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Editorial Board Members’ Collection Series: Multimodality Cardiovascular Imaging 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 (31 August 2023) | Viewed by 4309

Special Issue Editors


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Guest Editor
Clinic for Internal Medicine II, University Clinic Ulm, Albert-Einstein Allee 23, 89081 Ulm, Germany
Interests: hypertension; diabetes; obesity; metabolic syndrome; echocardiohgraphy; speckle tracking; 3D echocardiography; cardiac magnetic resonancecardiography; cardiac magnetic resonance
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Special Issue Information

Dear Colleagues,

The timely diagnosis of cardiovascular diseases represents the cornerstone of modern medicine. The current aim is to recognize the first subtle and subclinical cardiovascular changes, before the first symptoms occur. This approach significantly reduces the occurrence of adverse cardiovascular events and possible complications. Not only is this approach is cost-effective, it also significantly improves the outcomes and quality of life of patients. This is valid for both primary and secondary cardiovascular prevention. 

Many cardiovascular risk factors, such as hypertension, diabetes, obesity and metabolic syndrome, are leading to significant cardiac remodeling that may lead to the occurrence of major cardiovascular events. The use of 2D and 3D speckle tracking echocardiography can detect subclinical changes in left and right ventricular mechanics, as well as in left atrial function, that reveal patients who are at higher risk of adverse events and therefore deserve close monitoring and strict regulation of their risk factors (increased blood pressure, hyperglycemia, obesity, etc.). 

The same techniques could be used in the risk stratification of patients with different cardiomyopathies, heart failure, arrhythmias, valvular heart disease, coronary artery disease and other cardiovascular conditions that are treated on daily basis. In these disorders, one may be more considered for secondary prevention, but primary prevention should not be neglected. 

Aside from echocardiography, which still represents a cornerstone in cardiac imaging and a first-line visualization technique used in clinical circumstances, one should not underestimate the importance of other techniques such as cardiac magnetic resonance (CMR), cardiac computed tomography (CCT) and positron emission computed tomography (PET-CT).

The aim of this Special Issue is to present the full spectrum of currently available cardiovascular imaging techniques used for the evaluation of cardiac structure, function, mechanics and metabolism in various cardiovascular disorders, as well as in patients in primary and secondary prevention. 

Prof. Dr. Marijana Tadic
Prof. Dr. Costantino Mancusi
Guest Editors

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Published Papers (3 papers)

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Research

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11 pages, 1041 KiB  
Article
Myocardial Work in Middle-Aged Adults with Overweight and Obesity: Associations with Sex and Central Arterial Stiffness
by Katrine Tryti Lindseth, Eva Gerdts, Helga Midtbø, Nadia Pristaj, Dana Cramariuc and Eigir Einarsen
J. Clin. Med. 2023, 12(17), 5676; https://doi.org/10.3390/jcm12175676 - 31 Aug 2023
Cited by 2 | Viewed by 1218
Abstract
We explored global myocardial work index (GWI), a novel measure of myocardial function that integrates left ventricular (LV) hemodynamic load, in relation to sex and increased body mass index (BMI). We used data from 467 individuals (61% women, average age 47 ± 9 [...] Read more.
We explored global myocardial work index (GWI), a novel measure of myocardial function that integrates left ventricular (LV) hemodynamic load, in relation to sex and increased body mass index (BMI). We used data from 467 individuals (61% women, average age 47 ± 9 years and BMI 31.2 kg/m2) without known cardiac disease. Central arterial function was analysed by applanation tonometry. GWI was calculated from global longitudinal strain (GLS) and post-echocardiography supine blood pressure (BP). Covariables of GWI were identified in linear regression analyses. Women had higher BMI, aortic augmentation pressure (12 ± 7 vs. 8 ± 6 mmHg), LV GLS (20.0 ± 2.8 vs. 18.8 ± 2.8%), and GWI (2126 ± 385 vs. 2047 ± 389 mmHg%) than men (all p < 0.05). In univariable analyses, higher GWI was associated with female sex, higher age, systolic BP, LV wall stress, LV ejection fraction, left atrial size, LV ejection time, and with lower waist circumference (all p < 0.05). In multivariable analysis, adjusting for these correlates, female sex remained independently associated with higher GWI (β = 0.13, p = 0.007). After additional adjustment for aortic augmentation pressure or central pulse pressure, this association became non-significant. In conclusion, the higher GWI in women compared to men was mainly explained by increased LV workload due to higher aortic augmentation pressure in women. Full article
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12 pages, 922 KiB  
Article
Multimodality Imaging Evaluation to Detect Subtle Right Ventricular Involvement in Patients with Acute Myocarditis and Preserved Left Ventricular Ejection Fraction
by Michela Bonanni, Gianmarco Angelini, Laura Anna Leo, Susanne Anna Schlossbauer, Luca Bergamaschi, Antonio Landi, Giuseppe Massimo Sangiorgi, Cinzia Forleo, Elena Pasotti, Giovanni Pedrazzini, Marco Valgimigli, Francesco F. Faletra, Marco Guglielmo and Anna Giulia Pavon
J. Clin. Med. 2023, 12(13), 4308; https://doi.org/10.3390/jcm12134308 - 27 Jun 2023
Cited by 1 | Viewed by 1146
Abstract
Background: Evaluation of the right ventricle (RV) in patients with acute myocarditis (MY) remains challenging with both 2D transthoracic echocardiography (TTE) and cardiovascular magnetic resonance (CMR). We examined the incremental diagnostic value of CMR feature tracking (FT) to evaluate RV involvement in patients [...] Read more.
Background: Evaluation of the right ventricle (RV) in patients with acute myocarditis (MY) remains challenging with both 2D transthoracic echocardiography (TTE) and cardiovascular magnetic resonance (CMR). We examined the incremental diagnostic value of CMR feature tracking (FT) to evaluate RV involvement in patients with myocarditis. Methods: We enrolled 54 patients with myocarditis and preserved left ventricle (LV) ejection fraction (EF). The CMR protocol included T2-weighted images for edema detection and late gadolinium enhancement (LGE) images. Global longitudinal strain (GLS) of the left ventricle (LV) and RV free wall strain (CMR-FWS) were obtained with CMR-FT. We identified 34 patients (62%) with inferior and lateral segment (IL-MY) involvement and 20 (38%) noIL-MY in case of any other myocardial segment involved. Here, 20 individuals who underwent CMR for suspected cardiac disease, which was not confirmed thereafter, were considered as the control population. Results: TTE and CMR showed normal RV function in all patients without visible RV involvement at the LGE or T2-weighted sequences. At CMR, LV-GLS values were significantly lower in patients with MY compared to the control group (median −19.0% vs. −21.0%, p = 0.029). Overall, CMR RV-FWS was no different between MY patients and controls (median −21.2% vs. −23.2 %, p = 0.201) while a significant difference was found between RV FWS in IL-MY and noIL-MY (median −18.17% vs. −24.2%, p = 0.004). Conclusions: CMR-FT has the potential to unravel subclinical RV involvement in patients with acute myocarditis, specifically in those with inferior and lateral injuries that exhibit lower RV-FWS values. In this setting, RV deformation analysis at CMR may be effectively implemented for a comprehensive functional assessment. Full article
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Review

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16 pages, 10142 KiB  
Review
Multimodality Imaging in Right Heart Tumors: Proposed Algorithm towards an Appropriate Diagnosis
by Mariana Floria, Alexandru Burlacu, Paula Cristina Morariu, Alexandru-Florinel Oancea, Diana-Elena Iov, Genoveva Livia Baroi, Celina Silvia Stafie, Viorel Scripcariu and Daniela Maria Tănase
J. Clin. Med. 2024, 13(4), 1000; https://doi.org/10.3390/jcm13041000 - 9 Feb 2024
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Abstract
A right heart tumor can be identified by transthoracic echocardiography during a routine examination or due to cardiac symptoms. The first step is the assessment by echocardiography, with its multiple techniques, and the obtained information must be judged in a clinical and biological [...] Read more.
A right heart tumor can be identified by transthoracic echocardiography during a routine examination or due to cardiac symptoms. The first step is the assessment by echocardiography, with its multiple techniques, and the obtained information must be judged in a clinical and biological context. The second step comprises one, sometimes even two, of the more complex modality imaging methods. The choice is driven not only by the advantages of each imaging technique but also by local expertise or the preferred imaging modality in the center. This step is followed by staging, follow-up, and/or imaging-guided excision or biopsy, which is performed in selected cases in order to obtain anatomopathological confirmation. In the presence of features suggestive of malignancy or causing hemodynamic impairment, a transvenous biopsy is essential before the more complex imaging modalities (which are still relevant in the staging process). Using a structured imaging approach, it is possible to reach an appropriate diagnosis without a biopsy. Frequently, these imaging techniques have a complementary role, so an integrated imaging approach is recommended. This proposed algorithm for appropriate diagnosis of right heart tumors could serve as a practical guide for clinicians (not only imaging specialists). Full article
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