JACC. Cardiovascular imaging
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JACC Cardiovasc Imaging · Jun 2010
ReviewTakotsubo cardiomyopathy: a unique cardiomyopathy with variable ventricular morphology.
Takotsubo cardiomyopathy is an important differential diagnosis of acute coronary syndrome. It is characterized by normal (or near-normal) coronary arteries, regional wall motion abnormalities that extend beyond a single coronary vascular bed, and often, a precipitating stressor. Variants of the classical left ventricular apical ballooning, including mid- or basal left ventricular wall motion abnormalities, are increasingly recognized. ⋯ Diagnosis of takotsubo cardiomyopathy has important implications for clinical management at presentation and afterward. The long-term prognosis is generally favorable; however, a small subset has potentially life-threatening complications during the initial presentation. The pathophysiologic mechanism is unknown, but catecholamine excess likely has a central role.
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JACC Cardiovasc Imaging · Jun 2010
A retrospective comparison of mortality in critically ill hospitalized patients undergoing echocardiography with and without an ultrasound contrast agent.
To compare acute mortality in critically ill hospitalized patients undergoing echocardiography with and without an ultrasound contrast agent (UCA). ⋯ There is no increase in mortality in critically ill patients undergoing echocardiography with the UCA compared with case-matched control patients.
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JACC Cardiovasc Imaging · Jun 2010
Detection of pulmonary congestion by chest ultrasound in dialysis patients.
This study sought to investigate clinical and echocardiographic correlates of the lung comets score. ⋯ Pulmonary congestion is highly prevalent in symptomatic (New York Heart Association functional class III to IV) and asymptomatic dialysis patients. Chest ultrasound is a reliable technique that detects pulmonary congestion at a pre-clinical stage in end-stage renal disease.
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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.
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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.