Publications by authors named "Matthias Gutberlet"

Objective: Patient compliance and comfort during cardiac computed tomography (CT) are crucial for optimal imaging outcomes. Insufficient understanding or heightened anxiety can negatively impact patient experience and potentially image quality. This study evaluates the effectiveness of video-assisted informed consent in cardiac imaging (VAICICI) in improving patient satisfaction, preparedness, and anxiety during cardiac CT.

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Importance: The effect of computed tomography (CT) vs invasive coronary angiography (ICA) on health status outcomes is unknown.

Objective: To evaluate CT and ICA first-test strategies on quality of life (QOL) and angina.

Design, Setting, And Participants: The Diagnostic Imaging Strategies for Patients With Stable Chest Pain and Intermediate Risk of Coronary Artery Disease (DISCHARGE) randomized clinical trial, conducted between October 2015 and April 2019 in 26 European centers, followed up patients with stable chest pain and intermediate probability of coronary artery disease for a median 3.

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Purpose: To assess the relationship between the COVID-19 pandemic and the spectrum of indications for cardiac magnetic resonance imaging (MRI) with a focus on myocarditis.

Materials And Methods: This was a retrospective analysis of data from the MRCT registry of the European Society of Cardiovascular Radiology (ESCR). Data regarding indications and diagnoses of myocarditis between January 1, 2018, and April 30, 2024, were extracted.

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Due to its high sensitivity and high negative predictive value, computed tomography angiography of the coronary arteries (CCTA) has proven to be particularly useful for ruling out obstructive coronary artery disease (CAD) in cases of suspected chronic coronary syndrome (CCS), which is why CCTA will also be included in the care of patients with statutory health insurance in Germany according to the G-BA decision of January 24, 2024. The value of CCTA is clearly confirmed in the current guidelines of the European Society of Cardiology (ESC) and the national care guideline from August 2024. However, good results from CCTA can only be achieved-in addition to appropriate qualifications of those performing the test and the necessary technical requirements-if the right patients are included, namely those with a low intermediate pretest probability for the presence of obstructive CAD.

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Article Synopsis
  • The study aimed to assess how often clinically relevant extracardiac findings occur during cardiac CT and MRI exams across various patient demographics and examination reasons.
  • The analysis included over 200,000 cardiac CT scans and over 228,000 cardiac MRI scans, revealing extracardiac findings in 3.28% of CT exams and 1.50% of MRI exams, with higher rates associated with specific procedures like transcatheter aortic valve replacement.
  • Older patients showed a significant increase in the prevalence of these findings, emphasizing the importance of age and examination purpose in assessing patient outcomes.
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: This study aimed to evaluate the diagnostic value of pre-existing computed tomography (CT) examinations for the detection of dental pathologies compared with clinical dental examination in patients with end-stage heart failure. : For this purpose, 59 patients with end-stage heart failure and pre-existing non-dental CT images of the craniofacial region were included. Virtual orthopantomograms (vOPG) were reconstructed.

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CT-derived fractional flow reserve (CT-FFR) can improve the specificity of coronary CT-angiography (cCTA) for ruling out relevant coronary artery disease (CAD) prior to transcatheter aortic valve replacement (TAVR). However, little is known about the reproducibility of CT-FFR and the influence of diffuse coronary artery calcifications or segment location. The objective was to assess the reliability of machine-learning (ML)-based CT-FFR prior to TAVR in patients without obstructive CAD and to assess the influence of image quality, coronary artery calcium score (CAC), and the location of measurement within the coronary tree.

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Purpose: Radiological reporting is transitioning to quantitative analysis, requiring large-scale multi-center validation of biomarkers. A major prerequisite and bottleneck for this task is the voxelwise annotation of image data, which is time-consuming for large cohorts. In this study, we propose an iterative training workflow to support and facilitate such segmentation tasks, specifically for high-resolution thoracic CT data.

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Clinical Issue: Due to advances in diagnostics and therapy, the survival rate of patients with congenital heart defects is continuously increasing. The aim of this review is to compare various imaging modalities that are used in the diagnosis of congenital heart defects.

Methods: Transthoracic echocardiography is the imaging method of choice in the presence of a congenital heart defect because of its wide availability and non-invasiveness.

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Aims: The aim of this study was to assess the pathophysiological implications of severe tricuspid regurgitation (TR) in patients with heart failure with preserved ejection fraction (HFpEF) by using tricuspid transcatheter edge-to-edge repair (T-TEER) as a model of right ventricular (RV) volume overload relief.

Methods And Results: This prospective interventional single arm trial (NCT04782908) included patients with invasively diagnosed HFpEF. The following parameters were prospectively assessed before and after T-TEER: left ventricular (LV) diastolic properties by invasive pressure-volume loop recordings; biventricular time-volume curves and function as well as septal curvature by cardiac magnetic resonance imaging; strain analyses for timing of septal motion.

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Background Coronary artery calcium (CAC) has prognostic value for major adverse cardiovascular events (MACE) in asymptomatic individuals, whereas its role in symptomatic patients is less clear. Purpose To assess the prognostic value of CAC scoring for MACE in participants with stable chest pain initially referred for invasive coronary angiography (ICA). Materials and Methods This prespecified subgroup analysis from the Diagnostic Imaging Strategies for Patients With Stable Chest Pain and Intermediate Risk of Coronary Artery Disease (DISCHARGE) trial, conducted between October 2015 and April 2019 across 26 centers in 16 countries, focused on adult patients with stable chest pain referred for ICA.

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Article Synopsis
  • Gadobutrol, a gadolinium-based contrast agent introduced in 1998, has been administered over 100 million times, leading to extensive safety data collection.
  • A review of safety data from clinical studies and postmarketing surveillance revealed low rates of adverse events (AEs), with drug-related AEs reported in 3.4% of patients, and serious AEs in less than 0.1%.
  • The analysis found that adverse drug reactions (ADRs) were rare, with no significant increase in AEs in at-risk populations, including children and the elderly.
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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.

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Importance: The effectiveness and safety of computed tomography (CT) and invasive coronary angiography (ICA) in different age groups is unknown.

Objective: To determine the association of age with outcomes of CT and ICA in patients with stable chest pain.

Design, Setting, And Participants: The assessor-blinded Diagnostic Imaging Strategies for Patients With Stable Chest Pain and Intermediate Risk of Coronary Artery Disease (DISCHARGE) randomized clinical trial was conducted between October 2015 and April 2019 in 26 European centers.

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Background Recent trials support the role of cardiac CT in the evaluation of symptomatic patients suspected of having coronary artery disease (CAD); however, body mass index (BMI) has been reported to negatively impact CT image quality. Purpose To compare initial use of CT versus invasive coronary angiography (ICA) on clinical outcomes in patients with stable chest pain stratified by BMI category. Materials and Methods This prospective study represents a prespecified BMI subgroup analysis of the multicenter Diagnostic Imaging Strategies for Patients with Stable Chest Pain and Intermediate Risk of Coronary Artery Disease (DISCHARGE) trial conducted between October 2015 and April 2019.

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Objective: To compare machine learning (ML)-based CT-derived fractional flow reserve (CT-FFR) in patients before transcatheter aortic valve replacement (TAVR) by observers with differing training and to assess influencing factors.

Background: Coronary computed tomography angiography (cCTA) can effectively exclude CAD, e.g.

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Background: The rotational direction (RD) of helical blood flow can be classified as either a clockwise (RD) or counter-clockwise (RD) flow. We hypothesized that this simple classification might not be sufficient for analysis and a simultaneous existence of RD may occur. We utilized volumetric velocity-sensitive cardiovascular magnetic resonance imaging (4D flow MRI) to analyze rotational blood flow in the thoracic aorta.

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Article Synopsis
  • This study aimed to compare the impact of cardiac CT versus invasive coronary angiography (ICA) on cardiovascular events, particularly looking at how smoking status affects these outcomes.
  • Results showed that the effectiveness of CT versus ICA in preventing major adverse cardiovascular events (MACE) was similar across different smoking groups, but a CT-first approach notably reduced complications and procedures needed, especially for smokers.
  • The findings suggest that a CT-first strategy is beneficial for detecting non-obstructive coronary artery disease in patients with stable chest pain, leading to fewer complications regardless of smoking status.
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Background: Gadobutrol has been administered more than 100 million times worldwide, since February 1998, that is, over the last 25 years. Numerous clinical studies in a broad range of indications document the long-term experience with gadobutrol.

Objective: The aim of this study was to provide a literature-based overview on gadobutrol's efficacy in 9 approved indications and use in children.

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Purpose: To utilize 4 D flow MRI to acquire normal values of "conventional 2 D flow MRI parameters" in healthy volunteers in order to replace multiple single 2 D flow measurements with a single 4 D flow acquisition.

Materials And Methods: A kt-GRAPPA accelerated 4 D flow sequence was used. Flow volumes were assessed by forward (FFV), backward (BFV), and net flow volumes (NFV) [ml/heartbeat] and flow velocities by axial (VAX) and absolute velocity (VABS) [m/s] in 116 volunteers (58 females, 43 ± 13 years).

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