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VIDEO: Better Flow Quantification and Rise of PET Among Trends in Cardiac Nuclear Imaging

Nuclear Imaging | November 07, 2019

Rob Beanlands, M.D., FASNC, 2019 American Society of Nuclear Cardiology (ASNC) president, shares a couple trends he sees in cardiac nuclear imaging. He is the Vered Chair and division head of cardiology and director of the National Cardiac PET Centre at the University of Ottawa Heart Institute, Canada.

He said overall trends he sees in nuclear cardiology include the use of better myocardial reserve quantification so it is clear whether revascularization would help patients. Beanlands also said there is increasing interest in positron emission tomography (PET) imaging because of its superior image quality and increasing access to PET radiotracers. New tracers on the horizon will also increase the image quality and flexibility of PET to accommodate exercise stress.

He spoke on artificial intelligence (AI) development for medical imaging in sessions at the 2019 American Society of Nuclear Cardiology (ASNC) annual meeting. 

Conference Videos

Nuclear Imaging | November 07, 2019

Rob Beanlands, M.D., FASNC, 2019 American Society of Nuclear Cardiology (ASNC) president, shares a couple trends he sees in cardiac nuclear imaging. He is the Vered Chair and division head of cardiology and director of the National Cardiac PET Centre at the University of Ottawa Heart Institute, Canada.

He said overall trends he sees in nuclear cardiology include the use of better myocardial reserve quantification so it is clear whether revascularization would help patients. Beanlands also said there is increasing interest in positron emission tomography (PET) imaging because of its superior image quality and increasing access to PET radiotracers. New tracers on the horizon will also increase the image quality and flexibility of PET to accommodate exercise stress.

He spoke on artificial intelligence (AI) development for medical imaging in sessions at the 2019 American Society of Nuclear Cardiology (ASNC) annual meeting. 

Artificial Intelligence | November 07, 2019

Piotr J. Slomka, Ph.D., FACC, research scientist in the Artificial Intelligence in Medicine Program, Department of Medicine at Cedars-Sinai, and professor of medicine in-residence of the David Geffen School of Medicine, UCLA. He explains how his team at Cedars-Sinai is working on intelligent patient risk prediction algorithms that will automatically extract information from medical imaging. He spoke on artificial intelligence (AI) development for medical imaging in sessions at the 2019 American Society of Nuclear Cardiology (ASNC) annual meeting. 

Find more articles and video on AI

 

Nuclear Imaging | November 06, 2019

Robert C. Hendel, M.D., explains some of the new cardiac radiotracers in the pipeline that were discussed in sessions at the American Society of Nuclear Cardiology (ASNC) 2019 meeting. Hendel is a professor of medicine and radiology and the Sidney W. And Marilyn S. Lassen Chair in Cardiovascular Medicine, Tulane University. He also serves as the chief of the section of cardiology and director of the Tulane University Heart and Vascular Institute. 

He outlined three new radiotracers that may impact cardiac imaging:

   • Flurpiridaz F-18 PET perfusion agent that offers high quality images and can be used with exercise stress;

   • MIBG imaging to help better assess heart failure classes and if patients may need an ICD;

   • New F-18 agents to image cardiac amyloidosis; and

   • Nuclear agents to enable annexin imaging, allowing direct vsualization of myocardial apoptotic cells.

 

PET-CT | October 30, 2019

Rupa Sanghani, M.D., FASNC, associate professor, Rush Medical College, director of nuclear cardiology and stress laboratory, Rush University Medical Center, and associate director, Rush Heart Center for Women, explains how to create a high-volume cardiac positron emission tomography (PET) imaging program. She spoke on this topic at the 2019 meeting of the American Society Nuclear Cardiology (ASNC) and led a tour for attendees of the PET-CT system at Rush, which was located close to the conference. 

Sanghani said the advantages of PET myocardial perfusion imaging include faster exam times and allowing additional information from coronary reserve flow assessments to better understand if revascularization will help a patient's heart recover. The 16-slice CT scanner is used not only to attenuate the PET images, but to perform a CT calcium scoring exam to assess the patient's risk for future cardiovascular events. The Rubidium-82 radiotracer used for PET exams only has a 75 second half life, so it can help increase the number of exams a center is able to perform each day. At higher volume centers, PET is optimized to handle all the patients who require pharmacological stress exams. 

In the video, Sanghani  outlines what Rush did to design its room, covers basics on training, what to look for in a scanner and other considerations when creating a PET program.

Find more coverage of the ASNC

Find more news on nuclear imaging

 

 

Cardiac Diagnostics | October 29, 2019

Clyde Yancy, M.D., MSc, cardiology chief and vice dean for diversity and inclusion at Northwestern University, Feinberg School of Medicine, was a keynote speaker at the 2019 American Society of Nuclear Cardiology (ASNC) annual meeting. He said the traditional biases of seeing a patient and automatically making clinical assumptions because they are a certain race or gender are obsolete. For example, he said not all black patients have hypertension. Yancy added that genetics, especially with racial intermarriage over the past several generations, no longer predisposes patients to what is typically assumed for certain ethnic or racial backgrounds.

Yancy also said new research is showing how diet plays a major role in patient health and disease progression for things previously thought to be based on genetics. This includes the people who live in "food deserts" in urban areas where there are no sources of fresh food and vegetables, so they consume large amounts of packaged and processed foods that contain high levels of salt, phosphates and preservatives. He said these chemicals and diet may be the root cause of hypertension and diabetes in black populations in low income areas, rather than genetics as previously thought.

 

Related Content: 

VIDEO: Reducing Hypertension Among African-Americans — Interview with Kim Allan Williams, Sr., M.D.

VIDEO: Use of Plant-Based Diet to Reduce Cardiovascular Disease Risk — Interview with Kim Allan Williams, Sr., M.D.

VIDEO: New PLATINUM Diversity Data Shows Early DAPT Cessation OK in Minorities With New Generation Stent — Interview with Roxana Mehran, M.D., 

 

Radial Access | October 22, 2019

Sunil Rao, M.D., chief of cardiology, Durham VA Health System and a professor at Duke University, and Prashant Kaul, M.D., director of the cath lab, Piedmont, Atlanta, discuss trends in radial access at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) annual meeting. They discuss how radial access adoption has grown rapidly in the past few years and now makes up between 40-50 percent of percutaneous coronary intervention (PCI) procedural volume in the United States. They also discuss recent clinical trial data and the new concept of using distal radial access. 

 

Related Radial Access Content:

Transradial Access Celebrates 25 Years

VIDEO: History of Radial Artery Access — Interview with Ferdinand Kiemeneij, M.D.

VIDEO: New Frontiers in Radial Access — Interview with Mladen I. Vidovich, M.D.

Find more news and on transradial access technique and technology

 

 

Vascular Closure Devices | October 17, 2019

Ashish Pershad, M.D., chief of interventional cardiology, Banner University Medical Center, Phoenix, explains the trend of using closure devices to seal larger vascular access sites from the use of TAVR, EVAR, TMVR and hemodynamic support devices at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) meeting. He was one of the moderators on a session on this topic at TCT 2019.

 

Related Large Bore Vascular Closure Device Content:

VIDEO: How to Achieve Hemostasis With Large Bore Device Access — Interview with Philippe Genereux, M.D.

First-in-Human Results Show Early Bird Device Effective in Early Detection of Internal Bleeding

Advances and Trends in Vascular Closure Devices

Manta Large-Bore Vascular Closure Device Cleared by the FDA

PerQseal Large Bore Closure Device Launches in Europe

Teleflex Acquires Essential Medical

 

Related Content With Dr. Pershad:

National Coverage Determination Will Make TAVR Available to More Patients at More Centers

VIDEO: Comparison Between Watchman vs. Amulet LAA Occluders
 

Antiplatelet and Anticoagulation Therapies | October 17, 2019

Roxana Mehran, M.D., FACC, FACP, FCCP, FESC, FAHA, FSCAI, professor of medicine and director of interventional cardiovascular research and clinical trials at the Zena and Michael A. Wiener Cardiovascular Institute at Mount Sinai School of Medicine, explains the use of short dual antiplatelet therapy (DAPT) in minorities from the PLATINUM Diversity Trial. The first trial data was released in 2017, and she presented new data from the study at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) meeting. 

The study looked at use of the Promus Element Plus Post-Approval Study and the clinical impact of dual-antiplatelet therapy (DAPT) cessation within 12 months of drug-eluting stent implantation in caucasians and minorities. It is one of the first large trials to stress the importance of diversity in clinical trials, which tent to reflect a population of older white men.

 

Find more news and videos from TCT 2019

Hemodynamic Support Devices | October 16, 2019

Jeffrey J. Popma, M.D., director of interventional cardiology clinical services at Beth Israel Deaconess Medical Center, professor of medicine at Harvard Medical School, explains the results of the PROTECT II and the new PROTECT III Study at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) meeting. PROTECT III is the follow up to PROTECT II RCT and the largest-ever FDA study of hemodynamically supported, high-risk PCI patients. 

He discusses the PROTECT II and PROTECT III studies, and real-life patient data from the Impella IQ Database. 

 

Find more news and videos from TCT 2019

Structural Heart | October 16, 2019

Vivian Ng, M.D., assistant professor of medicine and an interventional cardiologist at the NewYork-Presbyterian/Columbia University Medical Center Structural Heart and Valve Center, helped organize the first Women in Structural Heart (WISH) event at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) meeting. The evening session was standing room only and highlighted structural heart case presentations and discussion panels made up of all women. The session panelists and presenters were a whose-who of well known women in cardiology. The event was organized as a way to break the glass ceiling in the subspecialty of interventional cardiology, where women make up less than 5 percent of the operators.

 

Previous Video Interviews With Speakers and Panelists Involved in the WISH Session:

VIDEO: The Importance of the Neo-LVOT in Transcatheter Mitral Valve Replacement — Interview with Dee Dee Wang, M.D.

VIDEO: The Value of the Cardiovascular Service Line — Interview with Linda Gillam, M.D.,

VIDEO: Can We Live in 3-D Echo? — Interview with Lissa Sugeng, M.D.

VIDEO: Tricuspid Valve Imaging and Interventions Developing Hand-in-hand — Interview with Rebecca Hahn, M.D.

VIDEO: Strategies to Avoid Acute Kidney Injury Caused by Cath Lab Contrast — Interview with Roxana Mehran, M.D.,

 

 

Find more news and videos from TCT 2019

Antiplatelet and Anticoagulation Therapies | October 11, 2019

Ajay J. Kirtane, M.D., associate professor of medicine at Columbia University Irving Medical Center and director of the cardiac catheterization laboratories at NewYork-Presbyterian (NYP) Hospital, shares the findings of the late-breaking EVOLVE Short DAPT study presented as a late-breaking trial at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) meeting. It evaluated the safety of early dual antiplatelet therapy (DAPT) discontinuation in patients with high bleeding risk treated with the a Boston Scientific Synergy bioabsorbable polymer coated drug-eluting stent (DES).

With the advancement of new DES technologies using thinner struts and new types of drug-carrier polymer techniques, the risk of late-stent thrombosis has been greatly reduced, meaning there is less need for long-term DAPT. For patients who are at high risk for bleeding, who have ulcers or other types of gastrointestinal (GI) bleeding, or those going into surgery, it would be beneficial to reduce the time period for DAPT, and several late-breaking trials examined this at TCT 2019.
 

Here are the other late-breaking DAPT studies:

 

Find more news and videos from TCT 2019

Antiplatelet and Anticoagulation Therapies | October 10, 2019

Roxana Mehran, M.D., FACC, FACP, FCCP, FESC, FAHA, FSCAI, professor of medicine and director of interventional cardiovascular research and clinical trials at the Zena and Michael A. Wiener Cardiovascular Institute at Mount Sinai School of Medicine, explains insights from the Ticagrelor With Asprin or Alone in High-Risk patients after Coronary Intervention (TWILGHT) Trial. She presented this late-breaking study at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) meeting. Here is a link to the article on the TWILIGHT Trial.

 

Related Short DAPT Content:

VIDEO: Overview of Short DAPT in High-risk Bleeding Patients Who Receive Stents — Interview with AHA President Robert Harrington, M.D. at TCT 2019 

Onyx ONE: A Randomized Trial of a Durable-Polymer Drug-Eluting Stent vs a Polymer-Free Drug-Coated Stent in Patients at High Risk of Bleeding Treated With 1-Month DAPT - TCT 2019 late-breaker

IDEAL-LM: A Randomized Trial of a Bioabsorbable Polymer DES With 4-Month DAPT vs a Durable Polymer DES With 12-Month DAPT in Patients With Left Main Coronary Artery Disease - TCT 2019 late-breaker 

EVOLVE Short DAPT: A Single Arm Study of 3-Month DAPT in Patients at High Bleeding Risk Treated a Bioabsorbable Polymer-Based Everolimus-Eluting Stent - TCT 2019 late-breaker 

New Directions and Trends in Coronary Metallic Stents

Questions Remain on DAPT Prolongation

 

 

Find more TCT late-breaking news and video

Heart Valve Technology | October 09, 2019

Torsten Vahl, M.D., director of experimental and translational research, Structural Heart and Valve Center and at the Center for Interventional Vascular Therapy at NewYork-Presbyterian Hospital/Columbia University Medical Center, explains the current state of transcatheter arctic valve replacement (TAVR) following the U.S. Food and Drug Administration (FDA) clearance of TAVR in all surgical risk patient categories. Europe also cleared the use of the Sapien 3 device for low risk patients in November 2019.

He spoke on TAVR at the Transcatheter Cardiovascular Therapeutics (TCT) 2019 meeting. In August 2019, the FDA cleared the use of TAVR in all surgical risk classes of patients using the Edwards Sapien 3 and Medtronic CoreValve devices. This means the heart team made up of a cardiac surgeon, interventional cardiologist and cardiac imaging specialist can determine if surgical aortic valve replacement (SAVR) or TAVR should be used. It is widely expected TAVR use will rapidly rise in the next five years to take over 50 to 70 percent of the aortic valve replacement procedural volume. It is expected surgical volumes will drop to about 20 percent of patients who do not qualify for TAVR because of anatomic issues or other variables that make SAVR a safer option.

 

Related Transcatheter Valve Content:

FDA Approves TAVR for Low-risk Patients Creates A Paradigm Shift in Cardiology

Edwards Sapien 3 TAVI Granted European Approval to Treat Low-risk Patients

VIDEO: Tracking Transcatheter Valve Outcomes in the STS-ACC TVT Registry — John Carroll, M.D.

VIDEO: Transcatheter Mitral Valve Replacement Planning — Interview with Joao Cavalcante, M.D.

VIDEO: Overview of University of Colorado Structural Heart Program — Interview with John Carroll, M.D., Robert Quaife, M.D., and James Chen, Ph.D.

Advances in Transcatheter Tricuspid Valve Technologies

 

VIDEO: Update of Mitral Valve Repair and Replacement Technologies at TCT 2017 — Interview with Ted Feldman, M.D.,

TAVR Operator and Hospital Requirements Outlined in 2018 AATS/ACC/SCAI/STS Expert Consensus

VIDEO: Tricuspid Device Clinical Trial Overview — Interview with Ori Ben-Yehuda, M.D.

Recent Advances in Transcatheter Valve Technology

 

VIDEO: Tricuspid Valve Imaging and Interventions Developing Hand-in-hand at ASE 2018— Interview with Rebecca Hahn, M.D.

Hospital Consolidation May Increase Access to TAVR, New Cardiac Technologies

VIDEO: TAVR for Degenerated Surgical Valves - 2017 Update— Valve-in-Valve TAVR Procedures — Interview with Sammy Elmariah, M.D.

How to Perform Transcaval TAVR Access

 

VIDEO: The Essentials of CT Transcatheter Valve Imaging — Interview with Jonathon Leipsic, M.D.

Advances in Heart Valve Technology in 2017

VIDEO: TAVR For Asymptomatic Severe Aortic Stenosis — Interview with Philippe Genereux, M.D.

VIDEO: Conscious Sedation for TAVR Procedures — Interview with Mario Goessl, M.D.

 

VIDEO: Overview of the Henry Ford Hospital Structural Heart Program

Advances and Future Directions for Transcatheter Valves

Transcatheter Mitral Valve Replacement Devices in Development

 

 

 

 

Antiplatelet and Anticoagulation Therapies | October 08, 2019

American Heart Association President Robert Harrington, M.D., interventional cardiologist and the Arthur L. Bloomfield Professor of Medicine and chairman of the Department of Medicine at Stanford University, explains the reasons for shorter duration dual-antiplatelet therapy (DAPT) in high-risk bleeding patients. Newer-generation drug-eluting stents are designed for faster vessel healing and endothelialization, so the time required for DAPT can be reduced from 12 months to a shorter time period. At the 2019 Transcatheter Cardiovascular Therapeutics (TCT) meeting there were several late-breaking trials that looked at shorter duration DAPT or use of mono-therapy with ticagrelor. 

Related Short DAPT Content:

TWILIGHT: A Randomized Trial of Ticagrelor Monotherapy vs Ticagrelor Plus Aspirin Beginning at 3 Months in High-risk Patients Undergoing PCI - TCT 2019 late-breaker

Onyx ONE: A Randomized Trial of a Durable-Polymer Drug-Eluting Stent vs a Polymer-Free Drug-Coated Stent in Patients at High Risk of Bleeding Treated With 1-Month DAPT  - TCT 2019 late-breaker

IDEAL-LM: A Randomized Trial of a Bioabsorbable Polymer DES With 4-Month DAPT vs a Durable Polymer DES With 12-Month DAPT in Patients With Left Main Coronary Artery Disease - TCT 2019 late-breaker

EVOLVE Short DAPT: A Single Arm Study of 3-Month DAPT in Patients at High Bleeding Risk Treated a Bioabsorbable Polymer-Based Everolimus-Eluting Stent  - TCT 2019 late-breaker

 

TCT | October 04, 2019

Chandan Devireddy, M.D., offers insights about what he saw as the top take aways from the 2019 Transcatheter Cardiovascular Therapeutics (TCT) annual meeting. He is cath lab director at Emory University Hospital Midtown, associate professor of medicine of interventional cardiology at Emory University, and chairperson for the Society of Cardiovascular Angiography and Interventions (SCAI) Communications Committee. 

Devireddy said his key take aways from TCT 2019 were:

   • The poor results of the Boston Scientific Acurate Neo self-explaining TAVR system compared to the current devices on the U.S. market;

   • Results of the Abbott Portico TAVR system;

   • Levant Trial shows no increased mortality due to use of a paclitaxel-coated balloon; and

   • CT study of TAVR valve leaflet thrombosis.

 

Find more TCT late-breaking news and video

 

Hemodynamic Support Devices | September 22, 2019

There was a 77 percent increase in survival in cardiogenic shock patients treated using a new protocol in the National Cardiogenic Shock Initiative. The data was presented at the 2018 Transcatheter Cardiovascular Therapeutics (TCT) meeting. The details are discussed here with Babar Basir, D.O., and William O'Neill, M.D., from Henry Ford Hospital

Watch the related VIDEO: Overview of the National Cardiogenic Shock Initiative

Watch the related VIDEO: Support Protocols at Henry Ford Hospital

Additional articles and videos on Henry Ford Hospital 

(Editor's note - this video was originally published in September 2018 and was revised September 2019)

Hemodynamic Support Devices | September 12, 2019

A discussion with William O'Neill, M.D., director of the structural heart program, Henry Ford Hospital, and Michele Voeltz, M.D., fellowship program director, interventional cardiology, explaining their process for selecting various levels of hemodynamic support.

Henry Ford Hospital also helped spearhead the Detroit Cardiogenic Shock Initiative that morphed into the National Cardiogenic Shock Initiative using these same protocols. Watch an interview with O'Neill explaining the national initiative.

Additional articles and videos on Henry Ford Hospital 

(Editor's note - this video was originally published in September 2018 and was revised September 2019)

 

 

Advanced Visualization | August 09, 2019

An example of Siemens' photo-realistic Cinematic image reconstruction. This image is from a CTA exam from a Siemens Force CT scanner. 

Vendors who offer this realistic type of CT image rendering say it is not used for diagnostics. However, the technology can be helpful when explaining things to the patient and their family, educating physicians and staff, and for surgeons, since it offers a realistic view of the anatomy that is easier for most people to understand who are not familiar with cardiac anatomy as it appears in traditional CT multiplanar reconstruction (MPR) images. 

This example of software was demonstrated on the expo floor at the 2019 Society of Cardiovascular Computed Tomography (SCCT) meeting. 

 

Find more news and videos from the SCCT meeting

CT Angiography (CTA) | August 08, 2019

This is a quick video example of a cardiac computed tomography (CT) exam showing a Medtronic CoreValve transcatheter aortic valve replacement (TAVR) device implanted. The image was reconstructed using Canon Medical’s Global Illumination photo-realistic rendering advanced visualization post-processing software. Vendors who offer this realistic type of CT image rendering say it is not used for diagnostics. However, the technology can be helpful when explaining things to the patient and their family, educating physicians and staff, and for surgeons, since it offers a realistic view of the anatomy that is easier for most people to understand who are not familiar with cardiac anatomy as it appears in traditional CT multiplanar reconstruction (MPR) images. 

This example of software was demonstrated on the expo floor at the 2019 Society of Cardiovascular Computed Tomography (SCCT) meeting. 

 

 

 

CT Angiography (CTA) | August 08, 2019

This is an example of an automated calcium scoring software to speed review of coronary artery calcium (CAC) scoring cardiac computed tomography (CT) scans. This advanced visualization software from Ziosoft uses artificial intelligence to segment the coronary vessels, identify valves and the aorta and then color code tag the calcium deposits and quantify the amount of calcified plaque in each vessel. It tallies the score into a table and computes an overall Agatston risk score. This risk score correlates to that patient's risk for a heart attack in the future. The software notes calcium in the heart outside the coronaries in valve leaflets and the aorta, but excludes this data. This type of automation is now offered by most advanced visualization and CT system vendors. This automation can save a large amount of post-processing time and make it easier for hospitals to offer low-cost CAC CT screening programs. 

CAC scans can be used to determine if a patient needs to go on statin therapy. An Agatston score of zero means the patient has no risk of coronary disease. 

Calcium in arteries is a marker for damage caused by vessel wall inflammation from atherosclerosis. Calcium can form from previously ruptured necrotic, lipid core plaques, also referred to as vulnerable plaques. These are the types of plaque responsible for heart attacks. When the core of these plaques rupture, the blood reacts to the exposed core similar to a wound and begins to clot, forming a thrombus in the vessel, which can block the blood flow. When the vessel heals over time it calcifies, leaving behind an easily identifiable marker on CT imaging. 

This example of software was demonstrated on the expo floor at the 2019 Society of Cardiovascular Computed Tomography (SCCT) meeting. 

 

Related CT Calcium Scorining Content:

VIDEO: The History of CT Calcium Scoring — Interview with Arthur Agatston, M.D.

VIDEO: New Cholesterol Guidelines Support CT Calcium Scoring for Risk Assessment — Interview with Matthew Budoff, M.D.

CT Calcium Scoring Becoming a Key Risk Factor Assessment

ACC and AHA Release Updated Cholesterol Guidelines for 2018

VIDEO: CT Calcium Scoring to Screen For Who Should Take Statins — Interview with Matthew Budoff, M.D.

 

 

Computed Tomography (CT) | August 07, 2019

This is an example of in-stent restenosis shown using spectral CT imaging. This example was demonstrated by Philips Healthcare at the 2019 meeting of the Society Of Cardiovascular Computed Tomography (SCCT). It can sometimes be difficult to determine if showing inside a stent of CT is artifact or real. Spectral CT can definitely help make a diagnosis. This example shows Philips’ Effective Z visualization, where the image is created based on the atomic number of the elements present in the image. After removal of iodine from the image, it shows the shadow in the stent has the same atomic composition as the vessel intima.  

This example is from a Philips IQon dual-energy CT scanner. This system has spectral imaging always on without any need to change protocols. This allows the spectral to be used when needed for additional information without need to rescan a patient.

Read more on this CT system.

VIDEO: Applications of Spectral CT — Interview with Suhny Abbara, M.D.

 

Cardiac Imaging | July 30, 2019

Nate Bachman, graduate research assistant in the Human Cardiovascular Physiology Lab of the Dept. of Health and Exercise Science at Colorado State University, describes how he and fellow researchers used multiple types of cardiac imaging to evaluate the cardiovascular health of athletes who compete in endurance events lasting six hours or more, and what the results may suggest for future screening.

EP Lab | July 26, 2019

Mark Ibrahim, M.D., FACC, assistant professor of medicine and radiology, associate program director, advanced cardiac imaging fellowship, University of Utah, explains what radiologists and cardiologists need to know what is needed from CT imaging prior to ablation procedures for atrial fibrillation (AF) and ventricular fibrillation (VF). He spoke at a joint session of the Heart Rhythm Society (HRS) and the Society of Cardiovascular Computed Tomography (SCCT) at the 2019 SCCT meeting. 

 

Find more SCCT news and videos

CT Angiography (CTA) | July 26, 2019

Andrew Choi, M.D., FACC, FSCCT, co-director, cardiac CT and MRI, assistant professor of medicine and radiology, George Washington University, Division of Cardiology, Washington, D.C., explains the role of social media to extend the reach of cardiovascular research from peer review journals. He spoke on this topic in multiple sessions at the Society of Cardiovascular Computed Tomography (SCCT) 2019 meeting.

 

Find more SCCT news and videos

 

EP Lab | July 25, 2019

Pierre Qian, MBBS, cardiac electrophysiologist fellow, Brigham and Women's Hospital, explains how his facility is working with radiation oncology to use radio therapy to noninvasively ablate ventricular tachycardia (VT). He spoke on this topics during a joint electrophysiology session by the Heart Rhythm Society (HRS) and the Society of Cardiovascular Computed Tomography (SCCT) at the SCCT 2019 meeting.

Here is a link to another radiotherapy EP project Qian recently had published - A Novel Microwave Catheter Can Perform Noncontact Circumferential Endocardial Ablation in a Model of Pulmonary Vein Isolation

 

Find more SCCT news and videos

Heart Valve Technology | July 24, 2019

Joao Cavalcante, M.D., FSCCT, director of structural heart CT and cardiac MRI, Minneapolis Heart Institute, discusses transcatheter mitral valve replacement (TMVR) imaging requirements at the Society of Cardiovascular Computed Tomography (SCCT) 2019 meeting. SCCT held its first TMVR planning hands-on workshop, which he was involved in. TMVR is expanding with currently FDA cleared valve-in-valve (VIV) and valve-in-ring (VIR) procedures.

 

Related TMVR Content:

Interventional Imagers: The Conductors of the Heart Team Orchestra

VIDEO: The Importance of the Neo-LVOT in Transcatheter Mitral Valve Replacement  — Interview with Dee Dee Wang, M.D.

VIDEO: Transcatheter Structural Heart Procedure Navigation Technology Advances  — Interview with Stephen Little, M.D.

Recent Advances in Transcatheter Valve Technology

Abbott Begins Tendyne Transcatheter Mitral Valve U.S. Pivotal Trial

VIDEO: The Essentials of CT Transcatheter Valve Imaging — Interview with Jonathon Leipsic, M.D.,

New LAMPOON Technique Reduces LVOT Obstruction in Transcatheter Mitral Valve Replacement

Find more SCCT news and videos

CT Angiography (CTA) | July 24, 2019

Arthur Agatston, M.D., clinical professor of medicine, Florida International University, Herbert Wertheim College of Medicine, is the name-sake of the Agatston score used in CT calcium scoring. He explains the history of the scoring system from the early 1990s and the evolution of CT technology for cardiac imaging. The latest American Heart Association (AHA) 2018 cholesterol guidelines now include the use of CT calcium scoring, which was a big topic at the Society of Cardiovascular Computed Tomography (SCCT) 2019 meeting.

Read the article How the Agatston Calcium Score Was Created and its Impact on Heart Attack Prevention.

See a quick example of a CT calcium scoring exam in the VIDEO: Example of an Automated CT Cardiac Calcium Scoring Exam.

 

 

Related CT Calcium Scorining Content:

VIDEO: New Cholesterol Guidelines Support CT Calcium Scoring for Risk Assessment — Interview with Matthew Budoff, M.D.

CT Calcium Scoring Becoming a Key Risk Factor Assessment

ACC and AHA Release Updated Cholesterol Guidelines for 2018

VIDEO: CT Calcium Scoring to Screen For Who Should Take Statins — Interview with Matthew Budoff, M.D.

 

Find more SCCT news and videos

 

SCCT | July 19, 2019

Ron Blankstein, M.D., director of cardiac computed tomography, Brigham and Women's Hospital, and associate professor of medicine and radiology, Harvard Medical School, and current SCCT president, offers an overview of the recent trends in cardiac CT and some of the new highlights at the Society of Cardiovascular Computed Tomography (SCCT) 2019 meeting. The  said key topics included integration of artificial intelligence into CT systems, the integration of CT calcium scoring into the 2018 American Heart Association (AHA) cholesterol management guidelines, structural heart assessments for transcatheter valve and left atrial appendage (LAA) occlusion, and partner sessions with TCT and HRS that explain the roll of CT in interventional cardiology and electrophysiology.

Find more SCCT news and videos

CT Angiography (CTA) | July 19, 2019

Quynh Truong, M.D., MPH, associate professor of radiology and medicine at Weill Cornell and director of cardiac CT, NewYork Presbyterian Hospital, offers 10 tips to help improve image quality for cardiovascular computed tomography (CTA) exams. She spoke on this topic at the Society of Cardiovascular Computed Tomography (SCCT) 2019 meeting.

Her discussion includes:

1. Practice the breath hold

2. Give nitrate to vasodilate

3. Slow the heart rate

4. Acquire multiple phases with padding

5. Include systolic imaging for irregular heart beats

6. Consider cauo-cranial imaging to avoid contrast enhancement issues

7. Use a high contrast injection rate

8. Right ventricular opacification for function

9. Use a hard kernel

10. Know your post-processing software

 

VIDEO: Tips and Tricks to Aid Cardiac CT Technologist Workflow

VIDEO: How to Prepare a Patient for a Cardiac CT Scan

Find more SCCT news and videos

Cardiovascular Ultrasound | July 10, 2019

This is an example of a cardiac echocardiography exam performed using an iPhone and the Butterfly IQ ultrasound transducer and app. The company is exhibiting at the American Society Of Echocardiography (ASE) 2019 meeting. This is the first “ultrasound system on a chip.” The Butterfly IQ ultrasound system consists of a transducer that connects to an iPhone or iPad to record ultrasound exams. The system has 18 different applications for specialized images, including cardiac imaging, vascular, lung, abdominal and others. The apps allow for quantification and offers many of the features of larger cart-based systems. The company is working on incorporating artificial intelligence technologies to automate some processes, such as auto ejection fractions.

This technology was picked as one of the big ultrasound advances in the VIDEO: 4 Recent Advances in Echocardiography Technology and in the VIDEO: Editor's Choice of the Most Innovative New Technology at RSNA 2018.

Artificial Intelligence | July 02, 2019

Judy Hung, M.D., director of echocardiography, Division of Cardiology, Massachusetts General Hospital, Boston, discusses how her center is partnering to develop artificial intelligence (AI) applications to help improve image quality and speed workflow in cardiac ultrasound. She spoke to DAIC at the 2019 American Society of Echocardiography (ASE).

 

Cardiovascular Ultrasound | July 01, 2019

Federico Asch, M.D., FASE, director of cardiac imaging research and director of the cardiovascular imaging lab, MedStar Health Research Institute, Washington, D.C., spoke about the cardiovascular impact of chagas disease and the symptoms that should be considered for patients who are from, or visited, South or Central America. He spoke on the topic at the 2019 American Society Of Echocardiography (ASE) meeting.

Chagas, also called trypanosomiasis, is a tropical parasitic disease caused by the protist Trypanosoma cruzi. It is spread through the bite of the triatominae insect, which is also known as the "kissing bug." Link to the Center for Disease Control (CDC) page on Chagas.

Asch served as the co-chair of the group that created the guidelines to image Chagas disease.

Read the guidelines at "Recommendations for Multimodality Cardiac Imaging in Patients with Chagas Disease: A Report from the American Society of Echocardiography in Collaboration With the InterAmerican Association of Echocardiography (ECOSIAC) and the Cardiovascular Imaging Department of the Brazilian Society of Cardiology (DIC-SBC).

 

Find more news and video from ASE 2019

 

Cardiovascular Ultrasound | July 01, 2019

Partho Sengupta, M.D., MBBS, chief of cardiology, West Virginia Heart and Vascular Institute, explains how wearable, smartphone-based apps and medical devices, and artificial intelligence (AI) might be used to cost-effectively triage larger numbers of patients in rural areas and in the developing world for serious diseases. He spoke at the 2019 American Society Of Echocardiography (ASE) meeting.

Sengupta is involved with a pilot program using the Butterfly app and transducer to turn a smartphone into an inexpensive ultrasound system. He said the idea is to have novice ultrasound users screen more patients with these types of devices and the exams either being sent to a remote hospital for reading. He said AI algorithms also could be used to help flag any exams that show abnormalities, which would greatly speed reads and getting these patients treatment. 

Watch the related VIDEO: How Smartphones May Revolutionize Healthcare in the Developing World — Interview with Jacques Kpodonu, M.D.,

Find more news and video from ASE 2019

 

Contrast Media | June 28, 2019

Sharon Mulvagh, M.D., FASE, FACC, FRCPC, professor of medicine, division of cardiology, Dalhousie University, Halifax, Nova Scotia, Canada, and professor emeritus, Mayo Clinic, explains the latest updates to guidelines for the use of cardiovascular ultrasound enhancing imaging agents. She spoke to DAIC at the 2019 American Society of Echocardiography (ASE) meeting.

The changes include a new term for contrast so the agents are not confused with safety issues regarding gadolinium, iodine-based contrast or radioactive nuclear radiotracers. She gives an overview of the 2018 guidelines that are based on a large level of clinical study evidence. Previously, the ASE issued a statement rather than a guideline, because the more clinical evidence was needed for more a more conclusive set of guidelines. 

Read the full guidelines: Clinical Applications of Ultrasonic Enhancing Agents in Echocardiography: 2018 American Society of Echocardiography Guidelines Update.

Find more news and videos from ASE 2019.

 

Artificial Intelligence | June 28, 2019

This is a quick example of how artificial intelligence (AI) is being integrated on the back end of cardiac ultrasound systems to help automate and speed workflows. This video segment is from the expo floor of the 2019  American Society of Echocardiography (ASE) meeting. It shows AI-based AFI automation features incorporated into the GE Vivid E95 echo system. 

Read a blog about how AI will help advance cardiac ultrasound imaging, Combatting the No. 1 Cause of Death With the Help of Artificial Intelligence and Advanced Technology.

Find more ASE 2019 coverage

 

Heart Failure | June 28, 2019

Federico Asch, M.D., FASE, director of cardiac imaging research and director of the cardiovascular imaging lab, MedStar Health Research Institute, Washington, D.C., explains the importance of the COAPT Trial and the cardiac ultrasound findings from the study. It was presented as a late-breaking study at the American College of Cardiology (ACC) 2019 meeting and the sub-study was discussed in several sessions at the 2019 American Society of Echocardiography (ASE) conference.

The trial showed the Abbott MitraClip can be used to help large numbers of patients with heart failure who experience increasing levels of mitral valve regurgitation due to the enlargement of their hearts. 

Read more about the COAPT Trial

VIDEO: MitraClip to Treat Heart Failure - Results of the COAPT Trial — Interview with William Abraham M.D. 

VIDEO: Impact of the COAPT Trial on Heart Failure Patients With Functional Mitral Regurgitation — Interview with Andreas Brieke, M.D.

FDA Approves MitraClip for Use in Heart Failure Patients With Functional Mitral Regurgitation

360 View of the TEE Echo Workstation During a MitraClip Procedure

 

 

 

 

Cardiovascular Ultrasound | June 27, 2019

Judy Hung, M.D., director of echocardiography, Division of Cardiology, Massachusetts General Hospital, Boston, explains some of the changes in recent guidelines for cardiac ultrasound assessments of aortic and mitral valves. She spoke at the 2019 American Society of Echocardiography (ASE) meeting.

 

Links to ASE guidelines:

   • Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation

   • Recommendations on the Echocardiographic Assessment of Aortic Valve Stenosis: A Focused Update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography

 

Find more ASE 2019 coverage

 

Virtual and Augmented Reality | June 27, 2019

Roberto Lang, M.D., director of cardiac imaging at the University of Chicago, has been working with TomTec for the past three years on a project to use virtual reality (VR) to edit and view 3-D cardiac ultrasound and CT scans. He spoke at a couple sessions this week at the 2019 American Society Of Echocardiography (ASE) meeting, where doctors were able to view the session using VR headsets. The hands-on demonstration of this technology in the TomTec booth at ASE 2018 and 2019 was one of the most popular exhibits with attendees both years.

Read more about this technology in Top Technology Trends in Echocardiography at ASE 2018

See examples of VR technology for echo in the  VIDEO: Editor’s Choice of the Most Innovative Echo Technology at ASE 2018

Here is a video example of this technology being demonstrated at ASE19.

 

Cath Lab | June 26, 2019

Thomas Porter, M.D., FASE, the Theordore F. Hubbard Distinguished Chair of Cardiology and a professor of medicine at the University of Nebraska Medical Center, explains a new study on how cardiac ultrasound imaging combined with bubble contrast was able to break down blood clots and restore blood flow to blocked vessels in STEMI heart attack patients. He gave an update on this new potential therapeutic direction for ultrasound at the 2019 American Society Of Echocardiography (ASE) meeting.

The Brazilian study used this approach in about 100 ST-elevated myocardial infarction (STEMI) patients and was recently published in the Journal of the American College of Cardiology (JACC). Porter said about 50 percent of patients had their ST resolved by the time they made it to the cath lab for percutaneous coronary intervention (PCI). Two more studies in Amsterdam and Pittsburgh are now starting to see if this technique can be used while transporting patients in an ambulance to further improve heart attack outcomes and to reduce infarct size.

Porter also explains recent research that shows ultrasound pulses promote ATP and nitric acid production, which have a lasting beneficial effect on small vessel perfusion in the area treated and down stream for hours after the use of the transducer. 

Watch the VIDEO: Therapeutic Applications for Contrast Ultrasound — another  interview with Porter. 

 

 

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