Advances in the Diagnosis of Cardiovascular Diseases

Special Issue Editors


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Guest Editor
Department of Cardiology and Electrotherapy, Medical University of Gdańsk, 80-210 Gdańsk, Poland
Interests: echocardiographies; cardiomyopathy; heart failure; arrhythmias

E-Mail Website
Guest Editor
Department of Cardiology and Electrotherapy, Medical University of Gdańsk, 80-210 Gdańsk, Poland
Interests: echocardiography; cardiomyopathy; heart failure; arrhythmias

Special Issue Information

Dear Colleagues,

In the last decade, the field of cardiothoracic imaging has seen the rapid growth of many innovative technologies. Cardiovascular imaging indices, including those based on modern advanced technology, significantly influence heart disorders’ prevention, diagnosis, and treatment options. This Special Issue seeks submissions to expand the understanding and highlight the clinical importance of emerging or changing technologies, guidelines, and expert recommendations in cardiovascular imaging. A combination of research papers, case series including exciting images, and reviews aims to highlight significant developments across all the cardiovascular imaging techniques we deal with, i.e., echocardiography, nuclear techniques, cardiovascular magnetic resonance, cardiac computed tomography, and others.

Prof. Dr. Ludmiła Daniłowicz‑Szymanowicz
Dr. Elżbieta Wabich
Guest Editors

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Keywords

  • cardiovascular imaging
  • echocardiography
  • cardiac magnetic resonance
  • cardiac computed tomography
  • nuclear techniques
  • cardiovascular pathology

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Published Papers (7 papers)

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Research

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11 pages, 1040 KiB  
Article
Cardiac Magnetic Resonance Relaxometry Parameters, Late Gadolinium Enhancement, and Feature-Tracking Myocardial Longitudinal Strain in Patients Recovered from COVID-19
by Jadwiga Fijalkowska, Anna Glinska, Marcin Fijalkowski, Katarzyna Sienkiewicz, Dorota Kulawiak-Galaska, Edyta Szurowska, Joanna Pienkowska and Karolina Dorniak
J. Cardiovasc. Dev. Dis. 2023, 10(7), 278; https://doi.org/10.3390/jcdd10070278 - 29 Jun 2023
Cited by 1 | Viewed by 1423
Abstract
COVID-19 infection is associated with myocarditis, and cardiovascular magnetic resonance (CMR) is the reference non-invasive imaging modality for myocardial tissue characterization. Quantitative CMR techniques, such as feature tracking (FT) and left ventricular global longitudinal strain (GLS) analysis, have been introduced as promising diagnostic [...] Read more.
COVID-19 infection is associated with myocarditis, and cardiovascular magnetic resonance (CMR) is the reference non-invasive imaging modality for myocardial tissue characterization. Quantitative CMR techniques, such as feature tracking (FT) and left ventricular global longitudinal strain (GLS) analysis, have been introduced as promising diagnostic tools to improve the diagnostic accuracy of suspected myocarditis. The aim of this study was to analyze the left ventricular global longitudinal strain (GLS) and the influence of T1 and T2 relaxation times, ECV, and LGE appearance on GLS parameters in a multiparametric imaging protocol in patients who recovered from COVID-19. The 86 consecutive patients enrolled in the study had all recovered from mild or moderate COVID-19 infections; none required hospitalization. Their persistent symptoms and suspected myocarditis led to cardiac magnetic resonance imaging within 3 months of the diagnosis of the SARS-CoV-2 infection. Results: Patients with GLS less negative than −15% had significantly lower LVEF (53.6% ± 8.9 vs. 61.6% ± 4.8; <0.001) and were significantly more likely to have prolonged T1 (28.6% vs. 7.5%; p = 0.019). Left ventricular GLS correlated significantly with T1 (r = 0.303; p = 0.006) and LVEF (r = −0.732; p < 0.001). Left ventricular GLS less negative than −15% was 7.5 times more likely in patients with prolonged T1 (HR 7.62; 95% CI 1.25–46.64). The reduced basal inferolateral longitudinal strain had a significant impact on the global left ventricular longitudinal strain. ROC results suggested that a GLS of 14.5% predicted prolonged T1 relaxation time with the best sensitivity and specificity. Conclusions: CMR abnormalities, including a myocarditis pattern, are common in patients who have recovered from COVID-19. The CMR feature-tracking left ventricular GLS is related to T1 relaxation time and may serve as a novel parameter to detect global and regional myocardial injury and dysfunction in patients with suspected myocardial involvement after recovery from COVID-19. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Cardiovascular Diseases)
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18 pages, 39311 KiB  
Article
Left Ventricle Segmental Longitudinal Strain and Regional Myocardial Work Index Could Help Determine Mitral Valve Prolapse Patients with Increased Risk of Ventricular Arrhythmias
by Ludmiła Daniłowicz-Szymanowicz, Agnieszka Zienciuk-Krajka, Elżbieta Wabich, Marcin Fijałkowski, Jadwiga Fijałkowska, Krzysztof Młodziński and Grzegorz Raczak
J. Cardiovasc. Dev. Dis. 2023, 10(4), 181; https://doi.org/10.3390/jcdd10040181 - 20 Apr 2023
Cited by 3 | Viewed by 2458
Abstract
Mitral valve prolapse (MVP) could associate with malignant ventricular arrhythmias (VAs). Mitral annular disjunction, a putative mechanism for an arrhythmic substrate, leads to excessive mobility, stretch, and damage of some segments. Speckle tracking echocardiography (STE), with particular attention to the segmental longitudinal strain [...] Read more.
Mitral valve prolapse (MVP) could associate with malignant ventricular arrhythmias (VAs). Mitral annular disjunction, a putative mechanism for an arrhythmic substrate, leads to excessive mobility, stretch, and damage of some segments. Speckle tracking echocardiography (STE), with particular attention to the segmental longitudinal strain and myocardial work index (MWI), could be an indicator of the segments we aimed to check. Seventy-two MVP patients and twenty controls underwent echocardiography. Complex VAs documented prospectively after the enrollment was qualified as the primary endpoint, which was noticed in 29 (40%) patients. Pre-specified cut-off values for peak segmental longitudinal strain (PSS) and segmental MWI for basal lateral (−25%, 2200 mmHg%), mid-lateral (−25%, 2500 mmHg%), mid-posterior (−25%, 2400 mmHg%), and mid-inferior (−23%, 2400 mmHg%) segments were accurate predictors of complex VAs. A combination of PSS and MWI increased the probability of the endpoint, reaching the highest predictive value for the basal lateral segment: odds ratio 32.15 (3.78–273.8), p < 0.001 for PSS ≥ −25% and MWI ≥ 2200 mmHg%. STE may be a valuable tool for assessing the arrhythmic risk in MVP patients. Excessively increased segmental longitudinal strain with an augmented regional myocardial work index identifies patients with the highest risk of complex VAs. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Cardiovascular Diseases)
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Review

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21 pages, 2177 KiB  
Review
Current and Clinically Relevant Echocardiographic Parameters to Analyze Left Atrial Function
by Mario Mangia, Emilio D’Andrea, Antonella Cecchetto, Riccardo Beccari, Donato Mele and Stefano Nistri
J. Cardiovasc. Dev. Dis. 2024, 11(8), 241; https://doi.org/10.3390/jcdd11080241 - 5 Aug 2024
Viewed by 1416
Abstract
The evaluation of the left atrial (LA) size using the LA volume index (LAVI) is clinically relevant due to its prognostic significance in various conditions. Nonetheless, adding a LA function assessment to the LAVI provides further clinical and prognostic information in different cardiovascular [...] Read more.
The evaluation of the left atrial (LA) size using the LA volume index (LAVI) is clinically relevant due to its prognostic significance in various conditions. Nonetheless, adding a LA function assessment to the LAVI provides further clinical and prognostic information in different cardiovascular (CV) diseases. The assessment of LA function by echocardiography primarily includes volumetric measurements (LA ejection fraction [LAEF]), tissue Doppler imaging (TDI) (mitral annular late diastolic velocity [a’]), and speckle-tracking methods, such as LA longitudinal reservoir strain (LA strain). This review analyzes and discusses the current medical evidence and potential clinical usefulness of these different methods to analyze LA function. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Cardiovascular Diseases)
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12 pages, 1296 KiB  
Review
Myocardial Functional Imaging in Pediatric Nuclear Cardiology
by Marco Alfonso Perrone, Andrea Cimini, Maria Ricci, Milena Pizzoferro, Maria Carmen Garganese, Massimiliano Raponi and Orazio Schillaci
J. Cardiovasc. Dev. Dis. 2023, 10(9), 361; https://doi.org/10.3390/jcdd10090361 - 24 Aug 2023
Cited by 2 | Viewed by 1545
Abstract
The role of nuclear medicine in pediatric cardiology has grown rapidly over the years, providing useful functional and prognostic information and playing a complementary role to morphological imaging in the evaluation of myocardial perfusion, cardiovascular inflammation and infections, and cardiac sympathetic innervation. The [...] Read more.
The role of nuclear medicine in pediatric cardiology has grown rapidly over the years, providing useful functional and prognostic information and playing a complementary role to morphological imaging in the evaluation of myocardial perfusion, cardiovascular inflammation and infections, and cardiac sympathetic innervation. The aim of this narrative review is to summarize and highlight the most important evidence on pediatric nuclear cardiology, describing clinical applications and the possibilities, advantages, and limitations of nuclear medicine techniques. Moreover, a special focus will be given to the minimization of radiation exposure in pediatric nuclear cardiology imaging, a critical topic in children. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Cardiovascular Diseases)
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14 pages, 4015 KiB  
Review
Clinical Use of Blood Flow Analysis through 4D-Flow Imaging in Aortic Valve Disease
by Omer Mansoor and Julio Garcia
J. Cardiovasc. Dev. Dis. 2023, 10(6), 251; https://doi.org/10.3390/jcdd10060251 - 9 Jun 2023
Viewed by 1964
Abstract
Bicuspid aortic valve (BAV), which affects 1% of the general population, results from the abnormal fusion of the cusps of the aortic valve. BAV can lead to the dilatation of the aorta, aortic coarctation, development of aortic stenosis (AS), and aortic regurgitation. Surgical [...] Read more.
Bicuspid aortic valve (BAV), which affects 1% of the general population, results from the abnormal fusion of the cusps of the aortic valve. BAV can lead to the dilatation of the aorta, aortic coarctation, development of aortic stenosis (AS), and aortic regurgitation. Surgical intervention is usually recommended for patients with BAV and bicuspid aortopathy. This review aims to examine 4D-flow imaging as a tool in cardiac magnetic resonance imaging for assessing abnormal blood flow and its clinical application in BAV and AS. We present a historical clinical approach summarizing evidence of abnormal blood flow in aortic valve disease. We highlight how abnormal flow patterns can contribute to the development of aortic dilatation and novel flow-based biomarkers that can be used for a better understanding of the disease progression. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Cardiovascular Diseases)
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22 pages, 1558 KiB  
Review
Artificial Intelligence Technologies in Cardiology
by Łukasz Ledziński and Grzegorz Grześk
J. Cardiovasc. Dev. Dis. 2023, 10(5), 202; https://doi.org/10.3390/jcdd10050202 - 6 May 2023
Cited by 14 | Viewed by 4669
Abstract
As the world produces exabytes of data, there is a growing need to find new methods that are more suitable for dealing with complex datasets. Artificial intelligence (AI) has significant potential to impact the healthcare industry, which is already on the road to [...] Read more.
As the world produces exabytes of data, there is a growing need to find new methods that are more suitable for dealing with complex datasets. Artificial intelligence (AI) has significant potential to impact the healthcare industry, which is already on the road to change with the digital transformation of vast quantities of information. The implementation of AI has already achieved success in the domains of molecular chemistry and drug discoveries. The reduction in costs and in the time needed for experiments to predict the pharmacological activities of new molecules is a milestone in science. These successful applications of AI algorithms provide hope for a revolution in healthcare systems. A significant part of artificial intelligence is machine learning (ML), of which there are three main types—supervised learning, unsupervised learning, and reinforcement learning. In this review, the full scope of the AI workflow is presented, with explanations of the most-often-used ML algorithms and descriptions of performance metrics for both regression and classification. A brief introduction to explainable artificial intelligence (XAI) is provided, with examples of technologies that have developed for XAI. We review important AI implementations in cardiology for supervised, unsupervised, and reinforcement learning and natural language processing, emphasizing the used algorithm. Finally, we discuss the need to establish legal, ethical, and methodical requirements for the deployment of AI models in medicine. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Cardiovascular Diseases)
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Other

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9 pages, 6960 KiB  
Brief Report
Maturation and Function of the Intercalated Disc: Report of Two Pediatric Cases Focusing on Cardiac Development and Myocardial Hyperplasia
by Willem B. van Ham, Esmeralda E. M. Meijboom, Merel L. Ligtermoet, Peter G. J. Nikkels and Toon A. B. van Veen
J. Cardiovasc. Dev. Dis. 2023, 10(8), 354; https://doi.org/10.3390/jcdd10080354 - 19 Aug 2023
Cited by 1 | Viewed by 1471
Abstract
The development of the normal human heart, ranging from gestational age to the mature adult heart, relies on a very delicate and timely orchestrated order of processes. One of the most striking alterations in time is the gradual extinction of the ability for [...] Read more.
The development of the normal human heart, ranging from gestational age to the mature adult heart, relies on a very delicate and timely orchestrated order of processes. One of the most striking alterations in time is the gradual extinction of the ability for cardiomyocytes to proliferate. Once passing this event, cardiomyocytes grow and increase in contractile strength by means of physiological hypertrophy. This process, importantly, seems to depend on an adequate development of electromechanical coupling that is achieved by the appropriate formation of the intercellular junction named the intercalated disc (ICD). In this report, we describe two sudden death cases of young and apparently healthy-born individuals without external abnormalities compared to an age-matched control. Histological examination, including the comparison with the age-matched and histology-matched controls, showed a disturbed formation of the protein machinery composing the electromechanical junctions at the ICD and an increased nuclei count for both patients. As a cause or consequence, cardiomyocytes in both sudden death cases showed signs of a delayed developmental stage, presumably resulting in an exaggerated degree of hyperplasia. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Cardiovascular Diseases)
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