JACC. Cardiovascular imaging
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JACC Cardiovasc Imaging · Apr 2010
Comparative StudySensitivity of transcranial Doppler versus intracardiac echocardiography in the detection of right-to-left shunt.
The purpose of this study was to understand the reason for variation in the sensitivity of different methods of detecting right-to-left shunts (RLS). ⋯ Transcranial Doppler with immediate feedback provided by forced expiration against a manometer to 40 mm Hg is more sensitive than echocardiographic imaging for the detection of RLS. These observations have significant implications for determining the incidence of RLS in patients with stroke or migraine.
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JACC Cardiovasc Imaging · Apr 2010
ReviewHeart failure with normal ejection fraction: the complementary roles of echocardiography and CMR imaging.
Heart failure with normal ejection fraction (HFNEF), previously referred to as diastolic heart failure, has increased in prevalence as a cause of heart failure, now accounting for up to 50% of all cases. Contrary to initial evidence, the prognostic outlook in HFNEF may be similar to that of heart failure with reduced ejection fraction. According to current consensus statements, the diagnosis of HFNEF requires the demonstration of relatively preserved systolic left ventricular function and evidence of diastolic dysfunction. ⋯ With respect to CMR, this review will highlight its value in the assessment of systolic left ventricular function, will review ancillary CMR findings that may support the diagnosis of HFNEF such as tissue characterization, and will provide a brief overview of CMR techniques to assess diastolic function. We propose that these 2 modalities may play a complementary role in the diagnosis of HFNEF. The importance of imaging in the diagnosis of HFNEF extends to both the individual patient and to clinical trials of therapies for this condition.
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JACC Cardiovasc Imaging · Apr 2010
Comparative StudyFeasibility of FDG imaging of the coronary arteries: comparison between acute coronary syndrome and stable angina.
This study tested the hypothesis that fluorodeoxyglucose (FDG) uptake within the ascending aorta and left main coronary artery (LM), measured using positron emission tomography (PET), is greater in patients with recent acute coronary syndrome (ACS) than in patients with stable angina. ⋯ This study shows that in patients with recent ACS, FDG accumulation is increased both within the culprit lesion as well as in the ascending aorta and LM. This observation suggests inflammatory activity within atherosclerotic plaques in acute coronary syndromes and supports intensification of efforts to refine PET methods for molecular imaging of coronary plaques.