scholarly journals Cardiogoniometry – new and efficient non-invasive method in diagnosing coronary artery disease in women

2014 ◽  
Vol 9 (9-10) ◽  
pp. 414-414
Author(s):  
Ivan Zeljkovic ◽  
Hrvoje Pintaric
2021 ◽  
Vol 8 ◽  
Author(s):  
Jolanda Sabatino ◽  
Salvatore De Rosa ◽  
Isabella Leo ◽  
Antonio Strangio ◽  
Carmen Spaccarotella ◽  
...  

Background: Non-invasive prediction of critical coronary artery stenosis (CAST) in patients with coronary artery disease (CAD) is challenging. Strain parameters can often capture an impairment of regional longitudinal function; however, they are load dependent. A novel non-invasive method to estimate Myocardial Work (MW) has been recently proposed, showing a strong correlation with invasive work measurements. Our aim was to investigate the ability of non-invasive MW to predict the ischaemic risk area underlying a CAST.Methods and Results: The study population comprises 80 individuals: 50 patients with CAST and 30 controls (CTRL). Echocardiography recordings were obtained before coronary angiography to measure global longitudinal strain (GLS), Myocardial Work Index (MWI), Myocardial Constructive Work (MCW), Myocardial Wasted work (MWW), Myocardial Work Efficiency (MWE). Global MWI (p = 0.048), MWE (p < 0.001), and MCW (p = 0.048) at baseline were significantly reduced in patients with CAST compared to controls (p < 0.05). Regional MWE within the myocardial segments underlying the CAST, but not LS, was significantly reduced compared to non-target segments (p < 0.001). At ROC analysis, the diagnostic performance to predict CAST for regional MWE (AUC = 0.920, p < 0.001) was higher compared to both regional post-systolic shortening index (PSI) (AUC = 0.600, p = 0.129) and regional LS (AUC = 0.546, p = 0.469).Conclusions: Non-invasive estimation of MW work indices is able to predict a CAST before invasive angiography.


2021 ◽  
Vol 15 (1) ◽  
pp. 59-68
Author(s):  
Akansha Singh ◽  
Ashish Payal

Coronary artery disease (CAD) is the most common cardiovascular disease, causing death all over the world. An invasive method, Angiography is used to diagnose this disease but it is very costly and has some side effects. Hence, non-invasive methods such as machine learning were being used for diagnosing CAD. One of the ways to detect the presence of CAD is to find out the stenotic artery. The proposed study has diagnosed whether the arteries are stenotic or not. This study aims to provide the best accuracy while balancing the dataset using a spreadsubsample filter. Data pre-processing and feature selection has been done on the dataset to improve accuracy. Different supervised classifiers were applied to the selected features. The highest accuracies for left anterior descending (LAD), left circumflex (LCX), and right coronary artery (RCA) obtained by Random Forest are 95.70%, 91.41%, and 94.38% respectively. Among all the arteries, LAD has the highest accuracy indicating that chances of a person having LAD as stenotic are very high.


2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Shingo Kato ◽  
Kazuki Fukui ◽  
Sho Kodama ◽  
Mai Azuma ◽  
Naoki Nakayama ◽  
...  

Abstract Background Phase-contrast cine cardiovascular magnetic resonance (CMR) of the coronary sinus has emerged as a non-invasive method to measure coronary sinus blood flow (CSBF) and coronary flow reserve (CFR). We aimed to compare the prognostic value of resting CSBF and CFR for predicting major adverse cardiac events (MACE) in patients with known or suspected coronary artery disease (CAD) who underwent vasodilator stress CMR. Methods We studied 693 patients with known CAD and 519 patients with suspected CAD admitted to our hospital between 2009 and 2019. The CFR was calculated as the CSBF during adenosine triphosphate infusion divided by CSBF at rest. MACE was defined as composite of cardiovascular death, acute coronary syndrome, heart failure hospitalization, and sustained ventricular tachyarrhythmia. Results During a median follow-up of 4.6 years, 92 patients (8%) experienced MACE. The resting CSBF was significantly higher in patients with MACE than in patients without MACE (114.7 ± 44.9 mL/min vs. 84.7 ± 30.9 mL/min, p < 0.001 for known CAD; 122.2 ± 33.3 mL/min vs. 86.6 ± 36.7 mL/min, p < 0.001 for suspected CAD). The resting CSBF remained a significant predictor for MACE after adjusting clinical and CMR variables (hazard ratio [HR] of resting CSBF higher than the median: 3.18, p = 0.0083 for known CAD; HR: 23.3, p < 0.001 for suspected CAD). The area under the curve for predicting MACE was 0.73 for resting CSBF, 0.72 for CFR (p = 0.78) in patients with known CAD, and 0.82 for resting CSBF, 0.83 (p = 0.58) for CFR in patients with suspected CAD. Conclusions The resting CSBF may be a useful non-invasive method for the risk stratification of patients with known or suspected CAD without any radiation exposure, contrast media, or pharmacological vasodilator agents.


2011 ◽  
Vol 7 (3) ◽  
pp. 172
Author(s):  
Benoy Nalin Shah ◽  
Roxy Senior ◽  
◽  

The development of stable transpulmonary ultrasound contrast agents (UCAs) has allowed the echocardiographic assessment of myocardial perfusion, a technique known as myocardial contrast echocardiography (MCE). MCE exploits the ultrasonic properties of UCAs, which consist of acoustically active gas-filled microspheres. These are intravascular agents that have a rheology similar to red blood cells and thus allow analysis of myocardial blood flow both at rest and after stress. The combined assessment of wall motion and myocardial perfusion provides significant diagnostic and prognostic information during stress echocardiography. Functional imaging tests, such as myocardial perfusion scintigraphy and stress cardiac magnetic resonance imaging, are also used for non-invasive assessment of coronary disease. The principal advantages of MCE are that it does not expose the patient to ionising radiation or radioactive pharmaceuticals, is not contraindicated in patients with an implanted metallic device or who suffer from claustrophobia and it can be performed at the bedside. The purpose of this article is to outline the physiological principles underpinning ischaemia testing with MCE before proceeding to review the evidence base for MCE in patients with known or suspected coronary artery disease.


Author(s):  
Wiebe G Knol ◽  
Ali R Wahadat ◽  
Jolien W Roos-Hesselink ◽  
Nicolas M Van Mieghem ◽  
Wilco Tanis ◽  
...  

Abstract OBJECTIVES In patients with unknown coronary status undergoing surgery for acute infective endocarditis (IE), the need to screen for coronary artery disease (CAD) and the risk of embolization during invasive coronary angiography (ICA) are debated. Coronary computed tomography angiography (CCTA) is a non-invasive alternative in these patients. We aimed to evaluate the safety and feasibility of ICA and CCTA to diagnose CAD, and the necessity to treat CAD to prevent CAD-related postoperative complications. METHODS In this single-centre retrospective cohort study, all patients with acute aortic IE between 2009 and 2019 undergoing surgery were selected. Outcomes were any clinically evident embolization after preoperative ICA, in-hospital mortality, perioperative myocardial infarction or unplanned revascularization and postoperative renal function. RESULTS Of the 159 included patients, CAD status was already known in 14. No preoperative diagnostics for CAD was done in 46/145, a CCTA was performed in 54/145 patients and an ICA in 52/145 patients. Significant CAD was found after CCTA in 22% and after ICA in 21% of patients. In 1 of the 52 (2%) patients undergoing preoperative ICA, a cerebral embolism occurred. The rate of perioperative myocardial infarction or unplanned revascularization in patients not screened for CAD was 2% (1 out of 46 patients). CONCLUSIONS Although the risk of embolism after preoperative ICA is low, it should be carefully weighed against the estimated risk of CAD-related perioperative complications. CCTA can serve as a gatekeeper for ICA in most patients with acute aortic IE.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Arbas Redondo ◽  
D Tebar Marquez ◽  
I.D Poveda Pinedo ◽  
R Dalmau Gonzalez-Gallarza ◽  
S.C Valbuena Lopez ◽  
...  

Abstract Introduction Cardiac computed tomography (CT) use has progressively increased as the preferred initial test to rule out coronary artery disease (CAD) when clinical likelihood is low. Coronary artery calcium (CAC) detected by CT is a well-established marker for cardiovascular risk. However, it is not recommended for diagnosis of obstructive CAD. Absence of CAC, defined as an Agatston score of zero, has been associated to good prognosis despite underestimation of non-calcified plaques. Purpose To evaluate whether zero CAC score could help ruling out obstructive CAD in a safely manner. Methods Observational study based on a prospective database of patients (pts) referred to cardiac CT between 2017 and 2019. Pts with an Agatston score of zero were selected. Results We included 176 pts with zero CAC score and non-invasive coronary angiography performed. The median duration of follow-up was 23.9 months. Baseline characteristics of the population are shown in Table 1. In 117 pts (66.5%), cardiac CT was indicated as part of their chest pain evaluation. Mean age was 57.2 years old, 68.2% were women and only and 9.4% were active smokers. Normal coronary arteries were found in 173 pts (98.3%). Obstructive CAD, defined as ≥50% luminal diameter stenosis of a major vessel, was present in 1/176 (0.6%); while non-obstructive atherosclerotic plaques were found in 2 pts (1.1%). During follow-up, one patient died of out-of-hospital cardiac arrest. None either suffered from myocardial infarction or needed coronary revascularization. Conclusions In our cohort, a zero CAC score detected by cardiac CT rules out obstructive coronary artery disease in 98.3%, with only 1.7% of non-calcified atherosclerosis plaques and 0.6% of major adverse events. Although further research on this topic is needed, these results support the fact that non-invasive coronary angiography could be avoided in patients with low clinical likelihood of CAD and zero CAC score, facilitating the management of the increasing demand for coronary CT and reduction of radiation dose. Funding Acknowledgement Type of funding source: None


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