Emerging role of cardiac computed tomography in heart failure

Aziz, Waqar; Claridge, Simon; Ntalas, Ioannis; Gould, Justin; Vecchi, Adelaide de; Razeghi, Orod; Tóth, Dániel; Mountney, Peter; Preston, Rebecca; Rinaldi, Christopher Aldo; Razavi, Reza; Niederer, Steven; Rajani, Ronak

doi:10.1002/ehf2.12479

Cited by 24 publications

(19 citation statements)

References 60 publications

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“…Rapid acquisition of isotropic 3‐dimensional (3D) whole heart data sets with submillimetre spatial resolution allows accurate assessment of coronary venous anatomy, 5 regional or global LV systolic function assessment 5,7 and evaluation of LV dyssynchrony or LMA 5,8 . Additionally, CT may detect regional hypoperfusion and myocardial scar 9 albeit with varying results with no current standardized imaging protocols to reliably identify late iodine enhancement 10 …”

Section: Introductionmentioning

confidence: 99%

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Feasibility of intraprocedural integration of cardiac CT to guide left ventricular lead implantation for CRT upgrades

Gould

Sidhu

Sieniewicz

et al. 2021

Cardiovasc electrophysiol

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Background Optimal positioning of the left ventricular (LV) lead is an important determinant of cardiac resynchronization therapy (CRT) response. Objective Evaluate the feasibility of intraprocedural integration of cardiac computed tomography (CT) to guide LV lead implantation for CRT upgrades. Methods Patients undergoing LV lead upgrade underwent ECG‐gated cardiac CT dyssynchrony and LV scar assessment. Target American Heart Association segment selection was determined using latest non‐scarred mechanically activating segments overlaid onto real‐time fluoroscopy with image co‐registration to guide optimal LV lead implantation. Hemodynamic validation was performed using a pressure wire in the LV cavity (dP/dtmax)). Results 18 patients (male 94%, 55.6% ischemic cardiomyopathy) with RV pacing burden 60.0 ± 43.7% and mean QRS duration 154 ± 30 ms underwent cardiac CT. 10/10 ischemic patients had CT evidence of scar and these segments were excluded as targets. Seventeen out of 18 (94%) patients underwent successful LV lead implantation with delivery to the CT target segment in 15 out of 18 (83%) of patients. Acute hemodynamic response (dP/dtmax ≥ 10%) was superior with LV stimulation in CT target versus nontarget segments (83.3% vs. 25.0%; p = .012). Reverse remodeling at 6 months (LV end‐systolic volume improvement ≥15%) occurred in 60% of subjects (4/8 [50.0%] ischemic cardiomyopathy vs. 5/7 [71.4%] nonischemic cardiomyopathy, p = .608). Conclusion Intraprocedural integration of cardiac CT to guide optimal LV lead placement is feasible with superior hemodynamics when pacing in CT target segments and favorable volumetric response rates, despite a high proportion of patients with ischemic cardiomyopathy. Multicentre, randomized controlled studies are needed to evaluate whether intraprocedural integration of cardiac CT is superior to standard care.

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Section: Introductionmentioning

confidence: 99%

“… 5 , 8 Additionally, CT may detect regional hypoperfusion and myocardial scar 9 albeit with varying results with no current standardized imaging protocols to reliably identify late iodine enhancement. 10 …”

Section: Introductionmentioning

confidence: 99%

Feasibility of intraprocedural integration of cardiac CT to guide left ventricular lead implantation for CRT upgrades

Gould

Sidhu

Sieniewicz

et al. 2021

Cardiovasc electrophysiol

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“…Heart failure (HF) is a systemic disease afflicting up to 2% of the population worldwide [44,45]. Although it represents a major burden in terms of expenditure of socio-economic resources and costs [46], the successful accomplishments in diagnostics [47] and treatment [48][49][50] achieved in the last decades have led to an improvement in outcomes [51] and to an increased life expectancy [52]. Consequently, the number of older HF patients with increasing clinical complexity is progressively growing [53].…”

Section: Sarcopenia In Hfmentioning

confidence: 99%

Muscle Wasting and Sarcopenia in Heart Failure—The Current State of Science

Lena

Anker

Springer

2020

IJMS

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Sarcopenia is primarily characterized by skeletal muscle disturbances such as loss of muscle mass, quality, strength, and physical performance. It is commonly seen in elderly patients with chronic diseases. The prevalence of sarcopenia in chronic heart failure (HF) patients amounts to up to 20% and may progress into cardiac cachexia. Muscle wasting is a strong predictor of frailty and reduced survival in HF patients. Despite many different techniques and clinical tests, there is still no broadly available gold standard for the diagnosis of sarcopenia. Resistance exercise and nutritional supplementation represent the currently most used strategies against wasting disorders. Ongoing research is investigating skeletal muscle mitochondrial dysfunction as a new possible target for pharmacological compounds. Novel agents such as synthetic ghrelin and selective androgen receptor modulators (SARMs) seem promising in counteracting muscle abnormalities but their effectiveness in HF patients has not been assessed yet. In the last decades, many advances have been accomplished but sarcopenia remains an underdiagnosed pathology and more efforts are needed to find an efficacious therapeutic plan. The purpose of this review is to illustrate the current knowledge in terms of pathogenesis, diagnosis, and treatment of sarcopenia in order to provide a better understanding of wasting disorders occurring in chronic heart failure.

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“…However, even within a niche field like HF, it is possible to analyse which issues gain more interest and are more requested, thus partially representing the ‘news value’ of a journal. Tables 2–5 report the top 10 articles published in 2019 and 2020 in the European Journal of Heart Failure and ESC Heart Failure , according to their Altmetric Attention Score 5–44 . 2020 was the year of…”

Section: Communication Means Pointsmentioning

confidence: 99%