Surgical myectomy for hypertrophic cardiomyopathy: procedural volume and outcomes.

Background And Aims: Outcomes after surgical myectomy in hypertrophic obstructive cardiomyopathy (HOCM) patients have not been investigated in a multicentre registry with detailed clinical data. Hence, the objectives of this multicentre Dutch study are to describe the 30-day clinical outcomes after surgical myectomy, and to assess factors associated with increased 30-day complication rates.

Methods: All HOCM patients (n = 335) who underwent surgery between 2012 and 2020 across 12 Dutch hospitals were analysed using data from the Netherlands Heart Registration.

From Clinic to Cloud: Efficacy of AI-Assisted Remote Monitoring of Patients With Implantable Cardiac Devices.

The integration of telehealth, particularly remote monitoring (RM), has profoundly improved the care of patients with cardiac implantable electronic devices (CIEDs). The recent COVID-19 pandemic has further accelerated the adoption of RM systems. The implementation of RM to standard clinical care has been accompanied by a surge of device transmissions.

Imaging of metabolic dysfunction in genetic cardiomyopathies.

Genetic cardiomyopathies (CMPs) are a known cause of morbidity and mortality, with up to 50% of patients diagnosed below the age of 40 years for certain CMPs. With the improved availability of advanced imaging tools, significant progress has been made in early diagnosis and subsequent management. Due to the growing scientific interest in the genetic variants underlying these CMPs, data supporting a possible direct effect of the disease-defining genetic variant on cardiac metabolism have accumulated.

Redefining the risk of major arrhythmic events in non-ischaemic cardiomyopathy: insights from the DERIVATE-NICM study.

Aims: Selection of the patients for implantable cardioverter defibrillator primary prevention therapy in non-ischaemic cardiomyopathy (NICM) needs to be improved. To evaluate the additional prognostic value of a new cardiac magnetic resonance (CMR) score based on late gadolinium enhancement (LGE) pattern distribution (DERIVATE Risk Score 2.0) when compared with previously published DERIVATE Risk Score 1.

From Acquisition to Prognosis: The Role of AI in Cardiac Magnetic Resonance Imaging Evaluation of Ischemic Cardiomyopathy.

Acute and chronic ischemic cardiomyopathy (ICM) still represents a leading cause of morbidity and mortality. Cardiac magnetic resonance (CMR) imaging plays a central role in the diagnosis and management of ICM, offering detailed visualization of cardiac structures and function. The evolving role of artificial intelligence (AI) in enhancing CMR exams, from acquisition to prognosis, is rapidly expanding in clinical practice, particularly in CMR of patients with ICM, emphasizing the integration of AI algorithms to optimize imaging workflows in standard protocols.

Sex differences in pre- and post-surgical left ventricular remodelling and outcomes in primary mitral regurgitation.

Aims: Studies suggest that females have worse post-surgical left ventricular (LV) reverse remodelling and clinical outcomes than males in primary mitral regurgitation (MR). These studies were retrospective, used linear dimensions of the LV, and did not account for MR severity. This study is to determine if there are sex differences with respect to pre- and post-surgical LV remodelling and clinical outcomes.

Upstream and Downstream Cardiovascular Changes in Rheumatic Mitral Stenosis: An Update.

Rheumatic heart disease (RHD) and its complications are major health problems worldwide, especially in developing countries, owing to their high prevalence. Mitral stenosis (MS) is one of the most common lesions in RHD, either isolated or in combination with mitral regurgitation, and eventually leads to atrial fibrillation (AF), congestive heart failure, pulmonary hypertension (PH), and other complications, including ischemic stroke or limb ischemia, if not promptly diagnosed and treated. Recent studies have suggested that MS affects the cardiovascular system beyond mere obstructions.

Before and Beyond Tissue Characterization: Cardiac Magnetic Resonance Imaging in the Morphological, Volumetric, and Functional Evaluation of the Right Ventricle in Arrhythmogenic Right Ventricular Cardiomyopathy, a Narrative Review.

Arrhythmogenic right ventricular cardiomyopathy is a condition characterized by fibro-fatty replacement, primarily affecting the right ventricle (RV), with variable involvement of the left ventricle, characterized by an increased risk of ventricular arrhythmias and sudden cardiac death. In addition to tissue characterization, which is not the subject of this review, dilation, global systolic dysfunction, and regional kinetic abnormalities of the RV are important components of the diagnostic process for this disease, serving as essential diagnostic criteria. Cardiac magnetic resonance, a central examination in the evaluation of cardiomyopathies, has gained progressive importance because of its greater diagnostic accuracy than echocardiography in detecting morphological volumetric and functional abnormalities, especially of the RV.

Resource and OUTcome Impact of routiNE availability of Computed Tomography Perfusion.

Aims: Stress computed tomography perfusion (Stress-CTP) is a functional technique added on top of coronary computed tomography angiography (cCTA) to improve the management of subjects with coronary artery disease (CAD). The ROUTINE-CTP Registry is a prospective study aimed at evaluating the impact of routine implementation of combined cCTA plus Stress-CTP for the assessment of patients with intermediate to high CAD risk or known CAD symptomatic for chest pain in a real-world setting.

Methods And Results: Data collected during follow-up included radiation exposure, reclassification rates between cCTA alone and cCTA with Stress-CTP, subsequent non-invasive testing, referral rates for invasive coronary angiography (ICA), prevalence of non-obstructive CAD at ICA, rates of revascularization, and major adverse cardiac events (MACE).

Ablation of Ventricular and Atrial Arrhythmias in the Era of Cardiac Magnetic Resonance.

In the past decade, cardiac magnetic resonance (CMR) has undergone remarkable progress, emerging as a pivotal tool in various cardiological scenarios. Its capacity for tissue characterization, both with and without contrast agents, makes CMR the perfect tool to study the substrate of arrhythmia. This review highlights the potential role of CMR in electrophysiology (EP) and its role in the ablation of atrial and ventricular arrhythmias.

Optimizing CRT Lead Placement Accuracy With CMR-Guided On-Screen Targeting: A Randomized Controlled Trial (ADVISE-CRT III).

Background: To improve cardiac resynchronization therapy (CRT) an on-screen image-guidance platform, CARTBox-Suite (CART-Tech B.V.), was developed to identify left ventricular pacing electrode (LVPE) implantation sites and facilitate precise LVPE placement.

Non-invasive imaging assessment in angina with non-obstructive coronary arteries (ANOCA).

Due to its significant prevalence and clinical implications, angina with non-obstructive coronary arteries (ANOCA) has become a major focus in modern cardiology. In fact, diagnosing ANOCA presents a significant challenge. The final diagnosis is often difficult, delayed, and frequently necessitates an invasive assessment through coronary angiography.

CarDiac magnEtic Resonance for prophylactic Implantable cardioVerter defibrillAtor ThErapy in Non-Dilated Left Ventricular Cardiomyopathy: a sub-study from the DERIVATE registry.

Aims: Accurate risk stratification for patients with non-dilated left ventricular cardiomyopathy (NDLVC) remains challenging due to lack of dedicated clinical trials. This post hoc analysis aims to delineate the arrhythmic risk and assess the incremental value of cardiac magnetic resonance (CMR) imaging in the CarDiac magnEtic Resonance for prophylactic Implantable-cardioVerter defibrillAtor ThErapy (DERIVATE) study cohort meeting the NDLVC diagnostic criteria.

Methods And Results: Patients with NDLVC from the DERIVATE registry were identified in the absence of left ventricular (LV) dilatation and in the presence of non-ischaemic LV scarring ('fibrotic NDLVC') or isolated LV systolic dysfunction (LV ejection fraction < 50%) without fibrosis ('hypokinetic NDLVC').

How to perform and evaluate a myocardial perfusion imaging by computed tomography.

Stress computed tomography perfusion (CTP) delivers a comprehensive evaluation of both the anatomical and functional aspects in a single examination. It stands out as the only non-invasive technique capable of quantifying coronary stenosis and assessing its functional impact, offering a consolidated diagnostic and management approach for patients with confirmed or suspected coronary artery disease (CAD). This very practical review ('How to.

Multimodality Imaging in the Diagnostic Work-Up of Patients With Cardiac Masses: State-of-the-Art Review.

Cardiac masses encompass a diverse range of benign and malignant tumors as well as pseudotumors. Accurate histologic identification is essential for guiding appropriate treatment, yet the diagnostic process remains challenging. Although biopsy is traditionally the diagnostic gold standard, its invasive nature and associated risks limit its application.

Prognostic value of myocardial computed tomography-derived extracellular volume in severe aortic stenosis requiring aortic valve replacement: a systematic review and meta-analysis.

Computed tomography (CT)-derived extracellular volume (ECV) fraction is a non-invasive method to quantify myocardial fibrosis. Evaluating CT-ECV during aortic valve replacement (AVR) planning CT in severe aortic stenosis (AS) may aid prognostic stratification. This meta-analysis evaluated the prognostic significance of CT-ECV in severe AS necessitating AVR.

State of the art of CT myocardial perfusion.

Coronary computed tomography angiography (CCTA) is a powerful tool to rule out coronary artery disease (CAD). In the last decade, myocardial perfusion CT (CTP) technique has been developed for the evaluation of myocardial ischemia, thereby increasing positive predictive value for diagnosis of obstructive CAD. A diagnostic strategy combining CCTA and perfusion acquisitions provides both anatomical coronary evaluation and functional evaluation of the stenosis, increasing the specificity and the positive predictive value of cardiac CT.

Clinical parameters of death and heart failure hospitalization in biventricular systolic dysfunction assessed via cardiac magnetic resonance.

Aims: While factors associated with adverse events are well elucidated in setting of isolated left ventricular dysfunction, clinical and imaging-based prognosticators of adverse outcomes are lacking in context of biventricular dysfunction. The purpose of this study was to establish role of clinical variables in prognosis of biventricular heart failure (HF), as assessed by cardiac magnetic resonance imaging.

Methods: Study cohort consisted of 840 patients enrolled in DERIVATE registry with coexisting CMR-derived right ventricular (RV) and left ventricular (LV) dysfunction, as defined by RV and LV ejection fractions ≤45 % and ≤ 50 %, respectively.

Novel Insights into Non-Invasive Diagnostic Techniques for Cardiac Amyloidosis: A Critical Review.

Cardiac amyloidosis (CA) is a cardiac storage disease caused by the progressive extracellular deposition of misfolded proteins in the myocardium. Despite the increasing interest in this pathology, it remains an underdiagnosed condition. Non-invasive diagnostic techniques play a central role in the suspicion and detection of CA, also thanks to the continuous scientific and technological advances in these tools.