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Clinical Applications of Cardiac Imaging Techniques in Patients with Ventricular Arrhythmias

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 August 2021) | Viewed by 3962

Special Issue Editors


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Guest Editor
Cardiac Imaging Unit, NorthWest Heart Centre, Manchester University NHS Foundation Trust, Manchester, UK
Interests: cardiac magnetic resonance; cardiac computed tomography; echocardiography; multimodality imaging; cardiomyopathies; ventricular arrhythmias

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Guest Editor
Cardiac Electrophysiology, Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
Interests: cardiac magnetic resonance; cardiac computed tomography; echocardiography; multimodality imaging; cardiomyopathies; ventricular arrhythmias

Special Issue Information

Dear Colleagues,

We have the pleasure to announce this Special Issue on “Clinical Applications of Cardiac Imaging Techniques in Patients with Ventricular Arrhythmias”. Ventricular arrhythmias are a major health issue in patients with structural heart disease (SHD). Myocardial scars play a central role in the genesis and maintenance of re-entrant ventricular arrhythmias as the coexistence of surviving myocardial fibers within fibrotic tissue leads to the formation of slow conduction pathways, dispersion of activation, and refractoriness, which constitute the milieu for ventricular arrhythmias circuits. Cardiac imaging, enabling the ventricular arrhythmogenic substrate to be characterized, has become a fundamental aid in this patient population for diagnostic, prognostic, and also procedural purposes, allowing planning and guiding of catheter ablation procedures by integrating structural and electrophysiological information and enabling effective ablation targets to be identified with increasing precision.

The aim of this Special Issue on “Clinical Applications of Cardiac Imaging Techniques in Patients with Ventricular Arrhythmias” is to provide readers with contemporary knowledge on the utility of different cardiac imaging modalities (including speckle-tracking echocardiography, intracardiac echocardiography, cardiac magnetic resonance, multidetector computed tomography, and nuclear imaging) in this clinical setting. We are therefore looking forward to receiving your research and review articles on this very interesting topic.

Dr. Gaetano Nucifora
Dr. Daniele Muser
Guest Editors

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Keywords

  • Cardiac imaging
  • Cardiac magnetic resonance
  • Cardiac computed tomography
  • Echocardiography
  • Late gadolinium enhancement
  • Nuclear imaging
  • Scar
  • Ventricular arrhythmias
  • Catheter ablation
  • Implantable cardioverter-defibrillator

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Published Papers (1 paper)

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Research

11 pages, 1483 KiB  
Article
The Combination of Chest Computed Tomography and Standard Electrocardiogram Provides Prognostic Information and Pathophysiological Insights in COVID-19 Pneumonia
by Matteo Bertini, Emanuele D’Aniello, Alberto Cereda, Marco Toselli, Filippo Maria Verardi, Luca Rossi, Daniela Aschieri, Alberto Monello, Marco Manfrini, Davide Vignale, Anna Palmisano, Antonio Esposito, Roberto Ferrari, Claudio Rapezzi and Francesco Giannini
J. Clin. Med. 2021, 10(14), 3031; https://doi.org/10.3390/jcm10143031 - 7 Jul 2021
Cited by 5 | Viewed by 3161
Abstract
Aims. Several studies have unveiled the great heterogeneity of COVID-19 pneumonia. Identification of the “vascular phenotype” (involving both pulmonary parenchyma and its circulation) has prognostic significance. Our aim was to explore the combined role of chest computed tomography (CT) scan and electrocardiogram (ECG) [...] Read more.
Aims. Several studies have unveiled the great heterogeneity of COVID-19 pneumonia. Identification of the “vascular phenotype” (involving both pulmonary parenchyma and its circulation) has prognostic significance. Our aim was to explore the combined role of chest computed tomography (CT) scan and electrocardiogram (ECG) at hospital admission in predicting short-term prognosis and to draw pathophysiological insights. Methods and Results. We analyzed the chest CT scan and ECG performed at admission in 151 consecutive COVID-19 patients admitted between 20 March and 4 April 2020. All-cause mortality within 30 days was the primary endpoint. Median age was 71 years (IQR: 62–76). Severe pneumonia was present in 25 (17%) patients, and 121 (80%) had abnormal ECG. During a median follow-up of 7 days (IQR: 4–13), 54 (36%) patients died. Deceased patients had more severe pneumonia than survivors did (80% vs. 64%, p = 0.044). ECG in deceased patients showed more frequently atrial fibrillation/flutter (17% vs. 6%, p = 0.039) and acute right ventricular (RV) strain (35% vs. 10%, p < 0.001), suggesting the “vascular phenotype”. ECG signs of acute RV strain (HR 2.46, 95% CIs 1.36–4.45, p = 0.0028) were independently associated with all-cause mortality in multivariable analysis, and in the likelihood ratio test, showed incremental prognostic value over chest CT scan, age, and C-reactive protein. Conclusions. Combining chest CT scan and ECG data improves risk stratification in COVID-19 pneumonia by identifying a distinctive phenotype with both parenchymal and vascular damage of the lung. Patients with severe pneumonia at chest CT scan plus ECG signs of acute RV strain have an extremely poor short-term prognosis. Full article
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