Archives of Cardiovascular Imaging

Commentary Article

30/11/2023

Imaging Approach for Coronary-Cameral Fistula: A Relatively Rare Anomaly That May Be Accidentally Detected

Dario Buccheri, Giuliana Cimino

Research Article

30/11/2023

3D Analysis of Thin-Cap Fibroatheromas by an Automatic Graph-Based Approach in Intravascular Optical Coherence Tomography

Ali Kermani, Arash Taki, Ahmad Ayatollahi

Methods: A new 2-step graph-based method was used to extract the 3D morphology of the fibrous cap in an intravascular OCT image sequence. A linear cost function was applied by adding novel hard constraints. Then, an undirected graph was performed with specified edge weighting. The min-cut problem was solved for segmentation. It was divided into 2 phases: The former extracted a media region from the lumen region, and the latter extracted the fibrous cap from the media. Finally, the TCFA was extracted by the quantification of the fibrous cap thickness.

Research Article

30/11/2023

Echocardiographic Assessment of Right Ventricular Systolic Function: A 2D, Anatomical, and Conventional M-Mode Comparison Study

Arezou Zoroufian, Hossein Sate, Masoumeh Lotfi-Tokaldany, Mohammad Sahebjam, Hakimeh Sadeghian, Arash Jalali

Results: The mean age of the patients was 53.27 ± 14.29 years and 52.9% were male. The patients were mostly diagnosed as having left-sided valvular disease in terms of mitral stenosis, mitral regurgitation, aortic stenosis, or aortic regurgitation (63 patients, 41.4%). Heart failure was in 18.4% and coronary artery disease in 15.8%. Among 152 patients, 17 (11.2%) had normal findings in echocardiography. Concerning RV-FAC, we categorized the patients into 3 groups: 116 patients with RV-FAC equal to or greater than 35%, 24 patients with RV-FAC between 35% and 25%, and 12 patients with RV-FAC equal to or smaller than 25%. To discriminate normal from abnormal RV-FACs (≥ 35% vs < 35%), TAPSE by AMM had specificity of 96.5% and sensitivity of 60.5% (P < 0.001) for a cutoff point of 19.5 mm to separate the patients with RV-FAC equal to or greater than 35% from those with RV-FAC smaller than 35%. TAPSE by CMM had similar specificity and sensitivity (98.5% and 53.8%, respectively [P < 0.001]) for a cutoff point of 17.5 mm.

Research Article

30/11/2023

Left Atrial Mapping in Patients with Atrial Fibrillation: A Comparison Study of Image Quality and Radiation Dose Between High-Pitch Spiral CT Angiography and Retrospective ECG-Gated CT Angiography

Hamidreza Pooraliakbar, Maryam Khalili Sadrabad, Zahra Emkanjoo, Majid Haghjoo, Ahmadali Khalili Sadrabad

Methods: Fifty-nine patients (29 women; mean age = 53 y) underwent CT angiography between 2013 and 2016: 26 patients with retrospective ECG-gated (classic) and 33 with high-pitch (Flash) protocols on a second-generation 128-DSCT system (SOMATOM Definition Flash). CT images of the LA were integrated into an electroanatomic system (NavX). Two independent blinded readers evaluated IQ using a 3-point scale and the LA contrast density. Dose-length product (DLP) was obtained from each patient protocol, and effective radiation dose (ERD) was calculated according to the European guideline for CT.

Results: The rate of diagnostic IQ (score 3 or 2) was 87.9% for the flash group and 96.2% for the classic group, which was not significantly different between the 2 groups (P = 0.250). The results of objective IQ measurements showed that a central LA contrast density above 350 Hounsfield units (diagnostic) was present in 21 (80.8%) images in the classic group and 26 (78.8%) images in the flash group, which was not statistically different between the 2 groups (P = 0.850). There were significant differences (P < 0.001) in DLP and ERD between the 2 groups: the values were lower in high-pitch scan than in retrospective ECG-gated scan (151.30 ± 39.44 vs. 776.61 ± 243.63 and 2.11 ± 0.55 vs. 10.872 ± 3.41, respectively).

Case Report

26/11/2023

Giant Left Main Coronary Artery Aneurysm and Atherosclerotic Coronary Tree: Additive Value of Coronary CT Angiography Over Conventional Angiography

Mehmet Onur Omaygenc, Ibrahim Oguz Karaca, Beytullah Cakal, Haci Murat Gunes, Arda Ozyuksel, Cengiz Erol

Introduction: Giant aneurysms are extremely rare anomalies of the coronary tree. Regarding the site of involvement, the left main coronary artery (LMCA) is the least encountered of all. Coronary angiography is invariably the diagnostic method of choice but infrequently, standard injections might be inadequate to clearly opacify the distal segments. In this particular state, coronary computed tomography angiography (CCTA) offers comprehensive imaging of the entire coronary tree and the contents of the aneurysm (calcification and thrombus). CCTA may also facilitate demonstrating the mass effect of the aneurysm, if it exists.

Case Presentation: A 44-year-old patient on routine dialysis treatment was suspected of having significant coronary artery disease due to typical exertional symptoms and abnormal stress test results in the course of evaluation for eligibility for renal transplantation. Coronary angiography was performed, and a giant aneurysm over 4 cm in diameter possibly emerging from the LMCA, was detected. The left anterior descending artery (LAD) could not be opacified in the left coronary injections, and the coronary segments adjacent to the origin of the aneurysm were not visualized either. Therefore, a CCTA was scheduled and it illustrated not only the LAD course but also 2 other intermediate arteries that were not recognized on coronary angiography, nature of the aneurysm, and atherosclerotic burden of the entire coronary tree. The patient was treated with surgery due to proven severe myocardial ischemia and to modify the risk of the upcoming transplantation procedure. The occlusion of the branches originating from the LMCA, sac shrinkage, and bypass grafting were the consecutive steps of the selected method of heart surgery.

Case Report

30/11/2023

Keratoglobus Associated with Hypertrophic Cardiomyopathy: A Case Report of a Concomitant Disorder of Heart and Eye

Azin Alizadehasl, Anita Sadeghpour, Nehzat Akiash, Mahdi Peighambari, Alireza Alizadeh Ghavidel

A 30-year-old woman was referred to our department for a cardiology visit. She had a medical history of ophthalmologic disorders. Her chief complaints were dyspnea, lightheadedness, and fainting after the Valsalva maneuver. Physical examination showed systolic murmurs at the left upper sternal border as well as corneal thinning and bulging in the 2 eyes. Transthoracic echocardiography revealed local significant hypertrophy in the base of the interventricular septum with significant left ventricular outflow obstruction and severe mitral regurgitation.

Case Report

30/11/2023

Left Ventricular Pseudoaneurysm After Mitral Valve Replacement

Hoorak Poorzand, Farah Fani

Archives of Cardiovascular Imaging: Nov 2016, 4 (4), 7 articles.