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The Roles of Cardiac Imaging in Medical Diagnosis and Management

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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 15142

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Special Issue Editor

Dr. Patrick Martineau

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Guest Editor

Department of Radiology, University of Manitoba, Winnipeg, MB, Canada
Interests: myocardial perfusion imaging; cardiac sarcoidosis; cardiac amyloidosis; endocarditis; vasculitis; heart failure; viability; atherosclerosis; cardiac hardware infection

Special Issue Information

Dear Colleagues,

Imaging has long played a key role in the diagnosis of cardiac pathology with significant impact on medical and surgical management decisions. Traditional cardiac imaging has largely been concerned with the assessment of cardiac perfusion and function; however, the last few years have seen an important increase in the range of modalities and applications with particular emphasis on the diagnosis of cardiac inflammatory and infectious pathologies. Furthermore, emerging techniques, such as atherosclerosis imaging, continue to evolve and may prove to be clinically useful in the era of personalized medicine.

The aim of this Special Issue is to review key applications and innovations in the field of multimodality cardiac imaging, including but not limited to:

1) Myocardial perfusion imaging

2) Assessment of cardiac function

3) Cardiac viability imaging

4) Imaging of systemic pathologies with cardiac involvement such as sarcoidosis and amyloidosis

5) Cardiac infection imaging such with applications to endocarditis and cardiac hardware infection

6) Advances in atherosclerosis imaging

Authors are encouraged to discuss the impact of particular imaging techniques on subsequent clinical management.

Dr. Patrick Martineau
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

Myocardial perfusion imaging
Cardiac sarcoidosis
Cardiac amyloidosis
Endocarditis
Vasculitis
Heart failure
Viability
Atherosclerosis
Cardiac hardware infection

Published Papers (3 papers)

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Research

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15 pages, 1584 KiB

Open AccessArticle

Radiological Cardiothoracic Ratio as a Potential Predictor of Right Ventricular Enlargement in Patients with Suspected Pulmonary Embolism Due to COVID-19

by Krystian Truszkiewicz, Małgorzata Poręba, Rafał Poręba and Paweł Gać

J. Clin. Med. 2021, 10(23), 5703; https://doi.org/10.3390/jcm10235703 - 4 Dec 2021

Cited by 4 | Viewed by 2799

Abstract

The aim of the study was to determine the usefulness of the radiological cardiothoracic ratio (CTR) as a predictor of right ventricular enlargement in patients with suspected pulmonary embolism during COVID-19. The study group consisted of 61 patients with confirmed COVID-19, suspected of pulmonary embolism based on physical examination and laboratory tests (age: 67.18 ± 12.47 years). Computed tomography angiography (CTA) of pulmonary arteries and chest radiograph in AP projection with cardiothoracic ratio assessment were performed in all patients. Right ventricular enlargement was diagnosed by the ratio of right ventricular to left ventricular (RV/LV) dimensions in pulmonary CTA with two cut-off points: ≥0.9 and ≥1.0. Heart silhouette enlargement was found when CTR on the chest radiograph in the projection AP > 0.55. The mean values of RV/LV and CTR in the studied group were 0.96 ± 0.23 and 0.57 ± 0.05, respectively. Pulmonary embolism was diagnosed in 45.9%. Right ventricular enlargement was documented in 44.3% or 29.5% depending on the adopted criterion RV/LV ≥ 0.9 or RV/LV ≥ 1.0. Heart silhouette enlargement was found in 60.6%. Patients with confirmed pulmonary embolism (PE+) had a significantly higher RV/LV ratio and CTR than patients with excluded pulmonary embolism (PE−) (RV/LV: PE+ 1.08 ± 0.24, PE− 0.82 ± 0.12; CTR: PE+ 0.60 ± 0.05, PE− 0.54 ± 0.04; p < 0.05). The correlation analysis showed a statistically significant positive correlation between the RV/LV ratio and CTR (r = 0.59, p < 0.05). Based on the ROC curves, CTR values were determined as the optimal cut-off points for the prediction of right ventricular enlargement (RV/LV ≥ 0.9 or RV/LV ≥ 1.0), being 0.54 and 0.55, respectively. The sensitivity, specificity, and accuracy of the CTR criterion >0.54 as a predictor of RV/LV ratio ≥0.9 were 0.412, 0.963, and 0.656, respectively, while those of the CTR criterion >0.55 as a predictor of RV/LV ratio ≥1.0 were 0.488, 0.833, and 0.590, respectively. In summary, in patients with suspected pulmonary embolism during COVID-19, the radiographic cardiothoracic ratio can be considered as a prognostic factor for right ventricular enlargement, especially as a negative predictor of right ventricular enlargement in the case of lower CTR values. Full article

(This article belongs to the Special Issue The Roles of Cardiac Imaging in Medical Diagnosis and Management)

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13 pages, 895 KiB

Open AccessArticle

The Role of Light Kappa and Lambda Chains in Heart Function Assessment in Patients with AL Amyloidosis

by Emilia Czyżewska, Agnieszka Wiśniewska, Anna Waszczuk-Gajda and Olga Ciepiela

J. Clin. Med. 2021, 10(6), 1274; https://doi.org/10.3390/jcm10061274 - 18 Mar 2021

Cited by 6 | Viewed by 2401

Abstract

There are reports indicating that myocardial dysfunction in systemic immunoglobulin light chain amyloidosis (AL amyloidosis) stems not only from the amyloid deposit in the organ but also the cardiotoxicity of the amyloid precursor free light chains (FLCs) circulating in the blood. The aim of the study is to analyze the role of sFLC κ and λ in the assessment of heart involvement and the degree of myocardial damage in AL amyloidosis. The study involved 71 patients diagnosed with primary AL amyloidosis. The relationship between sFLC concentrations and cardiac biochemical and echocardiographic parameters was assessed. The median concentrations of N-terminal pro b-type natriuretic peptide(NT-proBNP) and troponin I (TnI) were significantly higher in patients with amyloids formed from monoclonal λ chains compared to patients with monoclonal κ proliferation. In patients with heart involvement by amyloids formed from monoclonal FLC, the study demonstrated a statistically significant positive correlation between the concentration of monoclonal antibody λ chain and TnI (R = 0.688; p < 0.05), NT-proBNP (R = 0.449; p < 0.05), and the value of diastolic dimension of the interventricular septum (IVS; R = 0.496, p < 0.05). The above data indicate that the presence of monoclonal λ chains in patients with AL amyloidosis may be associated with more severe damage to cardiomyocytes and dysfunction of the myocardium. Full article

(This article belongs to the Special Issue The Roles of Cardiac Imaging in Medical Diagnosis and Management)

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Review

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9 pages, 1750 KiB

Open AccessReview

Radiological Cardiothoracic Ratio in Evidence-Based Medicine

by Krystian Truszkiewicz, Rafał Poręba and Paweł Gać

J. Clin. Med. 2021, 10(9), 2016; https://doi.org/10.3390/jcm10092016 - 8 May 2021

Cited by 27 | Viewed by 9331

Abstract

The cardiothoracic ratio (CTR), expressing the relationship between the size of the heart and the transverse dimension of the chest measured on a chest PA radiograph, is a commonly used parameter in the assessment of cardiomegaly with a cut-off value of 0.5. A value of >0.5 should be interpreted as enlargement of the heart. The following review describes the current state of available knowledge in terms of contentious issues, limitations and useful aspects regarding the CTR. The review was carried out on the basis of an analysis of scientific articles available in the PubMed database, searched for using the following keywords: “CTR”, “cardiothoracic ratio”, “cardiopulmonary ratio”, “cardiopulmonary index”, and “heart-lung ratio”. According to the accumulated knowledge, the CTR can still be used as an important parameter that can be easily determined in establishing enlargement of the heart. However, an increased CTR does not directly relate to heart function. In the era following the development of diagnostic methods such as computed tomography, magnetic resonance imaging, and ultrasonography, CTR modifications based on these methods are used with varying clinical usefulness. It is important to consider the definition of the CTR and remember to base measurements on PA radiographs, as attempts to mark it in other projections face many limitations. Full article

(This article belongs to the Special Issue The Roles of Cardiac Imaging in Medical Diagnosis and Management)

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