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New Horizons and Current Concepts in Cardiac Computed Tomography

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 10018

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Special Issue Editors

Dr. Wolfgang Dichtl

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Guest Editor

Department of Internal Medicine III (Cardiology), Medizinische Universität Innsbruck, Innsbruck, Austria
Interests: cardiac electrophysiology; takotsubo syndrome; cardiac computed tomography; sleep apnea

Prof. Dr. Gudrun Feuchtner

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Guest Editor

Department of Radiology, Medizinische Universität Innsbruck, Innsbruck, Austria
Interests: coronary CTA; coronary artery disease; computed tomography angiography
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Dear Colleagues,

Cardiac imaging has evolved rapidly over the past decades. Multi-slice computed tomography (CT) is now the preferred imaging modality for non-invasive diagnosis of coronary artery disease. Detection of high-risk coronary plaques allows for improved selection of patients at high risk for future major clinical events. Furthermore, other structures of the heart such as valve morphology, the amount of valvular calcification, and the characteristics of cardiac chambers including the left atrial appendage (size, wall thickness), epicardial fat, embolic sources (thrombus, endocarditis) and extra-cardiac vessels can be assessed. Cardiac CT plays a key role in guiding cardiovascular interventions such as transcatheter aortic valve implantation, pulmonary vein isolation, or left atrial appendage occlusion.

We are inviting original research articles and reviews (state-of-the-art and novel clinical applications) to be submitted until 31th December 2021.

Dr. Wolfgang Dichtl
Prof. Dr. Gudrun Feuchtner
Guest Editors

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Keywords

structural heart disease
cardiac imaging
high-risk plaque
atherosclerosis
coronary artery disease
valvular calcification
thrombus detection

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Published Papers (4 papers)

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Editorial

Jump to: Research, Review

4 pages, 202 KiB

Open AccessEditorial

Cardiac Computed Tomography: State of the Art and Future Horizons

by Gudrun M. Feuchtner, Fabian Plank, Christoph Beyer, Fabian Barbieri, Gerlig Widmann, Philipp Spitaler and Wolfgang Dichtl

J. Clin. Med. 2022, 11(15), 4429; https://doi.org/10.3390/jcm11154429 - 29 Jul 2022

Cited by 4 | Viewed by 1667

Abstract

Cardiac computed tomography (CT) has evolved over the past 20 years from an alternative, promising noninvasive imaging modality to a Class I indication for the non-invasive evaluation of patients with low-to-intermediate, pre-test probability of coronary artery disease (CAD), as per the European Society [...] Read more.

(This article belongs to the Special Issue New Horizons and Current Concepts in Cardiac Computed Tomography)

Research

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6 pages, 977 KiB

Open AccessArticle

Bicuspid Aortic Valve Is Associated with Less Coronary Calcium and Coronary Artery Disease Burden

by Gudrun Feuchtner, Sven Bleckwenn, Leon Stoessl, Fabian Plank, Christoph Beyer, Nikolaos Bonaros, Thomas Schachner, Thomas Senoner, Gerlig Widmann, Can Gollmann-Tepeköylü, Johannes Holfeld, Wolfgang Dichtl and Fabian Barbieri

J. Clin. Med. 2021, 10(14), 3070; https://doi.org/10.3390/jcm10143070 - 11 Jul 2021

Cited by 4 | Viewed by 2556

Abstract

(1) Background. Bicuspid aortic valve (BAV) is associated with genetic defects (NOTCH 1, GATA 5) and aortopathy. Differences in the flow patterns and a genetic predisposition could also affect coronary arteries. The objective was to assess the coronary artery calcium score (CACS) and coronary artery disease (CAD) burden by coronary computed tomography angiography (CTA) in patients with BAV stenosis, as compared to stenotic tricuspid aortic valves (TAV). (2) Methods. A retrospective case–control study. A total of 47 patients with BAV stenosis (68.9 years ± 12.9, 38.3% females) who underwent CTA were matched with 47 TAV stenosis patients for age, gender, smoking, arterial hypertension, dyslipidemia, diabetes, body-mass-index and chronic kidney disease. (3) Results. The coronary artery calcium score (CACS) was lower in BAV (237.4 vs. 1013.3AU; p < 0.001) than in TAV, and stenosis severity was less (CAD-RAD^TM: p < 0.001). More patients with BAV had CACS zero (27.7% vs. 0%; p < 0.001). The majority (68.1%) of patients with BAV had no or non-obstructive CAD but only 25.5% of TAV (p < 0.001). Obstructive CAD (>50% stenosis) by CTA was more frequently observed in patients with TAV (68.1%; p < 0.001). (4) Conclusions and Relevance. Patients with BAV stenosis have markedly less coronary calcium and less severe coronary stenosis. CTA succeeds to rule out obstructive CAD in the majority of BAV, with adherent implications for TAVR planning. Full article

(This article belongs to the Special Issue New Horizons and Current Concepts in Cardiac Computed Tomography)

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13 pages, 908 KiB

Open AccessArticle

Gender Differences in the Atherosclerosis Profile by Coronary CTA in Coronary Artery Calcium Score Zero Patients

by Thomas Senoner, Fabian Plank, Christoph Beyer, Christian Langer, Katharina Birkl, Fabian Steinkohl, Gerlig Widmann, Fabian Barbieri, Agne Adukauskaite, Guy Friedrich, Axel Bauer, Wolfgang Dichtl and Gudrun M. Feuchtner

J. Clin. Med. 2021, 10(6), 1220; https://doi.org/10.3390/jcm10061220 - 15 Mar 2021

Cited by 12 | Viewed by 2516

Abstract

Background: The coronary artery calcium score (CACS) is a powerful tool for cardiovascular risk stratification. Coronary computed tomography angiography (CTA) allows for a more distinct analysis of atherosclerosis. The aim of the study was to assess gender differences in the atherosclerosis profile of CTA in patients with a CACS of zero. Methods: A total of 1451 low- to intermediate-risk patients (53 ± 11 years; 51% females) with CACS <1.0 Agatston units (AU) who underwent CTA and CACS were included. Males and females were 1:1 propensity score-matched. CTA was evaluated for stenosis severity (Coronary Artery Disease – Reporting and Data System (CAD-RADS) 0–5: minimal <25%, mild 25–49%, moderate 50–69%, severe ≥70%), mixed-plaque burden (G-score), and high-risk plaque (HRP) criteria (low-attenuation plaque, spotty calcification, napkin-ring sign, and positive remodeling). All-cause mortality, cardiovascular mortality, and major cardiovascular events (MACEs) were collected. Results: Among the patients, 88.8% had a CACS of 0 and 11.2% had an ultralow CACS of 0.1–0.9 AU. More males than females (32.1% vs. 20.3%; p < 0.001) with a CACS of 0 had atherosclerosis, while, among those with an ultralow CACS, there was no difference (88% vs. 87.1%). Nonobstructive CAD (25.9% vs. 16.2%; p < 0.001), total plaque burden (2.2 vs. 1.4; p < 0.001), and HRP were found more often in males (p < 0.001). After a follow-up of mean 6.6 ± 4.2 years, all-cause mortality was higher in females (3.5% vs. 1.8%, p = 0.023). Cardiovascular mortality and MACEs were low (0.2% vs. 0%; p = 0.947 and 0.3% vs. 0.6%; p = 0.790) for males vs. females, respectively. Females were more often symptomatic for chest pain (70% vs. 61.6%; p = 0.004). (4) Conclusions: In patients with a CACS of 0, males had a higher prevalence of atherosclerosis, a higher noncalcified plaque burden, and more HRP criteria. Nonetheless, females had a worse long–term outcome and were more frequently symptomatic. Full article

(This article belongs to the Special Issue New Horizons and Current Concepts in Cardiac Computed Tomography)

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Review

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15 pages, 2108 KiB

Open AccessReview

Molecular Imaging of Vulnerable Coronary Plaque with Radiolabeled Somatostatin Receptors (SSTR)

by Luz Kelly Anzola, Jose Nelson Rivera, Juan Carlos Ramirez, Alberto Signore and Fernando Mut

J. Clin. Med. 2021, 10(23), 5515; https://doi.org/10.3390/jcm10235515 - 25 Nov 2021

Cited by 9 | Viewed by 2500

Abstract

Atherosclerosis is responsible for the majority of heart attacks and is characterized by several modifications of the arterial wall including an inflammatory reaction. The silent course of atherosclerosis has made it necessary to develop predictors of disease complications before symptomatic lesions occur. Vulnerable to rupture atherosclerotic plaques are the target for molecular imaging. To this aim, different radiopharmaceuticals for PET/CT have emerged for the identification of high-risk plaques, with high specificity for the identification of the cellular components and pathophysiological status of plaques. By targeting specific receptors on activated macrophages in high-risk plaques, radiolabelled somatostatin analogues such as ⁶⁸Ga-DOTA-TOC, TATE,0 or NOC have shown high relevance to detect vulnerable, atherosclerotic plaques. This PET radiopharmaceutical has been tested in several pre-clinical and clinical studies, as reviewed here, showing an important correlation with other risk factors. Full article

(This article belongs to the Special Issue New Horizons and Current Concepts in Cardiac Computed Tomography)

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