JACC. Cardiovascular imaging
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JACC Cardiovasc Imaging · Oct 2017
Multicenter StudyRV Contractile Function and its Coupling to Pulmonary Circulation in Heart Failure With Preserved Ejection Fraction: Stratification of Clinical Phenotypes and Outcomes.
This study sought to investigate how right ventricular (RV) contractile function and its coupling with pulmonary circulation (PC) stratify clinical phenotypes and outcome in heart failure preserved ejection fraction (HFpEF) patients. ⋯ A thorough assessment of RV-PC coupling and RV contractile function stratify HFpEF phenotypes at different level of risk. These observations shift the interest toward therapeutic strategies that may benefit the right heart as primary unmet need in the complex pathophysiology of the HFpEF syndrome.
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JACC Cardiovasc Imaging · Oct 2017
Comparative StudyAccuracy of Noncontrast Quiescent-Interval Single-Shot Lower Extremity MR Angiography Versus CT Angiography for Diagnosis of Peripheral Artery Disease: Comparison With Digital Subtraction Angiography.
This study sought to evaluate the image quality and diagnostic accuracy of noncontrast quiescent-interval single-shot (QISS) magnetic resonance angiography (MRA) versus iodine-contrast computed tomography angiography (CTA) in patients with peripheral artery disease (PAD), with invasive digital subtraction angiography (DSA) as the reference standard. ⋯ Noncontrast QISS-MRA provides high diagnostic accuracy compared with DSA, while being less prone to image artifacts than CTA. QISS better visualizes heavily calcified segments with impaired flow. QISS-MRA obviates the need for contrast administration in PAD patients.
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JACC Cardiovasc Imaging · Oct 2017
Left Atrial Function Dynamics During Exercise in Heart Failure: Pathophysiological Implications on the Right Heart and Exercise Ventilation Inefficiency.
The hypothesis of this study was that left atrial (LA) dynamic impairment during exercise may trigger right ventricular (RV)-to-pulmonary circulation (PC) uncoupling and ventilation inefficiency. ⋯ In heart failure, an impaired LA-strain response is a key hemodynamic trigger for RV-to-PC uncoupling and exercise ventilation inefficiency with some overlap between HFpEF and HFrEF phenotypes. Reversibility of LA dynamics seems to be an unmet target of specific therapeutic interventions.
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JACC Cardiovasc Imaging · Sep 2017
Multicenter Study Observational StudyFDG Uptake by Prosthetic Arterial Grafts in Large Vessel Vasculitis Is Not Specific for Active Disease.
This study investigated the incidence and clinical significance of arterial graft-associated uptake of fluorodeoxyglucose in large-vessel vasculitis (LVV). ⋯ Significant [18F]FDG uptake that is confined to arterial graft sites in patients with LVV does not reflect clinically relevant disease activity or progression. To minimize exposure to immunosuppression and in the face of negative blood culture, clinically quiescent arteritis, normal or stably raised C-reactive protein levels, we elected not to escalate treatment and monitor progression with MRA.