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Book ; Thesis: Experimentelle Visualisierung und Evaluation von Koronarstents in der kardialen Computertomographie

André, Florian

2015

Author's details	Florian Tobias André
Language	German
Size	v, 126 Blätter, Illustrationen
Publishing place	Heidelberg
Publishing country	Germany
Document type	Book ; Thesis
Thesis / German Habilitation thesis	Dissertation, Ruprecht-Karls-Universität Heidelberg, 2016
HBZ-ID	HT019009469
Database	Catalogue ZB MED Medicine, Health

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Article ; Online: Systematic review and meta-analysis for the value of cardiac magnetic resonance strain to predict cardiac outcomes

Grigorios Korosoglou / Marios Sagris / Florian André / Henning Steen / Moritz Montenbruck / Norbert Frey / Sebastian Kelle

Scientific Reports, Vol 14, Iss 1, Pp 1-

2024 Volume 10

Abstract: Abstract Cardiac magnetic resonance (CMR) is the gold standard for the diagnostic classification and risk stratification in most patients with cardiac disorders. The aim of the present study was to investigate the ability of Strain-encoded MR (SENC) for ... ...

Abstract	Abstract Cardiac magnetic resonance (CMR) is the gold standard for the diagnostic classification and risk stratification in most patients with cardiac disorders. The aim of the present study was to investigate the ability of Strain-encoded MR (SENC) for the prediction of major adverse cardiovascular events (MACE). A systematic review and meta-analysis was performed according to the PRISMA Guidelines, including patients with or without cardiovascular disease and asymptomatic individuals. Myocardial strain by HARP were used as pulse sequences in 1.5 T scanners. Published literature in MEDLINE (PubMed) and Cochrane’s databases were explored before February 2023 for studies assessing the clinical utility of myocardial strain by Harmonic Phase Magnetic Resonance Imaging (HARP), Strain-encoded MR (SENC) or fast-SENC. In total, 8 clinical trials (4 studies conducted in asymptomatic individuals and 4 in patients with suspected or known cardiac disease) were included in this systematic review, while 3 studies were used for our meta-analysis, based on individual patient level data. Kaplan–Meier analysis and Cox proportional hazard models were used, testing the ability of myocardial strain by HARP and SENC/fast-SENC for the prediction of MACE. Strain enabled risk stratification in asymptomatic individuals, predicting MACE and the development of incident heart failure. Of 1332 patients who underwent clinically indicated CMR, including SENC or fast-SENC acquisitions, 19 patients died, 28 experienced non-fatal infarctions, 52 underwent coronary revascularization and 86 were hospitalized due to heart failure during median 22.4 (17.2–28.5) months of follow-up. SENC/fast-SENC, predicted both all-cause mortality and MACE with high accuracy (HR = 3.0, 95% CI = 1.2–7.6, p = 0.02 and HR = 4.1, 95% CI = 3.0–5.5, respectively, p < 0.001). Using hierarchical Cox-proportional hazard regression models, SENC/fast-SENC exhibited incremental value to clinical data and conventional CMR parameters. Reduced myocardial strain predicts of ...
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2024-01-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Coronary Computed Tomography vs. Cardiac Magnetic Resonance Imaging in the Evaluation of Coronary Artery Disease

Lukas D. Weberling / Dirk Lossnitzer / Norbert Frey / Florian André

Diagnostics, Vol 13, Iss 1, p

2022 Volume 125

Abstract: Coronary artery disease (CAD) represents a widespread burden to both individual and public health, steadily rising across the globe. The current guidelines recommend non-invasive anatomical or functional testing prior to invasive procedures. Both ... ...

Abstract	Coronary artery disease (CAD) represents a widespread burden to both individual and public health, steadily rising across the globe. The current guidelines recommend non-invasive anatomical or functional testing prior to invasive procedures. Both coronary computed tomography angiography (cCTA) and stress cardiac magnetic resonance imaging (CMR) are appropriate imaging modalities, which are increasingly used in these patients. Both exhibit excellent safety profiles and high diagnostic accuracy. In the last decade, cCTA image quality has improved, radiation exposure has decreased and functional information such as CT-derived fractional flow reserve or perfusion can complement anatomic evaluation. CMR has become more robust and faster, and advances have been made in functional assessment and tissue characterization allowing for earlier and better risk stratification. This review compares both imaging modalities regarding their strengths and weaknesses in the assessment of CAD and aims to give physicians rationales to select the most appropriate modality for individual patients.
Keywords	cCTA ; CMR ; cardiovascular imaging ; coronary artery disease ; stress test ; CMR perfusion ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2022-12-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Response to: The Impact of Obesity on Plastic Surgery Outcomes: A Systematic Review and Meta-Analysis.

Bigarella, Lucas Goldmann / Dal Bó, Elisa Fioreze / Pires, Gabriel Cervi / Florian, André Biegelmeyer / Bridi, Isadora Michielon Rech / Ballardin, Ana Carolina / Ballotin, Vinicius Remus

Aesthetic surgery journal

2023 Volume 43, Issue 4, Page(s) NP295–NP296

MeSH term(s)	Humans ; Surgery, Plastic ; Plastic Surgery Procedures/adverse effects ; Obesity/complications ; Obesity/surgery
Language	English
Publishing date	2023-01-07
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	2087022-X
ISSN	1527-330X ; 1090-820X ; 1084-0761
ISSN (online)	1527-330X
ISSN	1090-820X ; 1084-0761
DOI	10.1093/asj/sjad006
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Zs.A 5721: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Simultaneous assessment of heart and lungs with gated high-pitch ultra-low dose chest CT using artificial intelligence-based calcium scoring

Florian Andre / Sebastian Seitz / Philipp Fortner / Thomas Allmendinger / André Sommer / Matthias Brado / Roman Sokiranski / Joana Fink / Hans-Ulrich Kauczor / Claus P. Heussel / Felix Herth / Norbert Frey / Johannes Görich / Sebastian J. Buss

European Journal of Radiology Open, Vol 10, Iss , Pp 100481- (2023)

2023

Abstract: Purpose: The combined testing for coronary artery and pulmonary diseases is of clinical interest as risk factors are shared. In this study, a novel ECG-gated tin-filtered ultra-low dose chest CT protocol (GCCT) for integrated heart and lung acquisition ... ...

Abstract	Purpose: The combined testing for coronary artery and pulmonary diseases is of clinical interest as risk factors are shared. In this study, a novel ECG-gated tin-filtered ultra-low dose chest CT protocol (GCCT) for integrated heart and lung acquisition and the applicability of artificial intelligence (AI)-based coronary artery calcium scoring were assessed. Methods: In a clinical registry of 10481 patients undergoing heart and lung CT, GCCT was applied in 44 patients on a dual-source CT. Coronary calcium scans (CCS) with 120 kVp, 100 kVp, and tin-filtered 100 kVp (Sn100) of controls, matched with regard to age, sex, and body-mass index, were retrieved from the registry (ntotal=176, 66.5 (59.4–74.0) years, 52 men). Automatic tube current modulation was used in all scans. In 20 patients undergoing GCCT and Sn100 CCS, Agatston scores were measured both semi-automatically by experts and by AI, and classified into six groups (0, <10, <100, <400, <1000, ≥1000). Results: Effective dose decreased significantly from 120 kVp CCS (0.50 (0.41–0.61) mSv) to 100 kVp CCS (0.34 (0.26–0.37) mSv) to Sn100 CCS (0.14 (0.11–0.17) mSv). GCCT showed higher values (0.28 (0.21–0.32) mSv) than Sn100 CCS but lower than 120 kVp and 100 kVp CCS (all p < 0.05) despite greater scan length. Agatston scores correlated strongly between GCCT and Sn100 CCS in semi-automatic and AI-based measurements (both ρ = 0.98, p < 0.001) resulting in high agreement in Agatston score classification (κ = 0.97, 95% CI 0.92–1.00; κ = 0.89, 95% CI 0.79–0.99). Regarding chest findings, further diagnostic steps were recommended in 28 patients. Conclusions: GCCT allows for reliable coronary artery disease and lung cancer screening with ultra-low radiation exposure. GCCT-derived Agatston score shows excellent agreement with standard CCS, resulting in equivalent risk stratification.
Keywords	Coronary artery disease ; Coronary artery calcium scoring ; Chest CT ; Tin-filter ; Dose reduction ; Artificial intelligence ; Medical physics. Medical radiology. Nuclear medicine ; R895-920
Subject code	610
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Human AI Teaming for Coronary CT Angiography Assessment

Florian Andre / Philipp Fortner / Matthias Aurich / Sebastian Seitz / Ann-Kathrin Jatsch / Max Schöbinger / Michael Wels / Martin Kraus / Mehmet Akif Gülsün / Norbert Frey / Andre Sommer / Johannes Görich / Sebastian J. Buss

Diagnostics, Vol 13, Iss 23, p

Impact on Imaging Workflow and Diagnostic Accuracy

2023 Volume 3574

Abstract: As the number of coronary computed tomography angiography (CTA) examinations is expected to increase, technologies to optimize the imaging workflow are of great interest. The aim of this study was to investigate the potential of artificial intelligence ( ... ...

Abstract	As the number of coronary computed tomography angiography (CTA) examinations is expected to increase, technologies to optimize the imaging workflow are of great interest. The aim of this study was to investigate the potential of artificial intelligence (AI) to improve clinical workflow and diagnostic accuracy in high-volume cardiac imaging centers. A total of 120 patients (79 men; 62.4 (55.0–72.7) years; 26.7 (24.9–30.3) kg/m 2 ) undergoing coronary CTA were randomly assigned to a standard or an AI-based (human AI) coronary analysis group. Severity of coronary artery disease was graded according to CAD-RADS. Initial reports were reviewed and changes were classified. Both groups were similar with regard to age, sex, body mass index, heart rate, Agatston score, and CAD-RADS. The time for coronary CTA assessment (142.5 (106.5–215.0) s vs. 195.0 (146.0–265.5) s; p < 0.002) and the total reporting time (274.0 (208.0–377.0) s vs. 350 (264.0–445.5) s; p < 0.02) were lower in the human AI than in the standard group. The number of cases with no, minor, or CAD-RADS relevant changes did not differ significantly between groups (52, 7, 1 vs. 50, 8, 2; p = 0.80). AI-based analysis significantly improves clinical workflow, even in a specialized high-volume setting, by reducing CTA analysis and overall reporting time without compromising diagnostic accuracy.
Keywords	coronary artery disease ; coronary CT angiography ; artificial intelligence ; workflow ; human AI teaming ; computed tomography ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2023-11-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Electrical Ventricular Remodeling in Dilated Cardiomyopathy

Christine Mages / Heike Gampp / Pascal Syren / Ann-Kathrin Rahm / Florian André / Norbert Frey / Patrick Lugenbiel / Dierk Thomas

Cells, Vol 10, Iss 2767, p

2021 Volume 2767

Abstract: Ventricular arrhythmias contribute significantly to morbidity and mortality in patients with heart failure (HF). Pathomechanisms underlying arrhythmogenicity in patients with structural heart disease and impaired cardiac function include myocardial ... ...

Abstract	Ventricular arrhythmias contribute significantly to morbidity and mortality in patients with heart failure (HF). Pathomechanisms underlying arrhythmogenicity in patients with structural heart disease and impaired cardiac function include myocardial fibrosis and the remodeling of ion channels, affecting electrophysiologic properties of ventricular cardiomyocytes. The dysregulation of ion channel expression has been associated with cardiomyopathy and with the development of arrhythmias. However, the underlying molecular signaling pathways are increasingly recognized. This review summarizes clinical and cellular electrophysiologic characteristics observed in dilated cardiomyopathy (DCM) with ionic and structural alterations at the ventricular level. Furthermore, potential translational strategies and therapeutic options are highlighted.
Keywords	dilated cardiomyopathy ; ion channel ; remodeling ; sudden cardiac death ; ventricular arrhythmia ; Biology (General) ; QH301-705.5
Subject code	610
Language	English
Publishing date	2021-10-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Normalizing Flows for Out-of-Distribution Detection

Costin Florian Ciușdel / Lucian Mihai Itu / Serkan Cimen / Michael Wels / Chris Schwemmer / Philipp Fortner / Sebastian Seitz / Florian Andre / Sebastian Johannes Buß / Puneet Sharma / Saikiran Rapaka

Applied Sciences, Vol 12, Iss 3839, p

Application to Coronary Artery Segmentation

2022 Volume 3839

Abstract: Coronary computed tomography angiography (CCTA) is an effective imaging modality, increasingly accepted as a first-line test to diagnose coronary artery disease (CAD). The accurate segmentation of the coronary artery lumen on CCTA is important for the ... ...

Abstract	Coronary computed tomography angiography (CCTA) is an effective imaging modality, increasingly accepted as a first-line test to diagnose coronary artery disease (CAD). The accurate segmentation of the coronary artery lumen on CCTA is important for the anatomical, morphological, and non-invasive functional assessment of stenoses. Hence, semi-automated approaches are currently still being employed. The processing time for a semi-automated lumen segmentation can be reduced by pre-selecting vessel locations likely to require manual inspection and by submitting only those for review to the radiologist. Detection of faulty lumen segmentation masks can be formulated as an Out-of-Distribution (OoD) detection problem. Two Normalizing Flows architectures are investigated and benchmarked herein: a Glow-like baseline, and a proposed one employing a novel coupling layer. Synthetic mask perturbations are used for evaluating and fine-tuning the learnt probability densities. Expert annotations on a separate test-set are employed to measure detection performance relative to inter-user variability. Regular coupling-layers tend to focus more on local pixel correlations and to disregard semantic content. Experiments and analyses show that, in contrast, the proposed architecture is capable of capturing semantic content and is therefore better suited for OoD detection of faulty lumen segmentations. When compared against expert consensus, the proposed model achieves an accuracy of 78.6% and a sensitivity of 76%, close to the inter-user mean of 80.9% and 79%, respectively, while the baseline model achieves an accuracy of 64.3% and a sensitivity of 48%.
Keywords	out-of-distribution ; normalizing flows ; coronary computed tomography angiography ; lumen segmentation ; Technology ; T ; Engineering (General). Civil engineering (General) ; TA1-2040 ; Biology (General) ; QH301-705.5 ; Physics ; QC1-999 ; Chemistry ; QD1-999
Subject code	004
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Factors influencing the safety of outpatient coronary CT angiography

Norbert Frey / Florian André / Sebastian J Buss / Philipp Fortner / Mostafa Emami / Sebastian Seitz / Matthias Brado / Friedemann Gückel / Roman Sokiranski / André Sommer / Johannes Görich

BMJ Open, Vol 12, Iss

a clinical registry study

2022 Volume 8

Abstract: Objectives Since the safety of coronary CT angiography (CTA) is of great importance, especially with regard to widening indications and increasing morbidity, the aim of this study was to assess influencing factors.Methods Patients undergoing coronary CTA ...

Abstract	Objectives Since the safety of coronary CT angiography (CTA) is of great importance, especially with regard to widening indications and increasing morbidity, the aim of this study was to assess influencing factors.Methods Patients undergoing coronary CTA in a third-generation dual-source CT in a radiological centre were included in a clinical registry. Up to 20 mg metoprolol was administered intravenously to attain a heart rate ≤65/min. Glyceryl trinitrate (GTN) was administered in doses of 0.8 mg and 0.4 mg. Blood pressure was measured before the administration and after the CTA.Results Out of 5500 consecutive patients (3194 men, 62.3 (54.9–70.0) years), adverse events occurred in 68 patients (1.2%) with mild anaphylactoid reactions (0.4%), vasovagal symptoms (0.3%) and extravasation (0.3%) being most frequent. Anti-allergic drugs were given in 17 patients, atropine in 3 patients and volume in 1 patient. Drug administration resulted in a significant mean arterial pressure decline (96.0 (88.3–106.0) vs 108.7 (99.7–117.3) mmHg; p<0.001). Patients who suffered systolic blood pressure drops >20 mmHg or >40 mmHg were older (66.5 (58.6–73.3) vs 60.5 (53.6–68.3) years; 70.2 (63.3–76.5) vs 62.1 (54.7–69.6) years), more often male (65.1% vs 54.4%; 68.9% vs 57.3%) and had higher Agatston score equivalents (83.0 (2.0–432.0) vs 15.0 (0.0–172.0); 163.0 (16.3–830.8) vs 25.0 (0.0–220.0); all p<0.001). GTN dose reduction lowered the fraction of patients suffering from blood pressure drops >20 mmHg or >40 mmHg from 34.5% to 27.4% and from 6.1% to 3.5% (both p<0.001), respectively. The proportion of coronary segments with impaired image quality did not differ significantly.Conclusions Coronary CTA with intravenous beta-blocker administration is a safe procedure in an outpatient setting as adverse events are rare and mostly mild. Reduced GTN doses can further improve safety by lowering the rate of significant blood pressure drops, which occurred especially in elderly men with increased plaque burden.Trial ...
Keywords	Medicine ; R
Subject code	610
Language	English
Publishing date	2022-08-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Hypverventilation strain CMR imaging in patients with acute chest pain

Deborah Siry / Johannes H. Riffel / Janek Salatzki / Florian Andre / Marco Ochs / Lukas D. Weberling / Evangelos Giannitsis / Hugo A. Katus / Matthias G. Friedrich

Scientific Reports, Vol 12, Iss 1, Pp 1-

2022 Volume 10

Abstract: Abstract In patients with suspected acute coronary syndrome high-sensitivity cardiac tropnonin T is used for rapid patient triage. Some acute coronary syndrome patients assigned to the observe zone based on high-sensitivity cardiac troponin T after 1 h ... ...

Abstract	Abstract In patients with suspected acute coronary syndrome high-sensitivity cardiac tropnonin T is used for rapid patient triage. Some acute coronary syndrome patients assigned to the observe zone based on high-sensitivity cardiac troponin T after 1 h require further diagnostic testing. Fast-strain encoded CMR imaging with breathing maneuvers may accelerate diagnostic work-up and identify patients suffering from acute coronary syndrome. Patients presenting with acute chest pain (high-sensitivity cardiac troponin T level 5–52 ng/L) were prospectively enrolled (consecutive sampling, time of recruitment: 09/18–06/19). Fast-strain-encoded imaging was performed within the 1-h timeframe (0 h/1 h algorithm) prior to 2nd high-sensitivity troponin T lab results. Images were acquired at rest as well as after 1-min of hyperventilation followed by a short breath-hold. In 108 patients (59 male; mean age: 57 ± 17y) the mean study time was 17 ± 3 min. An abnormal strain response after the breathing maneuver (persistent/increased/new onset of increased strain rates) correctly identified all 17 patients with a high-sensitivity troponin T dynamic (0 h/1 h algorithm) and explanatory significant coronary lesions, while in 86 patients without serologic or angiographic evidence for severe coronary artery disease the strain response was normal (sensitivity 100%, specificity 94.5%; 5 false positive results). The number of dysfunctional segments (strain > − 10%) proved to be a quantifiable marker for identifying patients with acute coronary syndrome. In patients with suspected acute coronary syndrome and inconclusive initial high-sensitivity troponin T, fast-strain-encoded imaging with a breathing maneuver may safely and rapidly identify patients with acute coronary syndrome, without the need for vasodilators, stress, or contrast agents.
Keywords	Medicine ; R ; Science ; Q
Subject code	610 ; 616
Language	English
Publishing date	2022-08-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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