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Trends and Novelties in Cardiovascular Imaging

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A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (30 November 2021) | Viewed by 30621

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Special Issue Editors

Dr. Andrea Baggiano

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Guest Editor

Cardiovascular Imaging Department and Heart Failure, Clinical Cardiology and Rehabilitation Cardiology, Centro Cardiologico Monzino IRCCS, Milan, Italy

Dr. Matteo Cameli

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Guest Editor

Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy
Interests: heart failure; atrial fibrillation; echocardiography; hypertension; heart; cardiology; transesophageal echocardiography; cardiovascular system; cardiac function; electrocardiographyh
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Special Issue Information

Dear Colleagues,

Cardiovascular diseases represent the major causes of mortality and morbidity both for men and women in developed countries, with ischaemic heart disease and non-ischaemic cardiomyopathies playing the most relevant role.

As several inherited and acquired processes have been recognized as the causes of myocardial dysfunction, potentially leading to heart decompensation, life-threatening arrhythmias and eventually death, prompt detection of myocardial structural and functional abnormalities is considered a crucial step in taking care of such subjects.

The ultimate role of cardiovascular imaging in managing cardiovascular diseases has been highlighted, not only from a diagnostic perspective, but also for prognostic purposes.

Many imaging techniques, whether non-invasive (echocardiography, cardiac computed tomography, cardiac magnetic resonance, single-photon emission computed tomography, positron emission tomography) or invasive (angiography, intravascular ultrasound, optical coherence tomography) could be used alone, in sequential approach or even with merged images, to correctly assess patients with cardiac diseases, and recent technical development has further extended the application of such technics in many clinical scenarios.

This Special Issue of Diagnostics aims to present the role of non-invasive and invasive imaging modalities in the diagnosis and management of cardiovascular diseases, with a particular attention not only to what nowadays represents the standard of care, but mostly to novelties that could represent relevant achievements for the next future.

Dr. Andrea Baggiano
Prof. Matteo Cameli
Guest Editors

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Keywords

Ischaemic cardiomyopathy
Non-ischaemic cardiomyopathy
Echocardiography
Cardiovascular Magnetic Resonance (CMR)
Cardiac Computed Tomography (CCT)
Single-photon emission computed tomography (SPECT)
Positron emission tomography (PET)
Angiography
Intravascular ultrasound (IVUS)
Optical coherence tomography (OCT)

Published Papers (11 papers)

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Research

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12 pages, 2197 KiB

Open AccessArticle

Cardiac Reverse Remodelling by 2D and 3D Echocardiography in Heart Failure Patients Treated with Sacubitril/Valsartan

by Valentina Mantegazza, Valentina Volpato, Massimo Mapelli, Valentina Sassi, Elisabetta Salvioni, Irene Mattavelli, Gloria Tamborini, Piergiuseppe Agostoni and Mauro Pepi

Diagnostics 2021, 11(10), 1845; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11101845 - 06 Oct 2021

Cited by 10 | Viewed by 2165

Abstract

In terms of sacubitril/valsartan (S/V)-induced changes in heart failure with reduced ejection fraction (HFrEF) via three-dimensional (3D) transthoracic echocardiography (TTE) and S/V effects based on HF aetiology, data are lacking. We prospectively enrolled 51 HFrEF patients (24 ischaemic, 27 non-ischaemic). At baseline and at 6-month follow-up (6MFU) after S/V treatment optimisation, we assessed the N-terminal pro-B-type natriuretic peptide (NT-proBNP), and cardiac remodelling by two-dimensional (2D) and 3DTTE. In non-ischaemic patients, 2D and 3DTTE showed an improvement in left ventricular (LV) size and biventricular function at 6MFU vs. baseline: 3D-LV end-diastolic volume (EDV) 103 ± 30 vs. 125 ± 32 mL/m² (p < 0.05), 3D-LV ejection fraction (EF) 40 ± 9 vs. 32 ± 5% (p < 0.05), right ventricular (RV) 3D-EF 48.4 ± 6.5 vs. 44.3 ± 7.5% (p < 0.05); only the 3D method detected RV size reduction: 3D-RVEDV 63 ± 27 vs. 71 ± 30 mL/m² (p < 0.05). In ischaemic patients, only 3DTTE showed biventricular size and LV function improvement: 3D-LVEDV 112 ± 29 vs. 121 ± 27 mL/m² (p < 0.05), 3D-LVEF 35 ± 6 vs. 32 ± 5% (p < 0.05), 3D-RVEDV 57 ± 11 vs. 63 ± 14 mL/m² (p < 0.05); RV function did not ameliorate. In both ischaemic and non-ischaemic patients, diastolic function and NT-proBNP significantly improved. In HFrEF patients treated with S/V, 3DTTE helps to ascertain subtle changes in heart chambers’ size and function, which have a major impact on HFrEF prognosis. S/V has significantly different effects on LV function in non-ischaemic vs. ischaemic patients. Full article

(This article belongs to the Special Issue Trends and Novelties in Cardiovascular Imaging)

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17 pages, 3245 KiB

Open AccessArticle

IVUS Longitudinal and Axial Registration for Atherosclerosis Progression Evaluation

by Nikos Tsiknakis, Constantinos Spanakis, Panagiota Tsompou, Georgia Karanasiou, Gianna Karanasiou, Antonis Sakellarios, George Rigas, Savvas Kyriakidis, Michael Papafaklis, Sotirios Nikopoulos, Frank Gijsen, Lampros Michalis, Dimitrios I. Fotiadis and Kostas Marias

Diagnostics 2021, 11(8), 1513; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11081513 - 22 Aug 2021

Cited by 2 | Viewed by 2334

Abstract

Intravascular ultrasound (IVUS) imaging offers accurate cross-sectional vessel information. To this end, registering temporal IVUS pullbacks acquired at two time points can assist the clinicians to accurately assess pathophysiological changes in the vessels, disease progression and the effect of the treatment intervention. In this paper, we present a novel two-stage registration framework for aligning pairs of longitudinal and axial IVUS pullbacks. Initially, we use a Dynamic Time Warping (DTW)-based algorithm to align the pullbacks in a temporal fashion. Subsequently, an intensity-based registration method, that utilizes a variant of the Harmony Search optimizer to register each matched pair of the pullbacks by maximizing their Mutual Information, is applied. The presented method is fully automated and only required two single global image-based measurements, unlike other methods that require extraction of morphology-based features. The data used includes 42 synthetically generated pullback pairs, achieving an alignment error of

0.1853

frames per pullback, a rotation error

0.93 °

and a translation error of

0.0161

mm. In addition, it was also tested on 11 baseline and follow-up, and 10 baseline and post-stent deployment real IVUS pullback pairs from two clinical centres, achieving an alignment error of

4.3 \pm 3.9

for the longitudinal registration, and a distance and a rotational error of

0.56 \pm 0.323

mm and

12.4 ° \pm 10.5 °

, respectively, for the axial registration. Although the performance of the proposed method does not match that of the state-of-the-art, our method relies on computationally lighter steps for its computations, which is crucial in real-time applications. On the other hand, the proposed method performs even or better that the state-of-the-art when considering the axial registration. The results indicate that the proposed method can support clinical decision making and diagnosis based on sequential imaging examinations. Full article

(This article belongs to the Special Issue Trends and Novelties in Cardiovascular Imaging)

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12 pages, 2837 KiB

Open AccessArticle

Effect of Loading Changes on the Intraventricular Pressure Measured by Color M-Mode Echocardiography in Rats

by Akira Yairo, Ahmed S. Mandour, Katsuhiro Matsuura, Tomohiko Yoshida, Danfu Ma, Pitipat Kitpipatkun, Konosuke Kato, Chieh-Jen Cheng, Hussein M. El-Husseiny, Takashi Tanaka, Kazumi Shimada, Lina Hamabe, Akiko Uemura, Ken Takahashi and Ryou Tanaka

Diagnostics 2021, 11(8), 1403; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11081403 - 03 Aug 2021

Cited by 17 | Viewed by 2435

Abstract

Evaluation of diastolic function is a pivotal challenge due to limitations of the conventional echocardiography, especially when the heart rate is rapid as in rats. Currently, by using color M-mode echocardiography (CMME), intraventricular pressure difference (IVPD) and intraventricular pressure gradient (IVPG) in early diastole can be generated and are available as echocardiographic indices. These indices are expected to be useful for the early diagnosis of heart failure (HF), especially diastolic dysfunction. There have not been any studies demonstrating changes in IVPD and IVPG in response to changes in loading conditions in rats. Therefore, the present study aims to evaluate CMME-derived IVPD and IVPG changes in rats under various loading conditions. Twenty rats were included, divided into two groups for two different experiments, and underwent jugular vein catheterization under inhalational anesthetics. Conventional echocardiography, CMME, and 2D speckle tracking echocardiography were measured at the baseline (BL), after intravenous infusion of milrinone (MIL, n = 10), and after the infusion of hydroxyethyl starch (HES, n = 10). Left ventricular IVPD and IVPG were calculated from color M-mode images and categorized into total, basal, mid-to-apical, mid, and apical parts, and the percentage of the corresponding part was calculated. In comparison to the BL, the ejection fraction, mid-to-apical IVPG, mid IVPG, and apical IVPD were significantly increased after MIL administration (p < 0.05); meanwhile, the end-diastolic volume, E-wave velocity, total IVPD, and basal IVPD were significantly increased with the administration of HES (p < 0.05). The increase in mid-to-apical IVPD, mid IVPD, and apical IVPD indicated increased relaxation. A significant increase in basal IVPD reflected volume overloading by HES. CMME-derived IVPD and IVPG are useful tools for the evaluation of various loading conditions in rats. The approach used in this study provides a model for continuous data acquisition in chronic cardiac disease models without drug testing. Full article

(This article belongs to the Special Issue Trends and Novelties in Cardiovascular Imaging)

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13 pages, 1709 KiB

Open AccessArticle

Prognostic Value of CTA-Derived Left Ventricular Mass in Neonates with Congenital Heart Disease

by Stephan Ellmann, Julie-Marie Nickel, Rafael Heiss, Nouhayla El Amrani, Wolfgang Wüst, Oliver Rompel, Andre Rueffer, Robert Cesnjevar, Sven Dittrich, Michael Uder and Matthias S. May

Diagnostics 2021, 11(7), 1215; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11071215 - 06 Jul 2021

Cited by 1 | Viewed by 1972

Abstract

For therapeutic decisions regarding uni- or biventricular surgical repair in congenital heart disease (CHD), left ventricular mass (LVM) is an important factor. The aim of this retrospective study was to determine the LVM of infants with CHD in thoracic computed tomography angiographies (CTAs) and to evaluate its usefulness as a prognostic parameter, with special attention paid to hypoplastic left heart (HLH) patients. Manual segmentation of the left ventricular endo- and epicardial volumes was performed in CTAs of 132 infants. LVMs were determined from these volumes and normalized to body surface area. LVMs of patients with different types of CHD were compared to each other using analyses of variances (ANOVA). An LVM cutoff for discrimination between uni- and biventricular repair was determined using receiver operating characteristics. Survival rates were calculated using Kaplan–Meier statistics. Patients with a clinical diagnosis of an HLH had significantly lower mean LVM (21.88 g/m²) compared to patients without applicable disease (50.22 g/m²; p < 0.0001) and compared to other CHDs, including persistent truncus arteriosus, left ventricular outflow tract obstruction, transposition of the great arteries, pulmonary artery stenosis or atresia, and double-outlet right ventricle (all, p < 0.05). The LVM cutoff for uni- vs. biventricular surgery was 33.9 g/m² (sensitivity: 82.3%; specificity: 73.7%; PPV: 94.9%). In a subanalysis of HLH patients, a sensitivity of 50.0%, specificity of 100%, PPV of 100%, and NPV of 83.3% was determined. Patient survival was not significantly different between the surgical approaches or between patients with LVM above or below the cutoff. LVM can be measured in chest CTA of newborns with CHD and can be used as a prognostic factor. Full article

(This article belongs to the Special Issue Trends and Novelties in Cardiovascular Imaging)

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10 pages, 3331 KiB

Open AccessArticle

End-to-End, Pixel-Wise Vessel-Specific Coronary and Aortic Calcium Detection and Scoring Using Deep Learning

by Gurpreet Singh, Subhi J. Al’Aref, Benjamin C. Lee, Jing Kai Lee, Swee Yaw Tan, Fay Y. Lin, Hyuk-Jae Chang, Leslee J. Shaw, Lohendran Baskaran and on behalf of the CREDENCE and ICONIC Investigators

Diagnostics 2021, 11(2), 215; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11020215 - 02 Feb 2021

Cited by 10 | Viewed by 2343

Abstract

Conventional scoring and identification methods for coronary artery calcium (CAC) and aortic calcium (AC) result in information loss from the original image and can be time-consuming. In this study, we sought to demonstrate an end-to-end deep learning model as an alternative to the conventional methods. Scans of 377 patients with no history of coronary artery disease (CAD) were obtained and annotated. A deep learning model was trained, tested and validated in a 60:20:20 split. Within the cohort, mean age was 64.2 ± 9.8 years, and 33% were female. Left anterior descending, right coronary artery, left circumflex, triple vessel, and aortic calcifications were present in 74.87%, 55.82%, 57.41%, 46.03%, and 85.41% of patients respectively. An overall Dice score of 0.952 (interquartile range 0.921, 0.981) was achieved. Stratified by subgroups, there was no difference between male (0.948, interquartile range 0.920, 0.981) and female (0.965, interquartile range 0.933, 0.980) patients (p = 0.350), or, between age <65 (0.950, interquartile range 0.913, 0.981) and age ≥65 (0.957, interquartile range 0.930, 0.9778) (p = 0.742). There was good correlation and agreement for CAC prediction (rho = 0.876, p < 0.001), with a mean difference of 11.2% (p = 0.100). AC correlated well (rho = 0.947, p < 0.001), with a mean difference of 9% (p = 0.070). Automated segmentation took approximately 4 s per patient. Taken together, the deep-end learning model was able to robustly identify vessel-specific CAC and AC with high accuracy, and predict Agatston scores that correlated well with manual annotation, facilitating application into areas of research and clinical importance. Full article

(This article belongs to the Special Issue Trends and Novelties in Cardiovascular Imaging)

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12 pages, 4054 KiB

Open AccessArticle

Multimodality Approach for Endovascular Left Atrial Appendage Closure: Head-To-Head Comparison among 2D and 3D Echocardiography, Angiography, and Computer Tomography

by Gianpiero Italiano, Anna Maltagliati, Valentina Mantegazza, Laura Fusini, Maria Elisabetta Mancini, Alessio Gasperetti, Denise Brusoni, Francesca Susini, Alberto Formenti, Gianluca Pontone, Gaetano Fassini, Claudio Tondo and Mauro Pepi

Diagnostics 2020, 10(12), 1103; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics10121103 - 17 Dec 2020

Cited by 4 | Viewed by 2623

Abstract

Background: Percutaneous left atrial appendage closure (LAAC) requires accurate pre- and intraprocedural measurements, and multimodality imaging is an essential tool for guiding the procedure. Two-dimensional (2D TOE) and three-dimensional (3D TOE) transoesophageal echocardiography, cardiac computed tomography (CCT), and conventional cardiac angiography (CCA) are commonly used to evaluate left atrial appendage (LAA) size. However, standardized approaches in measurement methods by different imaging modalities are lacking. The aims of the study were to evaluate the LAA dimension and morphology in patients undergoing LAAC and to compare data obtained by different imaging modalities: 2D and 3D TOE, CCT, and CCA. Methods: A total of 200 patients (mean age 70 ± 8 years, 128 males) were examined by different imaging techniques (161 2D TOE, 103 3D TOE, 98 CCT, and 200 CCA). Patients underwent preoperative CCT and intraoperative 2D and 3D TOE and CCA. Results: A significant correlation was found among all measurements obtained by different modalities. In particular, 3D TOE and CCT measurements were highly correlated with an excellent agreement for the landing zone (LZ) dimensions (LZ diameter: r = 0.87; LAA depth: r = 0.91, p < 0.001). Conclusions: Head-to-head comparison among imaging techniques (2D and 3D TOE, CCT, and CCA) showed a good correlation among LZ diameter measurements obtained by different imaging modalities, which is a parameter of paramount importance for the choice of the LAAC device size. LZ diameters and area by 3D TOE had the best correlation with CCT. Full article

(This article belongs to the Special Issue Trends and Novelties in Cardiovascular Imaging)

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13 pages, 1032 KiB

Open AccessArticle

Multicentric Atrial Strain COmparison between Two Different Modalities: MASCOT HIT Study

by Matteo Cameli, Marcelo Haertel Miglioranza, Julien Magne, Giulia Elena Mandoli, Giovanni Benfari, Roberta Ancona, Gerolamo Sibilio, Vlatka Reskovic Luksic, Dosen Dejan, Leonardo Griseli, Caroline M. Van De Heyning, Philippe Mortelmans, Blazej Michalski, Karolina Kupczynska, Giovanna Di Giannuario, Fiorella Devito, Raluca Dulgheru, Federica Ilardi, Alessandro Salustri, Galal Abushahba, Doralisa Morrone, Iacopo Fabiani, Martin Penicka, Asim Katbeh, Giuseppe Sammarco, Roberta Esposito, Ciro Santoro, Maria Concetta Pastore, Salvatore Comenale Pinto, Artem Kalinin, Žanna Pičkure, Katja Ažman Juvan, Anja Zupan Mežnar, Augustine Coisne, Amandine Coppin, Mihaela Maria Opris, Dan Octavian Nistor, Riitta Paakkanen, Tor Biering-Sørensen, Flemming Javier Olsen, Tomas Lapinskas, Jolanta Justina Vaškelyté, Laura Galian-Gay, Guillem Casas, Andreea Iulia Motoc, Constantinos Hristou Papadopoulos, Savvas Loizos, Gergely Ágoston, Istvan Szabó, Krasimira Hristova, Svetlin Netkov Tsonev, Elena Galli, Dragos Vinereanu, Sorina Mihaila Baldea, Denisa Muraru, Sergio Mondillo, Erwan Donal, Maurizio Galderisi, Bernard Cosyns, Thor Edvardsen and Bogdan A. Popescu Show full author list Hide full author list

Diagnostics 2020, 10(11), 946; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics10110946 - 13 Nov 2020

Cited by 41 | Viewed by 4544

Abstract

Two methods are currently available for left atrial (LA) strain measurement by speckle tracking echocardiography, with two different reference timings for starting the analysis: QRS (QRS-LASr) and P wave (P-LASr). The aim of MASCOT HIT study was to define which of the two was more reproducible, more feasible, and less time consuming. In 26 expert centers, LA strain was analyzed by two different echocardiographers (young vs senior) in a blinded fashion. The study population included: healthy subjects, patients with arterial hypertension or aortic stenosis (LA pressure overload, group 2) and patients with mitral regurgitation or heart failure (LA volume–pressure overload, group 3). Difference between the inter-correlation coefficient (ICC) by the two echocardiographers using the two techniques, feasibility and analysis time of both methods were analyzed. A total of 938 subjects were included: 309 controls, 333 patients in group 2, and 296 patients in group 3. The ICC was comparable between QRS-LASr (0.93) and P-LASr (0.90). The young echocardiographers calculated QRS-LASr in 90% of cases, the expert ones in 95%. The feasibility of P-LASr was 85% by young echocardiographers and 88% by senior ones. QRS-LASr young median time was 110 s (interquartile range, IR, 78-149) vs senior 110 s (IR 78-155); for P-LASr, 120 s (IR 80-165) and 120 s (IR 90-161), respectively. LA strain was feasible in the majority of patients with similar reproducibility for both methods. QRS complex guaranteed a slightly higher feasibility and a lower time wasting compared to the use of P wave as the reference. Full article

(This article belongs to the Special Issue Trends and Novelties in Cardiovascular Imaging)

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14 pages, 18789 KiB

Open AccessReview

Inferior Vena Cava Edge Tracking Echocardiography: A Promising Tool with Applications in Multiple Clinical Settings

by Stefano Albani, Luca Mesin, Silvestro Roatta, Antonio De Luca, Alberto Giannoni, Davide Stolfo, Lorenza Biava, Caterina Bonino, Laura Contu, Elisa Pelloni, Emilio Attena, Vincenzo Russo, Francesco Antonini-Canterin, Nicola Riccardo Pugliese, Guglielmo Gallone, Gaetano Maria De Ferrari, Gianfranco Sinagra and Paolo Scacciatella

Diagnostics 2022, 12(2), 427; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12020427 - 07 Feb 2022

Cited by 7 | Viewed by 3679

Abstract

Ultrasound (US)-based measurements of the inferior vena cava (IVC) diameter are widely used to estimate right atrial pressure (RAP) in a variety of clinical settings. However, the correlation with invasively measured RAP along with the reproducibility of US-based IVC measurements is modest at best. In the present manuscript, we discuss the limitations of the current technique to estimate RAP through IVC US assessment and present a new promising tool developed by our research group, the automated IVC edge-to-edge tracking system, which has the potential to improve RAP assessment by transforming the current categorical classification (low, normal, high RAP) in a continuous and precise RAP estimation technique. Finally, we critically evaluate all the clinical settings in which this new tool could improve current practice. Full article

(This article belongs to the Special Issue Trends and Novelties in Cardiovascular Imaging)

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16 pages, 1541 KiB

Open AccessReview

Imaging Cardiovascular Inflammation in the COVID-19 Era

by Andras Mester, Imre Benedek, Nora Rat, Cosmin Tolescu, Stefania Alexandra Polexa and Theodora Benedek

Diagnostics 2021, 11(6), 1114; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11061114 - 18 Jun 2021

Cited by 8 | Viewed by 2637

Abstract

Cardiac complications are among the most frequent extrapulmonary manifestations of COVID-19 and are associated with high mortality rates. Moreover, positive SARS-CoV-2 patients with underlying cardiovascular disease are more likely to require intensive care and are at higher risk of death. The underlying mechanism for myocardial injury is multifaceted, in which the severe inflammatory response causes myocardial inflammation, coronary plaque destabilization, acute thrombotic events, and ischemia. Cardiac magnetic resonance (CMR) imaging is the non-invasive method of choice for identifying myocardial injury, and it is able to differentiate between underlying causes in various and often challenging clinical scenarios. Multimodal imaging protocols that incorporate CMR and computed tomography provide a complex evaluation for both respiratory and cardiovascular complications of SARS-CoV2 infection. This, in relation to biological evaluation of systemic inflammation, can guide appropriate therapeutic management in every stage of the disease. The use of artificial intelligence can further improve the diagnostic accuracy of these imaging techniques, thus enabling risk stratification and evaluation of prognosis. The present manuscript aims to review the current knowledge on the possible modalities for imaging COVID-related myocardial inflammation or post-COVID coronary inflammation and atherosclerosis. Full article

(This article belongs to the Special Issue Trends and Novelties in Cardiovascular Imaging)

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12 pages, 1919 KiB

Open AccessReview

Left Ventricular Deformation and Vortex Analysis in Heart Failure: From Ultrasound Technique to Current Clinical Application

by Simona Sperlongano, Antonello D’Andrea, Donato Mele, Vincenzo Russo, Valeria Pergola, Andreina Carbone, Federica Ilardi, Marco Di Maio, Roberta Bottino, Francesco Giallauria, Eduardo Bossone and Paolo Golino

Diagnostics 2021, 11(5), 892; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11050892 - 17 May 2021

Cited by 7 | Viewed by 2587

Abstract

Heart failure (HF) is a leading cause of cardiovascular morbidity and mortality. However, its symptoms and signs are not specific or can be absent. In this context, transthoracic echocardiography plays a key role in diagnosing the various forms of HF, guiding therapeutic decision making and monitoring response to therapy. Over the last few decades, new ultrasound modalities have been introduced in the field of echocardiography, aiming at better understanding the morpho-functional abnormalities occurring in cardiovascular diseases. However, they are still struggling to enter daily and routine use. In our review article, we turn the spotlight on some of the newest ultrasound technologies; in particular, analysis of myocardial deformation by speckle tracking echocardiography, and intracardiac flow dynamics by color Doppler flow mapping, highlighting their promising applications to HF diagnosis and management. We also focus on the importance of these imaging modalities in the selection of responses to cardiac resynchronization therapy. Full article

(This article belongs to the Special Issue Trends and Novelties in Cardiovascular Imaging)

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Other

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4 pages, 1491 KiB

Open AccessInteresting Images

Arrhythmic Mitral Valve Prolapse in the Young: A Rare but Concerning Entity

by Nicolò Martini, Alberto Cipriani, Bortolo Martini, Barbara Bauce, Martina Perazzolo Marra, Sabino Iliceto and Domenico Corrado

Diagnostics 2022, 12(7), 1519; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12071519 - 22 Jun 2022

Viewed by 1582

Abstract

Arrhythmic mitral valve prolapse (MVP) is an increasingly recognized clinical entity, characterized by the association of myxomatous mitral valve, ventricular arrhythmias (VAs) and sudden cardiac death (SCD). Prevalence of MVP is reported ranging between 2% and 5% of the general population, and risk of SCD is estimated approximately 0.3% per year. Diagnosis of MVP and the occurrence of fatal events involve generally adults aged 30 to 50 years, whereas in younger and even pediatric individuals has rarely been described. Herein, we report two clinical cases of malignant MVP in young patients, with the aim to point out the clinical features and the challenge of clinical management and risk stratification. Full article

(This article belongs to the Special Issue Trends and Novelties in Cardiovascular Imaging)

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