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Developments in multimodality imaging in coronary artery disease: back to the future

ESC Congress Report

•    Biomarkers are needed for diagnosis, prediction and assessment of treatment efficacy in cardiovascular diseases.
•    Imaging to prevent risk.
•    The potential of CT-FFR as more effective gatekeeper for invasive angiography and inappropriate revascularization.
•    Developments of hybrid imaging (PET-CT, PET-CMR 3D echo-CT, echo- fluoroscopy).
•    The economic burden of imaging.

Non-invasive Imaging: Echocardiography



There was an impressive discussion of the latest advances in multimodality imaging of coronary artery disease in this session.

It began with Professor Udo Sechtem (Stuttgart, DE) who provided an elegant overview of the role of imaging to predict risk, according to the 2013 ESC Stable Angina Guidelines. Using a case report to better illustrate the challenges in the clinical practice, Prof. Sechtem pointed out the indications and sources of evidence for the use of the different imaging modalities in risk stratification before and after revascularization. 

Doctor Francesca Pugliese (London, GB) then focused on the developments in anatomical imaging and its importance in risk stratification. The evidence for CT scan in risk assessment was thoroughly reviewed, considering calcium score, coronary arteries anatomy and atheroma volume, as well as the potential of CT-FFR as more effective gatekeeper for invasive angiography and inappropriate revascularization.

Doctor Oliver Gaemperli (Zurich, CH) was next with an exciting synopsis on the developments in anatomical-functional imaging. The data on the utility of functional evaluation of ischemia were reviewed, over and above the timeline and evidence on the developments of hybrid imaging, considering PET-CT, PET-CMR 3D echo-CT, echo- fluoroscopy.

Finally, Professor Leslee Shaw (Atlanta, US) comprehensively presented the economic burden of imaging.  In addition to an update on the utilization patterns for cardiovascular imaging across the world, the evidence of appropriateness for imaging tests use were reviewed. Moreover, cost effectiveness planes and the need for data to guide healthcare policies were methodically discussed.

Overall, it was a fantastic session that went beyond the current knowledge in multimodality imaging for coronary artery disease and provided the opportunity to consider future possibilities.

References


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Developments in multimodality imaging in coronary artery disease: back to the future

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.