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Article ; Online: Preventing Sudden Cardiac Death in Mitral Valve Prolapse

Anna Giulia Pavon / Luca Bergamaschi / Marco Guglielmo

Journal of Clinical Medicine, Vol 11, Iss 5112, p

When Multimodality Imaging Is the Key to Success

2022 Volume 5112

Abstract: Mitral valve prolapse (MVP) is a common cardiac anomaly that is estimated to affect 1–3% of the general population [.] ...

Abstract	Mitral valve prolapse (MVP) is a common cardiac anomaly that is estimated to affect 1–3% of the general population [.]
Keywords	n/a ; Medicine ; R
Language	English
Publishing date	2022-08-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Non-Invasive Diagnosis of Chronic Coronary Syndrome

Léon Groenhoff / Giulia De Zan / Pietro Costantini / Agnese Siani / Eleonora Ostillio / Serena Carriero / Giuseppe Muscogiuri / Luca Bergamaschi / Giuseppe Patti / Carmine Pizzi / Sandro Sironi / Anna Giulia Pavon / Alessandro Carriero / Marco Guglielmo

Journal of Clinical Medicine, Vol 12, Iss 3793, p

A Focus on Stress Computed Tomography Perfusion and Stress Cardiac Magnetic Resonance

2023 Volume 3793

Abstract: Coronary artery disease is still a major cause of death and morbidity worldwide. In the setting of chronic coronary disease, demonstration of inducible ischemia is mandatory to address treatment. Consequently, scientific and technological efforts were ... ...

Abstract	Coronary artery disease is still a major cause of death and morbidity worldwide. In the setting of chronic coronary disease, demonstration of inducible ischemia is mandatory to address treatment. Consequently, scientific and technological efforts were made in response to the request for non-invasive diagnostic tools with better sensitivity and specificity. To date, clinicians have at their disposal a wide range of stress-imaging techniques. Among others, stress cardiac magnetic resonance (S-CMR) and computed tomography perfusion (CTP) techniques both demonstrated their diagnostic efficacy and prognostic value in clinical trials when compared to other non-invasive ischemia-assessing techniques and invasive fractional flow reserve measurement techniques. Standardized protocols for both S-CMR and CTP usually imply the administration of vasodilator agents to induce hyperemia and contrast agents to depict perfusion defects. However, both methods have their own limitations, meaning that optimizing their performance still requires a patient-tailored approach. This review focuses on the characteristics, drawbacks, and future perspectives of these two techniques.
Keywords	coronary artery disease ; cardiac coronary syndrome ; stress imaging ; cardiac computed tomography perfusion ; stress magnetic cardiac resonance ; Medicine ; R
Subject code	610
Language	English
Publishing date	2023-05-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Multimodality Imaging Evaluation to Detect Subtle Right Ventricular Involvement in Patients with Acute Myocarditis and Preserved Left Ventricular Ejection Fraction

Michela Bonanni / Gianmarco Angelini / Laura Anna Leo / Susanne Anna Schlossbauer / Luca Bergamaschi / Antonio Landi / Giuseppe Massimo Sangiorgi / Cinzia Forleo / Elena Pasotti / Giovanni Pedrazzini / Marco Valgimigli / Francesco F. Faletra / Marco Guglielmo / Anna Giulia Pavon

Journal of Clinical Medicine, Vol 12, Iss 4308, p

2023 Volume 4308

Abstract: Background: Evaluation of the right ventricle (RV) in patients with acute myocarditis (MY) remains challenging with both 2D transthoracic echocardiography (TTE) and cardiovascular magnetic resonance (CMR). We examined the incremental diagnostic value of ... ...

Abstract	Background: Evaluation of the right ventricle (RV) in patients with acute myocarditis (MY) remains challenging with both 2D transthoracic echocardiography (TTE) and cardiovascular magnetic resonance (CMR). We examined the incremental diagnostic value of CMR feature tracking (FT) to evaluate RV involvement in patients with myocarditis. Methods: We enrolled 54 patients with myocarditis and preserved left ventricle (LV) ejection fraction (EF). The CMR protocol included T2-weighted images for edema detection and late gadolinium enhancement (LGE) images. Global longitudinal strain (GLS) of the left ventricle (LV) and RV free wall strain (CMR-FWS) were obtained with CMR-FT. We identified 34 patients (62%) with inferior and lateral segment (IL-MY) involvement and 20 (38%) noIL-MY in case of any other myocardial segment involved. Here, 20 individuals who underwent CMR for suspected cardiac disease, which was not confirmed thereafter, were considered as the control population. Results: TTE and CMR showed normal RV function in all patients without visible RV involvement at the LGE or T2-weighted sequences. At CMR, LV-GLS values were significantly lower in patients with MY compared to the control group (median −19.0% vs. −21.0%, p = 0.029). Overall, CMR RV-FWS was no different between MY patients and controls (median −21.2% vs. −23.2 %, p = 0.201) while a significant difference was found between RV FWS in IL-MY and noIL-MY (median −18.17% vs. −24.2%, p = 0.004). Conclusions: CMR-FT has the potential to unravel subclinical RV involvement in patients with acute myocarditis, specifically in those with inferior and lateral injuries that exhibit lower RV-FWS values. In this setting, RV deformation analysis at CMR may be effectively implemented for a comprehensive functional assessment.
Keywords	cardiovascular magnetic resonance ; right ventricle ; acute myocarditis feature tracking CMR ; Medicine ; R
Subject code	610
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Application of AI in cardiovascular multimodality imaging

Giuseppe Muscogiuri / Valentina Volpato / Riccardo Cau / Mattia Chiesa / Luca Saba / Marco Guglielmo / Alberto Senatieri / Gregorio Chierchia / Gianluca Pontone / Serena Dell’Aversana / U. Joseph Schoepf / Mason G. Andrews / Paolo Basile / Andrea Igoren Guaricci / Paolo Marra / Denisa Muraru / Luigi P. Badano / Sandro Sironi

Heliyon, Vol 8, Iss 10, Pp e10872- (2022)

2022

Abstract: Technical advances in artificial intelligence (AI) in cardiac imaging are rapidly improving the reproducibility of this approach and the possibility to reduce time necessary to generate a report.In cardiac computed tomography angiography (CCTA) the main ... ...

Abstract	Technical advances in artificial intelligence (AI) in cardiac imaging are rapidly improving the reproducibility of this approach and the possibility to reduce time necessary to generate a report.In cardiac computed tomography angiography (CCTA) the main application of AI in clinical practice is focused on detection of stenosis, characterization of coronary plaques, and detection of myocardial ischemia.In cardiac magnetic resonance (CMR) the application of AI is focused on post-processing and particularly on the segmentation of cardiac chambers during late gadolinium enhancement. In echocardiography, the application of AI is focused on segmentation of cardiac chambers and is helpful for valvular function and wall motion abnormalities.The common thread represented by all of these techniques aims to shorten the time of interpretation without loss of information compared to the standard approach.In this review we provide an overview of AI applications in multimodality cardiac imaging.
Keywords	Cardiac computed tomography angiography ; Cardiac magnetic resonance ; echocardiography ; Artificial intelligence ; Coronary plaque ; Late gadolinium enhancement ; Science (General) ; Q1-390 ; Social sciences (General) ; H1-99
Subject code	610
Language	English
Publishing date	2022-10-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Changing Paradigms in the Diagnosis of Ischemic Heart Disease by Multimodality Imaging

Andrea Baggiano / Gianpiero Italiano / Marco Guglielmo / Laura Fusini / Andrea Igoren Guaricci / Riccardo Maragna / Carlo Maria Giacari / Saima Mushtaq / Edoardo Conte / Andrea Daniele Annoni / Alberto Formenti / Maria Elisabetta Mancini / Daniele Andreini / Mark Rabbat / Mauro Pepi / Gianluca Pontone

Journal of Clinical Medicine, Vol 11, Iss 477, p

2022 Volume 477

Abstract: Coronary artery disease (CAD) represents the most common cardiovascular disease, with high morbidity and mortality. Historically patients with chest pain of suspected coronary origin have been assessed with functional tests, capable to detect ... ...

Abstract	Coronary artery disease (CAD) represents the most common cardiovascular disease, with high morbidity and mortality. Historically patients with chest pain of suspected coronary origin have been assessed with functional tests, capable to detect haemodynamic consequences of coronary obstructions through depiction of electrocardiographic changes, myocardial perfusion defects or regional wall motion abnormalities under stress condition. Stress echocardiography (SE), single-photon emission computed tomography (SPECT), positron emission tomography (PET) and cardiovascular magnetic resonance (CMR) represent the functional techniques currently available, and technical developments contributed to increased diagnostic performance of these techniques. More recently, cardiac computed tomography angiography (cCTA) has been developed as a non-invasive anatomical test for a direct visualisation of coronary vessels and detailed description of atherosclerotic burden. Cardiovascular imaging techniques have dramatically enhanced our knowledge regarding physiological aspects and myocardial implications of CAD. Recently, after the publication of important trials, international guidelines recognised these changes, updating indications and level of recommendations. This review aims to summarise current standards with main novelties and specific limitations, and a diagnostic algorithm for up-to-date clinical management is also proposed.
Keywords	coronary artery disease ; echocardiography ; single-photon emission computed tomography ; positron emission tomography ; magnetic resonance ; computed tomography angiography ; Medicine ; R
Subject code	610
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Multimodality Imaging in Ischemic Chronic Cardiomyopathy

Giuseppe Muscogiuri / Marco Guglielmo / Alessandra Serra / Marco Gatti / Valentina Volpato / Uwe Joseph Schoepf / Luca Saba / Riccardo Cau / Riccardo Faletti / Liam J. McGill / Carlo Nicola De Cecco / Gianluca Pontone / Serena Dell’Aversana / Sandro Sironi

Journal of Imaging, Vol 8, Iss 35, p

2022 Volume 35

Abstract: Ischemic chronic cardiomyopathy (ICC) is still one of the most common cardiac diseases leading to the development of myocardial ischemia, infarction, or heart failure. The application of several imaging modalities can provide information regarding ... ...

Abstract	Ischemic chronic cardiomyopathy (ICC) is still one of the most common cardiac diseases leading to the development of myocardial ischemia, infarction, or heart failure. The application of several imaging modalities can provide information regarding coronary anatomy, coronary artery disease, myocardial ischemia and tissue characterization. In particular, coronary computed tomography angiography (CCTA) can provide information regarding coronary plaque stenosis, its composition, and the possible evaluation of myocardial ischemia using fractional flow reserve CT or CT perfusion. Cardiac magnetic resonance (CMR) can be used to evaluate cardiac function as well as the presence of ischemia. In addition, CMR can be used to characterize the myocardial tissue of hibernated or infarcted myocardium. Echocardiography is the most widely used technique to achieve information regarding function and myocardial wall motion abnormalities during myocardial ischemia. Nuclear medicine can be used to evaluate perfusion in both qualitative and quantitative assessment. In this review we aim to provide an overview regarding the different noninvasive imaging techniques for the evaluation of ICC, providing information ranging from the anatomical assessment of coronary artery arteries to the assessment of ischemic myocardium and myocardial infarction. In particular this review is going to show the different noninvasive approaches based on the specific clinical history of patients with ICC.
Keywords	chronic ischemic cardiomyopathy ; multimodality imaging ; computed tomography angiography ; echocardiography ; cardiac magnetic resonance ; nuclear medicine ; Photography ; TR1-1050 ; Computer applications to medicine. Medical informatics ; R858-859.7 ; Electronic computers. Computer science ; QA75.5-76.95
Subject code	610
Language	English
Publishing date	2022-02-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Stress CMR in Known or Suspected CAD

Francesca Baessato / Marco Guglielmo / Giuseppe Muscogiuri / Andrea Baggiano / Laura Fusini / Stefano Scafuri / Mario Babbaro / Rocco Mollace / Ada Collevecchio / Andrea I. Guaricci / Gianluca Pontone

BioMed Research International, Vol

Diagnostic and Prognostic Role

2021 Volume 2021

Abstract: The recently published 2019 guidelines on chronic coronary syndromes (CCS) focus on the need for noninvasive imaging modalities to accurately establish the diagnosis of coronary artery disease (CAD) and assess the risk of clinical scenario occurrence. ... ...

Abstract	The recently published 2019 guidelines on chronic coronary syndromes (CCS) focus on the need for noninvasive imaging modalities to accurately establish the diagnosis of coronary artery disease (CAD) and assess the risk of clinical scenario occurrence. Appropriate patient management should rely on controlling symptoms, improving prognosis, and guiding each therapeutic strategy as well as monitoring disease progress. Among the noninvasive imaging modalities, cardiovascular magnetic resonance (CMR) has gained broad acceptance in past years due to its unique features in providing a complete assessment of CAD through data on cardiac anatomy and function and myocardial viability, with high spatial and temporal resolution and without ionizing radiation. In detail, evaluation of the presence and extent of myocardial ischemia through stress CMR (S-CMR) has shown a high rule-in power in detecting functionally significant coronary artery stenosis in patients suspected of CCS. Moreover, S-CMR technique may add significant prognostic value, as demonstrated by different studies which have progressively evidenced the valuable power of this multiparametric imaging modality in predicting adverse cardiac events. The latest scientific progress supports a greater expansion of S-CMR with improvement of quantitative myocardial perfusion analysis, myocardial strain, and native mapping within the same examination. Although further study is warranted, these techniques, which are currently mostly restricted to the research field, are likely to become increasingly prevalent in the clinical setting with the scope of increasing accuracy in the selection of patients to be sent to invasive revascularization. This review investigates the diagnostic and prognostic role of S-CMR in the context of CAD, by analysing a strong, long-standing, scientific evidence together with an appraisal of new advanced techniques which may potentially enrich CAD management in the next future.
Keywords	Medicine ; R
Subject code	610
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Hindawi Limited
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Corrigendum to “Old and New NICE Guidelines for the Evaluation of New Onset Stable Chest Pain

Nazario Carrabba / Angela Migliorini / Silvia Pradella / Manlio Acquafresca / Marco Guglielmo / Andrea Baggiano / Giuseppe Muscogiuri / Renato Valenti

BioMed Research International, Vol

A Real World Perspective”

2019 Volume 2019

Keywords	Medicine ; R
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	Hindawi Limited
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Mid-Diastolic Events (L Events)

Emanuele Di Virgilio / Francesco Monitillo / Daniela Santoro / Silvia D’Alessandro / Marco Guglielmo / Andrea Baggiano / Laura Fusini / Riccardo Memeo / Mark G. Rabbat / Stefano Favale / Matteo Cameli / Andrea Igoren Guaricci / Gianluca Pontone

Journal of Clinical Medicine, Vol 10, Iss 5654, p

A Critical Review

2021 Volume 5654

Abstract: Mid-diastolic events (L events) include three phenomena appreciable on echocardiography occurring during diastasis: mid-diastolic transmitral flow velocity (L wave), mid-diastolic mitral valve motion (L motion), and mid-diastolic mitral annular velocity ( ...

Abstract	Mid-diastolic events (L events) include three phenomena appreciable on echocardiography occurring during diastasis: mid-diastolic transmitral flow velocity (L wave), mid-diastolic mitral valve motion (L motion), and mid-diastolic mitral annular velocity (L’ wave). L wave is a known marker of advanced diastolic dysfunction in different pathological clinical settings such as left ventricle and atrial remodeling, overloaded states, and cardiomyopathies. Patients with L events have poor outcomes with a higher risk of developing heart failure symptoms and arrhythmic complications, including sudden cardiac death. The exact mechanism underlying the genesis of mid-diastolic events is not fully understood, just as the significance of these events in healthy young people or their presence at the tricuspid valve level. We also report an explicative case of a patient with L events studied using speckle tracking imaging of the left atrium and ventricle at the same reference heartbeat supporting the hypothesis of a post-early diastolic relaxation or a “two-step” ventricular relaxation for L wave genesis. Our paper seeks to extend knowledge about the pathophysiological mechanisms on mid-diastolic events and summarizes the current knowledge.
Keywords	echocardiography ; diastolic function ; diastasis ; L wave ; speckle tracking imaging ; Medicine ; R
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Arrhythmic Mitral Valve Prolapse

Deni Kukavica / Marco Guglielmo / Andrea Baggiano / Giuseppe Muscogiuri / Laura Fusini / Manuela Muratori / Gloria Tamborini / Valentina Mantegazza / Alessandro Trancuccio / Carlo Arnò / Andrea Mazzanti / Mauro Pepi / Silvia Giuliana Priori / Gianluca Pontone

Diagnostics, Vol 11, Iss 3, p

Introducing an Era of Multimodality Imaging-Based Diagnosis and Risk Stratification

2021 Volume 467

Abstract: Mitral valve prolapse is a common cardiac condition, with an estimated prevalence between 1% and 3%. Most patients have a benign course, but ever since its initial description mitral valve prolapse has been associated to sudden cardiac death. Although ... ...

Abstract	Mitral valve prolapse is a common cardiac condition, with an estimated prevalence between 1% and 3%. Most patients have a benign course, but ever since its initial description mitral valve prolapse has been associated to sudden cardiac death. Although the causal relationship between mitral valve prolapse and sudden cardiac death has never been clearly demonstrated, different factors have been implicated in arrhythmogenesis in patients with mitral valve prolapse. In this work, we offer a comprehensive overview of the etiology and the genetic background, epidemiology, pathophysiology, and we focus on the state-of-the-art imaging-based diagnosis of mitral valve prolapse. Going beyond the classical, well-described clinical factors, such as young age, female gender and auscultatory findings, we investigate multimodality imaging features, such as alterations of anatomy and function of the mitral valve and its leaflets, the structural and contractile anomalies of the myocardium, all of which have been associated to sudden cardiac death.
Keywords	mitral valve prolapse ; sudden cardiac death ; arrhythmia ; risk factors ; multimodality imaging ; echocardiography ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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