom evaluating studies on dyspnoea in the primary care setting. The prevalence of dyspnoea as reason for consultation ranges from 0.87 to 2.59 % in general practice. Among all dyspnoea patients 2.7 % (CI 2.2–3.3) suffer from pneumonia. Further specification of underlying aetiologies seems difficult due to the studies’ heterogeneity showing a great variety of probabilities. |
4 |
| 4. Pesola GR, Ahsan H. Dyspnea as an independent predictor of mortality. Clin Respir J 2016;10:142-52. |
Review/Other-Dx |
10 studies |
To evaluate the etiology of the common correlates (smoking and lung function) of chronic dyspnea, their impact on mortality and to determine if persistent dyspnea itself is an independent predictor of mortality, separate from these correlated factors. |
From over 3000 potential references, 10 longitudinal studies met all criteria and were included. All 10 studies suggested that dyspnea was an independentpredictor of mortality with point estimates by odds ratio, rate ratio or hazard ratios ranging from 1.3 up to 2.9-fold greater than baseline. All 10 studies had actual or implied 95% confidence interval bands greater than the null value of one. |
4 |
| 5. American College of Radiology. ACR Appropriateness Criteria®: Nonischemic Myocardial Disease with Clinical Manifestations (Ischemic Cardiomyopathy Already Excluded). Available at: https://acsearch.acr.org/docs/3082580/Narrative/. |
Review/Other-Dx |
N/A |
Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for a specific clinical condition. |
No abstract available. |
4 |
| 6. White RD, Kirsch J, Bolen MA, et al. ACR Appropriateness Criteria® Suspected New-Onset and Known Nonacute Heart Failure. J Am Coll Radiol 2018;15:S418-S31. |
Review/Other-Dx |
N/A |
Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for suspected new-onset and known nonacute heart failure. |
No results stated in abstract. |
4 |
| 7. Croucher B. The challenge of diagnosing dyspnea. AACN Adv Crit Care. 2014;25(3):284-290. |
Review/Other-Dx |
N/A |
To discuss the differential diagnoses associated with dyspnea. |
Dyspnea is a subjective and nonspecific symptom, yet very distressing for those who experience it. Acute onset dyspnea and exacerbation of chronic dyspnea from heart or lung disease significantly add to the number of emergency department visits and inpatient admissions. Although dyspnea may appear to be a simple condition to evaluate and manage, it is actually complex in description and quality. As such, dyspnea is the first symptom of many diseases. The onset of dyspnea can be due to a new acute disease, the exacerbation of an existing chronic illness, or a new disease compounding a chronic illness. Finding the cause of dyspnea is generally more difficult than it originally may appear. |
4 |
| 8. Do DH, Eyvazian V, Bayoneta AJ, et al. Cardiac magnetic resonance imaging using wideband sequences in patients with nonconditional cardiac implanted electronic devices. Heart Rhythm. 15(2):218-225, 2018 02. |
Observational-Dx |
111 patients |
To evaluate the safety of cardiac magnetic resonance imaging (CMR) in non-MRI-conditional cardiac implantable electronic devices (CIEDs) and the interpretability of images using wideband sequences. |
A total of 111 CMR studies were completed successfully. There were no patient deaths, new arrhythmias, immediate generator or lead failures, electrical resets, or pacing capture failures in dependent patients. Right atrial, right ventricular, and left ventricular lead impedances were significantly lower post-CMR, median difference -7? (IQR -20 to 0?) (p<0.0001), 0? (IQR -19 to 0?) (p=0.0001), and -10? (IQR -30 to 0?) (p=0.023), respectively. These changes persisted through follow-up with median difference -18.5? (IQR -41 to -66?) (p=0.007) and -19? (IQR -44 to -7?) (p=0.006), and -30? (IQR -130 to 0?) (p = 0.003), respectively. Ninety-seven (87%) studies had no artifact limiting interpretation. |
3 |
| 9. Hilbert S, Jahnke C, Loebe S, et al. Cardiovascular magnetic resonance imaging in patients with cardiac implantable electronic devices: a device-dependent imaging strategy for improved image quality. Eur Heart J Cardiovasc Imaging. 19(9):1051-1061, 2018 09 01. |
Observational-Dx |
128 patients |
To prospectively determine evaluability of routine cardiovascular magnetic resonance (CMR) diagnostic modules in a referral population of implanted rhythm device all-comers, and to establish a device-dependent CMR imaging strategy to achieve optimal image quality. |
One hundred and twenty-eight patients with cardiac implantable electronic devices [insertable cardiac monitoring system, n?=?14; implantable loop-recorder, n?=?21; pacemaker, n?=?31; implantable cardioverter-defibrillator (ICD), n?=?50; and cardiac resynchronization therapy defibrillator (CRT-D), n?=?12] underwent clinically indicated CMR at 1.5?T. CMR protocols were tailored to the clinical indication and consisted of cine, perfusion, T1-/T2-weighted, late-gadolinium enhancement (LGE), 3D angiographic, and post-contrast cine spoiled gradient echo (SGE) scans. Image quality was determined using a 4-grade visual score per myocardial segment. Segmental evaluability was strongly influenced by device type and location with the highest proportion of non-diagnostic images encountered in the presence of ICD/CRT-D systems. Cine steady-state free-precession (SSFP) imaging was found to be mostly non-diagnostic in ICD/CRT-D patients, but a significant improvement of image quality was demonstrated when using SGE sequences with a further incremental improvement post-contrast resulting in an overall four-fold higher likelihood of achieving good image quality. LGE scans were found to be non-diagnostic in about one-third of left-ventricular segments of ICD/CRT-D patients but were artefact-free in?>?94% for all other device types. |
2 |
| 10. Hilbert S, Weber A, Nehrke K, et al. Artefact-free late gadolinium enhancement imaging in patients with implanted cardiac devices using a modified broadband sequence: current strategies and results from a real-world patient cohort. Europace. 20(5):801-807, 2018 05 01. |
Observational-Dx |
4 males (volunteer study), 28 patients (patient study) |
To investigate the relationship between implanted cardiac devices and the optimal frequency offset on broadband late gadolinium enhancement (LGE)-CMR imaging to increase the artefact-free visibility of myocardial segments. |
A phantom study was performed to characterize magnetic field disturbances related to 15 different cardiac devices. This was complemented by B0 and B1+ imaging of three different device types in four healthy volunteers. Findings were validated in 28 patients with an indication for arrhythmogenic substrate characterization before catheter ablation. In the phantom study, the placement of a PM, implantable cardioverter-defibrillator (ICD) or CRT-D generator led to a significant impairment of the radiofrequency field. B0 mapping in phantom and volunteers showed the highest off-resonance maximum with CRT-D systems with the maximum off-resonance significantly decreasing for ICD or PM systems, respectively. In all patients, with conventional LGE imaging 73.1% (61.5-92.3%) of LV segments were free of device-related artefacts, while with the broadband LGE technique, a significant increase of artefact-free segments was achieved [96.4% (85.7-100%); P = 0.00008]. |
3 |
| 11. Hong K, Jeong EK, Wall TS, Drakos SG, Kim D. Wideband arrhythmia-Insensitive-rapid (AIR) pulse sequence for cardiac T1 mapping without image artifacts induced by an implantable-cardioverter-defibrillator. Magn Reson Med. 74(2):336-45, 2015 Aug. |
Observational-Dx |
10 males, 1 female (in Experiment 4) |
To develop and evaluate a wideband arrhythmia-insensitive-rapid (AIR) pulse sequence for cardiac T1 mapping without image artifacts induced by implantable-cardioverter-defibrillator (ICD). |
In five phantoms representing native myocardium and blood and postcontrast blood/tissue T1 values, compared with the control T1 values measured with an inversion-recovery pulse sequence without ICD, T1 values measured with original AIR with ICD were considerably lower (absolute percent error > 29%), whereas T1 values measured with wideband AIR with ICD were similar (absolute percent error < 5%). Similarly, in 11 human subjects, compared with the control T1 values measured with original AIR without ICD, T1 measured with original AIR with ICD was significantly lower (absolute percent error > 10.1%), whereas T1 measured with wideband AIR with ICD was similar (absolute percent error < 2.0%). |
3 |
| 12. Chava R, Assis F, Herzka D, Kolandaivelu A. Segmented radial cardiac MRI during arrhythmia using retrospective electrocardiogram and respiratory gating. Magn Reson Med. 81(3):1726-1738, 2019 03. |
Review/Other-Dx |
N/A |
To improve segmented cardiac magnetic resonance imaging (MRI) image quality during arrhythmia. |
K-space sampling uniformity and image quality incrementally improve with additional occurrences of the desired normal sinus or arrhythmia heartbeat-type. To approach the image quality of breath-hold imaging, sufficiently restrictive gating parameters are required. Compared with real-time imaging, retrospective gated images had reduced noise and improved sharpness while maintaining desired cine temporal resolution. Variations of cardiac function between arrhythmia heartbeats could be observed in arrhythmia imaging cases that are not captured by conventional segmented imaging. |
4 |
| 13. Contijoch F, Iyer SK, Pilla JJ, et al. Self-gated MRI of multiple beat morphologies in the presence of arrhythmias. Magn Reson Med. 78(2):678-688, 2017 08. |
Observational-Dx |
15 patients |
To develop a self-gated magnetic resonance imaging (MRI) approach to image and quantify the hemodynamic parameters of distinct beat morphologies in arrhythmia patients. |
Images of distinct beat types were reconstructed except for two patients with infrequent premature ventricular contractions. Image contrast and sharpness were similar to sinus self-gated images (Contrast = 0.45±0.13 and 0.43±0.15; Sharpness = 0.21±0.11 and 0.20±0.05). Visual scoring was highest in self-gated images (4.1±0.3) compared to real-time (3.9±0.4) and ECG-gated cine (3.4±1.5). ECG-gated cine had less artifacts than self-gating (2.3±0.7 and 2.1±0.2), but was affected by misgating in two subjects. Among arrhythmia subjects, post-extrasystole/sinus (58.1 ± 8.6 mL) and interrupted sinus (61.4 ± 5.9 mL) stroke volume was higher than extrasystole (32.0 ± 16.5 mL; p<0.02). |
3 |
| 14. Contijoch F, Witschey WR, Rogers K, et al. User-initialized active contour segmentation and golden-angle real-time cardiovascular magnetic resonance enable accurate assessment of LV function in patients with sinus rhythm and arrhythmias. J Cardiovasc Magn Reson. 17:37, 2015 May 21. |
Observational-Dx |
22 patients |
To discuss methods of using user-initialized active contour segmentation and golden-angle real-time cardiovascular magnetic resonance enable accurate assessment of left ventricle (LV) function in patients with sinus rhythm and arrhythmias. |
ACS provides global LV volume measurements that are not significantly different from manual quantification of retrospectively gated cine images in sinus rhythm patients. With an exposure time of 95.2 ms and a frame rate of?>?89 frames per second, golden-angle real-time imaging accurately captures hemodynamic function over a range of patient heart rates. In four patients with frequent ectopic contractions, initial quantification of the impact of ectopic beats on hemodynamic function was demonstrated. |
3 |
| 15. Bhavnani SP, Sola S, Adams D, et al. A Randomized Trial of Pocket-Echocardiography Integrated Mobile Health Device Assessments in Modern Structural Heart Disease Clinics. JACC Cardiovasc Imaging. 11(4):546-557, 2018 04. |
Observational-Dx |
253 patients |
To determine whether mobile health (mHealth) device assessments used as clinical decision support tools at the point-of-care can reduce the time to treatment and improve long-term outcomes among patients with rheumatic and structural heart diseases (SHD). |
An initial mHealth assessment was associated with a shorter time to referral for valvuloplasty and/or valve replacement (83 ± 79 days vs. 180 ± 101 days; p <0.001) and was associated with an increased probability for valvuloplasty/valve replacement compared to standard-care (34% vs. 32%; adjusted hazard ratio: 1.54; 95% CI: 0.96 to 2.47; p = 0.07). Patients randomized to mHealth were associated with a lower risk of a hospitalization and/or death on follow-up (15% vs. 28%, adjusted hazard ratio: 0.41; 95% CI: 0.21 to 0.83; p = 0.013). |
2 |
| 16. Draper J, Subbiah S, Bailey R, Chambers JB. Murmur clinic: validation of a new model for detecting heart valve disease. Heart. 105(1):56-59, 2019 01. |
Observational-Dx |
175 patients |
To determine if auscultation or a point-of-care scan could reduce the need for standard echocardiography (transthoracic echocardiogram (TTE)) in community patients with asymptomatic murmurs. |
In the first phase (cardiologist), there were 75 patients, mean age 54 (56 women), and in the second phase there were 100 patients, mean age 60 (76 women). In the total population of 175, abnormalities were shown on TTE in 52 (30%), on point-of-care scan in 52 (30%) and predicted on auscultation in 45 (26%) (p=0.125; 95% CI -0.02 to 0.29). The sensitivity of auscultation was not significantly different for the cardiologist (91%) as for the scientist (83%) (p=0.18; 95% CI -0.22 to 0.175) and the specificity was 100% for both. Accuracy was 97% for the cardiologist and 95% for the scientist. For the point-of-care scan, the sensitivity, specificity, positive and negative predictive values and accuracy were 100% for both cardiologist and scientist. |
3 |
| 17. McGivery K, Atkinson P, Lewis D, et al. Emergency department ultrasound for the detection of B-lines in the early diagnosis of acute decompensated heart failure: a systematic review and meta-analysis. CJEM, Can. j. emerg. med. care. 20(3):343-352, 2018 05. |
Review/Other-Dx |
7 studies |
The objective of this systematic review was to assess the accuracy of early bedside lung ultrasound (US) in patients presenting to the ED with dyspnea |
Our results suggest that in patients presenting to the ED with undifferentiated dyspnea, B-lines from early bedside lung US may be reliably used as an adjunct to current diagnostic methods. The incorporation of lung US may lead to more appropriate and timely diagnosis of patients with undifferentiated ADHF. |
4 |
| 18. Zanobetti M, Scorpiniti M, Gigli C, et al. Point-of-Care Ultrasonography for Evaluation of Acute Dyspnea in the ED. Chest. 151(6):1295-1301, 2017 06. |
Observational-Dx |
2,683 patients |
The aim of the present study was to evaluate the feasibility and diagnostic accuracy of point-of-care ultrasonography (PoCUS) for the management of patients with acute dyspnea in the emergency department (ED). |
A total of 2,683 patients were enrolled. The average time needed to formulate the ultrasound diagnosis was significantly lower than that required for ED diagnosis (24 ± 10 min vs 186 ± 72 min; P = .025). The ultrasound and the ED diagnoses showed good overall concordance (k = 0.71). There were no statistically significant differences in the accuracy of PoCUS and the standard ED evaluation for the diagnosis of acute coronary syndrome, pneumonia, pleural effusion, pericardial effusion, pneumothorax, and dyspnea from other causes. PoCUS was significantly more sensitive for the diagnosis of heart failure, whereas a standard ED evaluation performed better in the diagnosis of COPD/asthma and pulmonary embolism. |
2 |
| 19. American College of Radiology. ACR–NASCI–SIR–SPR Practice Parameter for the Performance and Interpretation of Body Computed Tomography Angiography (CTA). Available at: https://gravitas.acr.org/PPTS/GetDocumentView?docId=164+&releaseId=2 |
Review/Other-Dx |
N/A |
Guidance document to promote the safe and effective use of diagnostic and therapeutic radiology by describing specific training, skills and techniques. |
No abstract available. |
4 |
| 20. Abd Alamir M, Radulescu V, Goyfman M, et al. Prevalence and correlates of mitral annular calcification in adults with chronic kidney disease: Results from CRIC study. Atherosclerosis. 242(1):117-22, 2015 Sep. |
Observational-Dx |
2,070 patients |
To determine whether there are independent relationships between mitral annular calcification (MAC) and demographics, traditional and novel cardiovascular disease (CVD) risk factors using cardiac computed tomography (CT) in the Chronic Renal Insufficiency Cohort (CRIC) in a cross-sectional study. |
Our study consisted of 2070 subjects, of which 331 had MAC (prevalence of 16.0%). The mean MAC score was 511.98 (SD 1368.76). Age and white race remained independently associated with presence of MAC. Decreased GFR was also a risk factor. African American and Hispanic race, as well as former smoking status were protective against MAC. In multivariable adjusted analyses, the remaining covariates were not significantly associated with MAC. Among renal covariates, elevated phosphate was significant. |
3 |
| 21. Chambers JB, Garbi M, Nieman K, et al. Appropriateness criteria for the use of cardiovascular imaging in heart valve disease in adults: a European Association of Cardiovascular Imaging report of literature review and current practice. [Review]. Eur Heart J Cardiovasc Imaging. 18(5):489-498, 2017 05 01. |
Review/Other-Dx |
N/A |
To summarize the current evidence for state-of-the-art clinical practice to inform appropriateness criteria for the use of cardiovascular imaging in heart valve disease in adults. |
No results stated in the abstract. |
4 |
| 22. Bak SH, Ko SM, Song MG, Shin JK, Chee HK, Kim JS. Fused aortic valve without an elliptical-shaped systolic orifice in patients with severe aortic stenosis: cardiac computed tomography is useful for differentiation between bicuspid aortic valve with raphe and tricuspid aortic valve with commissural fusion. Eur Radiol. 25(4):1208-17, 2015 Apr. |
Observational-Dx |
53 patients |
To determine cardiac computed tomography (CCT) features capable of differentiating between bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV) in severe aortic stenosis (AS) patients with fused cusp and without elliptical-shaped systolic orifices. |
At surgery, 19 patients had BAV and 34 had TAV. CCT features including uneven cusp size, uneven cusp area, round-shaped systolic orifice, longer cusp fusion, and dilatation of ascending aorta were significantly associated with BAV (P < 0.05). In particular, fusion length (OR, 1.76; P = 0.001), uneven cusp area (OR, 10.46; P = 0.012), and midline calcification (OR, 0.08; P = 0.013) were strongly associated with BAV. |
3 |
| 23. Cramer PM, Prakash SK. Misclassification of bicuspid aortic valves is common and varies by imaging modality and patient characteristics. Echocardiography. 36(4):761-765, 2019 04. |
Review/Other-Dx |
204 patients |
To evaluate clinical records and imaging reports from registry participants to determine the prevalence of and risk factors for bicuspid aortic valves (BAV) misclassification. |
About 40% of participants were misclassified in at least one imaging report. The mean interval between misclassification and correct diagnosis was 22 months. TEE, MR and CT were more sensitive than TTE and successfully reclassified 20% of participants, but were only used in 14% of patients. Misclassification was associated with age, the extent of valve calcification and image quality, but was not significantly associated with aortic regurgitation, gender, or cusp configuration. |
4 |
| 24. Doherty JU, Kort S, Mehran R, et al. ACC/AATS/AHA/ASE/ASNC/HRS/SCAI/SCCT/SCMR/STS 2017 Appropriate Use Criteria for Multimodality Imaging in Valvular Heart Disease: A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. J Am Soc Echocardiogr. 31(4):381-404, 2018 04. |
Review/Other-Dx |
N/A |
To provide guidelines on a comprehensive resource for multimodality imaging in the context of valvular and structural heart disease, encompassing multiple imaging modalities. |
No results stated in the abstract. |
4 |
| 25. Leipsic JA, Blanke P, Hanley M, et al. ACR Appropriateness Criteria® Imaging for Transcatheter Aortic Valve Replacement. J Am Coll Radiol 2017;14:S449-S55. |
Review/Other-Dx |
N/A |
Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for a specific clinical condition. |
No abstract available. |
4 |
| 26. Basra SS, Gopal A, Hebeler KR, et al. Clinical Leaflet Thrombosis in Transcatheter and Surgical Bioprosthetic Aortic Valves by Four-Dimensional Computed Tomography. Ann Thorac Surg. 106(6):1716-1725, 2018 12. |
Review/Other-Dx |
612 patients |
To focus on evaluation for leaflet thrombosis in patients when suspected for clinical or echocardiographic indications, or both, after both transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR). |
During the study period, 612 patients underwent TAVR, and 101 patients (55 TAVR; 46 SAVR) met the criteria for 4DCT imaging. Leaflet thrombosis was seen in 17 of 55 TAVR patients (30.9%) and 15 of 46 SAVR patients (32.6%). Follow-up imaging with 4DCT after treatment with anticoagulation showed improvement or resolution in thrombus burden and leaflet excursion in all TAVR patients and in two-thirds of SAVR patients. |
4 |
| 27. Belhaj Soulami R, Verhoye JP, Nguyen Duc H, et al. Computer-Assisted Transcatheter Heart Valve Implantation in Valve-in-Valve Procedures. Innovations. 11(3):193-200, 2016 May-Jun. |
Review/Other-Tx |
9 patients |
To evaluate the feasibility of computer guidance in transcatheter heart valve (THV) implantation during valve-in-valve (ViV) procedures. |
Between January 2014 and October 2014, nine patients underwent aortic ViV procedures in our institution. Among those nine patients, five procedures were retrospectively evaluated as a validation step using the proposed method. The mean (SD) superimposition error was 1.1 (0.75) mm. Subsequently, two live cases were prospectively carried out using our approach, successfully implanting the THV inside the degenerated tissue valve. |
4 |
| 28. Harowicz MR, Shah A, Zimmerman SL. Preoperative Planning for Structural Heart Disease. [Review]. Radiologic Clinics of North America. 58(4):733-751, 2020 Jul. |
Review/Other-Dx |
N/A |
To discuss preoperative imaging with computed tomography (CT) for structural heart disease. |
No abstract available. |
4 |
| 29. Ailawadi G, Agnihotri AK, Mehall JR, et al. Minimally Invasive Mitral Valve Surgery I: Patient Selection, Evaluation, and Planning. Innovations. 11(4):243-50, 2016 Jul-Aug. |
Review/Other-Dx |
N/A |
To outline current best practices in patient evaluation and selection for minimally invasive mitral valve procedures, and discusses preoperative planning for cannulation and myocardial protection. |
No abstract available. |
4 |
| 30. Alnabelsi TS, Alhamshari Y, Mulki RH, et al. Relation Between Epicardial Adipose and Aortic Valve and Mitral Annular Calcium Determined by Computed Tomography in Subjects Aged >=65 Years. Am J Cardiol. 118(7):1088-93, 2016 10 01. |
Observational-Dx |
294 patients |
To assess this association by measuring aortic valve and mitral annuls calcium using computed tomography (CT). |
We included 294 patients aged =65 years who had noncontrast computed tomography scans of the chest. Mean age was 76 ± 7 years; 47% were men. Using reconstructed images, EAT thickness was measured at various locations. MAC and AVC were quantified by Agatston technique. The sum of AVC and MAC was reported as the grand total score (GTS). Subjects were divided into 2 groups based on the value of GTS; GTS = 0, no cardiac calcification and GTS =1, cardiac calcification group. Epicardial fat (left and right atrioventricular grooves and superior interventricular groove) was significantly greater in the cardiac calcification group compared with the no cardiac calcification (all values, p <0.05). After adjusting for clinical variables including BMI, EAT at the superior interventricular groove remained significantly associated with total calcium. Left atrioventricular groove EAT demonstrated a trend toward an association with total calcium, but this did not reach statistical significance. |
3 |
| 31. Myerson SG, d'Arcy J, Mohiaddin R, et al. Aortic regurgitation quantification using cardiovascular magnetic resonance: association with clinical outcome. Circulation 2012;126:1452-60. |
Observational-Dx |
108 patients |
To compare the cardiovascular magnetic resonance (CMR) quantitation of aortic regurgitation (AR) and left ventricular (LV) volume/function indices for their relative predictive ability. |
One hundred thirteen patients with echocardiographic moderate or severe AR were monitored for up to 9 years (mean 2.6±2.1 years) following a CMR scan, and the progression to symptoms or other indications for surgery was monitored. AR quantification identified outcome with high accuracy: 85% of the 39 subjects with regurgitant fraction >33% progressed to surgery (mostly within 3 years) in comparison with 8% of 74 subjects with regurgitant fraction =33% (P<0.0001); the area under the curve on receiver operating characteristic analysis was 0.93 (P<0.0001). This ability remained strong on time-dependent Kaplan–Meier survival curves. CMR-derived left ventricular end-diastolic volume >246 mL had good, although lower, discriminatory ability (area under the curve 0.88), but the combination of this measure with regurgitant fraction provided the best discriminatory power. |
3 |
| 32. Uretsky S, Gillam L, Lang R, et al. Discordance between echocardiography and MRI in the assessment of mitral regurgitation severity: a prospective multicenter trial. J Am Coll Cardiol 2015;65:1078-88. |
Observational-Dx |
103 patients |
To compare magnetic resonance imaging (MRI) with echocardiography in the assessment of mitral regurgitation (MR) severity and to determine the extent to which these modalities can predict the degree of left ventricular (LV) remodeling after isolated mitral valve (MV) surgery. |
Agreement between MRI and echocardiographic estimates of MR severity was modest in the overall cohort (r = 0.6; p < 0.0001), and there was a poorer correlation in the subset of patients sent for surgery (r = 0.4; p = 0.01). There was a strong correlation between post-surgical LV remodeling and MR severity as assessed by MRI (r = 0.85; p < 0.0001), and no correlation between post-surgical LV remodeling and MR severity as assessed by echocardiography (r = 0.32; p = 0.1). |
2 |
| 33. Di Leo G, D'Angelo ID, Ali M, et al. Intra- and inter-reader reproducibility of blood flow measurements on the ascending aorta and pulmonary artery using cardiac magnetic resonance. Radiol Med (Torino). 122(3):179-185, 2017 Mar. |
Review/Other-Dx |
50 patients |
To estimate the intra- and inter-reader reproducibility of blood flow measurements in the ascending aorta and main pulmonary artery using cardiac magnetic resonance (CMR) and a semi-automated segmentation method. |
A total of 50 consecutive patients (35 males and 15 females; mean age±standard deviation 27±13 years) affected by congenital heart disease were reviewed. They underwent CMR for flow analysis of the ascending aorta and main pulmonary artery (1.5 T, through-plane phase-contrast sequences). Two independent readers (R1, trained radiology resident; R2, lower-trained technician student) obtained segmented images twice (>10-day interval), using a semi-automated method of segmentation. Peak velocity, forward and backward flows were obtained. Bland–Altman analysis was used and reproducibility was reported as complement to 100% of the ratio between the coefficient of repeatability and the mean. R1 intra-reader reproducibility for the aorta was 99% (peak velocity), 95% (forward flow) and 49% (backward flow); for the pulmonary artery, 99%, 91% and 90%, respectively. R2 intra-reader reproducibility was 92%, 91% and 38%; 98%, 86% and 87%, respectively. Inter-reader reproducibility for the aorta was 91%, 85% and 20%; for the pulmonary artery 96%, 75%, and 82%, respectively. Our results showed a good to excellent reproducibility of blood flow measurements of CMR together with a semiautomated method of segmentation, for all variables except the backward flow of the ascending aorta, with a limited impact of operator’s training. |
4 |
| 34. Karamitsos TD, Karvounis H. Magnetic resonance imaging is a safe technique in patients with prosthetic heart valves and coronary stents. HJC Hell. J. Cardiol.. 60(1):38-39, 2019 Jan - Feb. |
Review/Other-Dx |
N/A |
To the safety of magnetic resonance imaging (MRI) in patients with prosthetic heart valves or coronary stents. |
No abstract available. |
4 |
| 35. Cavalcante JL, Lalude OO, Schoenhagen P, Lerakis S. Cardiovascular Magnetic Resonance Imaging for Structural and Valvular Heart Disease Interventions. [Review]. JACC Cardiovasc Interv. 9(5):399-425, 2016 Mar 14. |
Review/Other-Dx |
N/A |
To review and demonstrate how cardiovascular magnetic resonance imaging can be used to assist in diagnosis, treatment planning, and follow-up of patients who are being considered for and/or who have undergone interventions for structural and valvular heart diseases. |
No results stated in the abstract. |
4 |
| 36. Elbaz MSM, Scott MB, Barker AJ, et al. Four-dimensional Virtual Catheter: Noninvasive Assessment of Intra-aortic Hemodynamics in Bicuspid Aortic Valve Disease. Radiology. 293(3):541-550, 2019 12. |
Observational-Dx |
91 patients |
To investigate the feasibility and reproducibility of a technique that uses a catheter-like mathematical model (virtual catheter) to assess volumetric intra-aortic hemodynamics from 4D flow magnetic resonance imaging (MRI) in patients with bicuspid aortic valve (BAV). |
The study included 91 participants (57 patients [mean age, 46 years ± 12], 18 women; 34 healthy participants [mean age: 44 years ± 14], 12 women; 15 healthy participants underwent test-retest examinations). Patients showed higher VELR values compared with healthy participants (median, 31 W/m3 [interquartile range, 21–72] vs 23 W/m3 [interquartile range, 17–30], respectively; P < .001) and vorticity (69 sec-1 [interquartile range, 59–87] vs 60 sec-1 [interquartile range, 50–67], respectively; P < .001). Four-dimensional virtual catheter showed differences among different AVS and AVR grades with the highest VELR (120 W/m3; interquartile range, 99–166; P < .001) and vorticity (108 sec-1; interquartile range, 84–151; P < .001) found in severe AVS. High test-retest reproducibility was found for all virtual catheter-derived metrics (intraclass correlation, 0.80 ± 0.07; coefficient of variation, 9% ± 3). |
3 |
| 37. Collins JD, Semaan E, Barker A, et al. Comparison of Hemodynamics After Aortic Root Replacement Using Valve-Sparing or Bioprosthetic Valved Conduit. Ann Thorac Surg. 100(5):1556-62, 2015 Nov. |
Observational-Dx |
37 patients |
To compare aortic hemodynamics and blood flow patterns using in-vivo four-dimensional (4D) flow magnetic resonance imaging (MRI) in patients after valve-sparing aortic root replacement (VSARR) and aortic root replacement with bioprosthetic valves (BIO-ARR). |
Peak systolic velocity (2.0 to 2.5m/second) in the aortic root and AAo in both VSARR and BIO-ARR were elevated compared with controls (1.1 to 1.3m/second, p < 0.005). Flow asymmetry in BIO-ARR was increased compared with VSARR, evidenced by more AAo outflow jets (9 of 16 BIO-ARR, 0 of 11 in VSARR). The BIO-ARR exhibited significantly (p < 0.001) increased helix flow in the AAo as a measure of increased flow derangement. Finally, peak systolic velocities were elevated at the aortic root for BIO-ARR (2.5 vs 2.0m/second, p < 0.05) but lower in the distal AAo when compared with VSARR. |
3 |
| 38. Blanken CPS, Farag ES, Boekholdt SM, et al. Advanced cardiac MRI techniques for evaluation of left-sided valvular heart disease. [Review]. J Magn Reson Imaging. 48(2):318-329, 2018 08. |
Review/Other-Dx |
N/A |
To discuss the emerging potential of state-of-the-art magnetic resonance imaging (MRI) including 4D flow MRI, tissue mapping, and strain quantification for the diagnosis and prognosis of left-sided valvular heart disease (VHD). |
No abstract available. |
4 |
| 39. Binter C, Gotschy A, Sundermann SH, et al. Turbulent Kinetic Energy Assessed by Multipoint 4-Dimensional Flow Magnetic Resonance Imaging Provides Additional Information Relative to Echocardiography for the Determination of Aortic Stenosis Severity. Circ Cardiovasc Imaging. 10(6), 2017 Jun. |
Observational-Dx |
61 patients |
To investigate whether turbulent kinetic energy (TKE) derived from 4D flow magnetic resonance imaging (MRI) correlates with echocardiographic measures for the determination of aortic stensois (AS) severity or provides independent and complementary information. |
Fifty-one patients with AS (67±15 years, 20 female) and 10 healthy age-matched controls (69±5 years, 5 female) were prospectively enrolled to undergo multipoint 4D flow magnetic resonance imaging. Patients were split into 2 groups (severe and mild/moderate AS) according to their echocardiographic mean pressure gradient. TKE values were integrated over the aortic arch to obtain peak TKE. Integrating over systole yielded total TKEsys and by normalizing for stroke volume, normalized TKEsys was obtained. Mean pressure gradient and TKE correlated only weakly (R2=0.26 for peak TKE and R2=0.32 for normalized TKEsys) in the entire study population including control subjects, while no significant correlation was observed in the AS patient group. In the patient population with dilated ascending aorta, both peak TKE and total TKEsys were significantly elevated (P<0.01), whereas mean pressure gradient was significantly lower (P<0.05). Patients with bicuspid aortic valves also showed significantly increased TKE metrics (P<0.01), although no significant difference was found for mean pressure gradient. |
2 |
| 40. Garcia J, Barker AJ, Murphy I, et al. Four-dimensional flow magnetic resonance imaging-based characterization of aortic morphometry and haemodynamics: impact of age, aortic diameter, and valve morphology. Eur Heart J Cardiovasc Imaging. 17(8):877-84, 2016 Aug. |
Observational-Dx |
165 patients |
To apply 4D flow magnetic resonance imaging (MRI) for the simultaneous semi-automatic assessment of aorta morphometry and flow parameters along the entire volume of the thoracic aorta. |
One hundred and sixty-five subjects, 65 controls, 50 patients with bicuspid aortic valve (BAV), and 50 patients with a dilated aorta, and a tricuspid aortic valve (TAV) underwent 4D flow MRI. Following 3D segmentation of the aorta, a vessel centreline was calculated and used to extract aorta diameter, peak systolic velocity, and normalized systolic flow displacement. Validation of 4D flow MRI-based morphometric measurements compared with manual diameter measurements from standard contrast-enhanced MR angiography in 20 controls showed good agreement (mean difference = 0.4 mm, limits of agreement = ±1.31 mm) except at the sinus of valsalva. BAV showed significant differences in average peak velocity (PV; P < 0.016) compared with TAV and controls between the left ventricle outflow tract to sino-tubular junction (BAV: 1.3 ± 0.3 m/s; TAV: 1.2 ± 0.2 m/s; controls: 1.0 ± 0.1 m/s) and the ascending aorta for average normalized flow displacement (BAV: 0.11 ± 0.02; TAV: 0.09 ± 0.02; controls: 0.06 ± 0.01, P < 0.016) despite similar average aortic dimensions for BAV (37 ± 1 mm) and TAV (39 ± 1 mm). Multivariate linear regression showed a significant correlation of maximal aortic diameter to age, PV, and normalized flow displacement (R2 = 0.413, P < 0.001). |
3 |
| 41. Bui AH, Roujol S, Foppa M, et al. Diffuse myocardial fibrosis in patients with mitral valve prolapse and ventricular arrhythmia. Heart. 103(3):204-209, 2017 02. |
Observational-Dx |
41 patients |
To investigate the association of diffuse myocardial fibrosis by cardiac magnetic resonance (CMR) T1 with complex ventricular arrhythmia (ComVA) in mitral valve prolapse (MVP). |
Patients with MVP had significantly shorter postcontrast T1 times when compared with controls (334±52 vs 363±58 ms; p=0.03) despite similar LV ejection fraction (LVEF) (63±7 vs 60±6%, p=0.10). In a multivariable analysis, LV end-diastolic volume, LVEF and mitral regurgitation fraction were all correlates of T1 times, with LVEF and LV end-diastolic volume being the strongest (p=0.005, p=0.008 and p=0.045, respectively; model adjusted R2=0.30). Patients with MVP with ComVA had significantly shorter postcontrast T1 times when compared with patients with MVP without ComVA (324 (296, 348) vs 354 (327, 376) ms; p=0.03) and only 5/14 (36%) had evidence of papillary muscle LGE. |
3 |
| 42. Dejgaard LA, Skjolsvik ET, Lie OH, et al. The Mitral Annulus Disjunction Arrhythmic Syndrome. J Am Coll Cardiol. 72(14):1600-1609, 2018 10 02. |
Observational-Dx |
116 patients |
To describe the clinical presentation, mitral annulus disjunction (MAD) morphology, association with mitral valve prolapse (MVP), and ventricular arrhythmias in patients with mitral annulus disjunction (MAD). |
The authors included 116 patients with MAD (age 49 ± 15 years; 60% female). Palpitations were the most common symptom (71%). Severe arrhythmic events occurred in 14 (12%) patients. Longitudinal MAD distance measured by CMR was 3.0 mm (interquartile range [IQR]: 0 to 7.0 mm) and circumferential MAD was 150° (IQR: 90° to 210°). Patients with severe arrhythmic events were younger (age 37 ± 13 years vs. 51 ± 14 years; p = 0.001), had lower ejection fraction (51 ± 5% vs. 57 ± 7%; p = 0.002) and had more frequently papillary muscle fibrosis (4 [36%] vs. 6 [9%]; p = 0.03). MVP was evident in 90 (78%) patients and was not associated with ventricular arrhythmia. |
2 |
| 43. Bennett S, Thamman R, Griffiths T, et al. Mitral annular disjunction: A systematic review of the literature. Echocardiography. 36(8):1549-1558, 2019 08. |
Review/Other-Dx |
19 studies |
To evaluate the prevalence of mitral annular disjunction (MAD), factors associated with MAD and clinical outcomes among patients with MAD. |
A total of 19 studies were included in this review, and the number of noncase report studies had between 23 and 1439 patients. The pooled rate of MAD in studies of myxomatous mitral valve patients was 66/130 (50.8%, 3 studies), and among patients with mitral valve prolapse was 95/291 (32.6%, 3 studies). One study suggests that 78% of patients with MAD had mitral valve prolapse, and another suggested it was strongly associated with myxomatous mitral valve disease (HR 5.04 95% CI 1.66–15.31). In terms of clinical significance, it has been reported that MAD with disjunction > 8.5 mm was associated with nonsustained ventricular tachycardia (OR 10 95% CI 1.28–78.1). There is also evidence that gadolinium enhancement in papillary muscle (OR 4.09 95% CI 1.28–13.05) and longitudinal MAD distance in posterolateral wall (OR 1.16 95% CI 1.02–1.33) was predictive of ventricular arrhythmia and late gadolinium enhancement in anterolateral papillary muscle was strongly associated with serious arrhythmic event (OR 7.35 95% CI 1.15–47.02). |
4 |
| 44. Lempel JK, Bolen MA, Renapurkar RD, Azok JT, White CS. Radiographic Evaluation of Valvular Heart Disease With Computed Tomography and Magnetic Resonance Correlation. [Review]. J Thorac Imaging. 31(5):273-84, 2016 Sep. |
Review/Other-Dx |
N/A |
To elucidate several principles relating to chamber modifications in response to pressure and volume overload as well as radiographic appearances associated with pulmonary fluid status and cardiac dysfunction. |
No results stated in the abstract. |
4 |
| 45. Aquila I, Gonzalez A, Fernandez-Golfin C, et al. Reproducibility of a novel echocardiographic 3D automated software for the assessment of mitral valve anatomy. Cardiovasc. ultrasound. 14(1):17, 2016 May 17. |
Review/Other-Dx |
61 patients |
To evaluate inter- and intra-observer reproducibility of a novel full-automated software in the evaluation of mitral valve (MV) anatomy compared to routine clinical manual 3D assessment. |
A significant correlation between both methods was found for all variables: intercommissural diameter (r?=?0.84, p?<?0.01), mitral annular area (r?=?0.94, p?>?0, 01), anterior leaflet length (r?=?0.83, p?<?0.01) and posterior leaflet length (r?=?0.67, p?<?0.01). Interobserver variability assessed by the intraclass correlation coefficient was superior for the automatic software: intercommisural distance 0.997 vs. 0.76; mitral annular area 0.957 vs. 0.858; anterior leaflet length 0.963 vs. 0.734 and posterior leaflet length 0.936 vs. 0.838. Intraobserver variability was good for both methods with a better level of agreement with the automatic software. |
4 |
| 46. Cersit S, Gunduz S, Ozan Gursoy M, et al. Relationship Between Pulmonary Venous Flow and Prosthetic Mitral Valve Thrombosis. J Heart Valve Dis. 27(1):65-70, 2018 Jan. |
Observational-Dx |
100 patients |
To determine the association between left superior pulmonary venous flow (PVF) and left atrial appendage (LAA) functions and mitral prosthetic valve thrombosis (PVT. |
No abstract available. |
4 |
| 47. Eibel S, Turton E, Mukherjee C, Bevilacqua C, Ender J. Feasibility of measurements of valve dimensions in en-face-3D transesophageal echocardiography. Int J Cardiovasc Imaging. 33(10):1503-1511, 2017 Oct. |
Review/Other-Dx |
29 patients |
To ascertain whether measurements performed in the en-face-3D TEE mode are comparable with conventional measurement methods based on 2D TEE and 3D using the multiple plane reconstruction mode with the Qlab® software. |
K-space sampling uniformity and image quality incrementally improve with additional occurrences of the desired normal sinus or arrhythmia heartbeat-type. To approach the image quality of breath-hold imaging, sufficiently restrictive gating parameters are required. Compared with real-time imaging, retrospective gated images had reduced noise and improved sharpness while maintaining desired cine temporal resolution. Variations of cardiac function between arrhythmia heartbeats could be observed in arrhythmia imaging cases that are not captured by conventional segmented imaging. |
4 |
| 48. Zoghbi WA, Chambers JB, Dumesnil JG, et al. Recommendations for evaluation of prosthetic valves with echocardiography and doppler ultrasound: a report From the American Society of Echocardiography's Guidelines and Standards Committee and the Task Force on Prosthetic Valves, developed in conjunction with the American College of Cardiology Cardiovascular Imaging Committee, Cardiac Imaging Committee of the American Heart Association, the European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography and the Canadian Society of Echocardiography, endorsed by the American College of Cardiology Foundation, American Heart Association, European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography, and Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2009;22(9):975-1014; quiz 1082-1014. |
Review/Other-Dx |
N/A |
To provide recommendations for evaluation of prosthetic valves with echocardiography and doppler ultrasound. |
No results stated in abstract. |
4 |
| 49. Ewen S, Karliova I, Weber P, et al. Echocardiographic criteria to detect unicuspid aortic valve morphology. Eur Heart J Cardiovasc Imaging. 20(1):40-44, 2019 01 01. |
Observational-Dx |
271 patients |
To systematically determine the echocardiographic criteria to diagnose unicuspid aortic valve (UAV) morphology. |
All patients underwent a preoperative baseline examination, including echocardiography. A total of 69 patients with intraoperatively confirmed UAV underwent an aortic valve repair procedure between August 2001 and May 2011. To compare the findings of UAV cases with those of other valve morphologies, we examined 99 consecutive patients with a bicuspid aortic valve (BAV) and 103 consecutive patients with a tricuspid aortic valve (TAV) undergoing isolated aortic valve surgery before May 2016. The mean age of the 271 patients was 44.2 ± 12.8 years; 85% were male, with a mean body mass index of 26.2 ± 4.0 kg/m2. Patients with UAV were younger and had fewer co-morbidities than patients with BAV or TAV, respectively. The major criteria for the echocardiographic diagnosis of UAV were defined based on our preoperative examination as follows: (i) single commissural attachment zone, (ii) rounded, leaflet-free edge on the opposite side of the commissural attachment zone, (iii) eccentric valvular orifice during systole, and (iv) patient age <20 years and mean transvalvular gradient >15 mmHg. The minor criteria were defined as an associated thoracic aortopathy and age <40 years. Three out of the four major criteria or two out of the four major criteria and one minor criterion were met in all patients with UAV and in none of the patients with BAV or TAV. Associated 95% confidence intervals were calculated for each estimate of sensitivity (94.7-100%) and specificity (98.1-100%), indicating that an adequate number of patients were included in each of the three groups. |
2 |
| 50. Jain R, Ammar KA, Kalvin L, et al. Diagnostic accuracy of bicuspid aortic valve by echocardiography. Echocardiography. 35(12):1932-1938, 2018 12. |
Observational-Dx |
745 patients |
To systematically evaluate the accuracy of bicuspid aortic valve (BAV) diagnosis in a large healthcare system of multiple echocardiography laboratories. |
Aurora Health Care is a multihospital, multi-clinic system across the state of Wisconsin encompassing 33 inpatient and outpatient echocardiography laboratories with 39 cardiologist readers and 72 sonographers. As all laboratories store echocardiograms in one database, we queried all patients with "bicuspid aortic valve" diagnosis on echocardiography. Echocardiograms were classified as "BAV" or "possible BAV" based on initial reader confidence. An expert review panel categorized each as BAV, no BAV, or Indeterminate. Of the 745 cases identified, 589 (79.1%, initial reader interpretation: n = 494 "BAV," n = 95 "possible") were BAV. A high level of agreement (84%) was present in BAV diagnosis. There were 156 (20.9%) echocardiograms that were no BAV (8.4%) or Indeterminate (12.4%). We identified three common reasons for misdiagnosis: poor image quality (n = 70, 44.9%), leaflet calcium (n = 44, 28.2%), and oblique axis imaging (n = 33, 21.1%). A clear reason for misclassification was not elucidated in nine cases (n = 9, 5.7%). |
3 |
| 51. Evangelista A, Gallego P, Calvo-Iglesias F, et al. Anatomical and clinical predictors of valve dysfunction and aortic dilation in bicuspid aortic valve disease. Heart. 104(7):566-573, 2018 04. |
Observational-Dx |
852 patients |
To assess the main determinants of valvular dysfunction and aorta dilation in a large series of patients with bicuspid aortic valve (BAV. |
Three BAV morphotypes were identified: right-left coronary cusp fusion (RL) in 72.9%, right-non-coronary (RN) in 24.1% and left-non-coronary (LN) in 3.0%. BAV without raphe was observed in 18.3%. Multivariate analysis showed aortic regurgitation (23%) to be related to male sex (OR: 2.80, p<0.0001) and valve prolapse (OR: 5.16, p<0.0001), and aortic stenosis (22%) to BAV-RN (OR: 2.09, p<0.001), the presence of raphe (OR: 2.75, p<0.001), age (OR: 1.03; p<0.001), dyslipidaemia (OR: 1.77, p<0.01) and smoking (OR: 1.63, p<0.05). Ascending aorta was dilated in 76% without differences among morphotypes and associated with significant valvular dysfunction. By contrast, aortic root was dilated in 34% and related to male sex and aortic regurgitation but was less frequent in aortic stenosis and BAV-RN. |
3 |
| 52. Cremer PC, Rodriguez LL, Griffin BP, et al. Early Bioprosthetic Valve Failure: Mechanistic Insights via Correlation between Echocardiographic and Operative Findings. [Review]. J Am Soc Echocardiogr. 28(10):1131-48, 2015 Oct. |
Review/Other-Dx |
N/A |
To organize causes of early bioprosthetic valve failure according to possible pathogenesis and demonstrate the correlation between echocardiographic and anatomic findings, and discuss potential treatments. |
No results stated in the abstract. |
4 |
| 53. Cho IJ, Hong GR, Lee SH, et al. Prosthesis-Patient Mismatch after Mitral Valve Replacement: Comparison of Different Methods of Effective Orifice Area Calculation. Yonsei Med J. 57(2):328-36, 2016 Mar. |
Review/Other-Dx |
166 patients |
To investigate incidence of prosthesis-patient mismatch (PPM) according to the different methods of calculating effective orifice area (EOA), including the continuity equation (CE), pressure half time (PHT) method and use of reference EOA, and to compare these with various echocardiographic variables. |
Prevalence of PPM was different depending on the methods used to calculate EOA, ranging from 7% in PHT method to 49% in referred EOA method to 62% in CE methods. The intraclass correlation coefficient was low between the methods. PPM was associated with raised trans-prosthetic pressure, only when calculated by CE (p=0.021). Indexed EOA(CE) was the only predictor of postoperative systolic pulmonary artery (PA) pressure, even after adjusting for age, preoperative systolic PA pressure and postoperative left atrial volume index (p<0.001). |
4 |
| 54. Abudiab MM, Chebrolu LH, Schutt RC, Nagueh SF, Zoghbi WA. Doppler Echocardiography for the Estimation of LV Filling Pressure in Patients With Mitral Annular Calcification. JACC Cardiovasc Imaging. 10(12):1411-1420, 2017 12. |
Observational-Dx |
71 patients (50 in training group, 21 in validation group) |
To identify Doppler parameters useful for the assessment of left ventricular filling pressure (LVFP) in patients with mitral annular calcification (MAC) and to develop and validate a decision algorithm for assessing LVFP in such patients. |
In the initial study group, 26 patients had mild MAC, and 24 had moderate or severe MAC. Mean LVFP was 17.0 ± 8.1 mm Hg (range 4 to 50 mm Hg). Of the variables tested, the best predictor of LVFP was the ratio of early-to-late diastolic filling velocity (mitral E/A) (r = 0.66; p < 0.001). This finding was observed in subjects with mild as well as moderate-to-severe MAC. Importantly, the ratio of early diastolic filling velocity-to-mitral annulus velocity (E/e') demonstrated weak correlation (r = 0.42; p = 0.003). A clinical algorithm using mitral E/A and isovolumic relaxation time (IVRT) was associated with good specificity (100%) and positive predictive value (100%), and moderate sensitivity (81%) and negative predictive value (67%) for high LVFP. Validation of the clinical algorithm in a separate prospective cohort yielded a diagnostic accuracy of 94%. |
2 |
| 55. d'Arcy JL, Coffey S, Loudon MA, et al. Large-scale community echocardiographic screening reveals a major burden of undiagnosed valvular heart disease in older people: the OxVALVE Population Cohort Study. Eur Heart J. 37(47):3515-3522, 2016 Dec 14. |
Observational-Dx |
2,500 patients |
To present a cross-sectional analysis of the population prevalence of undiagnosed and known VHD in the first 2500 participants and quantify the community prevalence of milder forms of valvular heart disease (VHD) for the first time. |
We enrolled 2500 individuals aged =65 years from a primary care population and screened for undiagnosed VHD using transthoracic echocardiography. Newly identified (predominantly mild) VHD was detected in 51% of participants. The most common abnormalities were aortic sclerosis (34%), mitral regurgitation (22%), and aortic regurgitation (15%). Aortic stenosis was present in 1.3%. The likelihood of undiagnosed VHD was two-fold higher in the two most deprived socioeconomic quintiles than in the most affluent quintile, and three-fold higher in individuals with atrial fibrillation. Clinically significant (moderate or severe) undiagnosed VHD was identified in 6.4%. In addition, 4.9% of the cohort had pre-existing VHD (a total prevalence of 11.3%). Projecting these findings using population data, we estimate that the prevalence of clinically significant VHD will double before 2050. |
2 |
| 56. Gardezi SKM, Myerson SG, Chambers J, et al. Cardiac auscultation poorly predicts the presence of valvular heart disease in asymptomatic primary care patients. Heart. 104(22):1832-1835, 2018 11. |
Observational-Dx |
251 patients |
To determine the contemporary accuracy of auscultation for diagnosing valvular heart disease (VHD) in primary care. |
Newly identified VHD was common, with mild disease in 170/251 participants (68%) and significant disease in 36/251 (14%). The sensitivity of auscultation was low for the diagnosis of mild VHD (32%) but slightly higher for significant VHD (44%), with specificities of 67% and 69%, respectively. Likelihood ratios were not statistically significant for the diagnosis of either mild or significant VHD in the overall cohort, but showed possible value for auscultation in non-overweight subjects (body mass index <25 kg/m2). |
3 |
| 57. Argulian E, Seetharam K. Echocardiographic 3D-guided 2D planimetry in quantifying left-sided valvular heart disease. [Review]. Echocardiography. 35(5):695-706, 2018 05. |
Review/Other-Dx |
N/A |
To highlight important clinical applications of this echocardiographic technique in quantifying left-sided valvular heart disease with emphasis on feasibility and reproducibility. |
No results stated in the abstract. |
4 |
| 58. Cheng Y, Gao H, Tang L, Li J, Yao L. Clinical utility of three-dimensional echocardiography in the evaluation of tricuspid regurgitation induced by implantable device leads. Echocardiography. 33(11):1689-1696, 2016 Nov. |
Observational-Dx |
144 patients (86 males and58 females) |
To evaluate the feasibility of using three-dimensional transthoracic echocardiography (3DTTE) to identify lead-induced tricuspid regurgitation (LITR). |
3DTTE clearly identified the course and position of the leads in 74% of the patients. The lead tips were located in the RV apex or outflow tract in 95% of patients and in the interventricular septum (IVS) in 5% of patients. At the tricuspid annular level, 25% of leads were impinging on a leaflet, 41% were located in the commissure of two leaflets, and 34% were in the middle of the tricuspid orifice. 3D images revealed that when the lead tip was in the IVS or the lead was impinging on a leaflet, the device lead was more likely to interfere with leaflet mobility (P<.05). Interfering leads were associated with more significant TR than noninterfering leads (P<.05). |
3 |
| 59. Cameli M, Sciaccaluga C, Mandoli GE, D'Ascenzi F, Tsioulpas C, Mondillo S. The role of the left atrial function in the surgical management of aortic and mitral valve disease. [Review]. Echocardiography. 36(8):1559-1565, 2019 08. |
Review/Other-Dx |
N/A |
To examine the evidence currently available on the left atrium (LA) as a promising marker to guide the optimal timing for the correction of aortic and mitral valve disease. |
No results stated in the abstract. |
4 |
| 60. Hulshof HG, van Dijk AP, George KP, Hopman MTE, Thijssen DHJ, Oxborough DL. Exploratory assessment of left ventricular strain-volume loops in severe aortic valve diseases. J Physiol (Lond). 595(12):3961-3971, 2017 06 15. |
Observational-Dx |
27 patients |
To examine left ventricular (LV) strain (?)–volume loops to provide novel insight into the haemodynamic cardiac consequences of aortic valve stenosis (AS) and aortic valve regurgitation (AR). |
Twenty-seven participants were retrospectively recruited: AR (n = 7), AS (n = 10) and control subjects (n = 10). Standard transthoracic echocardiography was used to obtain apical four-chamber images to construct ?–volume relationships, which were assessed using the following parameters: early systolic ? (?_ES); slope of ?–volume relationship during systole (Sslope); end-systolic peak ? (peak ?); and diastolic uncoupling (systolic ?–diastolic ? at same volume) during early diastole (UNCOUP_ED) and late diastole (UNCOUP_LD). Receiver operating characteristic curves were used to determine the ability to detect impaired LV function. Although LV ejection fraction was comparable between groups, longitudinal peak ? was reduced compared with control subjects. In contrast, ?_ES and Sslope were lower in both pathologies compared with control subejcts (P < 0.01), but also different between AS and AR (P < 0.05). UNCOUP_ED and UNCOUP_LD were significantly higher in both patient groups compared with control subjects (P < 0.05). Receiver operating characteristic curves revealed that loop characteristics (AUC = 0.99, 1.00 and 1.00; all P < 0.01) were better able then peak ? (AUC = 0.75, 0.89 and 0.76; P = 0.06, <0.01 and 0.08, respectively) and LV ejection fraction (AUC = 0.56, 0.69 and 0.69; all P > 0.05) to distinguish AS vs control, AR vs control and AS vs AR groups, respectively. Temporal changes in ?–volume characteristics provide novel insight into the haemodynamic cardiac impact of AS and AR. Contrary to traditional measures (i.e. ejection fraction, peak ?), these novel measures successfully distinguish between the haemodynamic cardiac impact of AS and AR. |
3 |
| 61. Aquila I, Frati G, Sciarretta S, Dellegrottaglie S, Torella D, Torella M. New imaging techniques project the cellular and molecular alterations underlying bicuspid aortic valve development. [Review]. J Mol Cell Cardiol. 129:197-207, 2019 04. |
Review/Other-Dx |
N/A |
To merge the evidences of imaging and basic science studies in a coherent hypothesis that underlies and thus projects the development of both bicuspid aortic valve (BAV) during embryogenesis and BAV-associated aortopathy and its complications in the adult life, with the final goal to identifying aneurysm formation/rupture susceptibility to improve diagnosis and management of patients with BAV-related aortopathy. |
No results stated in the abstract. |
4 |
| 62. Gentry Iii JL, Phelan D, Desai MY, Griffin BP. The Role of Stress Echocardiography in Valvular Heart Disease: A Current Appraisal. [Review]. Cardiology. 137(3):137-150, 2017. |
Review/Other-Dx |
N/A |
To discuss the role of stress echocardiography in the management of patients with valvular heart disease. |
No abstract available. |
4 |
| 63. Nakajima T, Kimura F, Kajimoto K, Kasanuki H, Hagiwara N. Utility of ECG-gated MDCT to differentiate patients with ARVC/D from patients with ventricular tachyarrhythmias. J Cardiovasc Comput Tomogr 2013;7:223-33. |
Observational-Dx |
77 |
To propose a comprehensive system for scoring characteristic CT findings to diagnose ARVC/D and discuss its utility. |
For overall (definite and borderline) and definite ARVC/D diagnosis, sensitivities were 77.8% and 87.0%, specificities were 96.0% and 94.4%,positive predictive values were 91.3% and 87.0%, negative predictive values were 88.9% and 94.4%, and accuracies were 89.6% and 92.2%, respectively |
3 |
| 64. Cochet H, Denis A, Komatsu Y, et al. Automated Quantification of Right Ventricular Fat at Contrast-enhanced Cardiac Multidetector CT in Arrhythmogenic Right Ventricular Cardiomyopathy. Radiology 2015;275:683-91. |
Experimental-Dx |
108 |
To evaluate an automated method for the quantification of fat in the right ventricular (RV) free wall on multidetector computed tomography (CT) images and assess its diagnostic value in arrhythmogenic RV cardiomyopathy (ARVC). |
Fat extent was 16.5% +/- 6.1 in ARVC and 4.6% +/- 2.7 in non-ARVC (P < .0001). No significant difference was observed between control and ischemic groups (P = .23). A fat extent threshold of 8.5% of RV free wall was used to diagnose ARVC with 94% sensitivity (95% confidence interval [CI]: 82%, 98%) and 92% specificity (95% CI: 83%, 96%). This diagnostic performance was higher than the one for RV volume (mean area under the ROC curve, 0.96 +/- 0.02 vs 0.88 +/- 0.04; P = .009). In patients with ARVC, fat correlated to RV volume (R = 0.63, P < .0001), RV function (R = -0.67, P = .001), epsilon waves (R = 0.39, P = .02), inverted T waves in V1-V3 (R = 0.38, P = .02), and presence of PKP2 mutations (R = 0.59, P = .02). Fat distribution differed between patients with ARVC and those without, with posterolateral RV wall being the most ARVC-specific area. CONCLUSION: Automated quantification of RV myocardial fat on multidetector CT images is feasible and performs better than RV volume in the diagnosis of ARVC. |
1 |
| 65. Aliyari Ghasabeh M, Te Riele ASJM, James CA, et al. Epicardial Fat Distribution Assessed with Cardiac CT in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy. Radiology. 289(3):641-648, 2018 12. |
Observational-Dx |
89 patients (44 patients with ARVD/C group, 45 patients in control group) |
To compare epicardial fat in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) with that in healthy subjects. |
Total EAT volume was higher in patients with ARVD/C than in healthy control group participants (median, 98 mL vs 76 mL, respectively; P = .04). Regionally, LV and RV EAT volumes were higher in patients with ARVD/C than in control group participants, most notably when indexed to MAT (median LV EAT index: 0.49 vs 0.15, respectively; median RV EAT index: 0.91 vs 0.52; P ? .0005 for both). The optimal cutoff for diagnosis of ARVD/C was an LV EAT index of 0.24, with a sensitivity and specificity of 91% and 71%, respectively. Atrial EAT volume and total intrathoracic adipose tissue volume were not different between groups. RV diameter showed a positive correlation with total EAT index and LV EAT index (r = 0.21, P = .05 and r = 0.33, P = .002, respectively). |
3 |
| 66. Jacobson JT.. Role of Imaging in the Management of Ventricular Arrhythmias. [Review]. Cardiol Rev. 27(6):308-313, 2019 Nov/Dec. |
Review/Other-Dx |
N/A |
To outline the application of different imaging modalities, such as ultrasonography, magnetic resonance imaging, computed tomography, and positron emission tomography, for the treatment of ventricular arrhythmias (VA). |
No abstract available. |
4 |
| 67. Esposito A, Palmisano A, Antunes S, et al. Cardiac CT With Delayed Enhancement in the Characterization of Ventricular Tachycardia Structural Substrate: Relationship Between CT-Segmented Scar and Electro-Anatomic Mapping. Jacc: Cardiovascular Imaging. 9(7):822-832, 2016 Jul. |
Observational-Dx |
42 patients |
To compare myocardial scars depicted by computed tomography (CT) with electrical features from electro-anatomic mapping (EAM), assessing the potential role of CT integration in ventricular tachycardia (VT) and radiofrequency catheter ablation (RFCA) procedures. |
CT scans identified scars in 39 patients and defined left ventricular wall involvement and mural distribution. Overall segmental concordance between CT and EAM was good (? = 0.536) despite the presence of implantable cardioverter-defibrillator, scar etiologies, and mural distribution. CT identified segments characterized by low voltages with good sensitivity (76%), good specificity (86%), and very high negative predictive value (95%). Late potentials and RF ablation points fell on scarred segments identified from CT in 79% and 81% of cases, respectively. Point-by-point quantitative comparison revealed good correlation between the average area of scar detected at CT and at bipolar mapping (CT = 4,901 mm(2), bipolar voltages-EAM = 4,070 mm(2); R = 0.78; p < 0.0001). In this study, 70% and 84% of low-amplitude bipolar points were mapped at a maximum distance of 5 mm and 10 mm from CT-segmented scar, respectively. |
3 |
| 68. Yamashita S, Sacher F, Mahida S, et al. Role of high-resolution image integration to visualize left phrenic nerve and coronary arteries during epicardial ventricular tachycardia ablation. Circ Arrhythm Electrophysiol 2015;8:371-80. |
Observational-Dx |
95 patients |
To assess the ability of multidetector computed tomography (MDCT) to allow safe ablation procedures by displaying high-resolution reconstruction of coronary arteries (CAs) and phrenic nerve (PN), and sought to define the anatomic relationship of CAs and PN locations with the electrophysiological substrates (LAVAs) according to the ventricular tachycardia (VT) pathogenesis in patients undergoing epicardial VT ablation for scar-related VT. |
Ninety-five consecutive patients (86 men; age, 57±15) with VT underwent cardiac multidetector computed tomography. The PN detection rate and anatomic variability were analyzed. In 49 patients undergoing epicardial mapping, real-time multidetector computed tomographic integration was used to display CAs/PN locations in 3-dimensional mapping systems. Elimination of local abnormal ventricular activities (LAVAs) was used as ablation end point. The distribution of CAs/PN with respect to LAVA was analyzed and compared between VT etiologies. Multidetector computed tomography detected PN in 81 patients (85%). Epicardial LAVAs were observed in 44 of 49 patients (15 ischemic cardiomyopathy, 15 nonischemic cardiomyopathy, and 14 arrhythmogenic right ventricular cardiomyopathy) with a mean of 35±37 LAVA points/patient. LAVAs were located within 1 cm from CAs and PN in 35 (80%) and 18 (37%) patients, respectively. The prevalence of LAVA adjacent to CAs was higher in nonischemic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy than in ischemic cardiomyopathy (100% versus 86% versus 53%; P<0.01). The prevalence of LAVAs adjacent to PN was higher in nonischemic cardiomyopathy than in ischemic cardiomyopathy (93% versus 27%; P<0.001). Epicardial ablation was performed in 37 patients (76%). Epicardial LAVAs could not be eliminated because of the proximity to CAs or PN in 8 patients (18%). |
3 |
| 69. Klein C, Brunereau J, Lacroix D, et al. Left atrial epicardial adipose tissue radiodensity is associated with electrophysiological properties of atrial myocardium in patients with atrial fibrillation. Eur Radiol. 29(6):3027-3035, 2019 Jun. |
Observational-Dx |
30 patients |
To evaluate whether the epicardial adipose tissue (EAT) phenotype is associated with the electrophysiological properties of adjacent atrial myocardium in patients with atrial fibrillation (AF). |
Ten patients (33.3%) presented at least one LVZ. Older age (65 ± 7 vs. 58 ± 10 years, p = 0.05) was the only clinicalparameter associated with LVZ. Despite no greater LA-EAT thickness by CT scan (3.0 [2.6–3.5] mm vs. 2.8 [2.2–3.1] mm, p =0.354), patients with LA-LVZ presented significantly lower LA-EAT radiodensity than patients with no LA-LVZ (- 101.8 ±12.5 HU vs. - 90.4 ± 6.3 HU, p = 0.004). No difference between total-EAT volume (131 ± 61 |
2 |
| 70. Gupta A, Harrington M, Albert CM, et al. Myocardial Scar But Not Ischemia Is Associated With Defibrillator Shocks and Sudden Cardiac Death in Stable Patients With Reduced Left Ventricular Ejection Fraction. JACC Clin Electrophysiol. 4(9):1200-1210, 2018 09. |
Observational-Dx |
439 patients |
To investigate the association of myocardial scar and ischemia with major arrhythmic events (MAEs) in patients with left ventricular ejection fraction (LVEF) =35%. |
Ninety-one MAEs including 20 sudden cardiac deaths occurred in 75 (17%) patients during a median follow-up of 3.2 years. Transmural myocardial scar was strongly associated with MAEs beyond age, sex, cardiovascular risk factors, beta-blocker therapy, and resting LVEF (adjusted hazard ratio per 10% increase in scar, 1.48 [95% confidence interval: 1.22 to 1.80]; p < 0.001). However, non transmural scar/hibernation or markers of myocardial ischemia on PET including global or peri-infarct ischemia, coronary flow reserve, and resting or hyperemic myocardial blood flows were not associated with MAEs in univariable or multivariable analysis. These findings remained robust in subgroup analyses of patients with ICD (n = 223), with ischemic cardiomyopathy (n = 287), and in patients without revascularization after the PET scan (n = 365). |
3 |
| 71. Kim EK, Chattranukulchai P, Klem I. Cardiac Magnetic Resonance Scar Imaging for Sudden Cardiac Death Risk Stratification in Patients with Non-Ischemic Cardiomyopathy. [Review]. Korean J Radiol. 16(4):683-95, 2015 Jul-Aug. |
Review/Other-Dx |
2,7,47 patients |
To discuss the evidence of cardiac magnetic resonance (CMR) scar imaging for the prediction of adverse cardiovascular outcomes in non-ischemic cardiomyopathy (NICM), and in particular for sudden cardiac death (SCD) risk stratification. |
From the 15 studies analyzed, with a total of 2747 patients, the average prevalence of myocardial scar was 41%. In patients with myocardial scar, the risk for adverse cardiac events was more than 3-fold higher, and risk for arrhythmic events 5-fold higher, as compared to patients without scar. |
4 |
| 72. Hen Y, Takara A, Iguchi N, et al. High Signal Intensity on T2-Weighted Cardiovascular Magnetic Resonance Imaging Predicts Life-Threatening Arrhythmic Events in Hypertrophic Cardiomyopathy Patients. Circ J. 82(4):1062-1069, 2018 03 23. |
Observational-Dx |
237 patients (143 male) |
To validate the significance of T2 high signal as a prognostic factor in predicting life-threatening arrhythmic events in a relatively large number of hypertrophic cardiomyopathy (HCM) patients who underwent gadolinium enhanced imaging and T2-weighted imaging (T2WI). |
A total of 237 HCM patients (median age, 62 years; 143 male) underwent T2-weighted, cine and late gadolinium enhancement (LGE) imaging, and were followed (median duration, 3.4 years) for life-threatening arrhythmic events. The clinical and magnetic resonance imaging characteristics were extracted, and predictors of life-threatening arrhythmic events were assessed on multivariate analysis. LGE was present in 180 patients (75.9%). Median LGE score was 3 in a left ventricle 17-segment model. T2 high signal was present in 49 patients (20.7%). The annual events rate was significantly higher in patients with extensive LGE (score =4) than in those without (3.0%/year vs. 0.5%/year, P=0.011). On multivariate analysis, extensive LGE (hazard ratio, 5.650; 95% CI: 1.263–25.000, P=0.024) as an independent predictor for life-threatening arrhythmic events. In patients with extensive LGE, the annual events rate was significantly higher in patients with T2 high signal than in those without (5.8%/year vs. 0.9%/year, P=0.008). |
3 |
| 73. Hulten E, Agarwal V, Cahill M, et al. Presence of Late Gadolinium Enhancement by Cardiac Magnetic Resonance Among Patients With Suspected Cardiac Sarcoidosis Is Associated With Adverse Cardiovascular Prognosis: A Systematic Review and Meta-Analysis. [Review]. Circ Cardiovasc Imaging. 9(9):e005001, 2016 Sep. |
Meta-analysis |
7 studies (694 patients) |
To systematically review and perform meta-analysis of the prognostic value of cardiac magnetic resonance imaging (MRI) for patients with known or suspected cardiac sarcoidosis. |
We systematically searched for cohort studies of patients with known sarcoidosis with suspected cardiac involvement who underwent cardiac MRI with LGE with at least 12 months of either prospective or retrospective follow-up data regarding post-MRI adverse cardiovascular outcomes. We identified 7 studies of 694 subjects (mean age 53; 42% men).One hundred and ninety-nine patients (29%) were LGE positive. All-cause mortality occurred in 19 LGE-positive versus 17 LGE-negative subjects (annualized incidence, 3.1% versus 0.6%). The pooled relative risk was 3.38 (95% confidence interval, 1.07-10.7; P=0.04). Cardiovascular mortality occurred in 10 LGE-positive versus 2 LGE-negative subjects (annualized incidence, 1.9% versus 0.3%; relative risk 10.7 [95% confidence interval, 1.34-86.3]; P=0.03). Ventricular arrhythmia occurred in 41 LGE-positive versus 0 LGE-negative subjects (annualized incidence, 5.9% versus 0%; relative risk 19.5 [95% confidence interval, 2.68-143]; P=0.003). A combined end point of death or ventricular arrhythmia occurred in 64 LGE-positive versus 18 LGE-negative subjects (annualized incidence, 8.8% versus 0.6%; relative risk 6.20 [95% confidence interval, 2.47-15.6]; P<0.001). There was no significant heterogeneity for any outcomes. |
Inadequate |
| 74. Di Marco A, Anguera I, Schmitt M, et al. Late Gadolinium Enhancement and the Risk for Ventricular Arrhythmias or Sudden Death in Dilated Cardiomyopathy: Systematic Review and Meta-Analysis. [Review]. JACC Heart Fail. 5(1):28-38, 2017 01. |
Meta-analysis |
29 studies |
The aim of this study was to evaluate the association between late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging and ventricular arrhythmias or sudden cardiac death (SCD) in patients with dilated cardiomyopathy (DCM). |
Twenty-nine studies were included, accounting for 2,948 patients. The studies covered a wide spectrum of DCM, with a mean left ventricular ejection fraction between 20% and 43%. LGE was significantly associated with the arrhythmic endpoint both in the overall population (odds ratio: 4.3; p < 0.001) and when including only those studies that performed multivariate analysis (hazard ratio: 6.7; p < 0.001). The association between LGE and the arrhythmic endpoint remained significant among studies with mean left ventricular ejection fractions >35% (odds ratio: 5.2; p < 0.001) and was maximal in studies that included only patients with primary prevention ICDs (odds ratio: 7.8; p = 0.008). |
Good |
| 75. Disertori M, Rigoni M, Pace N, et al. Myocardial Fibrosis Assessment by LGE Is a Powerful Predictor of Ventricular Tachyarrhythmias in Ischemic and Nonischemic LV Dysfunction: A Meta-Analysis. [Review]. JACC Cardiovasc Imaging. 9(9):1046-1055, 2016 09. |
Meta-analysis |
19 studies |
The present meta-analysis was to assess the role of late gadolinium enhancement (LGE) in risk stratification of ventricular tachyarrhythmic events in both ICM and NICM patients with ventricular dysfunction. |
Nineteen studies that evaluated 2,850 patients with 423 arrhythmic events over a mean/median follow-up of 2.8 years were identified. The composite arrhythmic endpoint was reached in 23.9% of patients with a positive LGE test (annualized event rate of 8.6%) versus 4.9% of patients with a negative LGE test (annualized event rate of 1.7%; p < 0.0001). LGE correlated with arrhythmic events in the different patient groups. In the overall population, the pooled OR was 5.62 (95% confidence interval [CI]: 4.20 to 7.51), with no significant differences between ICM and NICM patients. In a subgroup of 11 studies (1,178 patients) with mean ejection fraction (EF) =30%, the pooled OR for the arrhythmic events increased to 9.56 (95% CI: 5.63 to 16.23), with a negative likelihood ratio of 0.13 (95% CI: 0.06 to 0.30). |
Good |
| 76. Ekstrom K, Lehtonen J, Hanninen H, Kandolin R, Kivisto S, Kupari M. Magnetic Resonance Imaging as a Predictor of Survival Free of Life-Threatening Arrhythmias and Transplantation in Cardiac Sarcoidosis. J Am Heart Assoc. 5(5), 2016 05 02. |
Observational-Dx |
59 patients (38 female) |
To investigate whether cardiac magnetic resonance imaging also helps predict outcome in cardiac sarcoidosis. |
Our work involved 59 patients with cardiac sarcoidosis (38 female, mean age 46±10 years) seen at our hospital since February 2004 and followed up after contrast-enhanced cardiac magnetic resonance imaging. The extent of myocardial late gadolinium enhancement (measured as percentage of left ventricular mass), the volumes and ejection fractions of the left and right ventricles, and the thickness of the basal interventricular septum were determined and analyzed for prognostic significance. By April 2015, 23 patients had reached the study's end point, consisting of a composite of cardiac death (n=3), cardiac transplantation (n=1), and occurrence of life-threatening ventricular tachyarrhythmias (n=19; ventricular fibrillation in 5 and sustained ventricular tachycardia in 14 patients). In univariate analysis, myocardial extent of late gadolinium enhancement predicted event-free survival, as did scar-like thinning (<4 mm) of the basal interventricular septum and the ejection fraction of the right ventricle (P<0.05 for all). In multivariate Cox regression analysis, extent of late gadolinium enhancement was the only independent predictor of outcome events on cardiac magnetic resonance imaging, with a hazard ratio of 2.22 per tertile (95% CI 1.07–4.59). An extent of late gadolinium enhancement >22% (third tertile) had positive and negative predictive values for serious cardiac events of 75% and 76%, respectively. |
3 |
| 77. Balaban G, Halliday BP, Bai W, et al. Scar shape analysis and simulated electrical instabilities in a non-ischemic dilated cardiomyopathy patient cohort. PLoS Comput Biol. 15(10):e1007421, 2019 10. |
Observational-Dx |
157 patients |
To present a morphological analysis of fibrotic scarring in non-ischemic dilated cardiomyopathy, and its relationship to electrical instabilities which underlie reentrant arrhythmias. |
Two dimensional electrophysiological simulation models were constructed from a set of 699 late gadolinium enhanced cardiac magnetic resonance images originating from 157 patients. Areas of late gadolinium enhancement (LGE) in each image were assigned one of 10 possible microstructures, which modelled the details of fibrotic scarring an order of magnitude below the MRI scan resolution. A simulated programmed electrical stimulation protocol tested each model for the possibility of generating either a transmural block or a transmural reentry. The outcomes of the simulations were compared against morphological LGE features extracted from the images. Models which blocked or reentered, grouped by microstructure, were significantly different from one another in myocardial-LGE interface length, number of components and entropy, but not in relative area and transmurality. With an unknown microstructure, transmurality alone was the best predictor of block, whereas a combination of interface length, transmurality and number of components was the best predictor of reentry in linear discriminant analysis. |
3 |
| 78. Bissell LA, Dumitru RB, Erhayiem B, et al. Incidental significant arrhythmia in scleroderma associates with cardiac magnetic resonance measure of fibrosis and hs-TnI and NT-proBNP. Rheumatology (Oxford). 58(7):1221-1226, 2019 07 01. |
Review/Other-Dx |
19 patients |
To screen for significant arrhythmias with an implantable loop recorder (ILR) in patients with SSc and no known cardiovascular disease, and identify associated disease phenotype, blood and cardiovascular magnetic resonance (CMR) biomarkers. |
ILR data were available for 19 patients: 63% female, mean (s.d.) age of 53 (12) years, 32% diffuse SSc. Eight patients had significant arrhythmias over 3 years: one complete heart block, two non-sustained ventricular tachycardia [all three dcSSc, two anti-topoisomerase antibodies (Scl70) positive, three interstitial lung disease and two previous digital ulceration] and five atrial arrhythmias of which four were with limited SSc. These required interventions with one permanent pacemaker implantation, four anti-arrhythmic pharmacotherapy, one anticoagulation.Patients with significant arrhythmia had higher baseline high-sensitivity troponin I and N-terminal pro-brain natriuretic peptide [mean difference (95% CI) 117 (-11, 245) and 92 (-30, 215) ng/l, respectively], and CMR-extracellular volume [mean (s.d.) 32 (2) vs 29 (4)%]. Late gadolinium enhancement was observed in five patients, only one with significant arrhythmia. |
4 |
| 79. Acosta J, Fernandez-Armenta J, Borras R, et al. Scar Characterization to Predict Life-Threatening Arrhythmic Events and Sudden Cardiac Death in Patients With Cardiac Resynchronization Therapy: The GAUDI-CRT Study. JACC Cardiovasc Imaging. 11(4):561-572, 2018 04. |
Observational-Dx |
217 patients |
The aim of this study was to analyze whether scar characterization could improve the risk stratification for life-threatening ventricular arrhythmias and sudden cardiac death (SCD). |
217 patients (39.6% ischemic) were included. During a median follow-up of 35.5 months (12 to 62 months), the primary endpoint occurred in 25 patients (11.5%) and did not occur in patients without myocardial scar. Among patients with scar (n = 125, 57.6%), those with implantable cardioverter-defibrillator (ICD) therapies or SCD exhibited greater scar mass (38.7 ± 34.2 g vs. 17.9 ± 17.2 g; p < 0.001), scar heterogeneity (BZ mass/scar mass ratio) (49.5 ± 13.0 vs. 40.1 ± 21.7; p = 0.044), and BZ channel mass (3.6 ± 3.0 g vs. 1.8 ± 3.4 g; p = 0.018). BZ mass (hazard ratio: 1.06 [95% confidence interval: 1.04 to 1.08]; p < 0.001) and BZ channel mass (hazard ratio: 1.21 [95% confidence interval: 1.10 to 1.32]; p < 0.001) were the strongest predictors of the primary endpoint. An algorithm based on scar mass and the absence of BZ channels identified 148 patients (68.2%) without ICD therapy/SCD during follow-up with a 100% negative predictive value. |
2 |
| 80. Jablonowski R, Chaudhry U, van der Pals J, et al. Cardiovascular Magnetic Resonance to Predict Appropriate Implantable Cardioverter Defibrillator Therapy in Ischemic and Nonischemic Cardiomyopathy Patients Using Late Gadolinium Enhancement Border Zone: Comparison of Four Analysis Methods. Circ Cardiovasc Imaging. 10(9), 2017 Sep. |
Observational-Dx |
108 patients |
To determine whether size and heterogeneity of late gadolinium enhancement (LGE) predict appropriate implantable cardioverter defibrillator (ICD) therapy in ischemic cardiomyopathy (ICM) and nonischemic cardiomyopathy (NICM) patients and to evaluate 4 LGE border-zone algorithms. |
ICM and NICM patients who underwent LGE-CMR prior to ICD implantation were retrospectively included. Two semi-automatic algorithms, EWA (Expectation Maximization, weighted intensity, a priori information) and a weighted border zone algorithm (WBZ) were compared to a modified full-width half-maximum (mFWHM) and a 2–3SD threshold-based algorithm (2–3SD). Hazard ratios (HR) were calculated per 1% increase in LGE.A total of 74 ICM and 34 NICM were followed for 63 months [1–140] and 52 months [0–133] respectively. ICM patients had 27 appropriate ICD-events and NICM patients had seven ICD-events. In ICM patients with primary prophylactic ICD, LGE border zone predicted ICD-therapy in univariable and multivariable analysis measured by the EWA, WBZ and mFWHM algorithms (HR 1.23, 1.22 and 1.05 respectively, P<0.05, negative predictive value 92%). For NICM, total LGE by all four methods was the strongest predictor (HR 1.03–1.04, P<0.05), though the number of events was small. |
3 |
| 81. Boyle PM, Zghaib T, Zahid S, et al. Computationally guided personalized targeted ablation of persistent atrial fibrillation. Nat. biomed. eng.. 3(11):870-879, 2019 11. |
Review/Other-Dx |
10 patients |
To discuss computationally guided personalized targeted ablation of persistent atrial fibrillation. |
No results stated in the abstract. |
4 |
| 82. Bucciarelli-Ducci C, Baritussio A, Auricchio A. Cardiac MRI Anatomy and Function as a Substrate for Arrhythmias. [Review]. Europace. 18(suppl 4):iv130-iv135, 2016 12. |
Review/Other-Dx |
N/A |
To discuss the use of cardiac magnetic resonance imaging (MRI) anatomy and function as a substrate for arrhythmias. |
No abstract available. |
4 |
| 83. Marcus FI, McKenna WJ, Sherrill D, et al. Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia: proposed modification of the Task Force Criteria. Eur Heart J. 2010;31(7):806-814. |
Review/Other-Dx |
N/A |
To review the clinical diagnosis of ARVD/D. |
Revision of the diagnostic criteria provides guidance on the role of emerging diagnostic modalities and advances in the genetics of ARVD/D. The criteria have been modified to incorporate new knowledge and technology to improve diagnostic sensitivity, but with the important requisite of maintaining diagnostic specificity. The approach of classifying structural, histological, electrocardiographic, arrhythmic, and genetic features of the disease as major and minor criteria has been maintained. In this modification of the Task Force criteria, quantitative criteria are proposed and abnormalities are defined on the basis of comparison with normal subject data. |
4 |
| 84. Chiang KF, Cheng CM, Tsai SC, et al. Relationship of myocardial substrate characteristics as assessed by myocardial perfusion imaging and cardiac reverse remodeling levels after cardiac resynchronization therapy. Ann Nucl Med. 30(7):484-93, 2016 Aug. |
Observational-Dx |
41 patients (26 males) |
To evaluate the relationship of myocardial substrate characteristics as assessed by myocardial perfusion imaging (MPI) and cardiac RR post-CRT. |
Quantitative analysis of MPI showed that there were significant differences for scar burden [15.9 ± 9.5, 26.8 ± 16.1, and 45.6 ± 15.1 % for group I (n = 15), II (n = 16), and III (n = 10), respectively, p < 0.001], EDV (136.6 ± 64.9, 221.6 ± 123.9, and 351.8 ± 216.3 ml, p = 0.002), ESV (82.6 ± 59.8, 172.3 ± 117.2, and 293.3 ± 209.6 ml, p = 0.001), LVEF (44.9 ± 15.0, 25.6 ± 10.9, and 21.5 ± 11.7 %, p < 0.001), systolic phase SD (23.4° ± 10.3°, 36.0° ± 16.2°, and 57.0° ± 22.2°, p < 0.001), and bandwidth (72.5° ± 31.1°, 113.4° ± 56.4°, and 199.1° ± 90.1°, p < 0.001). Myocardial scar interfered with the normal propagation of mechanical activation, resulting in heterogeneous activation sequences. Compared with group II (MRR only), group I (ERR + MRR) had significantly less initial activation segments (1.9 ± 1.0 vs. 2.6 ± 0.7, p < 0.05) and shorter maximal contraction delay (46.9° ± 12.9° vs. 58.8° ± 18.5°, p < 0.05). During the periods of follow-up, 21 patients developed VT/VF, including only 1 patient (1 VT) in group I (6.7 %), 8 patients (7 VT and 1 VF) in group II (50 %), and 9 patients (7 VT and 5 VF) in group III (90 %). |
3 |
| 85. Aguade-Bruix S, Romero-Farina G, Candell-Riera J, Pizzi MN, Garcia-Dorado D. Mechanical dyssynchrony according to validated cut-off values using gated SPECT myocardial perfusion imaging. J Nucl Cardiol. 25(3):999-1008, 2018 06. |
Observational-Dx |
408 patients |
The aim of this study was to establish different degrees of mechanical dyssynchrony according to validated cut-off (CO) values of myocardial perfusion gated SPECT phase analysis parameters (SD, standard deviation; B, bandwidth; S, skewness; K, kurtosis). |
Agreement of CO values (SD > 18.4°; B > 51°; S = 3.2; K = 9.3) used to discriminate between normal subjects and patients was strong (c-statistic 0.9; 95% CI 0.98-0.99). Four degrees of dyssynchrony were found according to the number of abnormal phase parameters. All patients with mechanical and electrical criteria for cardiac resynchronization therapy (CCRT) (n: 82) had Grade 2 to 4 (two to four abnormal phase parameters). Agreement of CO values (SD > 40.2°; B > 132°; S = 2.3; K = 4.6) used to discriminate between patients with and without CCRT was strong (c-statistic 0.8; 95% CI 0.79-0.87) but 12% of patients with CCRT did not have any of these abnormal phase parameters. |
2 |
| 86. Chen Z, Bai W, Li C, et al. Left Atrial Appendage Parameters Assessed by Real-Time Three-Dimensional Transesophageal Echocardiography Predict Thromboembolic Risk in Patients With Nonvalvular Atrial Fibrillation. J Ultrasound Med. 36(6):1119-1128, 2017 Jun. |
Observational-Dx |
444 patients |
To determine the association between the left atrial appendage(LAA) real-time 3D transesophageal echocardiography (RT3D-TEE) parameters and the incidence of nonvalvular AF (NVAF)-related thromboembolism, as well as the potential of these parameters to predict thromboembolism. |
The orifice size, orifice area, and end-diastolic volumes of the LAA were increased with an increasing CHA2 DS2 -VASc risk score in the NVAF patients, whereas the emptying rate was decreased. The NVAF patients with LAA thrombus exhibited a significantly increased end-diastolic volume (7.39 ± 3.47 versus 5.21 ± 2.59 mL, P = .003) and higher prevalence of the cauliflower shaped LAA (64.3% versus 25%, P = .004) compared with those without thrombus. Logistic regression indicated that the LAA end-diastolic volume (P = .002; odds ratio 1.556; 95% confidence interval 1.176-2.057) and cauliflower shape (P = .001; odds ratio, 10.177; 95% confidence interval, 2.458-42.140) were independent predictors of thromboembolic events in patients with NVAF following adjustment for the CHA2 DS2 -VASc score. |
3 |
| 87. Akhabue E, Seok Park C, Pinney S, et al. Usefulness of Speckle Tracking Strain Echocardiography for Assessment of Risk of Ventricular Arrhythmias After Placement of a Left Ventricular Assist Device. Am J Cardiol. 120(9):1578-1583, 2017 Nov 01. |
Observational-Dx |
98 patients |
To investigate whether left ventricle circumferential strain (LVCS) as assessed by speckle tracking strain echocardiography could predict postoperative ventricle arrhythmias (VAs) after left ventricle assist devices (LVAD) implantation. |
We hypothesized that global left ventricular circumferential strain (LVCS), a marker of transmural impairment in myocardial function, would independently predict postoperative VA in patients who underwent LVAD implantation. We studied 98 consecutivepatients (57 ± 11 years, 83% men) who underwent HeartMate II axial flow LVAD placement. Speckle tracking-derived global circumferential strain was assessed from mid-left ventricular short-axis images. The primary composite end point was defined as any ventricular tachycardia that required intervention (anti-arrhythmic medication, cardioversion, implantable cardioverter defibrillator placement, implantable cardioverter defibrillator shock) or any ventricular fibrillation. A total of 33 patients (34%) experienced the primary end point (median follow-up: 7 months). Reduced LVCS was statistically significantly related to the primary end point (hazard ratio 1.77, 95% confidence interval 1.09 to 2.87 per 1 standard deviation reduction in LVCS, p = 0.02). LVCS above a cut-off value of -9.7% was associated with significantly reduced arrhythmia-free survival (log-rank p = 0.001). |
3 |
| 88. Kim M, Kim J, Lee JH, et al. Impact of Improved Left Ventricular Systolic Function on the Recurrence of Ventricular Arrhythmia in Heart Failure Patients With an Implantable Cardioverter-Defibrillator. J Cardiovasc Electrophysiol. 27(10):1191-1198, 2016 10. |
Observational-Dx |
93 patients |
To evaluate the incidence and predictors of improvement in left ventricular (LV) function and determine the impact of improved left ventricular ejection fraction (LVEF) on the occurrence of appropriate implantable cardioverter-defibrillator (ICD) therapy in patients with reduced LVEF and ICD for secondary prevention. |
The mean patient age was 56.9 ± 13.1 years, the median time of repeat LVEF assessment was 19.7 (10.4-29.7) months, and the mean LVEF was 30.6 ± 8.5%. Of the patients, 58 (62.4%) had nonischemic cardiomyopathy. LV function improved after ICD implantation in 24 (25.8%) of 93 patients. Multivariable logistic regression revealed a short duration from the time of diagnosis of heart failure to ICD implantation and the presence of ventricular fibrillation as significant predictors of improved LV function. The incidence of appropriate ICD therapy was lower in the patients with than in those without LV function improvement. The composite endpoint of all-cause mortality or heart transplant was lower in the patients with than in those without LV function improvement. |
3 |
| 89. Delgado-Montero A, Tayal B, Goda A, et al. Additive Prognostic Value of Echocardiographic Global Longitudinal and Global Circumferential Strain to Electrocardiographic Criteria in Patients With Heart Failure Undergoing Cardiac Resynchronization Therapy. Circ Cardiovasc Imaging. 9(6), 2016 Jun. |
Observational-Dx |
205 patients |
To determine the prognostic value of baseline global longitudinal strain (GLS) and global circumferential strain (GCS) with respect to long-term clinical outcomes after cardiac resynchronization therapy (CRT); to assess prognostic value of GLS and GCS in patient subgroups of ischemic cardiomyopathy versus nonischemic cardiomyopathy; and to determine the additive prognostic value of GLS and GCS in patients with intermediate electrocardiographic (ECG) criteria, where there is high interest in predicting CRT response. |
We studied 205 patients with heart failure referred for cardiac resynchronization therapy with QRS =120 ms and ejection fraction =35%. We tested the hypothesis that contractile function using speckle-tracking echocardiographic global circumferential strain (GCS) from 2 short-axis views and global longitudinal strain (GLS) from 3 apical views add prognostic value to electrocardiographic criteria. There were 112 patients (55%) with GLS >-9% and 136 patients (66%) with GCS >-9%. During 4 years, 81 patients reached the combined primary end point (death, circulatory support, or transplant) and 120 reached the secondary end point (heart failure hospitalization or death). Both GLS >-9% and GCS >-9% were associated with increased risk of unfavorable events as follows: for the primary end point (hazard ratio=2.91; 95% confidence interval, 1.88-4.49; P<0.001) and (hazard ratio=3.73; 95% confidence interval, 2.39-5.82; P<0.001) for the secondary end point (hazard ratio=2.10; 95% confidence interval, 1.45-3.05; P<0.001) and (hazard ratio=3.25; 95% confidence interval, 2.23-4.75; P<0.001). In a prespecified subgroup of 120 patients with QRS 120 to 149 ms or non-left bundle branch block, significant associations of baseline GLS and GCS and outcomes remained: P=0.014 and P=0.002 for the primary end point and P=0.049 and P=0.001 for the secondary end point. Global strain measures had additive prognostic value to routine clinical or electrocardiographic parameters (P<0.001). |
2 |
| 90. Hasselberg NE, Haugaa KH, Bernard A, et al. Left ventricular markers of mortality and ventricular arrhythmias in heart failure patients with cardiac resynchronization therapy. Eur Heart J Cardiovasc Imaging. 17(3):343-50, 2016 Mar. |
Observational-Dx |
170 patients |
To explore for echocardiographic predictors of ventricular arrhythmias and death, heart transplantation, or left ventricular assist device (LVAD) implantation in heart failure patients eligible for cardiac resynchronization therapy (CRT). |
We prospectively included 170 heart failure patients (66 ± 10 years, New York Heart Association class 2.8 ± 0.5, 48% ischaemic cardiomyopathy) and recorded ventricular arrhythmias and fatal end point defined as death, heart transplantation, or left ventricular assist device implantation during 2 years. Two-dimensional echocardiography was performed before and 6 months after CRT implantation. CRT response was defined as =15% reduction in end-systolic volume at 6 months. Speckle-tracking technique was performed to assess longitudinal and circumferential left ventricular function, defined as global longitudinal (GLS) and circumferential strain (GCS), and to assess mechanical dyssynchrony, defined as mechanical dispersion. GLS before CRT was a predictor of fatal end point independently of CRT response [hazard ratio, HR 1.14 (1.02-1.27), P = 0.02]. Patients with GLS better than -8.3% showed event-free survival benefit (log rank, P < 0.001). Mechanical dispersion at 6 months was an independent predictor of ventricular arrhythmias [HR 1.20 (1.06-1.35), P = 0.005]. CRT responders (59%) had improvement of both GLS and GCS. |
2 |
| 91. Barros MV, Leren IS, Edvardsen T, et al. Mechanical Dispersion Assessed by Strain Echocardiography Is Associated with Malignant Arrhythmias in Chagas Cardiomyopathy. J Am Soc Echocardiogr. 29(4):368-74, 2016 Apr. |
Observational-Dx |
62 patients |
To test the hypothesis that global longitudinal strain (GLS) and mechanical dispersion (MD) may be associated with malignant ventricular arrhythmias in patients with Chagas disease (ChD). |
Chamber dimensions, ejection fraction, and diastolic function showed no significant differences between patients with and those without ICDs. GLS was reduced in patients with ChD with ICDs compared with those without (P = .02). By receiver operating characteristic curve analyses, GLS identified patients with ChD with ICDs with sensitivity of 67% and specificity of 69%. MD was more pronounced in patients with ChD with ICDs compared with those without (P < .001), with a C statistic of 0.83 (95% CI, 0.71-0.91). MD > 57 msec detected ICD presence with sensitivity of 79% and specificity of 71% and was superior to GLS and ejection fraction (P < .05). In multivariate analysis, New York Heart Association functional class (odds ratio, 3.02; 95% CI, 1.09-8.39; P = .03), MD (odds ratio, 1.11; 95% CI, 1.04-1.19; P = .001), and GLS (odds ratio, 0.72; 95% CI, 0.54-0.96; P = .026) were significant and independently associated with malignant arrhythmic events. |
3 |
| 92. Barutcu A, Bekler A, Temiz A, et al. Assessment of the effects of frequent ventricular extrasystoles on the left ventricle using speckle tracking echocardiography in apparently normal hearts. Anatol J Cardiol. 16(1):48-54, 2016 Jan. |
Observational-Dx |
100 patients |
To use speckle tracking echocardiography (STE) for early detection of left ventricular (LV) dysfunction in patients with apparently normal hearts who have frequent ventricular extrasystoles (VESs) . |
Fifty-five patients with frequent VESs (mean age 47 years, range 22-60 years; 42.2% male) and 45 control subjects (mean age 46 years, range 22–60 years; 37.8% male) were enrolled in the study. Global LV longitudinal strain (GLS) was decreased in patients with frequent VESs (-18.41±3.37 and -21.82±2.43; p<0.001). In addition, global LV circumferential strain was decreased in patients with frequent VESs (-16.83±6.06, -20.51±6.02; p<0.001). The frequency and exposure time of VESs were negatively correlated with GLS (r=-0.398, p<0.001; r=-0.191, p=0.001, respectively). |
2 |
| 93. Gorcsan J 3rd, Sogaard P, Bax JJ, et al. Association of persistent or worsened echocardiographic dyssynchrony with unfavourable clinical outcomes in heart failure patients with narrow QRS width: a subgroup analysis of the EchoCRT trial. Eur Heart J. 37(1):49-59, 2016 Jan 01. |
Experimental-Tx |
614 patients |
To test for the potential for an interaction of cardiac resynchronization therapy (CRT) treatment on persistent or worsening dyssynchrony and clinical outcomes. |
We studied 614 EchoCRT patients with baseline and 6-month echocardiograms. Baseline dyssynchrony required for study inclusion was either tissue Doppler imaging longitudinal velocity delay =80 ms or speckle-tracking radial strain delay =130 ms. Persistent dyssynchrony at 6 months was observed similarly in both groups (77% in CRT-On; 76% in CRT-Off). Persistent dyssynchrony was associated with a significantly higher primary end point of death or HF hospitalization (HR = 1.54, 95% CI 1.03-2.30, P = 0.03), and in particular secondary endpoint of HF hospitalization (HR = 1.66, 95% CI 1.07-2.57, P = 0.02). HF hospitalizations were also associated with worsening longitudinal dyssynchrony (HR = 1.45, 95% CI 1.02-2.05, P = 0.037), and worsening radial dyssynchrony (HR = 1.81, 95% CI 1.16-2.81, P = 0.008). Associations of persistent or worsening dyssynchrony with outcomes were similar in CRT-Off and CRT-On groups. |
1 |
| 94. Akyel A, Yayla KG, Erat M, et al. Relationship between Epicardial Adipose Tissue Thickness and Atrial Electromechanical Delay in Hypertensive Patients. Echocardiography. 32(10):1498-503, 2015 Oct. |
Observational-Dx |
96 patients |
To investigate the relationship between epicardial adipose tissue (EAT) and atrial electromechanical delay (AEMD). |
The EAT thickness (3.7 ± 1.2 vs. 5.0 ± 1.6, P < 0.001) and LAVI (20.4 ± 2.9 vs. 24.5 ± 6.7, P = 0.001) were significantly higher in group 2. There was a significant positive correlation between AEMD parameters with EAT and LAVI. After multivariate logistic regression analysis, EAT (OR: 1.505; 95% CI: 1.056–2.143, P = 0.023) and LAVI (OR: 1.140; 95% CI: 1.018–1.277, P = 0.023) were found as independent predictors of prolonged AEMD. |
3 |
| 95. Canpolat U, Aytemir K, Yorgun H, Asil S, Dural M, Ozer N. The Impact of Echocardiographic Epicardial Fat Thickness on Outcomes of Cryoballoon-Based Atrial Fibrillation Ablation. Echocardiography. 33(6):821-9, 2016 Jun. |
Experimental-Dx |
234 patients |
To investigate the predictive value of echocardiographically measured epicardial fat thickness (EFT) on atrial fibrillation (AF) recurrence after cryoballoon-based catheter ablation. |
At a median follow-up of 20 (IQR: 13-24) months, 45 patients (19.2%) had developed AF recurrence. EFT thickness was significantly higher among patients with AF recurrence (7.79 ± 2.0 vs. 5.79 ± 1.38, P < 0.001) and was positively correlated with hs-CRP levels (r = 0.381, P < 0.001). Multivariate regression analysis showed EFT (HR: 1.36, 95% CI: 1.10–1.66, P = 0.004), left atrial diameter, and early AF recurrence were independent predictors of AF recurrence. Using a cutoff level of 6.92, preprocedural EFT predicted AF recurrence during follow-up with a sensitivity of 71.1% and specificity of 78.3% (AUC: 0.79; 95% CI: 0.71–0.87, P < 0.001). |
2 |
| 96. Dereli S, Bayramoglu A, Yontar OC, Cersit S, Gursoy MO. Epicardial fat thickness: A new predictor of successful electrical cardioversion and atrial fibrillation recurrence. Echocardiography. 35(12):1926-1931, 2018 12. |
Observational-Dx |
262 patients |
To investigate the procedural success rate of electrical cardioversion (ECV) and potential predictors of treatment failure in patients with nonvalvular persistent atrial fibrillation (AF). |
The success rate of ECV was 85% and the recurrence rate was 35% during the 6-month follow-up period. The mean EFT thickness was 8.67 ± 1.2 mm in the persistent AF group with unsuccessful ECV and 6.81 ± 0.8 in the patients in whom sinus rhythm (SR) was maintained, the EFT was significantly thicker in the AF group (P = 0.001). EFT (P = 0.001) and left ventricular end-diastolic diameters (LVEDD) (P = 0.001) were significantly different between those who had maintained SR and those with recurrent AF during the 6-month follow-up period after ECV. In the multiple logistic regression analysis, LVEDD (odds ratio [OR]: 1.320 (1.023–1.703 95% confidence interval [CI]), P = 0.032)] and EFT [OR: 3.029 (1.013–9.055 95% CI), P = 0.047)] were identified as independent predictors of successful ECV. |
1 |
| 97. Kanat S, Duran Karaduman B, Tutuncu A, Tenekecioglu E, Mutluer FO, Akar Bayram N. Effect of Echocardiographic Epicardial Adipose Tissue Thickness on Success Rates of Premature Ventricular Contraction Ablation. Balkan Med. J.. 36(6):324-330, 2019 10 28. |
Observational-Dx |
106 patients |
To assess the relationship between epicardial adipose tissue thickness and success rates of premature ventricular contraction ablation. |
Successful premature ventricular contraction ablation was achieved in 87 (82.1%) patients. Epicardial adipose tissue thickness was significantly higher in patients with unsuccessful ablation (p<0.001). Procedure time, total fluoroscopy time, and radiofrequency ablation time were statistically higher in the unsuccessful group (p<0.001). Stepwise multivariate logistic regression analysis showed that epicardial adipose tissue thickness and pseudo-delta wave time were independently associated with procedural success (both p values <0.001). In the receiver-operating curve analysis, epicardial adipose tissue thickness was found to be an important predictor for procedural success (area under the receiver-operating characteristic curve= 0.85, p=0.001), with a cutoff value of 7.7 mm, a sensitivity of 92%, and a specificity of 68%. |
3 |
| 98. Kang MK, Joung B, Shim CY, et al. Post-operative left atrial volume index is a predictor of the occurrence of permanent atrial fibrillation after mitral valve surgery in patients who undergo mitral valve surgery. Cardiovasc. ultrasound. 16(1):5, 2018 Mar 09. |
Review/Other-Dx |
442 patients (190 males) |
To investigate the factors determining the occurrence of permanent atrial fibrillation (AF) after mitral valve (MV) surgery in patients with preoperative sinus rhythm who underwent MV surgery. |
Permanent post-operative AF occurred in 81 (18%) patients even after successful MV surgery and preoperative sinus rhythm. It was more common in rheumatic etiology, a presence of mitral stenosis, lower pre- and post-operative left ventricular ejection fraction, higher post-operative mean diastolic pressure gradient across mitral prosthesis, larger post-operative left atrial volume index (LAVI) and lesser degrees of reduction in LAVI after surgery. In multiple regression analysis, post-operative LAVI was found to be an independent predictor for occurrence of AF. Post-operative LAVI > 39 ml/m2 was the cut-off value for best prediction of new onset permanent AF (sensitivity: 79%, AUC: 0.762, SE: 0.051, p < 0.001). |
4 |
| 99. Lazaros G, Antonopoulos AS, Imazio M, et al. Clinical significance of pleural effusions and association with outcome in patients hospitalized with a first episode of acute pericarditis. Internal & Emergency Medicine. 14(5):745-751, 2019 08.Intern. emerg. medicine. 14(5):745-751, 2019 08. |
Observational-Dx |
177 patients |
To identify predictive factors for pleural effusions (PLEs) and their association with the short- and long-term prognosis of patients with acute pericarditis. |
We enrolled 177 patients hospitalized with a first episode of acute pericarditis. In all cases an extensive clinical,biochemical, and diagnostic work-up to detect PLEs and establish etiological diagnosis was performed. All patients includedwere prospectively followed for a maximum of 18 months (median 12, range 1–18) and complications were recorded. PLEswere detected in n = 94 cases (53.1% of the cohort; bilateral 53.2%, left-sided 28.7%, right-sided 18.1%) and were stronglyassociated with c-reactive protein (CRP) levels at admission (rho = 0.328, p < 0.001). In multivariate logistic regression,independent predictors for PLEs were female gender (OR = 2.46, 95% CI 1.03–5.83), age (per 1-year increment OR = 1.030,95% CI 1.005–1.056), CRP levels (per 1 mg/L increment OR = 1.012, 95% CI 1.006–1.019) and size of pericardial effusion(per 1 cm increment, OR = 1.899, 95% CI 1.228–2.935). Bilateral PLEs were associated with increased risk for in-hospitalcardiac tamponade (OR = 7.52, 95% CI 2.16–26.21). There was no association of PLEs with new onset atrial fibrillation orpericarditis recurrence during long-term follow-up (?2 = 0.003, p = 0.958). We conclude that PLEs are common in patientshospitalized with a first episode of acute pericarditis. They are related to the intensity of inflammatory reaction, and theyshould not be considered necessarily as a marker of secondary etiology. Bilateral PLEs are associated with increased risk ofin-hospital cardiac tamponade, but do not affect the long-term risk of pericarditis recurrence. |
2 |
| 100. Chetrit M, Xu B, Verma BR, Klein AL. Multimodality Imaging for the Assessment of Pericardial Diseases. [Review]. Curr Cardiol Rep. 21(5):41, 2019 04 16. |
Review/Other-Dx |
N/A |
To highlight the key role of the various imaging modalities for the diagnosis and management of the spectrum of pericardial diseases. |
Cardiac imaging has become an integral part of the diagnostic process often beginning with echocardiography and supported by advanced imaging modalities including computed tomography, magnetic resonance imaging, and positive emission tomography. These modalities go beyond the simple identification of the pericardium, to identifying increased pericardial thickness, active pericardial edema and inflammation, and its effect on cardiac hemodynamics. Multimodality imaging has significantly facilitated the diagnosis and long-term management of patients with pericardial diseases. The role of these imaging modalities in overall prognosis and prevention remains to be investigated. |
4 |
| 101. Maleszewski JJ, Anavekar NS. Neoplastic Pericardial Disease. [Review]. Cardiol Clin. 35(4):589-600, 2017 Nov. |
Review/Other-Dx |
N/A |
To summarize the radiologic and pathologic findings of the most commonly encountered of these entities. |
No results stated in the abstract. |
4 |
| 102. Xu B, Kwon DH, Klein AL. Imaging of the Pericardium: A Multimodality Cardiovascular Imaging Update. [Review]. Cardiol Clin. 35(4):491-503, 2017 Nov. |
Review/Other-Dx |
N/A |
To provide a clinical update on multimodality cardiovascular imaging of the pericardium, incorporating echocardiography, multidetector computed tomography, and cardiac magnetic resonance imaging, focusing on guiding clinicians about when each cardiac imaging modality should be used in each relevant pericardial condition. |
No results stated in the abstract. |
4 |
| 103. Lazaros G, Antonopoulos AS, Oikonomou EK, et al. Prognostic implications of epicardial fat volume quantification in acute pericarditis. Eur J Clin Invest. 47(2):129-136, 2017 Feb. |
Observational-Dx |
50 patients |
To investigate the value of quantifying epicardial fat volume (EFV) as a biomarker in patients presenting with a first-episode acute pericarditis. |
Patients presenting with chest pain had lower EFV vs. patients without chest pain (167·2 ± 21·7 vs. 105·1 ± 11·1 cm3 , respectively, P < 0·01); EFV (but not body mass index) was strongly positively correlated with pericardial effusion size (r = 0·395, P = 0·007) and associated with in-hospital AF. At follow-up, patients that reached the composite clinical endpoint had lower EFV (P < 0·05). After adjustment for age, EFV was associated with lower odds ratio for the composite clinical endpoint point of poor response to NSAIDs or the development of constrictive, recurrent or incessant pericarditis during follow-up (per 20 cm3 increase in EFV: OR = 0·802 [0·656-0·981], P < 0·05). |
2 |
| 104. Chang SA, Choi JY, Kim EK, et al. [(18)F]Fluorodeoxyglucose PET/CT Predicts Response to Steroid Therapy in Constrictive Pericarditis. J Am Coll Cardiol 2017;69:750-52. |
Observational-Dx |
16 patients |
To determine if [18F]FDG PET/CT could predict the reversibility of constrictive pericarditis (CP) with steroid treatment to identify transient CP. |
No abstract available. |
3 |
| 105. Kim MS, Kim EK, Choi JY, Oh JK, Chang SA. Clinical Utility of [18F]FDG-PET /CT in Pericardial Disease. [Review]. Curr Cardiol Rep. 21(9):107, 2019 08 02. |
Review/Other-Dx |
N/A |
To review the clinical utility of [18F]-2-deoxy-2-fluoro-D-glucose positron emission tomography/computed tomography ([18F]FDG-PET/CT) in the diagnosis and treatment of pericardial disease. |
[18F]FDG-PET/CT can visualize the hypermetabolic tissues of both malignancy and inflammation. Distribution of [18F]FDG-PET/CT uptake can provide information for neoplastic disease. If malignancy is ruled out, high uptake of pericardium is associated with active inflammation of the pericardium, and thus response to anti-inflammatory agents can also be predicted with [18F]FDG-PET/CT imaging. |
4 |
| 106. Bolen MA, Rajiah P, Kusunose K, et al. Cardiac MR imaging in constrictive pericarditis: multiparametric assessment in patients with surgically proven constriction. Int J Cardiovasc Imaging 2015;31:859-66. |
Observational-Dx |
42 patients (3 female, 39 male) |
To assess the utility of cardiac magnetic resonance (MR) imaging in the diagnosis of constrictive pericarditis (CP). |
A total of 42 consecutive patients (mean age, 55 ± 16 years; 3 women, 39 men) with CP treated with pericardiectomy who had undergone cardiac MR before surgery were evaluated retrospectively. An additional 21 patients were evaluated as a control group; of these, 10 consecutive patients received cardiac MR for reasons other than suspected pericardial disease, and 11 consecutive patients had a history of pericarditis but no clinical suspicion of pericardial constriction. MR imaging parameters were analyzed independently and with a decision tree algorithm for usefulness in the prediction of CP. Catheterization data were also reviewed when available. A model combining pericardial thickness and relative interventricular septal (IVS) excursion provided the best overall performance in prediction of CP (C statistic, 0.98, 100% sensitivity, 90% specificity). Several individual parameters also showed strong predictive value in the assessment of constriction, including relative IVS excursion (sensitivity, 93%; specificity, 95%), pericardial thickness (sensitivity, 83%; specificity, 100%), qualitative assessment of pathologic coupling (sensitivity, 88%; specificity, 100%), diastolic IVS bounce (sensitivity, 90%; specificity, 85%), left ventricle area change (sensitivity, 86%; specificity, 100%), and eccentricity index (sensitivity, 86%; specificity, 90%; all P < 0.001). Strong agreement was observed between catheterization and surgical findings of constriction (97%). Cardiac MR provides robust quantitative and qualitative analysis for the diagnosis of CP. |
2 |
| 107. Cremer PC, Kumar A, Kontzias A, et al. Complicated Pericarditis: Understanding Risk Factors and Pathophysiology to Inform Imaging and Treatment. [Review]. J Am Coll Cardiol. 68(21):2311-2328, 2016 11 29. |
Review/Other-Dx |
N/A |
To focus on the care of the minority of patients develop complicated pericarditis |
No results stated in the abstract. |
4 |
| 108. Alraies MC, AlJaroudi W, Yarmohammadi H, et al. Usefulness of cardiac magnetic resonance-guided management in patients with recurrent pericarditis. Am J Cardiol. 115(4):542-7, 2015 Feb 15. |
Observational-Dx |
507 patients |
To assess the utility of cardiac magnetic resonance imaging (CMR) in the management of recurrent pericarditis (RP) compared with standard therapy |
A total of 507 consecutive patients with RP after the first attack, all of whom were treated with colchicine and nonsteroidal anti-inflammatory drugs as first-line therapy, were retrospectively evaluated. There were 257 patients who were treated with medications and received CMR-guided therapy (group 1) and 250 patients who were treated with medications without CMR (group 2). The 2 groups had similar baseline characteristics and follow-up periods (17 ± 7.9 vs 16.3 ± 16.2 months, respectively, p = 0.97). CMR was used to assess the presence of pericardial inflammation, and on the basis of the results, the clinician made changes to the steroid dose dictated by the severity of inflammation. There was no significant difference in the incidence of constrictive pericarditis, pericardial window, or pericardiectomy between groups during the follow-up. However, group 2 patients had a larger number of steroid pulse therapies (defined as prednisone 50 mg/day orally for 10 days and tapering to none over 4 weeks), and higher overall total milligrams of steroid administered compared with the CMR group (p = 0.003 and p = 0.001, respectively). Recurrence and pericardiocentesis rates were lower in group 1 (p <0.0001). |
2 |
| 109. Kumar A, Sato K, Yzeiraj E, et al. Quantitative Pericardial Delayed Hyperenhancement Informs Clinical Course in Recurrent Pericarditis. JACC Cardiovasc Imaging. 10(11):1337-1346, 2017 11. |
Observational-Dx |
159 patients |
To evaluate the prognostic value of quantitative assessment of pericardial delayed hyperenhancement (DHE) among patients with recurrent pericarditis (RP). |
The mean age of our patients was 46 ± 14 years, and 52% were women. During a median follow-up period of 23 months (interquartile range: 15 to 34 months), 32 (20%) patients achieved clinical remission. In the multivariable Cox proportional hazards model, lower quantitative pericardial DHE (hazard ratio: 0.77; 95% confidence interval: 0.64 to 0.93; p = 0.008) was independently associated with clinical remission. When added to background clinical and laboratory variables, quantitative pericardial DHE had incremental prognostic value over baseline clinical and laboratory variables (integrated discrimination improvement: 8%; net reclassification improvement: 36%). Furthermore, patients with a higher quantitative DHE had shorter time to subsequent recurrence (p = 0.012) and had a higher recurrence rate at 6 months (p = 0.026). |
3 |
| 110. Zhou W, Srichai MB. Multi-modality Imaging Assessment of Pericardial Masses. [Review]. Curr Cardiol Rep. 19(4):32, 2017 04. |
Review/Other-Dx |
N/A |
To discuss the application of various imaging modalities including their advantages and disadvantages in the evaluation of the most common pericardial masses with a focus on pericardial cysts, tumors, and hematomas. |
No results stated in the abstract. |
4 |
| 111. Ha JW, Andersen OS, Smiseth OA. Diastolic Stress Test: Invasive and Noninvasive Testing. [Review]. JACC Cardiovasc Imaging. 13(1 Pt 2):272-282, 2020 01. |
Review/Other-Dx |
N/A |
To review and focus on the clinical need for diastolic stress testing, both invasively and noninvasively. |
Many patients have Doppler echocardiographic evidence of impaired diastolic function but do not have any symptoms of heart failure at rest. In many of these patients, symptoms of diastolic dysfunction occur only during exercise, as left ventricular filling pressure is normal at rest, but increases with exercise. This implies that filling pressures should also be measured during exercise. The diastolic stress test refers to the evaluation of diastolic function, either invasively or noninvasively, during exercise. |
4 |
| 112. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: https://www.acr.org/-/media/ACR/Files/Appropriateness-Criteria/RadiationDoseAssessmentIntro.pdf. |
Review/Other-Dx |
N/A |
To provide evidence-based guidelines on exposure of patients to ionizing radiation. |
No abstract available. |
4 |
