The coronary artery calcium (CAC) score (CACS) is recommended in clinical guidelines for coronary artery disease evaluation. However, it is being replaced by coronary computed tomography angiography as the primary diagnostic tool for patients with stable chest pain. This study aimed to develop and validate a deep learning model for predicting the CACS categories from chest X-ray radiographs (CXRs).
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Aortic dissection after heart transplantation for early Fontan failure: A rare complication
A four-year-old girl with heterotaxy syndrome and right atrial isomerism, right dominant atrioventricular septal defect, pulmonary atresia, and right aortic arch status post single ventricle palliative surgery with a bidirectional Glenn presented for the Fontan procedure. She had a tri-leaflet aortic valve and no history of aortic arch reconstruction. Although she tolerated her Fontan procedure well, her postoperative course was complicated by ventricular tachycardia and severely depressed right…
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Racial differences in atherosclerosis and coronary plaque characteristics using enhanced AI quantification (RACE-AI)
Cardiac computed tomography angiography (CCTA) has become a cornerstone in cardiovascular risk assessment, allowing for the quantification of coronary artery disease (CAD) burden and characterization of high-risk plaque features associated with adverse outcomes. Coronary artery calcium (CAC) scoring, utilizing the Agatston method, has been extensively validated as a predictor of cardiovascular events, with calcified plaques considered more stable and non-calcified plaques (NCP) linked to heighte…
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Improved prediction of periprocedural myocardial injury by plaque quantification from coronary CT angiography
High-risk plaque characteristics on coronary computed tomography angiography (CCTA) were reported to be associated with periprocedural myocardial injury (PMI) after elective percutaneous coronary intervention (PCI).1 However, the binary categorization of low-attenuation plaque (LAP) based on visual assessment lacks spatial information. Here, we introduced a new LAP index, “peak x-mm LAP volume (peakLAPxmm),” which accounts for the size and density of LAP voxels. We aimed to develop a PMI predict…
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Accuracy of coronary CTA using spectral CT in patients with high calcium score
The effectiveness of coronary computed tomography angiography (CTA) is hindered by high coronary calcium scores, which create blooming artefacts that obscure the coronary lumen and lead to inaccurate stenosis assessments.1 Spectral CT, utilizing multi-energy CT technology, allows data acquisition at different energy levels, improving coronary artery visualization, particularly in the presence of calcified plaques.2–4 This study evaluates the accuracy of coronary CTA using spectral CT in patients…
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Air pollution, coronary artery disease, and cardiovascular events: Insights from the PROMISE trial
Air pollution is associated with mortality and major adverse cardiovascular events (MACE) in the general population. However, little is known about the relationship between air pollution and coronary artery disease (CAD) and how this relates to MACE.
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CT scan criteria for definition of intramural course in anomalous coronary artery with an interarterial course: A word of caution
Anomalous aortic origin of the coronary artery with an inter-arterial course has been associated with sudden cardiac death. The intramural course (the passage of the coronary artery within the aortic wall) has been described as a morphological substrate associated with an increased risk of myocardial ischemia. As previously noted, not all anomalous inter-arterial coronary arteries have an intramural segment.1 According to previous publications, patients with anomalous coronary artery and intramu…
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Optimization and scaling of coronary CT angiography workflows in a quaternary health system
With the recognition of coronary CT angiography (CCTA) as a first-line imaging modality for coronary artery disease by various guidelines, there has been an increasing demand across the United States to offer CCTA both in emergency departments and as an outpatient. Frequently, large quaternary centers would be required to cater to a large catchment area, and there is a need to improve access to coronary CT scans in the community. However, several barriers hinder the scaling up of CCTA, including…
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Membranous septum area and the risk of conduction abnormalities following transcatheter aortic valve implantation
Conduction abnormalities (CA) after TAVI remain problematic. Membranous septum (MS) depth correlates inversely with new CA though within-patient variability exists.
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Clinical impact of CCT-FFR as first-strategy in patients with symptomatic stable coronary artery disease: A systematic review and meta-analysis
Despite the promising results, the clinical implications of the CCT-FFR is already debated. This metanalysis aimed to determine the potential benefits of incorporating FFRCT into stable CAD management.After searching for studies comparing outcomes of patients with suspected stable CAD who underwent CCT-FFR as a first strategy versus non-urgent cardiovascular testing after a clinical judgment, we calculated odds ratios (ORs) and 95 % confidence intervals (CIs) using a random-effects or fixed-eff…