The impact of lipid compositions on siRNA and mRNA lipid nanoparticle performance for pulmonary delivery.

Lipid nanoparticles (LNPs) are of significant interest as delivery systems for various RNA therapeutics, not least due to their outstanding success in applications including the COVID-19 vaccines and the siRNA therapeutic Onpattro®. As LNPs consist of different lipids, the lipid composition determines key properties of these particles. This study examines how lipid composition, especially helper and PEG-lipids, and RNA cargo (siRNA and mRNA) affect LNP performance in pulmonary delivery.

The Hidden Dangers of Additional Shunts in Patent Foramen Ovale Treatment.

Background: Unroofed coronary sinus (UCS) is a rare congenital defect that causes a left-to-right shunt, often associated with anomalies such as persistent left superior vena cava. Its diagnosis and management are challenging.

Case Summary: A 49-year-old woman with worsening dyspnea, orthopnea, and peripheral edema unresponsive to diuretics was referred for evaluation.

Case Report: Anaphylactic shock and ST-elevation myocardial infarction following a bee sting: two deadly diseases in a patient with Kounis syndrome.

Kounis syndrome is an acute coronary syndrome occurring in the setting of an allergic reaction, usually caused by drug administration, food ingestion, or insect sting. We report the case of an elderly woman who presented to the emergency room suffering from an anaphylactic shock caused by a bee sting and who was diagnosed with an anterolateral ST-elevation myocardial infarction (STEMI) with moderately impaired left ventricular ejection. The patient was successfully managed with the administration of intravenous antihistaminic drugs and steroids, intravenous fluid volume resuscitation, and intramuscular epinephrine.

The Potential Influence of Associated Antidepressants on the Pharmacokinetic Profile of Esketamine in Patients Affected by Treatment-resistant Depression.

Introduction/objective: Esketamine is administered intranasally in combination with at least another antidepressant in patients with treatment-resistant depression. Some of these antidepressants might affect ketamine's pharmacokinetic profile by inhibiting cytochrome-P (CYP) isoforms. Our aim was to establish how different types of combined antidepressants affect serum and salivary levels of esketamine at the time of maximum plasma concentrations and afterward in TRD patients receiving esketamine in a real-world context.

Cardiac MRI study of adverse events in patients treated with immune checkpoint inhibitors: a prospective cohort study of cardiac adverse events.

Immune checkpoint inhibitors (ICIs) revolutionized cancer therapy, yet require management of immune-related adverse events (irAEs). Fulminant myocarditis is a rare irAE, but lower-severity cardiac events are being reported more frequently, leading to an unmet need for irAE prevention, early diagnosis, and treatment, especially for long-life-expectancy patients. We recruited 57 patients, stratified according to therapy regime (monotherapy (30%) or combination (33%) cohort) or history of cardiac disease or presence of at least two cardiovascular risk factors other than prior or active smoking (cardiovascular cohort (37%)).

To Each Imaging Modality, Their Own MAD.

Purpose: The clinical significance of mitral annular disjunction (MAD) is uncertain. Imaging modality might impact the prevalence of MAD. We aimed to assess MAD prevalence at transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR) as well as their inter-modality agreement.

Trends in Clinical Cardiac Photon-Counting Detector CT Research: A Comprehensive Bibliometric Analysis.

Photon-counting detector computed tomography (PCD-CT) represents a significant advancement in radiological imaging, offering substantial potential for cardiac applications that remain partially underexplored. This bibliometric analysis investigates the evolution and current clinical application of cardiac PCD-CT by examining research trends from 2019 to 2024. The analysis aims to understand the development of this technology, its clinical implications, and future directions.

Pharmacological regression of atherosclerotic plaque in patients with type 2 diabetes.

Atherosclerosis of the coronary arteries continues to be one of the major global health burdens and acute coronary syndrome is responsible annually for at least 30 % of all deaths globally. Acute coronary syndrome may be the consequence of thrombus formation after erosion or rupture of obstructive or non-obstructive atherosclerotic plaque. The rupture of plaques is mostly caused by mechanical stress usually called cap fatigue.

Evaluating the role of 7-Tesla magnetic resonance imaging in neurosurgery: Trends in literature since clinical approval.

Background: After approval for clinical use in 2017, early investigations of ultra-high-field abdominal magnetic resonance imaging (MRI) have demonstrated its feasibility as well as diagnostic capabilities in neuroimaging. However, there are no to few systematic reviews covering the entirety of its neurosurgical applications as well as the trends in the literature with regard to the aforementioned application.

Aim: To assess the impact of 7-Tesla MRI (7T MRI) on neurosurgery, focusing on its applications in diagnosis, treatment planning, and postoperative assessment, and to systematically analyze and identify patterns and trends in the existing literature related to the utilization of 7T MRI in neurosurgical contexts.

Mitral annulus disjunction in consecutive patients undergoing cardiovascular magnetic resonance: Where is the boundary between normality and disease?

Background: The presence of mitral annulus disjunction (MAD) has been considered a high-risk feature for sudden cardiac death based on selected study populations. We aimed to assess the prevalence of MAD in consecutive patients undergoing clinically indicated cardiovascular magnetic resonance (CMR), its association with ventricular arrhythmias, mitral valve prolapse (MVP), and other CMR features.

Methods: This single-center retrospective study included consecutive patients referred to CMR at our institution between June 2021 and November 2021.

CT imaging post-TAVI: Murphy's first law in action-preparing to recognize the unexpected.

Transfemoral aortic valve implantation (TAVI) has been long considered the standard of therapy for high-risk patients with severe aortic-stenosis and is now effectively employed in place of surgical aortic valve replacement also in intermediate-risk patients. The potential lasting consequences of minor complications, which might have limited impact on elderly patients, could be more noteworthy in the longer term when occurring in younger individuals. That's why a greater focus on early diagnosis, correct management, and prevention of post-procedural complications is key to achieve satisfactory results.

Competence of radiologists in cardiac CT and MR imaging in Europe: insights from the ESCR Registry.

Rationale: To provide an overview of the current status of cardiac multimodality imaging practices in Europe and radiologist involvement using data from the European Society of Cardiovascular Radiology (ESCR) MRCT-registry.

Materials And Methods: Numbers on cardiac CT and MRI examinations were extracted from the MRCT-registry of the ESCR, entered between January 2011 and October 2023 (n = 432,265). Data collection included the total/annual numbers of examinations, indications, complications, and reporting habits.

Imaging biomarkers in cardiac CT: moving beyond simple coronary anatomical assessment.

Cardiac computed tomography angiography (CCTA) is considered the standard non-invasive tool to rule-out obstructive coronary artery disease (CAD). Moreover, several imaging biomarkers have been developed on cardiac-CT imaging to assess global CAD severity and atherosclerotic burden, including coronary calcium scoring, the segment involvement score, segment stenosis score and the Leaman-score. Myocardial perfusion imaging enables the diagnosis of myocardial ischemia and microvascular damage, and the CT-based fractional flow reserve quantification allows to evaluate non-invasively hemodynamic impact of the coronary stenosis.

From strength to precision: A systematic review exploring the clinical utility of 7-Tesla magnetic resonance imaging in abdominal imaging.

Background: After approval for clinical use in 2017 early investigations of ultra-high-field abdominal magnetic resonance imaging (MRI) have demonstrated the feasibility as well as diagnostic capabilities of liver, kidney, and prostate MRI at 7-Tesla. However, the elevation of the field strength to 7-Tesla not only brought advantages to abdominal MRI but also presented considerable challenges and drawbacks, primarily stemming from heightened artifacts and limitations in Specific Absorption Rate, Furthermore, evidence in the literature is relatively scarce concerning human studies in comparison to phantom/animal studies which necessitates an investigation into the evidence so far in humans and summarizing all relevant evidence.

Aim: To offer a comprehensive overview of current literature on clinical abdominal 7T MRI that emphasizes current trends, details relevant challenges, and provides a concise set of potential solutions.

Cardiac Masses and Pseudomasses: An Overview about Diagnostic Imaging and Clinical Background.

A cardiac lesion detected at ultrasonography might turn out to be a normal structure, a benign tumor or rarely a malignancy, and lesion characterization is very important to appropriately manage the lesion itself. The exact relationship of the mass with coronary arteries and the knowledge of possible concomitant coronary artery disease are necessary preoperative information. Moreover, the increasingly performed coronary CT angiography to evaluate non-invasively coronary artery disease leads to a rising number of incidental findings.

Imaging for the assessment of the arrhythmogenic potential of mitral valve prolapse.

Mitral valve prolapse (MVP) is the most common valve disease in the western world and recently emerged as a possible substrate for sudden cardiac death (SCD). It is estimated an annual risk of sudden cardiac death of 0.2 to 1.

Fabry Disease: More than a Phenocopy of Hypertrophic Cardiomyopathy.

Fabry disease (FD) is a genetic lysosomal storage disease with frequent cardiovascular involvement, whose presence is a major determinant of adverse clinical outcomes. As a potentially treatable cause of left ventricular hypertrophy (LVH) and heart failure with preserved ejection fraction, the early recognition of FD is crucial to initiate enzyme replacement therapy and improve long-term prognosis. Multimodality imaging plays a central role in the evaluation of patients with FD and helps in the differential diagnosis of other conditions presenting with LVH.

Deep Learning Image Reconstruction Algorithm for CCTA: Image Quality Assessment and Clinical Application.

Objective: The increasing number of coronary computed tomography angiography (CCTA) requests raised concerns about dose exposure. New dose reduction strategies based on artificial intelligence have been proposed to overcome limitations of iterative reconstruction (IR) algorithms. Our prospective study sought to explore the added value of deep-learning image reconstruction (DLIR) in comparison with a hybrid IR algorithm (adaptive statistical iterative reconstruction-veo [ASiR-V]) in CCTA, even in clinical challenging scenarios, as obesity, heavily calcified vessels and coronary stents.

Multimodality imaging in cardio-oncology: the added value of CMR and CCTA.

During the last 30 years, we have assisted to a great implementation in anticancer treatment with a subsequent increase of cancer survivors and decreased mortality. This has led to an ongoing interest about the possible therapy-related side-effects and their management to better guide patients therapy and surveillance in the chronic and long-term setting. As a consequence cardio-oncology was born, involving several different specialties, among which radiology plays a relevant role.