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Cardiovascular Imaging


To celebrate the ESC's 2016 EuroEcho-Imaging meeting in Leipzig, this issue of the ESC Virtual Journal highlights some of the must read articles on Cardiovascular Imaging from across the ESC Journal Family. We have made these free to view in their full text formats, so that you can fully benefit from the science we publish.

Detection and prognostic value of pulmonary congestion by lung ultrasound in ambulatory heart failure patients
Elke Platz, Eldrin F. Lewis, Hajime Uno, Julie Peck, Emanuele Pivetta, Allison A. Merz, Dorothea Hempel, Christina Wilson, Sarah E. Frasure, Pardeep S. Jhund, Susan Cheng, Scott D. Solomon. Eur Heart J. 2016;37:1244

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Four-dimensional flow magnetic resonance imaging-based characterization of aortic morphometry and haemodynamics: impact of age, aortic diameter, and valve morphology
Julio Garcia, Alex J. Barker, Ian Murphy, Kelly Jarvis, Susanne Schnell, Jeremy D. Collins, James C. Carr, S. Chris Malaisrie, Michael Markl. EHJ CVI. 2016;17:877

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Simultaneous dual-isotope solid state detector SPECT for improved tracking of white blood cells in suspected endocarditis
Federico Caobelli, Tim Wollenweber, Udo Bavendiek, Christian Kühn, Christian Schütze, Lilli Geworski, James T. Thackeray, Johann Bauersachs, Axel Haverich, Frank M. Bengel. Eur Heart J 2016 July 28.

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Early hypo-attenuated leaflet thickening in balloon-expandable transcatheter aortic heart valves
Gregor Pache, Simon Schoechlin, Philipp Blanke, Stephan Dorfs, Nikolaus Jander, Chesnal D. Arepalli, Michael Gick, Heinz-Joachim Buettner, Jonathon Leipsic, Mathias Langer, Franz-Josef Neumann, Philipp Ruile. Eur Heart J 2016;37:2263-71

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Magnetic resonance imaging of infarct-induced canonical wingless/integrated (Wnt)/β-catenin/T-cell factor pathway activation, in vivo
Marco Matteucci, Valentina Casieri, Khatia Gabisonia, Giovanni Donato Aquaro, Silvia Agostini, Giuseppe Pollio, Daniela Diamanti, Marco Rossi, Massimiliano Travagli, Valentina Porcari, Fabio A. Recchia, Vincenzo Lionetti. Cardiovascular Research Sep 2016

In vivo assessment of cardiac metabolism and function in the abdominal aortic banding model of compensated cardiac hypertrophy
Anne-Marie L. Seymour, Lucia Giles, Vicky Ball, Jack J. Miller, Kieran Clarke, Carolyn A. Carr, Damian J. Tyler. 
Cardiovascular Research May 2015, 106 (2) 249-260

Plaque imaging to refine indications for emerging lipid-lowering drugs
Alkhalil M, Chai JT, Choudhury RP. Cardiovascular Research March 2015

Ultrasound of extravascular lung water: a new standard for pulmonary congestion
Eugenio Picano, Patricia A. Pellikka. European Heart Journal Jul 2016, 37 (27) 2097-2104

Detection and prognostic value of pulmonary congestion by lung ultrasound in ambulatory heart failure patients
Elke Platz, Eldrin F. Lewis, Hajime Uno, Julie Peck, Emanuele Pivetta, Allison A. Merz, Dorothea Hempel, Christina Wilson, Sarah E. Frasure, Pardeep S. Jhund, Susan Cheng, Scott D. Solomon.

Left ventricular systolic function assessment in secondary mitral regurgitation: left ventricular ejection fraction vs. speckle tracking global longitudinal strain
Kamperidis V, Marsan NA, Delgado V, Bax JJ.

Calcium imaging and selective computed tomography angiography in comparison to functional testing for suspected coronary artery disease: the multicentre, randomized CRESCENT trial
Marisa Lubbers, Admir Dedic, Adriaan Coenen, Tjebbe Galema, Jurgen Akkerhuis, Tobias Bruning, Boudewijn Krenning, Paul Musters, Mohamed Ouhlous, Ahno Liem, Andre Niezen, Miriam Hunink, Pim de Feijter, Koen Nieman.

Early hypo-attenuated leaflet thickening in balloon-expandable transcatheter aortic heart valves
Gregor Pache, Simon Schoechlin, Philipp Blanke, Stephan Dorfs, Nikolaus Jander, Chesnal D. Arepalli, Michael Gick, Heinz-Joachim Buettner, Jonathon Leipsic, Mathias Langer, Franz-Josef Neumann, Philipp Ruile

Coronary plaque quantification and fractional flow reserve by coronary computed tomography angiography identify ischaemia-causing lesions
Gaur S, Ovrehus KA, Dey D, et al.

Simultaneous dual-isotope solid state detector SPECT for improved tracking of white blood cells in suspected endocarditis.
Caobelli F, Wollenweber T, Bavendiek U, Kühn C, Schütze C, Geworski L, Thackeray JT, Bauersachs J, Haverich A, Bengel FM.

A clinical risk score of myocardial fibrosis predicts adverse outcomes in aortic stenosis
Calvin W.L. Chin, David Messika-Zeitoun, Anoop S.V. Shah, Guillaume Lefevre, Sophie Bailleul, Emily N.W. Yeung, Maria Koo, Saeed Mirsadraee, Tiffany Mathieu, Scott I. Semple, Nicholas L. Mills, Alec Vahanian, David E. Newby, Marc R. Dweck.

Prognostic significance of infarct core pathology revealed by quantitative non-contrast in comparison with contrast cardiac magnetic resonance imaging in reperfused ST-elevation myocardial infarction survivors
David Carrick, Caroline Haig, Sam Rauhalammi, Nadeem Ahmed, Ify Mordi, Margaret McEntegart, Mark C. Petrie, Hany Eteiba, Stuart Hood, Stuart Watkins, Mitchell Lindsay, Ahmed Mahrous, Ian Ford, Niko Tzemos, Naveed Sattar, Paul Welsh, Aleksandra Radjenovic, Keith G. Oldroyd, Colin Berry.

Relationship of visually assessed apical rocking and septal flash to response and long-term survival following cardiac resynchronization therapy (PREDICT-CRT)
Ivan Stankovic, Christian Prinz, Agnieszka Ciarka, Ana Maria Daraban, Martin Kotrc, Marit Aarones, Mariola Szulik, Stefan Winter, Ann Belmans, Aleksandar N. Neskovic, Tomasz Kukulski, Svend Aakhus, Rik Willems, Wolfgang Fehske, Martin Penicka, Lothar Faber, Jens-Uwe Voigt


Association of left bundle branch block with obstructive coronary artery disease on coronary CT angiography: a case–control study
Olivier F. Clerc, Mathias Possner, René Maire, Riccardo Liga, Tobias A. Fuchs, Julia Stehli, Jan Vontobel, Fran Mikulicic, Christoph Gräni, Dominik C. Benz, Thomas F. Lüscher, Bernhard A. Herzog, Ronny R. Buechel, Philipp A. Kaufmann, Oliver Gaemperli

Prognostic significance of 123I-mIBG SPECT myocardial imaging in heart failure: differences between patients with ischaemic and non-ischaemic heart failure
Ian P. Clements, Anita A. Kelkar, Ernest V. Garcia, Javed Butler, Ji Chen, Russell Folks, Arnold F. Jacobson

Four-dimensional flow magnetic resonance imaging-based characterization of aortic morphometry and haemodynamics: impact of age, aortic diameter, and valve morphology.
Garcia J1, Barker AJ1, Murphy I1, Jarvis K2, Schnell S1, Collins JD1, Carr JC1, Malaisrie SC3, Markl M4

T1 and T2 mapping for early diagnosis of dilated non-ischaemic cardiomyopathy in middle-aged patients and differentiation from normal physiological adaptation.
Mordi I, Carrick D, Bezerra H, Tzemos N.

Multicentre multi-device hybrid imaging study of coronary artery disease: results from the EValuation of INtegrated Cardiac Imaging for the Detection and Characterization of Ischaemic Heart Disease (EVINCI) hybrid imaging population
Riccardo Liga, Jan Vontobel, Daniele Rovai, Martina Marinelli, Chiara Caselli, Mikko Pietila, Anna Teresinska, Santiago Aguadé-Bruix, Maria Nazarena Pizzi, Giancarlo Todiere, Alessia Gimelli, Dante Chiappino, Paolo Marraccini, Stephen Schroeder, Tanja Drosch, Rosa Poddighe, Giancarlo Casolo, Constantinos Anagnostopoulos, Francesca Pugliese, Francois Rouzet, Dominique Le Guludec, Francesco Cappelli, Serafina Valente, Gian Franco Gensini, Camilla Zawaideh, Selene Capitanio, Gianmario Sambuceti, Fabio Marsico, Pasquale Perrone Filardi, Covadonga Fernández-Golfín, Luis M. Rincón, Frank P. Graner, Michiel A. de Graaf, Julia Stehli, Eliana Reyes, Sandy Nkomo, Maija

Targeting of vascular cell adhesion molecule-1 by 18F-labelled nanobodies for PET/CT imaging of inflamed atherosclerotic plaques.
Gezim Bala, Anneleen Blykers, Catarina Xavier, Benedicte Descamps, Alexis Broisat, Catherine Ghezzi, Daniel Fagret, Guy Van Camp, Vicky Caveliers, Christian Vanhove, Tony Lahoutte, Steven Droogmans, Bernard Cosyns, Nick Devoogdt, Sophie Hernot

Left atrial booster pump function is an independent predictor of subsequent life-threatening ventricular arrhythmias in non-ischaemic cardiomyopathy
Kazuaki Negishi, Tomoko Negishi, Omeed Zardkoohi, Elizabeth A. Ching, Nivedita Basu, Bruce L. Wilkoff, Zoran B. Popović, Thomas H. Marwick

Clinical and prognostic utility of cardiovascular magnetic resonance imaging in myeloma patients with suspected cardiac amyloidosis
Sabha Bhatti, Evan Watts, Fahd Syed, Srikanth Vallurupalli, Tarun Pandey, Kedar Jambekar, Wojciech Mazur, Abdul HakeemEur

Static and dynamic assessment of myocardial perfusion by computed tomography
Ibrahim Danad, Jackie Szymonifka, Joshua Schulman-Marcus, James K. Min

Computer-generated real-time digital holography: first time use in clinical medical imaging
Elchanan Bruckheimer, Carmel Rotschild, Tamir Dagan, Gabriel Amir, Aviad Kaufman, Shaul Gelman, Einat Birk

Right ventricular function in long-term adult survivors of childhood lymphoma and acute lymphoblastic leukaemia
JonR.Christiansen, Richard Massey, Håvard Dalen, Adriani Kanellopoulos, Hanne Hamre, Ellen Ruud, Cecilie E. Kiserud, Sophie D.Fosså, Svend Aakhus

Pulmonary hypertension is associated with worse survival in hypertrophic cardiomyopathy
Kevin C. Ong, Jeffrey B. Geske, Virginia B. Hebl, Rick A. Nishimura, Hartzell V. Schaff, Michael J. Ackerman, Kyle W. Klarich, Konstantinos C. Siontis, Thais Coutinho, Joseph A. Dearani, Steve R. Ommen, Bernard J. Gersh

Strain echocardiography is related to fibrosis and ventricular arrhythmias in hypertrophic cardiomyopathy
Trine F. Haland, Vibeke M. Almaas, Nina E. Hasselberg, Jørg Saberniak, Ida S. Leren, Einar Hopp, Thor Edvardsen, Kristina H.Haugaa

Strain echocardiographic assessment of left atrial function predicts recurrence of atrial fibrillation Sebastian I. Sarvari, Kristina H. Haugaa, Thomas M. Stokke, Hamza Z. Ansari, Ida S. Leren, Finn Hegbom, Otto A. Smiseth, ThorEdvardsen

Role of cardiac dyssynchrony and resynchronization therapy in functional mitral regurgitation
Marco Spartera, Maurizio Galderisi, Donato Mele, Matteo Cameli, Antonello D'Andrea, Andrea Rossi, Sergio Mondillo, GiuseppinaNovo, Roberta Esposito, Flavio D'Ascenzi, Roberta Montisci, Sabina Gallina, Alberto Margonato, Eustachio Agricola on behalf of the Echocardiographic Study Group of the Italian Society of Cardiology (SIC)

Prognostic significance of 123I-mIBG SPECT myocardial imaging in heart failure: differences between patients with ischaemic and non-ischaemic heart failure
Ian P. Clements, Anita A. Kelkar, Ernest V. Garcia, Javed Butler, Ji Chen, Russell Folks, Arnold F. Jacobson

Comparison of the standard and speckle tracking echocardiographic features of wild-type and mutated transthyretin cardiac amyloidoses
Masatoshi Minamisawa, Jun Koyama, Yoshiki Sekijima, Shu-ichi Ikeda, Ayako Kozuka, Soichiro Ebisawa, Takashi Miura, HirohikoMotoki, Ayako Okada, Atsushi Izawa, Uichi Ikeda

Left ventricular markers of mortality and ventricular arrhythmias in heart failure patients with cardiac resynchronization therapy
NinaE. Hasselberg, KristinaH. Haugaa, Anne Bernard, MargarethP. Ribe, Erik Kongsgaard, Erwan Donal, Thor Edvardsen

Relationship of visually assessed apical rocking and septal flash to response and long-term survival following cardiac resynchronization therapy (PREDICT-CRT)
Ivan Stankovic, Christian Prinz, Agnieszka Ciarka, AnaMaria Daraban, Martin Kotrc, Marit Aarones, Mariola Szulik, Stefan Winter, AnnBelmans, Aleksandar N. Neskovic, Tomasz Kukulski, Svend Aakhus, Rik Willems, Wolfgang Fehske, Martin Penicka, Lothar Faber, Jens-Uwe Voigt

Incremental value of quantitative CMR including parametric mapping for the diagnosis of acute myocarditis
Julian A. Luetkens, Rami Homsi, Alois M. Sprinkart, Jonas Doerner, Darius Dabir, Daniel L. Kuetting, Wolfgang Block, René Andrié, Christian Stehning, Rolf Fimmers, Juergen Gieseke, Daniel K. Thomas, Hans H. Schild, Claas P. Naehle

Three-dimensional echocardiography vs. computed tomography for transcatheter aortic valve replacement sizing
Beatriz Vaquerizo, Marco Spaziano, Juwairia Alali, Darren Mylote, Pascal Theriault-Lauzier, Rashed Alfagih, Giuseppe Martucci, JeanBuithieu, Nicolo Piazza

Correlation between left atrial appendage morphology and flow velocity in patients with paroxysmal atrial fibrillation
Keiko Fukushima, Noritoshi Fukushima, Ken Kato, Koichiro Ejima, Hiroki Sato, Kenji Fukushima, Chihiro Saito, Keiko Hayashi, KotaroArai, Tetsuyuki Manaka, Kyomi Ashihara, Morio Shoda, Nobuhisa Hagiwara

Comments on potential health effects of MRI-induced DNA lesions: quality is more important to consider than quantity You have accessM.A. Hill, P. O'Neill, W.G. McKenna Eur Heart J Cardiovasc Imaging (2016) 17 (11): 1230-1238

Editors Summaries

#1 The incremental diagnostic and prognostic value of the use of lung ultrasound was investigated in 195 heart failure patients with New York Heart Association (NYHA) class II-IV symptoms evaluated at the outpatient clinic. Of the 185 patients with adequate lung ultrasound data, 59 (32%) had ≥3 B-lines while only 17 (9%) had crackles on auscultation. Patients with higher number of Blines showed more severe heart failure symptoms and higher levels of NT-pro brain natriuretic peptide. In addition, patients with ≥3 B-lines had a four-fold higher risk of the primary endpoint (hospitalization for worsening of heart failure or all-cause mortality) at 6 months follow-up compared with patients without B-lines (adjusted hazard ratio [HR] 4.08; 95% confidence interval [CI] 1.95-8.54; p<0.001). The use of lung ultrasound provided incremental prognostic value over auscultation as shown by an incremental discrimination improvement of 6.4% for the primary endpoint. These results are promising and indicate that the use of lung ultrasound may help in the risk stratification of heart failure patients.  Back to top

#2 Four-dimensional flow CMR has provided insight into the relation between blood flow patterns in the ascending aorta and valve morphology. Using this technique, Garcia et al howed in 50 patients with bicuspid and 50 patients with tricuspid aortic valve and dilated aorta that patients with bicuspid aortic valve have higher peak flow jet velocity between the LV outflow tract and the sinotubular junction compared with patients with tricuspid valve, despite having comparable aortic dimensions. On multivariate analysis, age and peak flow jet velocity were the only significant correlates of maximal aortic dimensions.  Back to top

#3 Nuclear imaging techniques have provided important diagnostic information in patients with suspected endocarditis. Caobelli et al performed dual-isotope imaging in 34 patients with suspected endocarditis of native (n=12) or prosthetic (n=22) valves employing 111In-labeled white blood cells (WBC) and 99mTc for perfusion imaging on a dedicated cadmium-zinc-telluride (CZT) detector equipped SPECT (Figure 4). The high-energy resolution and sensitivity of novel CZT detector equipped camera enable simultaneous imaging of multiple isotopes enhancing the detection of molecular/cellular signals. Compared to standard 111In-WBC planar scintigraphy and SPECT, dual-isotope CZT imaging yielded superior image quality, improved reader confidence, and improved diagnostic accuracy based on surgery or Duke Criteria during follow-up, thus demonstrating feasibility and added diagnostic value.  Back to top

#4 Early hypo-attenuated leaflet thickening (HALT) of trans-catheter aortic valve implants (TAVI) has emerged as a new entity with uncertain prognostic and therapeutic implications. Pache and colleagues followed 156 TAVI patients with early routine coronary CTA (a median of 5 days post-TAVI with a balloonexpandable prosthesis) and found HALT in 16 (10.3%) patients (Figure 2). The occurrence of HALT was not associated with antiplatelet regimen or any of the baseline or procedural characteristics. HALT did not produce any symptoms but was associated with restrictive cusp motion and slightly higher transaortic mean pressure gradient (14.9±5.3 vs. 11.6±3.4 mmHg, p=0.026). Full anticoagulation restored normal cusp morphology and motion in almost all patients.  Back to top