Cardiovascular Computed Tomography in Clinical Practice

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

Deadline for manuscript submissions: closed (15 July 2023) | Viewed by 3967

Special Issue Editors

1. Department of Cardiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
2. Department of Cardiology, Haga Teaching Hospital, 2545 GM The Hague, The Netherlands
Interests: echocardiography; cardiac imaging; cardiac MRI; cardiac CT; cardiovascular imaging; transesophageal echocardiography; transthoracic echocardiography
Special Issues, Collections and Topics in MDPI journals
Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
Interests: coronary artery disease; coronary angiography; interventional cardiology; diagnostic imaging; PCI; PET imaging; cardiac catheterization; cardiac imaging; PET; cardiology
Department of Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Via C. Parea 4, 20138, Milan, Italy
Interests: cardiac CT; cardiac MRI; invasive coronary angiography; fractional flow reserve; angina; microcirculation
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Special Issue Information

Dear Colleagues,

During the last 20 years, cardiac computed tomography (CCT) has emerged as a technique that can provide crucial diagnostic and prognostic information in different clinical scenarios. CCT is now recommended by the international scientific society as a key tool in patients with acute and chronic coronary artery disease (CAD). CCT cannot only rule out obstructive CAD, but also provides valuable information about the atherosclerotic burden, plaque composition, and pericoronary fat inflammation. Moreover, recent developments such as the study of myocardial perfusion and fractional flow reserve have transformed CCT into a one-stop test able to offer all the anatomical and functional information to guide the management of patients with CAD.  CCT is also increasingly used in other clinical settings, such as congenital and structural heart disease. Finally, there is increasing evidence that CCT can be used for tissue characterization with remarkable clinical value, including the assessment of ischemic and non-ischemic cardiomyopathies.

This Special Issue aims to discuss the potential and challenges of new and established clinical applications of cardiovascular CT. 

Dr. Marco Guglielmo
Dr. Ibrahim Danad
Dr. Saima Mushtaq
Guest Editors

Manuscript Submission Information

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Keywords

  • cardiac computed tomography (CCT)
  • coronary artery disease
  • structural heart disease
  • congenital heart disease
  • atherosclerosis
  • plaque composition
  • pericoronary fat inflammation
  • ischemic and non-ischemic cardiomyopathies

Published Papers (3 papers)

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Research

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10 pages, 834 KiB  
Article
Morphology and Anatomical Classification of Pericardial Cavities: Oblique and Transverse Sinuses
by Marian Burysz, Jakub Batko, Wojciech Olejek, Michał Piotrowski, Radosław Litwinowicz, Artur Słomka, Mariusz Kowalewski, Piotr Suwalski, Krzysztof Bartuś and Daniel Rams
J. Clin. Med. 2023, 12(13), 4320; https://doi.org/10.3390/jcm12134320 - 27 Jun 2023
Cited by 1 | Viewed by 1005
Abstract
The pericardial sinuses are an important anatomical feature of the pericardial cavity, however, their clinical anatomy has not been thoroughly studied. In this study, we aim to provide the first classification of the oblique and transverse sinuses. We analyzed 121 computer tomography scans [...] Read more.
The pericardial sinuses are an important anatomical feature of the pericardial cavity, however, their clinical anatomy has not been thoroughly studied. In this study, we aim to provide the first classification of the oblique and transverse sinuses. We analyzed 121 computer tomography scans (46.3% female, age of 66 ± 12 years) of the pericardial cavity. The oblique sinuses were classified into four types: 1 (shallow with narrow entrance), 2 (shallow with wide entrance), 3 (deep with narrow entrance), and 4 (deep with wide entrance). The transverse sinuses were classified into four types: Concave, Wine-type, Straight, and Convex. The most common oblique sinus type was Type 1. The median oblique sinus volume was 8.4 (5.3) mL, the median entrance length was 33.0 (13.2) mm, and the depth was 38.2 (11.8) mm. The most common transverse sinus type was Concave. The median transverse sinus volume was 14.8 (6.5) mL, and the median length was 52.8 (17.7) mm. Our study provides an anatomical classification of the pericardial sinuses. The individual variability of the sinuses’ morphology highlights the importance of understanding the clinical topography of the sinuses, particularly for minimally invasive thoracic ablation procedures. Full article
(This article belongs to the Special Issue Cardiovascular Computed Tomography in Clinical Practice)
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Review

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13 pages, 5639 KiB  
Review
Cardiac Computed Tomography in Monitoring Revascularization
by Elisabetta Tonet, Veronica Amantea, Davide Lapolla, Paolo Assabbi, Alberto Boccadoro, Maria Letizia Berloni, Marco Micillo, Federico Marchini, Serena Chiarello, Alberto Cossu and Gianluca Campo
J. Clin. Med. 2023, 12(22), 7104; https://doi.org/10.3390/jcm12227104 - 15 Nov 2023
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Abstract
The use of coronary computed tomography angiography (CCTA) in the setting of stable coronary artery disease is highly recommended for low-risk patients. High-risk patients, such as symptomatic subjects with prior revascularization, are suggested to be investigated with noninvasive functional tests or invasive coronary [...] Read more.
The use of coronary computed tomography angiography (CCTA) in the setting of stable coronary artery disease is highly recommended for low-risk patients. High-risk patients, such as symptomatic subjects with prior revascularization, are suggested to be investigated with noninvasive functional tests or invasive coronary angiography. CCTA is not considered for these patients because of some well-known CCTA artifacts, such as blooming and motion artifacts. However, new technology has allowed us to obtain images with high spatial resolution, overcoming these well-known limitations of CCTA. Furthermore, the introduction of CT-derived fractional flow reserve and stress CT perfusion has made CCTA a comprehensive examination, including anatomical and functional assessments of coronary plaques. Additionally, CCTA allows for plaque characterization, which has become a cornerstone for the optimization of medical therapy, which is not possible with functional tests. Recent evidence has suggested that CCTA could be used with the aim of monitoring revascularization, both after coronary bypass grafts and percutaneous coronary intervention. With this background information, CCTA can also be considered the exam of choice in subjects with a history of revascularization. The availability of a noninvasive anatomic test for patients with previous coronary revascularization and its possible association with functional assessments in a single exam could play a key role in the follow-up management of these subjects, especially considering the rate of false-positive and negative results of noninvasive functional tests. The present review summarizes the main evidence about CCTA and coronary artery bypass grafts, complex percutaneous coronary intervention, and bioresorbable stent implantation. Full article
(This article belongs to the Special Issue Cardiovascular Computed Tomography in Clinical Practice)
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16 pages, 918 KiB  
Review
The Non-Invasive Diagnosis of Chronic Coronary Syndrome: A Focus on Stress Computed Tomography Perfusion and Stress Cardiac Magnetic Resonance
by Léon Groenhoff, Giulia De Zan, Pietro Costantini, Agnese Siani, Eleonora Ostillio, Serena Carriero, Giuseppe Muscogiuri, Luca Bergamaschi, Giuseppe Patti, Carmine Pizzi, Sandro Sironi, Anna Giulia Pavon, Alessandro Carriero and Marco Guglielmo
J. Clin. Med. 2023, 12(11), 3793; https://doi.org/10.3390/jcm12113793 - 31 May 2023
Cited by 1 | Viewed by 1213
Abstract
Coronary artery disease is still a major cause of death and morbidity worldwide. In the setting of chronic coronary disease, demonstration of inducible ischemia is mandatory to address treatment. Consequently, scientific and technological efforts were made in response to the request for non-invasive [...] Read more.
Coronary artery disease is still a major cause of death and morbidity worldwide. In the setting of chronic coronary disease, demonstration of inducible ischemia is mandatory to address treatment. Consequently, scientific and technological efforts were made in response to the request for non-invasive diagnostic tools with better sensitivity and specificity. To date, clinicians have at their disposal a wide range of stress-imaging techniques. Among others, stress cardiac magnetic resonance (S-CMR) and computed tomography perfusion (CTP) techniques both demonstrated their diagnostic efficacy and prognostic value in clinical trials when compared to other non-invasive ischemia-assessing techniques and invasive fractional flow reserve measurement techniques. Standardized protocols for both S-CMR and CTP usually imply the administration of vasodilator agents to induce hyperemia and contrast agents to depict perfusion defects. However, both methods have their own limitations, meaning that optimizing their performance still requires a patient-tailored approach. This review focuses on the characteristics, drawbacks, and future perspectives of these two techniques. Full article
(This article belongs to the Special Issue Cardiovascular Computed Tomography in Clinical Practice)
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