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Advances in Non-Invasive Cardiovascular Diagnostics
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Advances in Non-Invasive Cardiovascular Diagnostics

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 (15 June 2022) | Viewed by 5056

Special Issue Editor

Prof. Dr. Dominik Buckert

E-Mail Website
Guest Editor
Ulm University, UKU • Clinic of Internal Medicine II, 89081 Ulm, Germany
Interests: cardiac magnetic resonance imaging; ischemia and viability; tissue characterization and inflammatory myocardial diseases; myocardial deformation analysis and strain assessment; fusion imaging

Special Issue Information

Dear Colleagues,

Cardiac magnetic resonace (CMR) imaging has become an inevitable cornerstone of modern cardiology. Its accuracy and reliability combined with the ability to non-invasively provide comprehensive information in only one examination secured CMR’s pivotal role in numerous guidelines. Though coming a long way from sole evaluation of chamber size and function via cine imaging over assessment of ischemia and viability to tissue characterization by T1- and T2-weighted imaging, drive and passion of the CMR community to achieve further improvement is unbroken. As a result, new and innovative technologies arise constantly. Their ability to impact diagnostic pathways and clinical decision making processes needs careful and thorough evaluation – presupposing this, CMR’s significance will further grow.

In this Journal of Clinical Medicine’s Special Issue, basic, translational and clinical CMR science will be featured. We therefore cordially invite researchers to submit their original research, systematic reviews, and short communications. 

Prof. Dr. Dominik Buckert
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Cardiac magnetic resonance
  • Diagnostic strategies, risk stratification, utilization in clinical trials
  • Improvement of image acquisition and processing
  • Translational studies

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (4 papers)

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Research

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16 pages, 1800 KiB  
Article
Severe Impairment of Left Ventricular Regional Strain in STEMI Patients Is Associated with Post-Infarct Remodeling
by Giovanni Andrea Luisi, Gabriele Pestelli, Giulia Lorenzoni, Filippo Trevisan, Vittorio Smarrazzo, Andrea Fiorencis, Filippo Flamigni, Roberto Ferrari and Donato Mele
J. Clin. Med. 2022, 11(18), 5348; https://doi.org/10.3390/jcm11185348 - 12 Sep 2022
Cited by 1 | Viewed by 1489
Abstract
Background: Measures of global left ventricular (LV) systolic function have limitations for the prediction of post-infarct LV remodeling (LVR). Therefore, we tested the association between a new measure of regional LV systolic function—the percentage of severely altered strain (%SAS)- and LVR after acute [...] Read more.
Background: Measures of global left ventricular (LV) systolic function have limitations for the prediction of post-infarct LV remodeling (LVR). Therefore, we tested the association between a new measure of regional LV systolic function—the percentage of severely altered strain (%SAS)- and LVR after acute ST-elevation myocardial infarction (STEMI). As a secondary objective, we also evaluated the association between %SAS and clinical events during follow-up. Methods: Of 177 patients undergoing echocardiography within 24 h from primary percutaneous coronary angioplasty, 172 were studied for 3 months, 167 for 12 months, and 10 died. The %SAS was calculated by dividing the number of LV myocardial segments with ≥−5% peak systolic longitudinal strain by the total number of segments. LVR was defined as the increase in end-diastolic volume >20% at its first occurrence compared to baseline. Results: LVR percentage was 10.2% and 15.8% at 3 and 12 months, respectively. Based on univariable analysis, a number of clinical, laboratory, electrocardiographic and echocardiographic variables were associated with LVR. Based on multivariable analysis, %SAS and TnI peak remained associated with LVR (for %SAS 5% increase, OR 1.226, 95% CI 1.098–1.369, p < 0.0005; for TnI peak, OR 1.025, 95% CI 1.004–1.047, p = 0.022). %SAS and LVR were also associated with occurrence of clinical events at a median follow-up of 43 months (HR 1.02, 95% CI 1.0–1.04, p = 0.0165). Conclusions: In patients treated for acute STEMI, acute %SAS is associated with post-infarct LVR. Therefore, we suggest performing such evaluations on a routine basis to identify, as early as possible, STEMI patients at higher risk. Full article
(This article belongs to the Special Issue Advances in Non-Invasive Cardiovascular Diagnostics)
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16 pages, 2539 KiB  
Article
Real-Time Spiral CMR Is Superior to Conventional Segmented Cine-Imaging for Left-Ventricular Functional Assessment in Patients with Arrhythmia
by Nicoleta Nita, Johannes Kersten, Alexander Pott, Fabian Weber, Temsgen Tesfay, Marius-Tudor Benea, Patrick Metze, Hao Li, Wolfgang Rottbauer, Volker Rasche and Dominik Buckert
J. Clin. Med. 2022, 11(8), 2088; https://doi.org/10.3390/jcm11082088 - 8 Apr 2022
Cited by 5 | Viewed by 2515
Abstract
(1) Background: Segmented Cartesian Cardiovascular magnetic resonance (CMR) often fails to deliver robust assessment of cardiac function in patients with arrhythmia. We aimed to assess the performance of a tiny golden-angle spiral real-time CMR sequence at 1.5 T for left-ventricular (LV) volumetry in [...] Read more.
(1) Background: Segmented Cartesian Cardiovascular magnetic resonance (CMR) often fails to deliver robust assessment of cardiac function in patients with arrhythmia. We aimed to assess the performance of a tiny golden-angle spiral real-time CMR sequence at 1.5 T for left-ventricular (LV) volumetry in patients with irregular heart rhythm; (2) Methods: We validated the real-time sequence against the standard breath-hold segmented Cartesian sequence in 32 patients, of whom 11 presented with arrhythmia. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF) were assessed. In arrhythmic patients, real-time and standard Cartesian acquisitions were compared against a reference echocardiographic modality; (3) Results: In patients with sinus rhythm, good agreements and correlations were found between the segmented and real-time methods, with only minor, non-significant underestimation of EDV for the real-time sequence (135.95 ± 30 mL vs. 137.15 ± 31, p = 0.164). In patients with arrhythmia, spiral real-time CMR yielded superior image quality to the conventional segmented imaging, allowing for excellent agreement with the reference echocardiographic volumetry. In contrast, in this cohort, standard Cartesian CMR showed significant underestimation of LV-ESV (106.72 ± 63.51 mL vs. 125.47 ± 72.41 mL, p = 0.026) and overestimation of LVEF (42.96 ± 10.81% vs. 39.02 ± 11.72%, p = 0.039); (4) Conclusions: Real-time spiral CMR improves image quality in arrhythmic patients, allowing reliable assessment of LV volumetry. Full article
(This article belongs to the Special Issue Advances in Non-Invasive Cardiovascular Diagnostics)
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Review

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14 pages, 2629 KiB  
Review
Imaging Challenges in Patients with Severe Aortic Stenosis and Heart Failure: Did We Find a Way Out of the Labyrinth?
by Birgid Gonska, Dominik Buckert, Johannes Mörike, Dominik Scharnbeck, Johannes Kersten, Cesare Cuspidi, Wolfang Rottbauer and Marijana Tadic
J. Clin. Med. 2022, 11(2), 317; https://doi.org/10.3390/jcm11020317 - 10 Jan 2022
Cited by 2 | Viewed by 2611
Abstract
Aortic stenosis (AS) is the most frequent degenerative valvular disease in developed countries. Its incidence has been constantly rising due to population aging. The diagnosis of AS was considered straightforward for a very long time. High gradients and reduced aortic valve area were [...] Read more.
Aortic stenosis (AS) is the most frequent degenerative valvular disease in developed countries. Its incidence has been constantly rising due to population aging. The diagnosis of AS was considered straightforward for a very long time. High gradients and reduced aortic valve area were considered as “sine qua non” in diagnosis of AS until a growing body of evidence showed that patients with low gradients could also have severe AS with the same or even worse outcome. This completely changed the paradigm of AS diagnosis and involved large numbers of parameters that had never been used in the evaluation of AS severity. Low gradient AS patients may present with heart failure (HF) with preserved or reduced left ventricular ejection fraction (LVEF), associated with changes in cardiac output and flow across the aortic valve. These patients with low-flow low-gradient or paradoxical low-flow low-gradient AS are particularly challenging to diagnose, and cardiac output and flow across the aortic valve have become the most relevant parameters in evaluation of AS, besides gradients and aortic valve area. The introduction of other imaging modalities in the diagnosis of AS significantly improved our knowledge about cardiac mechanics, tissue characterization of myocardium, calcium and inflammation burden of the aortic valve, and their impact on severity, progression and prognosis of AS, not only in symptomatic but also in asymptomatic patients. However, a variety of novel parameters also brought uncertainty regarding the clinical relevance of these indices, as well as the necessity for their validation in everyday practice. The aim of this review is to summarize the prevalence of HF in patients with severe AS and elaborate on the diagnostic challenges and advantages of comprehensive multimodality cardiac imaging to identify the patients that may benefit from surgical or transcatheter aortic valve replacement, as well as parameters that may help during follow-up. Full article
(This article belongs to the Special Issue Advances in Non-Invasive Cardiovascular Diagnostics)
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Other

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5 pages, 554 KiB  
Brief Report
Chronotype of Lung Fluid Levels in Patients with Chronic Heart Failure
by Yohei Ueno, Teruhiko Imamura, Nikhil Narang and Koichiro Kinugawa
J. Clin. Med. 2022, 11(10), 2714; https://doi.org/10.3390/jcm11102714 - 11 May 2022
Cited by 6 | Viewed by 1644
Abstract
Background: The variation in lung fluid levels dependent on chronotype in patients with chronic heart failure is unclear. Remote dielectric sensing (ReDSTM) is a novel non-invasive system to quantify the lung fluids, which may correlate to intracardiac filling pressures. We aimed [...] Read more.
Background: The variation in lung fluid levels dependent on chronotype in patients with chronic heart failure is unclear. Remote dielectric sensing (ReDSTM) is a novel non-invasive system to quantify the lung fluids, which may correlate to intracardiac filling pressures. We aimed to understand the variation in ReDS measurements by chronotype in patients with chronic heart failure. Methods: The patients who were hospitalized for heart failure exacerbations between November 2021 and March 2022 were prospectively included. ReDS values were measured at clinically stable conditions at the following three time points during the day: 5:00 (morning), 12:00 (noon), and 21:00 (night) (manufacture-recommended reference of ReDS value: between 25% and 35%). Results: Twelve patients were included. The median age was 84 (75, 90) years and four patients (33%) were men. The median plasma B-type natriuretic peptide was 235 (178, 450) pg/mL. The median ReDS value was 38% (23%, 41%) in the morning. The ReDS value decreased significantly at the noon measurement, down to 28% (23%, 29%) (p = 0.005) and again increased significantly at the night measurement, up to 31% (27%, 42%) (p = 0.002). The patients were clinically stabilized during the observational period. Conclusions: the lung fluid level varied considerably in patients with chronic heart failure following clinical stabilization. Full article
(This article belongs to the Special Issue Advances in Non-Invasive Cardiovascular Diagnostics)
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