Cardiovascular Imaging: Opportunities and Challenges in Clinical Application - Part II

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

Deadline for manuscript submissions: closed (27 November 2023) | Viewed by 7439

Special Issue Editor


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Guest Editor
Department of Radiology, Division of Cardiology, NYU School of Medicine, NYU Langone Health Center for Biomedical Imaging, New York, NY 10016, USA
Interests: echocardiography; cardiovascular magnetic resonance imaging; cardiovascular computed tomography imaging; nuclear cardiology imaging; stress test with imaging; multimodality cardiovascular imaging; cardiomyopathy; coronary artery disease; microvascular disease; valvular heart disease
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Special Issue Information

Dear Colleagues,

At the end of the 2020, the first volume of the Special Issue “Cardiovascular Imaging: Opportunities and Challenges in Clinical Application” in JCM was released. We received many excellent papers, you can access the full text by the link below:

https://www.mdpi.com/journal/jcm/special_issues/Cardiovascular_Imaging_Application

Imaging has long been, and will continue to be, an integral part of clinical cardiovascular medicine. The depth of information that can be obtained from non-invasive cardiovascular imaging continues to expand. Increasing numbers of clinical decisions are being made without intervention given the various non-invasive cardiovascular imaging methods available. Each imaging modality assesses cardiovascular conditions from a particular perspective. The relatively new multimodality approach offers multiple perspectives and thus the possibility of a better understanding of disease status and processes.

This volume will collect manuscripts that discuss the role of all non-invasive cardiovascular imaging modalities in critical clinical decision making,as well as articles on recent advancements in non-invasive cardiovascular imaging. The imaging methods include, but are not limited to, echocardiography (TTE and TEE), cardiac magnetic resonance imaging (CMR), cardiovascular computed tomography imaging (CCT), nuclear cardiology, and stress test with imaging. We welcome the submission of research articles on multimodality approaches to non-invasive cardiovascular imaging, as well as review articles including meta-analytic approaches in non-invasive cardiovascular imaging.

Dr. Kana Fujikura
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • echocardiography
  • cardiovascular magnetic resonance imaging
  • cardiovascular computed tomography imaging
  • nuclear cardiology imaging
  • stress test with imaging
  • multimodality cardiovascular imaging
  • cardiomyopathy
  • coronary artery disease
  • microvascular disease
  • valvular heart disease

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Published Papers (5 papers)

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Editorial

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7 pages, 225 KiB  
Editorial
The Changing Complementary Role of Multimodality Imaging in Clinical Cardiology
by Gian Luigi Nicolosi
J. Clin. Med. 2022, 11(23), 7095; https://doi.org/10.3390/jcm11237095 - 30 Nov 2022
Viewed by 1094
Abstract
Over the past two decades, major technological developments and progress have been reached for all imaging modalities applied to clinical cardiology, from echocardiography to magnetic resonance, computed tomography, nuclear imaging, etc [...] Full article

Research

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12 pages, 1218 KiB  
Article
Downstream Imaging Studies Do Not Significantly Improve Outcome in Most Patients with Chest Pain Who Did Not Reach Their Target Heart Rate on a Stress ECHO Study
by Nativ Henkin, Ifat Karilker, Sergio L. Kobal, Rachel Golan, Aryeh Shalev, Shaul Atar and Yaakov Henkin
J. Clin. Med. 2023, 12(14), 4832; https://doi.org/10.3390/jcm12144832 - 22 Jul 2023
Viewed by 1068
Abstract
Echocardiographic stress tests are often used to evaluate patients who complain of chest pain. However, some patients fail to reach the target heart rate required for the test to be conclusive (usually defined as 85% of the predicted maximal heart rate based on [...] Read more.
Echocardiographic stress tests are often used to evaluate patients who complain of chest pain. However, some patients fail to reach the target heart rate required for the test to be conclusive (usually defined as 85% of the predicted maximal heart rate based on the patient’s age) and are often sent for additional imaging tests, such as myocardial perfusion imaging (MPI) or cardiac computed tomography angiography (CTA). Few studies have evaluated the effectiveness of these additional tests in patients who present with chest pain but did not meet the heart rate requirements for a stress test. The primary objective of the study was to evaluate the efficacy of additional imaging tests for patients who experience chest pain during daily activities but are unable to reach the target heart rate currently required for an echocardiographic stress test. The study group included 415 consecutive patients who underwent a stress echocardiogram, did not achieve their target heart rate, and did not demonstrate abnormal changes during the test. The control group consisted of 415 consecutive patients who did reach their target heart rate and demonstrated no signs of ischemia. Demographic and clinical data, medication use, imaging test results (MPI, CTA, and/or coronary catheterization) and documented cardiac events that occurred during 1 year of follow-up were obtained from the electronic medical records. Of the 415 patients in the study group, 73 (17.6%) were referred to another imaging test within 12 months. Of these 73 patients, 59 underwent MPI and 14 underwent cardiac CTA. In 12 of these patients (16.4%) the test was considered to be abnormal, but only 7 patients (1.7%) subsequently underwent a percutaneous intervention (PCI). In the control group, 28 (6.7%) patients were referred for another imaging test. Of these 28 patients, 14 underwent MPI and 14 underwent cardiac CTA. None of these tests were found to be abnormal, but two patients (0.5%) underwent a PCI (p = 0.2 between groups). There were no deaths during the study period and no patients underwent bypass surgery. The majority of the patients who underwent PCI had additional clinical risk factors (diabetes, hypertension, and/or known coronary artery disease), had taken a beta blocker within 24 h prior to the test, and/or did not reach a heart rate above 78% of their target heart rate. Our study suggests that in most patients with chest pain who do not show ischemic changes on a stress echocardiogram, additional imaging studies can be safely deferred, even if the required target heart rate was not reached. However, in patients with diabetes and/or known coronary disease, those who took a beta blocker 24 h prior to the test, or those who did not achieve a heart rate above 78% of the current target heart rate, additional imaging studies should be considered. Full article
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15 pages, 2111 KiB  
Article
Exploring the Potential of Artificial Intelligence in Pediatric Echocardiography—Preliminary Results from the First Pediatric Study Using AI Software Developed for Adults
by Corina Maria Vasile, Xavier Paul Bouteiller, Martina Avesani, Camille Velly, Camille Chan, Zakaria Jalal, Jean-Benoit Thambo and Xavier Iriart
J. Clin. Med. 2023, 12(9), 3209; https://doi.org/10.3390/jcm12093209 - 29 Apr 2023
Cited by 3 | Viewed by 1331
Abstract
(1) Background: Transthoracic echocardiography is the first-line non-invasive investigation for assessing pediatric patients’ cardiac anatomy, physiology, and hemodynamics, based on its accessibility and portability, but complete anatomic and hemodynamic assessment is time-consuming. (2) Aim: This study aimed to determine whether an automated software [...] Read more.
(1) Background: Transthoracic echocardiography is the first-line non-invasive investigation for assessing pediatric patients’ cardiac anatomy, physiology, and hemodynamics, based on its accessibility and portability, but complete anatomic and hemodynamic assessment is time-consuming. (2) Aim: This study aimed to determine whether an automated software developed for adults could be effectively used for the analysis of pediatric echocardiography studies without prior training. (3) Materials and Methods: The study was conducted at the University Hospital of Bordeaux between August and September 2022 and included 45 patients with normal or near normal heart architecture who underwent a 2D TTE. We performed Spearman correlation and Bland-Altman analysis. (4) Results: The mean age of our patients at the time of evaluation was 8.2 years ± 5.7, and the main reason for referral to our service was the presence of a heart murmur. Bland-Altman analysis showed good agreement between AI and the senior physician for two parameters (aortic annulus and E wave) regardless of the age of the children included in the study. A good agreement between AI and physicians was also achieved for two other features (STJ and EF) but only for patients older than 9 years. For other features, either a good agreement was found between physicians but not with the AI, or a poor agreement was established. In the first case, maybe proper training of the AI could improve the measurement, but in the latter case, for now, it seems unrealistic to expect to reach a satisfactory accuracy. (5) Conclusion: Based on this preliminary study on a small cohort group of pediatric patients, the AI soft originally developed for the adult population, had provided promising results in the evaluation of aortic annulus, STJ, and E wave. Full article
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13 pages, 980 KiB  
Article
Global Longitudinal Strain Is Associated with Mortality in Patients with Multiple Myeloma
by Zhu Cui, Francesco Castagna, Waqas Hanif, Samuel J. Apple, Lili Zhang, James M. Tauras, Ira Braunschweig, Gurbakhash Kaur, Murali Janakiram, Yanhua Wang, Yanan Fang, Juan C. Diaz, Carolina Hoyos, Jorge Marin, Patricia A. Pellikka, Jorge E. Romero, Mario J. Garcia, Amit K. Verma, Nishi Shah and Leandro Slipczuk
J. Clin. Med. 2023, 12(7), 2595; https://doi.org/10.3390/jcm12072595 - 30 Mar 2023
Cited by 1 | Viewed by 2481
Abstract
Patients with multiple myeloma (MM) are at a high risk for developing cardiovascular complications. Global longitudinal strain (GLS) can detect early functional impairment before structural abnormalities develop. It remains unknown if reduced GLS is associated with reduced survival in patients with MM. We [...] Read more.
Patients with multiple myeloma (MM) are at a high risk for developing cardiovascular complications. Global longitudinal strain (GLS) can detect early functional impairment before structural abnormalities develop. It remains unknown if reduced GLS is associated with reduced survival in patients with MM. We conducted a retrospective cohort analysis of patients diagnosed with MM between 1 January 2000 and 31 December 2017 at our institution. Patients with a 2D transthoracic echocardiogram completed within 1 year of MM diagnosis, left ventricular ejection fraction (LVEF) greater than 40%, and no history of myocardial infarction prior to MM diagnosis were included. GLS was measured using an artificial-intelligence-powered software (EchoGo Core), with reduced GLS defined as an absolute value of <18%. The primary outcome of interest was overall survival since myeloma diagnosis. Our cohort included 242 patients with a median follow up of 4.28 years. Fifty-two (21.5%) patients had reduced average GLS. Patients with reduced GLS were more likely to have an IVSd ≥ 1.2cm, E/E’ > 9.6, LVEF/GLS > 4.1, higher LV mass index, and low-voltage ECG. A Total of 126 (52.1%) deaths occurred during follow-up. Overall survival was lower among patients with reduced GLS (adjusted HR: 1.81, CI: 1.07–3.05). Full article
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Review

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12 pages, 1157 KiB  
Review
Current Insights and Novel Cardiovascular Magnetic Resonance-Based Techniques in the Prognosis of Non-Ischemic Dilated Cardiomyopathy
by Francesco Perone, Ilaria Dentamaro, Lucia La Mura, Angeliki Alifragki, Maria Marketou, Elena Cavarretta, Michael Papadakis and Emmanuel Androulakis
J. Clin. Med. 2024, 13(4), 1017; https://doi.org/10.3390/jcm13041017 - 9 Feb 2024
Viewed by 927
Abstract
Cardiac magnetic resonance (CMR) imaging has an important emerging role in the evaluation and management of patients with cardiomyopathies, especially in patients with dilated cardiomyopathy (DCM). It allows a non-invasive characterization of myocardial tissue, thus assisting early diagnosis and precise phenotyping of the [...] Read more.
Cardiac magnetic resonance (CMR) imaging has an important emerging role in the evaluation and management of patients with cardiomyopathies, especially in patients with dilated cardiomyopathy (DCM). It allows a non-invasive characterization of myocardial tissue, thus assisting early diagnosis and precise phenotyping of the different cardiomyopathies, which is an essential step for early and individualized treatment of patients. Using imaging techniques such as late gadolinium enhancement (LGE), standard and advanced quantification as well as quantitative mapping parameters, CMR-based tissue characterization is useful in the differential diagnosis of DCM and risk stratification. The purpose of this article is to review the utility of CMR in the diagnosis and management of idiopathic DCM, as well as risk prediction and prognosis based on standard and emerging CMR contrast and non-contrast techniques. This is consistent with current evidence and guidance moving beyond traditional prognostic markers such as ejection fraction. Full article
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