Archives of Cardiovascular Imaging

Letter

27/8/2023

Can Degenerative Changes Create Significant Tricuspid Valve Regurgitation?

Mona Yadollahi, Azin Alizadehasl

Research Article

28/8/2023

Role of Echocardiographic Deformation Indices in Predicting Mild Forms of Rejection in Heart Transplantation Recipients

Farah Naghashzadeh, Neda Behzadnia, Babak Sharif-Kashani, Zargham Hossein Ahmadi, Alireza Jahangirifard, Samira Chaibakhsh

Background: Endomyocardial biopsy (EMB) is currently the method of choice for the definite diagnosis of acute allograft heart rejection after transplantation. But, it is somewhat invasive and expensive and, on occasion, gives rise to serious complications. To find a non-invasive method for the identification of acute allograft rejection, we compared the results between EMB according to the criteria of the international society of heart and lung transplantation (ISHLT) and myocardial deformation indices (color-coded tissue Doppler imaging (TDI)-derived strain and strain rate (SR) imaging).

Results: All the 31 heart transplantation patients were included in the study. According to the ISHLT’s criteria, 13 EMB samples revealed grade IR rejection and only 1 biopsy sample revealed grade IIR. ROC curve analysis was used for all the 12 LV segments. There were no meaningful correlations between the TDI-derived mean strain and SR values and the EMB results. The only meaningful correlation was between the SR of the infero-basal segment and the pathology result. The area under the curve was 0.73 (P = 0.024).

Conclusions: Our results did not reveal a meaningful correlation between TDI-derived strain and SR and EMB results, but color-coded TDI-derived strain and SR imaging might have a complementary role for the identification of higher grades of acute allograft rejection in heart transplantation recipients. In our study, 1 EMB sample revealed grade IIR and no biopsy sample revealed grade IIIR; thus, a better assessment of the role of strain and SR imaging in predicting rejection requires further research with higher numbers of patients including higher grades of acute allograft rejection and novel techniques of stain rate imaging like speckle-tracking 2D strain imaging.

Research Article

28/8/2023

A Combined Spatial Fuzzy C-Means and Level Set Approach for Endocardium Segmentation in MRI Image Series

Hossein Yousefi-Banaem, Saeed Kermani, Omid Srrafzadeh

Background: Obtaining accurate left ventricular (LV) endocardium segmentation requires the exclusion of the papillary muscles from the cardiac wall, which is a significant, albeit challenging, step in cardiac image analysis. Most medical imaging systems suffer from noise in that it affects the processing procedure. We herein introduce a segmentation algorithm, which improves segmentation accuracy by excluding the papillary muscles and suppressing noise effects.

Results: We compared the obtained results with those obtained via manual segmentation as the gold standard vis-à-vis accuracy, Jaccard coefficient, dice coefficient, and false positive ratio. Also, the robustness of the proposed method to the noise was tested by adding the Gaussian noise with different variances to the original image. The obtained results showed 96 ± 1.3% accuracy in normal images and 89 ± 4% accuracy in noisy images with a signal-to-noise ratio of -2.2 to -1.

Case Report

28/8/2023

Huge Pericardial Cyst with Compressing Effects on the Right-Heart Chambers

Mehmet Onur Omaygenc, Ibrahim Oguz Karaca, Beytullah Cakal, Haci Murat Gunes, Filiz Kizilirmak, Bilal Boztosun

Case Report

27/8/2023

Primary Malignant Cardiac Tumor Presenting with Dyspnea: A Case Report

Hedieh Alimi, Masumeh Alvandi

Primary malignant cardiac tumors are rare tumors of the heart with a very poor prognosis. Complete excision is the treatment of choice, but it is dependent on the stage and extension of the tumor. We describe an old man with the initial presenting symptoms of progressive dyspnea. Our assessment revealed moderate pericardial effusion and a large infiltrative right ventricular mass. The initial differential diagnosis included malignant sarcoma, lymphoma, or melanoma. The patient underwent palliative excision of the tumor and chemotherapy. After biopsy, cardiac lymphoma was confirmed.

Case Report

29/8/2023

A Giant Right Atrial Mass with Concomitant Pulmonary Embolism

Fatemeh Mirrazeghi, Mohammad Esmaeil Rezaei, Anita Sadeghpour, Alireza Alizadeh Ghavidel, Kambiz Mozaffari

Myxomas are the most common primary cardiac tumors. They are mostly located in the left atrium, but 15% to 20% of them arise from the right atrium (RA). We herein describe a 22-year-old man with a giant RA mass and simultaneous pulmonary embolism. The mass was detected accidentally on transthoracic echocardiography in preoperative workup for an elective noncardiac surgery and was confirmed with multimodality imaging. The patient underwent surgical removal of the mass and concomitant pulmonary artery embolectomy. Histopathological examination confirmed the diagnosis of an RA myxoma. He had an uneventful recovery and was asymptomatic after 24 months of follow-up. This case is a villous RA myxoma, which is a very rare subtype with a high tendency to pulmonary embolism. We report this case as an unusual location of a very large myxoma and emphasize the role of multimodality imaging in the preoperative management of this patient as cardiac computed tomography angiography confirmed the associated pulmonary embolism.

Archives of Cardiovascular Imaging: Aug 2016, 4 (3), 6 articles.