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• W4226206891 abstract "HomeCirculation: Cardiovascular ImagingVol. 15, No. 4In This Issue of the Journal Free AccessEditorialPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessEditorialPDF/EPUBIn This Issue of the Journal Robert J. Gropler, MD Robert J. GroplerRobert J. Gropler https://orcid.org/0000-0002-6550-0570 Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO. Search for more papers by this author Originally published19 Apr 2022https://doi.org/10.1161/CIRCIMAGING.122.014256Circulation: Cardiovascular Imaging. 2022;15I want to welcome you to the April 2022 issue of Circulation: Cardiovascular Imaging. We provide a host of offerings that describe advances in cardiovascular imaging to improve cardiovascular disease detection and risk stratification and potential strategies for their rationale use.Accurate estimation of left ventricular diastolic function in patients with hypertrophic cardiomyopathy continues to be a challenge relying on the integration of multiple echocardiographic-derived values. Recently, left atrial reservoir strain as a measure of left ventricular diastolic function was reported to be a strong predictor of heart failure development in the general population. Lee and colleagues extend these observations to patients with hypertrophic cardiomyopathy by demonstrating left atrial reservoir strain categorizing of left ventricular diastolic function was independently associated with heart failure outcomes. Continuing Medical Education credit is available for this article. In their editorial, Oh and Miranda note that in the study cohort the prevalence of resting obstructive physiology and apical hypertrophy were relatively low and high, respectively, raising the question of applicability of the findings to other cohorts with hypertrophic cardiomyopathy.For pregnancies at higher risk of congenital heart disease a detailed fetal echocardiogram is recommended, including in the setting of a completely normal second-trimester ultrasound. However, the benefit of fetal echocardiography in this setting is unclear. Cardinal et al provide evidence suggesting in the setting of a normal second-trimester ultrasound, adding a fetal echocardiography for common fetal and maternal risk factors offered low incremental value to the detection rate of severe congenital heart disease in singleton pregnancies. In their commentary Simpson and Hornberger concisely summarize the strengths and weaknesses of the study and raise the important caveats of the likely dependence of the study findings on a highly developed screening program and the evolution of fetal echocardiography to beyond just screening for structural fetal congenital heart disease.The presence of coronary artery calcium, relative myocardial perfusion defects, and reduced myocardial flow reserve are all biomarkers of increased cardiovascular risk. However, their proportional contributions to cardiovascular risk is unclear. Patel and colleagues provide evidence that in symptomatic patients with without known coronary artery disease, reduced myocardial flow reserve offers a comprehensive assessment of future risk of death, beyond that offered by extent of atherosclerosis and relative perfusion assessment. In her editorial Taqueti nicely contextualizes the study results with current knowledge and makes the important observation that in this population, potentially nonatherothrombotic etiologies are the cause of death when calcium score of 0 is present.Extracellular volume (ECV) measured by cardiovascular magnetic resonance imaging (CMR) is the most common noninvasive technique to detect diffuse myocardial fibrosis. However, its wide spread applicability is limited by the need for the measurement of the hematocrit very near the time of CMR to provide accurate ECV measurements. Although, methods to measure ECV without blood sampling have been proposed they may be limited by a relatively narrow dynamic range and generalizability. Chen et al report on several modeling approaches that appear to overcome these challenges and accurately measure ECV.Endomyocardial biopsy continues to be the test of choice for surveillance for acute rejection in pediatric heart transplant recipients. Given the morbidity and mortality associated with repeated testing in this population, there is a strong interest in identifying noninvasive surveillance tools. Studies in adult patients have demonstrated the potential of multiparametric CMR to fulfill this role, but evidence in pediatric patients is more limited. In a Research Letter, Soslow and colleagues provide preliminary evidence that in pediatric heart transplant patients, CMR measurements native T2, ECV and global longitudinal strain can noninvasively distinguish those patients with and without acute rejection.In the Cardiovascular Images section, Elad et al present an example of how 3-dimensional cardiac computed tomography reconstruction detected outflow graft twisting as the cause of reduced flow of a left ventricular assist device. Castellani and colleagues describe how 2-dimensional transthoracic echocardiography and CMR imaging were used to detect a trileaflet mitral valve in a patient with hypertrophic cardiomyopathy. Pires et al illustrate how cardiac computed tomography angiography aided in the diagnosis of anomalous origin of the right coronary artery from the pulmonary artery. Derycke and colleagues present an example of where 3-dimensional modeling based on computed tomographic anatomic information and finite element analysis of the mechanical and geometric features of an aortic graft device could potentially predict subsequent graft failure.I thank you for reading Circulation: Cardiovascular Imaging and hope you enjoyed reading the various pieces and look forward to your future visits to the journal.FootnotesThe opinions expressed in this article are not necessarily those of the editors nor the American Heart Association.For Disclosures, see page 224. Previous Back to top Next FiguresReferencesRelatedDetails April 2022Vol 15, Issue 4 Advertisement Article InformationMetrics © 2022 American Heart Association, Inc.https://doi.org/10.1161/CIRCIMAGING.122.014256PMID: 35439038 Originally publishedApril 19, 2022 PDF download Advertisement" @default.
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