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Landsmann A, Sartoretti T, Mergen V, Jungblut L, Eberhard M, Kobe A, Alkadhi H, Euler A. Multi-Energy Low-Kiloelectron Volt versus Single-Energy Low-Kilovolt Images for Endoleak Detection at CT Angiography of the Aorta. Radiol Cardiothorac Imaging 2024; 6:e230217. [PMID: 38451189 DOI: 10.1148/ryct.230217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Purpose To compare image quality, diagnostic performance, and conspicuity between single-energy and multi-energy images for endoleak detection at CT angiography (CTA) after endovascular aortic repair (EVAR). Materials and Methods In this single-center prospective randomized controlled trial, individuals undergoing CTA after EVAR between August 2020 and May 2022 were allocated to imaging using either low-kilovolt single-energy images (SEI; 80 kV, group A) or low-kiloelectron volt virtual monoenergetic images (VMI) at 40 and 50 keV from multi-energy CT (80/Sn150 kV, group B). Scan protocols were dose matched (volume CT dose index: mean, 4.5 mGy ± 1.8 [SD] vs 4.7 mGy ± 1.3, P = .41). Contrast-to-noise ratio (CNR) was measured. Two expert radiologists established the reference standard for the presence of endoleaks. Detection and conspicuity of endoleaks and subjective image quality were assessed by two different blinded radiologists. Interreader agreement was calculated. Nonparametric statistical tests were used. Results A total of 125 participants (mean age, 76 years ± 8; 103 men) were allocated to groups A (n = 64) and B (n = 61). CNR was significantly lower for 40-keV VMI (mean, 19.1; P = .048) and 50-keV VMI (mean, 16.8; P < .001) as compared with SEI (mean, 22.2). In total, 45 endoleaks were present (A: 23 vs B: 22). Sensitivity for endoleak detection was higher for SEI (82.6%, 19 of 23; P = .88) and 50-keV VMI (81.8%, 18 of 22; P = .90) as compared with 40-keV VMI (77.3%, 17 of 22). Specificity was comparable among groups (SEI: 92.7%, 38 of 41; both VMI energies: 92.3%, 35 of 38; P = .99), with an interreader agreement of 1. Conspicuity of endoleaks was comparable between SEI (median, 2.99) and VMI (both energies: median, 2.87; P = .04). Overall subjective image quality was rated significantly higher for SEI (median, 4 [IQR, 4-4) as compared with 40 and 50 keV (both energies: median, 4 [IQR, 3-4]; P < .001). Conclusion SEI demonstrated higher image quality and comparable diagnostic accuracy as compared with 50-keV VMI for endoleak detection at CTA after EVAR. Keywords: Aneurysms, CT, CT Angiography, Vascular, Aorta, Technology Assessment, Multidetector CT, Abdominal Aortic Aneurysms, Endoleaks, Perigraft Leak Supplemental material is available for this article. © RSNA, 2024.
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Affiliation(s)
- Anna Landsmann
- From the Department of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zurich, Switzerland (A.L., T.S., V.M., L.J., M.E., A.K., H.A., A.E.); Department of Radiology, Spital Interlaken, Spitäler fmi AG, Unterseen, Switzerland (M.E.); and Department of Radiology, Kantonsspital Baden, Baden, Switzerland (A.E.)
| | - Thomas Sartoretti
- From the Department of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zurich, Switzerland (A.L., T.S., V.M., L.J., M.E., A.K., H.A., A.E.); Department of Radiology, Spital Interlaken, Spitäler fmi AG, Unterseen, Switzerland (M.E.); and Department of Radiology, Kantonsspital Baden, Baden, Switzerland (A.E.)
| | - Victor Mergen
- From the Department of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zurich, Switzerland (A.L., T.S., V.M., L.J., M.E., A.K., H.A., A.E.); Department of Radiology, Spital Interlaken, Spitäler fmi AG, Unterseen, Switzerland (M.E.); and Department of Radiology, Kantonsspital Baden, Baden, Switzerland (A.E.)
| | - Lisa Jungblut
- From the Department of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zurich, Switzerland (A.L., T.S., V.M., L.J., M.E., A.K., H.A., A.E.); Department of Radiology, Spital Interlaken, Spitäler fmi AG, Unterseen, Switzerland (M.E.); and Department of Radiology, Kantonsspital Baden, Baden, Switzerland (A.E.)
| | - Matthias Eberhard
- From the Department of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zurich, Switzerland (A.L., T.S., V.M., L.J., M.E., A.K., H.A., A.E.); Department of Radiology, Spital Interlaken, Spitäler fmi AG, Unterseen, Switzerland (M.E.); and Department of Radiology, Kantonsspital Baden, Baden, Switzerland (A.E.)
| | - Adrian Kobe
- From the Department of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zurich, Switzerland (A.L., T.S., V.M., L.J., M.E., A.K., H.A., A.E.); Department of Radiology, Spital Interlaken, Spitäler fmi AG, Unterseen, Switzerland (M.E.); and Department of Radiology, Kantonsspital Baden, Baden, Switzerland (A.E.)
| | - Hatem Alkadhi
- From the Department of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zurich, Switzerland (A.L., T.S., V.M., L.J., M.E., A.K., H.A., A.E.); Department of Radiology, Spital Interlaken, Spitäler fmi AG, Unterseen, Switzerland (M.E.); and Department of Radiology, Kantonsspital Baden, Baden, Switzerland (A.E.)
| | - André Euler
- From the Department of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zurich, Switzerland (A.L., T.S., V.M., L.J., M.E., A.K., H.A., A.E.); Department of Radiology, Spital Interlaken, Spitäler fmi AG, Unterseen, Switzerland (M.E.); and Department of Radiology, Kantonsspital Baden, Baden, Switzerland (A.E.)
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Holmes KR, Gulsin GS, Fairbairn TA, Hurwitz-Koweek L, Matsuo H, Nørgaard BL, Jensen JM, Sand NPR, Nieman K, Bax JJ, Pontone G, Chinnaiyan KM, Rabbat MG, Amano T, Kawasaki T, Akasaka T, Kitabata H, Rogers C, Patel MR, Payne GW, Leipsic JA, Sellers SL. Impact of Smoking on Coronary Volume-to-Myocardial Mass Ratio: An ADVANCE Registry Substudy. Radiol Cardiothorac Imaging 2024; 6:e220197. [PMID: 38483246 DOI: 10.1148/ryct.220197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Purpose To examine the relationship between smoking status and coronary volume-to-myocardial mass ratio (V/M) among individuals with coronary artery disease (CAD) undergoing CT fractional flow reserve (CT-FFR) analysis. Materials and Methods In this secondary analysis, participants from the ADVANCE registry evaluated for suspected CAD from July 15, 2015, to October 20, 2017, who were found to have coronary stenosis of 30% or greater at coronary CT angiography (CCTA) were included if they had known smoking status and underwent CT-FFR and V/M analysis. CCTA images were segmented to calculate coronary volume and myocardial mass. V/M was compared between smoking groups, and predictors of low V/M were determined. Results The sample for analysis included 503 current smokers, 1060 former smokers, and 1311 never-smokers (2874 participants; 1906 male participants). After adjustment for demographic and clinical factors, former smokers had greater coronary volume than never-smokers (former smokers, 3021.7 mm3 ± 934.0 [SD]; never-smokers, 2967.6 mm3 ± 978.0; P = .002), while current smokers had increased myocardial mass compared with never-smokers (current smokers, 127.8 g ± 32.9; never-smokers, 118.0 g ± 32.5; P = .02). However, both current and former smokers had lower V/M than never-smokers (current smokers, 24.1 mm3/g ± 7.9; former smokers, 24.9 mm3/g ± 7.1; never-smokers, 25.8 mm3/g ± 7.4; P < .001 [unadjusted] and P = .002 [unadjusted], respectively). Current smoking status (odds ratio [OR], 0.74 [95% CI: 0.59, 0.93]; P = .009), former smoking status (OR, 0.81 [95% CI: 0.68, 0.97]; P = .02), stenosis of 50% or greater (OR, 0.62 [95% CI: 0.52, 0.74]; P < .001), and diabetes (OR, 0.67 [95% CI: 0.56, 0.82]; P < .001) were independent predictors of low V/M. Conclusion Both current and former smoking status were independently associated with low V/M. Keywords: CT Angiography, Cardiac, Heart, Ischemia/Infarction Clinical trial registration no. NCT02499679 Supplemental material is available for this article. © RSNA, 2024.
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Affiliation(s)
- Kenneth R Holmes
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Gaurav S Gulsin
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Timothy A Fairbairn
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Lynne Hurwitz-Koweek
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Hitoshi Matsuo
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Bjarne L Nørgaard
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Jesper M Jensen
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Niels-Peter Rønnow Sand
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Koen Nieman
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Jeroen J Bax
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Gianluca Pontone
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Kavitha M Chinnaiyan
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Mark G Rabbat
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Tetsuya Amano
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Tomohiro Kawasaki
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Takashi Akasaka
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Hironori Kitabata
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Campbell Rogers
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Manesh R Patel
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Geoffrey W Payne
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Jonathon A Leipsic
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.)
| | - Stephanie L Sellers
- From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.)
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Diprose JP, Diprose WK, Chien TY, Wang MTM, McFetridge A, Tarr GP, Ghate K, Beharry J, Hong J, Wu T, Campbell D, Barber PA. Deep learning on pre-procedural computed tomography and clinical data predicts outcome following stroke thrombectomy. J Neurointerv Surg 2024:jnis-2023-021154. [PMID: 38527795 DOI: 10.1136/jnis-2023-021154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/23/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Deep learning using clinical and imaging data may improve pre-treatment prognostication in ischemic stroke patients undergoing endovascular thrombectomy (EVT). METHODS Deep learning models were trained and tested on baseline clinical and imaging (CT head and CT angiography) data to predict 3-month functional outcomes in stroke patients who underwent EVT. Classical machine learning models (logistic regression and random forest classifiers) were constructed to compare their performance with the deep learning models. An external validation dataset was used to validate the models. The MR PREDICTS prognostic tool was tested on the external validation set, and its performance was compared with the deep learning and classical machine learning models. RESULTS A total of 975 patients (550 men; mean±SD age 67.5±15.1 years) were studied with 778 patients in the model development cohort and 197 in the external validation cohort. The deep learning model trained on baseline CT and clinical data, and the logistic regression model (clinical data alone) demonstrated the strongest discriminative abilities for 3-month functional outcome and were comparable (AUC 0.811 vs 0.817, Q=0.82). Both models exhibited superior prognostic performance than the other deep learning (CT head alone, CT head, and CT angiography) and MR PREDICTS models (all Q<0.05). CONCLUSIONS The discriminative performance of deep learning for predicting functional independence was comparable to logistic regression. Future studies should focus on whether incorporating procedural and post-procedural data significantly improves model performance.
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Affiliation(s)
| | - William K Diprose
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | | | - Michael T M Wang
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Andrew McFetridge
- Department of Radiology, Auckland City Hospital, Auckland, New Zealand
| | - Gregory P Tarr
- Department of Radiology, Auckland City Hospital, Auckland, New Zealand
| | - Kaustubha Ghate
- Department of Neurology, Auckland City Hospital, Auckland, New Zealand
| | - James Beharry
- Department of Neurology, Christchurch Hospital, Christchurch, New Zealand
| | - JaeBeom Hong
- Department of Neurology, Auckland City Hospital, Auckland, New Zealand
| | - Teddy Wu
- Department of Neurology, Christchurch Hospital, Christchurch, New Zealand
| | - Doug Campbell
- Department of Anaesthesia and Perioperative Medicine, Auckland City Hospital, Auckland, New Zealand
| | - P Alan Barber
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Department of Neurology, Auckland City Hospital, Auckland, New Zealand
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4
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Xie Y, Wang J, Zou Y. Pulmonary arteriovenous fistula. J Vasc Surg Venous Lymphat Disord 2024; 12:101717. [PMID: 37972756 DOI: 10.1016/j.jvsv.2023.101717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/23/2023] [Accepted: 10/28/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Yong Xie
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China
| | - Jian Wang
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China.
| | - Yinghua Zou
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China
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5
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Diogo C, Na D, Sujijantarat N, Matouk C, Callahan B. Diagnostic accuracy of intraoperative neuromonitoring in transcarotid artery revascularization. J Neurointerv Surg 2024:jnis-2023-021282. [PMID: 38378240 DOI: 10.1136/jnis-2023-021282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 01/31/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND In recent years, transcarotid artery revascularization (TCAR) has emerged as a safe and effective alternative to carotid artery stenting. While intraoperative neuromonitoring (IONM) techniques such as electroencephalogram (EEG) and somatosensory evoked potentials (SSEPs) are often employed during TCAR, there is limited research on their diagnostic accuracy. METHODS The authors retrospectively reviewed a multi-institutional IONM database of TCAR procedures performed with EEG and SSEP monitoring. A total of 516 TCAR procedures were included in this study. Significant changes in EEG and/or SSEPs, surgeon's interventions, resolution of significant changes, and immediate postoperative neurological outcome were documented. Sensitivity, specificity, positive and negative predictive values were calculated. RESULTS The incidence of intraoperative onset new neurologic deficit was 0.4%. Significant changes in EEG and/or SSEPs occurred in 5.4% of the cases. Of the cases with IONM alerts, 78.5% returned to baseline with a surgical or hemodynamic intervention. From the cases with unresolved IONM alerts, 33.3% woke up with a new neurological deficit. The overall sensitivity and specificity for IONM was 100% and 99.2%, respectively. The positive predictive value was 33.3% and the negative predictive value was 100%. CONCLUSIONS IONM during TCAR offers high sensitivity and specificity in predicting postoperative outcome. Patients with resolved IONM alerts had immediate neurological outcomes that were comparable to those who had no IONM alerts.
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Affiliation(s)
- Cinira Diogo
- Physiology and Neurobiology, University of Connecticut, Storrs, Connecticut, USA
- Nuvasive Clinical Services, Columbia, Maryland, USA
| | - Doohwan Na
- Nuvasive Clinical Services, Columbia, Maryland, USA
| | | | - Charles Matouk
- Neurosurgery, Yale University, New Haven, Connecticut, USA
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6
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Debono S, Tzolos E, Syed MBJ, Nash J, Fletcher AJ, Dweck MR, Newby DE, Dey D, Forsythe RO, Williams MC. CT Attenuation of Periaortic Adipose Tissue in Abdominal Aortic Aneurysms. Radiol Cardiothorac Imaging 2024; 6:e230250. [PMID: 38329405 PMCID: PMC10912871 DOI: 10.1148/ryct.230250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/27/2023] [Accepted: 12/29/2023] [Indexed: 02/09/2024]
Abstract
Purpose To assess periaortic adipose tissue attenuation at CT angiography in different abdominal aortic aneurysm disease states. Materials and Methods In a retrospective observational study from January 2018 to December 2022, periaortic adipose tissue attenuation was assessed at CT angiography in patients with asymptomatic or symptomatic (including rupture) abdominal aortic aneurysms and controls without aneurysms. Adipose tissue attenuation was measured using semiautomated software in periaortic aneurysmal and nonaneurysmal segments of the abdominal aorta and in subcutaneous and visceral adipose tissue. Periaortic adipose tissue attenuation values between the three groups were assessed using Student t tests and Wilcoxon rank sum tests followed by a multiregression model. Results Eighty-eight individuals (median age, 70 years [IQR, 65-78]; 78 male and 10 female patients) were included: 70 patients with abdominal aortic aneurysms (40 asymptomatic and 30 symptomatic, including 24 with rupture) and 18 controls. There was no evidence of differences in the periaortic adipose tissue attenuation in the aneurysmal segment in asymptomatic patients versus controls (-81.44 HU ± 7 [SD] vs -83.27 HU ± 9; P = .43) and attenuation in nonaneurysmal segments between asymptomatic patients versus controls (-75.43 HU ± 8 vs -78.81 HU ± 6; P = .08). However, symptomatic patients demonstrated higher periaortic adipose tissue attenuation in both aneurysmal (-57.85 HU ± 7; P < .0001) and nonaneurysmal segments (-58.16 HU ± 8; P < .0001) when compared with the other two groups. Conclusion Periaortic adipose tissue CT attenuation was not increased in stable abdominal aortic aneurysm disease. There was a generalized increase in attenuation in patients with symptomatic disease, likely reflecting the systemic consequences of acute rupture. Keywords: Abdominal Aortic Aneurysm, Periaortic Adipose Tissue Attenuation, CT Angiography ClinicalTrials.gov registration no. NCT02229006 © RSNA, 2024.
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Affiliation(s)
- Samuel Debono
- From the University of Edinburgh Centre for Cardiovascular Science,
University of Edinburgh, 49 Little France Crescent, Chancellor’s
Building, Room SU.305, Edinburgh EH16 4SB, United Kingdom (S.D., E.T.,
M.B.J.S., J.N., A.J.F., M.R.D., D.E.N., R.O.F., M.C.W.); School of
Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United
Kingdom (A.J.F.); Department of Medicine, Division of Artificial Intelligence,
and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los
Angeles, Calif (D.D.); and Edinburgh Vascular Service, Royal Infirmary of
Edinburgh, NHS Lothian, Edinburgh, United Kingdom (R.O.F.)
| | - Evangelos Tzolos
- From the University of Edinburgh Centre for Cardiovascular Science,
University of Edinburgh, 49 Little France Crescent, Chancellor’s
Building, Room SU.305, Edinburgh EH16 4SB, United Kingdom (S.D., E.T.,
M.B.J.S., J.N., A.J.F., M.R.D., D.E.N., R.O.F., M.C.W.); School of
Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United
Kingdom (A.J.F.); Department of Medicine, Division of Artificial Intelligence,
and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los
Angeles, Calif (D.D.); and Edinburgh Vascular Service, Royal Infirmary of
Edinburgh, NHS Lothian, Edinburgh, United Kingdom (R.O.F.)
| | - Maaz B. J. Syed
- From the University of Edinburgh Centre for Cardiovascular Science,
University of Edinburgh, 49 Little France Crescent, Chancellor’s
Building, Room SU.305, Edinburgh EH16 4SB, United Kingdom (S.D., E.T.,
M.B.J.S., J.N., A.J.F., M.R.D., D.E.N., R.O.F., M.C.W.); School of
Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United
Kingdom (A.J.F.); Department of Medicine, Division of Artificial Intelligence,
and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los
Angeles, Calif (D.D.); and Edinburgh Vascular Service, Royal Infirmary of
Edinburgh, NHS Lothian, Edinburgh, United Kingdom (R.O.F.)
| | - Jennifer Nash
- From the University of Edinburgh Centre for Cardiovascular Science,
University of Edinburgh, 49 Little France Crescent, Chancellor’s
Building, Room SU.305, Edinburgh EH16 4SB, United Kingdom (S.D., E.T.,
M.B.J.S., J.N., A.J.F., M.R.D., D.E.N., R.O.F., M.C.W.); School of
Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United
Kingdom (A.J.F.); Department of Medicine, Division of Artificial Intelligence,
and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los
Angeles, Calif (D.D.); and Edinburgh Vascular Service, Royal Infirmary of
Edinburgh, NHS Lothian, Edinburgh, United Kingdom (R.O.F.)
| | - Alexander J. Fletcher
- From the University of Edinburgh Centre for Cardiovascular Science,
University of Edinburgh, 49 Little France Crescent, Chancellor’s
Building, Room SU.305, Edinburgh EH16 4SB, United Kingdom (S.D., E.T.,
M.B.J.S., J.N., A.J.F., M.R.D., D.E.N., R.O.F., M.C.W.); School of
Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United
Kingdom (A.J.F.); Department of Medicine, Division of Artificial Intelligence,
and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los
Angeles, Calif (D.D.); and Edinburgh Vascular Service, Royal Infirmary of
Edinburgh, NHS Lothian, Edinburgh, United Kingdom (R.O.F.)
| | - Marc R. Dweck
- From the University of Edinburgh Centre for Cardiovascular Science,
University of Edinburgh, 49 Little France Crescent, Chancellor’s
Building, Room SU.305, Edinburgh EH16 4SB, United Kingdom (S.D., E.T.,
M.B.J.S., J.N., A.J.F., M.R.D., D.E.N., R.O.F., M.C.W.); School of
Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United
Kingdom (A.J.F.); Department of Medicine, Division of Artificial Intelligence,
and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los
Angeles, Calif (D.D.); and Edinburgh Vascular Service, Royal Infirmary of
Edinburgh, NHS Lothian, Edinburgh, United Kingdom (R.O.F.)
| | - David E. Newby
- From the University of Edinburgh Centre for Cardiovascular Science,
University of Edinburgh, 49 Little France Crescent, Chancellor’s
Building, Room SU.305, Edinburgh EH16 4SB, United Kingdom (S.D., E.T.,
M.B.J.S., J.N., A.J.F., M.R.D., D.E.N., R.O.F., M.C.W.); School of
Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United
Kingdom (A.J.F.); Department of Medicine, Division of Artificial Intelligence,
and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los
Angeles, Calif (D.D.); and Edinburgh Vascular Service, Royal Infirmary of
Edinburgh, NHS Lothian, Edinburgh, United Kingdom (R.O.F.)
| | - Damini Dey
- From the University of Edinburgh Centre for Cardiovascular Science,
University of Edinburgh, 49 Little France Crescent, Chancellor’s
Building, Room SU.305, Edinburgh EH16 4SB, United Kingdom (S.D., E.T.,
M.B.J.S., J.N., A.J.F., M.R.D., D.E.N., R.O.F., M.C.W.); School of
Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United
Kingdom (A.J.F.); Department of Medicine, Division of Artificial Intelligence,
and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los
Angeles, Calif (D.D.); and Edinburgh Vascular Service, Royal Infirmary of
Edinburgh, NHS Lothian, Edinburgh, United Kingdom (R.O.F.)
| | - Rachael O. Forsythe
- From the University of Edinburgh Centre for Cardiovascular Science,
University of Edinburgh, 49 Little France Crescent, Chancellor’s
Building, Room SU.305, Edinburgh EH16 4SB, United Kingdom (S.D., E.T.,
M.B.J.S., J.N., A.J.F., M.R.D., D.E.N., R.O.F., M.C.W.); School of
Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United
Kingdom (A.J.F.); Department of Medicine, Division of Artificial Intelligence,
and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los
Angeles, Calif (D.D.); and Edinburgh Vascular Service, Royal Infirmary of
Edinburgh, NHS Lothian, Edinburgh, United Kingdom (R.O.F.)
| | - Michelle C. Williams
- From the University of Edinburgh Centre for Cardiovascular Science,
University of Edinburgh, 49 Little France Crescent, Chancellor’s
Building, Room SU.305, Edinburgh EH16 4SB, United Kingdom (S.D., E.T.,
M.B.J.S., J.N., A.J.F., M.R.D., D.E.N., R.O.F., M.C.W.); School of
Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United
Kingdom (A.J.F.); Department of Medicine, Division of Artificial Intelligence,
and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los
Angeles, Calif (D.D.); and Edinburgh Vascular Service, Royal Infirmary of
Edinburgh, NHS Lothian, Edinburgh, United Kingdom (R.O.F.)
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7
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Yuan Z, Hu X, Cheng G. Anomalous Single Pulmonary Venous Trunk. Radiol Cardiothorac Imaging 2024; 6:e230261. [PMID: 38175039 PMCID: PMC10915577 DOI: 10.1148/ryct.230261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024]
Affiliation(s)
- Zhidong Yuan
- From the Department of Radiology, Peking University Shenzhen
Hospital, 1120 Lianhua Road, Futian District, Shenzhen 518036, China (Z.Y.,
X.H., G.C.); and Paul C. Lauterbur Research Center for Biomedical Imaging,
Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences,
Shenzhen, China (X.H.)
| | - Xuehan Hu
- From the Department of Radiology, Peking University Shenzhen
Hospital, 1120 Lianhua Road, Futian District, Shenzhen 518036, China (Z.Y.,
X.H., G.C.); and Paul C. Lauterbur Research Center for Biomedical Imaging,
Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences,
Shenzhen, China (X.H.)
| | - Guanxun Cheng
- From the Department of Radiology, Peking University Shenzhen
Hospital, 1120 Lianhua Road, Futian District, Shenzhen 518036, China (Z.Y.,
X.H., G.C.); and Paul C. Lauterbur Research Center for Biomedical Imaging,
Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences,
Shenzhen, China (X.H.)
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8
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Subramanian P, Naganur SH, Sharma A, Singhal M. Unilateral Anomalous Pulmonary Venous Return into Coronary Sinus. Radiol Cardiothorac Imaging 2024; 6:e230359. [PMID: 38329406 PMCID: PMC10912887 DOI: 10.1148/ryct.230359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 02/09/2024]
Affiliation(s)
- Pavithra Subramanian
- From the Departments of Radiodiagnosis and Imaging (P.S., A.S., M.S.)
and Cardiology (S.H.N.), Postgraduate Institute of Medical Education and
Research, Madhya Marg, Sector 12, Chandigarh 160012, India
| | - Sanjeev Hanumanthacharya Naganur
- From the Departments of Radiodiagnosis and Imaging (P.S., A.S., M.S.)
and Cardiology (S.H.N.), Postgraduate Institute of Medical Education and
Research, Madhya Marg, Sector 12, Chandigarh 160012, India
| | - Arun Sharma
- From the Departments of Radiodiagnosis and Imaging (P.S., A.S., M.S.)
and Cardiology (S.H.N.), Postgraduate Institute of Medical Education and
Research, Madhya Marg, Sector 12, Chandigarh 160012, India
| | - Manphool Singhal
- From the Departments of Radiodiagnosis and Imaging (P.S., A.S., M.S.)
and Cardiology (S.H.N.), Postgraduate Institute of Medical Education and
Research, Madhya Marg, Sector 12, Chandigarh 160012, India
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9
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Gonzalez TV, Bookwalter CA, François CJ. Multimodality Imaging of a Mass Arising from a Cor Triatriatum Sinister Membrane. Radiol Cardiothorac Imaging 2024; 6:e230225. [PMID: 38421274 PMCID: PMC10912873 DOI: 10.1148/ryct.230225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/20/2023] [Accepted: 01/23/2024] [Indexed: 03/02/2024]
Abstract
Cor triatriatum sinister is a rare entity characterized by a membrane within the left atrium and posterior to the atrial appendage. This defect may cause obstructive symptoms analogous to mitral stenosis. The authors present a case of an incidentally detected enhancing mass originating from a cor triatriatum sinister membrane, with imaging characteristics most suggestive of myxoma. Keywords: MR Imaging, Cardiac, Left Atrium, Congenital, CT Angiography, Echocardiography Supplemental material is available for this article.
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Affiliation(s)
- Tomas V. Gonzalez
- From the Department of Radiology, Mayo Clinic, 200 First St SW,
Rochester, MN 55905
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10
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Mujanovic A, Windecker D, Serrallach BL, Kurmann CC, Almiri W, Meinel TR, Seiffge DJ, Piechowiak EI, Dobrocky T, Gralla J, Fischer U, Dorn F, Chapot R, Pilgram-Pastor S, Kaesmacher J. Connecting the DOTs: a novel imaging sign on flat-panel detector CT indicating distal vessel occlusions after thrombectomy. J Neurointerv Surg 2024:jnis-2023-021218. [PMID: 38253377 DOI: 10.1136/jnis-2023-021218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/29/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND Immediate non-contrast post-interventional flat-panel detector CT (FPDCT) has been suggested as an imaging tool to assess complications after endovascular therapy (EVT). We systematically investigated a new imaging finding of focal hyperdensities correlating with remaining distal vessel occlusion after EVT. METHODS A single-center retrospective analysis was conducted for all acute ischemic stroke patients admitted between July 2020 and December 2022 who underwent EVT and immediate post-interventional FPDCT. A blinded core lab performed reperfusion grading on post-interventional digital subtraction angiography (DSA) images and evaluated focal hyperdensities on FPDCT (here called the distal occlusion tracker (DOT) sign). DOT sign was defined as a tubular or punctiform, vessel confined, hyperdense signal within the initial occlusion target territory. We assessed sensitivity and specificity of the DOT sign when compared with DSA findings. RESULTS The median age of the cohort (n=215) was 74 years (IQR 63-82) and 58.6% were male. The DOT sign was positive in half of the cohort (51%, 110/215). The DOT sign had high specificity (85%, 95% CI 72% to 93%), but only moderate sensitivity (63%, 95% CI 55% to 70%) for detection of residual vessel occlusions. In comparison to the core lab, operators overestimated complete reperfusion in a quarter of the entire cohort (25%, 53/215). In more than half of these cases (53%, 28/53) there was a positive DOT sign, which could have mitigated this overestimation. CONCLUSION The DOT sign appears to be a frequent finding on immediate post-interventional FPDCT. It correlates strongly with incomplete reperfusion and indicates residual distal vessel occlusions. In the future, it may be used to complement grading of reperfusion success and may help mitigating overestimation of reperfusion in the acute setting.
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Affiliation(s)
- Adnan Mujanovic
- Department of Diagnostic and Interventional Neuroradiology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
- Graduate School of Health Sciences, University of Bern, Bern, Switzerland
| | - Daniel Windecker
- Department of Diagnostic and Interventional Neuroradiology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
| | - Bettina L Serrallach
- Department of Diagnostic and Interventional Neuroradiology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
| | - Christoph C Kurmann
- Department of Diagnostic and Interventional Neuroradiology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
- Graduate School of Health Sciences, University of Bern, Bern, Switzerland
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
| | - William Almiri
- Department of Diagnostic and Interventional Neuroradiology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
| | - Thomas R Meinel
- Department of Neurology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
| | - David J Seiffge
- Department of Neurology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
| | - Eike I Piechowiak
- Department of Diagnostic and Interventional Neuroradiology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
| | - Tomas Dobrocky
- Department of Diagnostic and Interventional Neuroradiology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
| | - Jan Gralla
- Department of Diagnostic and Interventional Neuroradiology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
| | - Urs Fischer
- Department of Neurology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
- Department of Neruology, University Hospital Basel, Basel, Switzerland
| | - Franziska Dorn
- Department of Neuroradiology, University Hospital Bonn, Bonn, Germany
| | - René Chapot
- Department of Neuroradiology and Endovascular Therapy, Alfried Krupp Hospital, Essen, Germany
| | - Sara Pilgram-Pastor
- Department of Diagnostic and Interventional Neuroradiology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
| | - Johannes Kaesmacher
- Department of Diagnostic and Interventional Neuroradiology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
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11
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Flores A, Garcia-Tornel A, Seró L, Ustrell X, Requena M, Pellisé A, Rodriguez P, Monterde A, Lara L, Gonzalez-de-Echavarri JM, Molina CA, Doncel-Moriano A, Dorado L, Cardona P, Cánovas D, Krupinski J, Más N, Purroy F, Zaragoza-Brunet J, Palomeras E, Cocho D, Garcia J, Colom C, Silva Y, Gomez-Cocho M, Jiménez X, Ros-Roig J, Abilleira S, Pérez de la Ossa N, Ribo M. Influence of vascular imaging acquisition at local stroke centers on workflows in the drip-n-ship model: a RACECAT post hoc analysis. J Neurointerv Surg 2024; 16:143-150. [PMID: 37068936 DOI: 10.1136/jnis-2023-020125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 03/26/2023] [Indexed: 04/19/2023]
Abstract
BACKGROUND The influence of vascular imaging acquisition on workflows at local stroke centers (LSCs) not capable of performing thrombectomy in patients with a suspected large vessel occlusion (LVO) stroke remains uncertain. We analyzed the impact of performing vascular imaging (VI+) or not (VI- at LSC arrival on variables related to workflows using data from the RACECAT Trial. OBJECTIVE To compare workflows at the LSC among patients enrolled in the RACECAT Trial with or without VI acquisition. METHODS We included patients with a diagnosis of ischemic stroke who were enrolled in the RACECAT Trial, a cluster-randomized trial that compared drip-n-ship versus mothership triage paradigms in patients with suspected acute LVO stroke allocated at the LSC. Outcome measures included time metrics related to workflows and the rate of interhospital transfers and thrombectomy among transferred patients. RESULTS Among 467 patients allocated to a LSC, vascular imaging was acquired in 277 patients (59%), of whom 198 (71%) had a LVO. As compared with patients without vascular imaging, patients in the VI+ group were transferred less frequently as thrombectomy candidates to a thrombectomy-capable center (58% vs 74%, P=0.004), without significant differences in door-indoor-out time at the LSC (median minutes, VI+ 78 (IQR 69-96) vs VI- 76 (IQR 59-98), P=0.6). Among transferred patients, the VI+ group had higher rate of thrombectomy (69% vs 55%, P=0.016) and shorter door to puncture time (median minutes, VI+ 41 (IQR 26-53) vs VI- 54 (IQR 40-70), P<0.001). CONCLUSION Among patients with a suspected LVO stroke initially evaluated at a LSC, vascular imaging acquisition might improve workflow times at thrombectomy-capable centers and reduce the rate of futile interhospital transfers. These results deserve further evaluation and should be replicated in other settings and geographies.
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Affiliation(s)
- Alan Flores
- Stroke Unit, Neurology Department, Hospital Universitari de Tarragona Joan XXIII. Institut d'Investigació Sanitaria Pere Virgili, Tarragona, Spain
| | | | - Laia Seró
- Stroke Unit, Neurology Department, Hospital Universitari de Tarragona Joan XXIII. Institut d'Investigació Sanitaria Pere Virgili, Tarragona, Spain
| | - Xavier Ustrell
- Stroke Unit, Neurology Department, Hospital Universitari de Tarragona Joan XXIII. Institut d'Investigació Sanitaria Pere Virgili, Tarragona, Spain
| | - Manuel Requena
- Stroke Unit, Department of Neurology, Hospital Vall d'Hebron, Barcelona, Spain
| | - Anna Pellisé
- Stroke Unit, Neurology Department, Hospital Universitari de Tarragona Joan XXIII. Institut d'Investigació Sanitaria Pere Virgili, Tarragona, Spain
| | - Paula Rodriguez
- Stroke Unit, Neurology Department, Hospital Universitari de Tarragona Joan XXIII. Institut d'Investigació Sanitaria Pere Virgili, Tarragona, Spain
| | - Angela Monterde
- Stroke Unit, Neurology Department, Hospital Universitari de Tarragona Joan XXIII. Institut d'Investigació Sanitaria Pere Virgili, Tarragona, Spain
| | - Lidia Lara
- Stroke Unit, Neurology Department, Hospital Universitari de Tarragona Joan XXIII. Institut d'Investigació Sanitaria Pere Virgili, Tarragona, Spain
| | - Jose María Gonzalez-de-Echavarri
- Stroke Unit, Neurology Department, Hospital Universitari de Tarragona Joan XXIII. Institut d'Investigació Sanitaria Pere Virgili, Tarragona, Spain
| | - Carlos A Molina
- Stroke Unit, Department of Neurology, Hospital Vall d'Hebron, Barcelona, Spain
| | - Antonio Doncel-Moriano
- Stroke Unit, Department of Neurology, Hospital Clinic de Barcelona, Barcelona, Catalunya, Spain
| | - Laura Dorado
- Stroke Unit, Department of Neurology, Hospital Germans Trias i Pujol, Badalona, Catalunya, Spain
| | - Pedro Cardona
- Bellvitge University Hospital, L'Hospitalet de Llobregat, Catalunya, Spain
| | - David Cánovas
- Department of Neurology, Consorci Sanitari Parc Taulí, Barcelona, Spain
| | | | - Natalia Más
- Department of Neurology, Hospital Althaia, Manresa, Manresa, Catalunya, Spain
| | | | - Jose Zaragoza-Brunet
- Stroke Unit, Department of Neurology, Hospital Verge de la Cinta, Tortosa, Catalunya, Spain
| | - Ernesto Palomeras
- Department of Neurology, Hospital de Mataró, Mataro, Catalunya, Spain
| | - Dolores Cocho
- Department of Neurology, Hospital General de Granollers, Granollers, Catalunya, Spain
| | - Jessica Garcia
- Department of Neurology, Consorci Sanitari Alt Penedès-Garraf, Vilafranca del Penedes, Catalunya, Spain
| | - Carla Colom
- Department of Neurology, Hospital Universitario de Igualada, Igualada, Catalunya, Spain
| | - Yolanda Silva
- Neurology Department, Stroke Unit, Doctor Josep Trueta University Hospital of Girona, Girona, Catalunya, Spain
| | - Manuel Gomez-Cocho
- Department of Neurology, Hospital de Sant Joan Despi Moises Broggi, Sant Joan Despi, Spain
| | - Xavier Jiménez
- Emergency Medical Services of Catalonia, Barcelona, Spain
| | - Josep Ros-Roig
- Stroke Programme, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain
| | - Sonia Abilleira
- Stroke Programme, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain
| | - Natalia Pérez de la Ossa
- Department of Neurology, Hospital Universitari Germans Trias i Pujol, Badalona, Catalunya, Spain
- Catalan Stroke Program, Barcelona, Spain
| | - Marc Ribo
- Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
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12
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Peng SH, Lai YJ, Lai WJ, Li AH, Yen HH, Huang LW, Tang CW. Impact of smoking on one year functional outcomes after thrombectomy for young stroke patients. J Neurointerv Surg 2023; 15:e343-e348. [PMID: 36572522 DOI: 10.1136/jnis-2022-019815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 12/14/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND The incidence of stroke in young patients (20-50 years old) has increased in recent decades. Unlike the use of good functional outcomes to evaluate prognosis, excellent functional outcomes are a better indicator of return to work among younger patients. The rate of return to work increases with time after stroke. This study investigated the short term (3 months) and long term (1 year) predictors of excellent functional outcomes in young patients after endovascular thrombectomy (EVT). METHODS We included young patients who underwent EVT for acute ischemic stroke (AIS) due to large vessel occlusion within 6 hours after stroke onset between 2015 and 2021. Patients with intracerebral hemorrhage on pretreatment CT were excluded. The associations between clinical, imaging, and procedure variables, and excellent functional outcomes were analyzed using univariate and multivariable logistic regression analyses. An excellent functional outcome was defined as a modified Rankin Scale score of ≤1. RESULTS Of the 361 patients with AIS eligible for EVT, 55 young patients (aged 24-50 years) were included. Of these, 36.4% and 41.8% achieved excellent functional outcomes at 3 and 12 months, respectively. Multivariate analysis revealed that smoking was the independent negative predictor of both 3 month (adjusted OR (aOR) 0.232, 95% CI 0.058 to 0.928; p=0.039) and 12 month (aOR 0.180, 95% CI 0.044 to 0.741; p=0.018) excellent functional outcomes. CONCLUSIONS Current or former smoking habit was an independent negative predictor of both short term and long term excellent functional outcomes in young adults with AIS.
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Affiliation(s)
- Szu-Hsiang Peng
- Division of Medical Imaging, Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Yen-Jun Lai
- Division of Medical Imaging, Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Wei-Jen Lai
- Division of Medical Imaging, Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Ai-Hsien Li
- Department of Cardiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Ho-Hsian Yen
- Division of Medical Imaging, Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Lih-Wen Huang
- Department of Neurology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chih-Wei Tang
- Department of Neurology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Institute of Brain Science, Brain Research Center, National Yang-Ming University, Taipei, Taiwan
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13
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Dong Z, Deng S, Zhang J, Chen S, Ye Z, Zhang L, Hu R, Zhong C, Liu X, Qin C. Simplified stroke imaging selection modality for endovascular thrombectomy in the extended time window: systematic review and meta-analysis. J Neurointerv Surg 2023; 16:101-106. [PMID: 36597953 PMCID: PMC10803987 DOI: 10.1136/jnis-2022-019556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND The impact of imaging selection modality on clinical outcomes of endovascular thrombectomy (EVT) in the 6-24-hour time window remains undetermined. We compared the clinical outcomes of a simplified stroke imaging selection modality using non-contrast computed tomography (NCCT)±CT angiography (CTA) with using advanced CT perfusion (CTP). METHODS PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials were searched from inception to 1 May 2022 to compare NCCT±CTA and CTP for patient selection for EVT in late-presenting stroke with large vessel occlusions (LVO). The primary outcome was the proportion of patients achieving functional independence (modified Rankin Scale score 0-2) within 180 days. The secondary outcomes included mortality within 90 days, successful recanalization, and any intracranial hemorrhage. RESULTS A total of 3419 patients in six articles were included in this meta-analysis. There was no significant difference between NCCT±CTA (no-CTP) and CTP in functional independence either in overall or subgroup analysis. However, the mortality in the no-CTP group was higher than in the CTP group. Furthermore, within the DAWN/DEFUSE 3-like subgroup, there were no significant differences in mortality, successful recanalization, and any intracranial hemorrhage between the two groups. CONCLUSION There was no significant difference between the simplified NCCT±CTA modality and the advanced CTP modality. The use of NCCT±CTA may represent a reasonable option for selecting patients for EVT in the extended time window, especially in the absence of CTP and acute phase MRI capabilities.
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Affiliation(s)
- Zimei Dong
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Department of Neurology, People's Hospital of Chuxiong Yi Autonomous Prefecture, Chuxiong, Yunnan, China
| | - Shan Deng
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Department of Neurology, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
| | - Jian Zhang
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Shijian Chen
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Ziming Ye
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Limei Zhang
- Department of Cardiology, People's Hospital of Chuxiong Yi Autonomous Prefecture, Chuxiong, Yunnan, China
| | - Ruiting Hu
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Cai Zhong
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xiuying Liu
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Chao Qin
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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14
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Wang C, Leng S, Tan RS, Chai P, Fam JM, Teo LLS, Chin CY, Ong CC, Baskaran L, Keng YJF, Low AFH, Chan MYY, Wong ASL, Chua SJT, Wu Q, Tan SY, Lim ST, Zhong L. Coronary CT Angiography-based Morphologic Index for Predicting Hemodynamically Significant Coronary Stenosis. Radiol Cardiothorac Imaging 2023; 5:e230064. [PMID: 38166346 DOI: 10.1148/ryct.230064] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
Purpose To develop a new coronary CT angiography (CCTA)-based index, α×LL/MLD4, that considers lesion entrance angle (α) in addition to lesion length (LL) and minimal lumen diameter (MLD) and to evaluate its efficacy in predicting hemodynamically significant coronary stenosis compared with invasive coronary angiography (ICA)-derived fractional flow reserve (FFR). Materials and Methods This prospective study enrolled participants (September 2016-March 2020) from two centers who underwent CCTA followed by ICA (ClinicalTrials.gov identifier: NCT03054324). CCTA images were processed semiautomatically to measure LL, MLD, and α for calculating α×LL/MLD4. Diagnostic performance and accuracy of α×LL/MLD4 and LL/MLD4 in detecting hemodynamically significant coronary stenosis were compared against the reference standard (invasive FFR ≤ 0.80). Results In total, 133 participants (mean age, 63 years ± 9 [SD]; 99 [74%] men) with 210 stenosed coronary arteries were analyzed. Median α×LL/MLD4 was 54.0 degree/mm3 (IQR, 25.3-128.7) in participants with invasive FFR of 0.80 or less and 6.7 degree/mm3 (IQR, 3.3-12.8) in participants with invasive FFR of more than 0.80 (P < .001). The per-vessel accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for discriminating ischemic lesions were 86.2%, 83.1%, 88.4%, 84.1%, and 87.7% for α×LL/MLD4 and 80.5%, 66.3%, 90.9%, 84.3%, and 78.6% for LL/MLD4, respectively. Area under the receiver operating characteristic curve for discriminating hemodynamically significant stenosis was 0.93 for α×LL/MLD4, which was significantly greater than the values of 0.84 for LL/MLD4 and 0.63 for diameter stenosis (both P < .001). Conclusion The new morphologic index, α×LL/MLD4, incorporating lesion entrance angle achieved higher diagnostic performance in detecting hemodynamically significant lesions compared with diameter stenosis and LL/MLD4. Keywords: CT Angiography, Cardiac, Coronary Arteries, Ischemia, Infarction, Technology Assessment Clinical trial registration no. NCT03054324 Supplemental material is available for this article. © RSNA, 2023 See also the commentary by Fairbairn and Nørgaard in this issue.
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Affiliation(s)
- Chenxi Wang
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Dr, 169609 Singapore (C.W., S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); The Second Affiliated Hospital of Nanchang University, Nanchang, China (C.W., Q.W.); Duke-NUS Medical School, Singapore (S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); Department of Cardiology, National University Heart Centre, Singapore (P.C., A.F.H.L., M.Y.Y.C.); Yong Loo Lin School of Medicine (P.C., L.L.S.T., C.C.O., Y.J.F.K., A.F.H.L., M.Y.Y.C.) and Department of Biomedical Engineering (L.Z.), National University of Singapore, Singapore; and Department of Diagnostic Imaging, National University Hospital, Singapore (L.L.S.T., C.C.O.)
| | - Shuang Leng
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Dr, 169609 Singapore (C.W., S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); The Second Affiliated Hospital of Nanchang University, Nanchang, China (C.W., Q.W.); Duke-NUS Medical School, Singapore (S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); Department of Cardiology, National University Heart Centre, Singapore (P.C., A.F.H.L., M.Y.Y.C.); Yong Loo Lin School of Medicine (P.C., L.L.S.T., C.C.O., Y.J.F.K., A.F.H.L., M.Y.Y.C.) and Department of Biomedical Engineering (L.Z.), National University of Singapore, Singapore; and Department of Diagnostic Imaging, National University Hospital, Singapore (L.L.S.T., C.C.O.)
| | - Ru-San Tan
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Dr, 169609 Singapore (C.W., S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); The Second Affiliated Hospital of Nanchang University, Nanchang, China (C.W., Q.W.); Duke-NUS Medical School, Singapore (S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); Department of Cardiology, National University Heart Centre, Singapore (P.C., A.F.H.L., M.Y.Y.C.); Yong Loo Lin School of Medicine (P.C., L.L.S.T., C.C.O., Y.J.F.K., A.F.H.L., M.Y.Y.C.) and Department of Biomedical Engineering (L.Z.), National University of Singapore, Singapore; and Department of Diagnostic Imaging, National University Hospital, Singapore (L.L.S.T., C.C.O.)
| | - Ping Chai
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Dr, 169609 Singapore (C.W., S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); The Second Affiliated Hospital of Nanchang University, Nanchang, China (C.W., Q.W.); Duke-NUS Medical School, Singapore (S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); Department of Cardiology, National University Heart Centre, Singapore (P.C., A.F.H.L., M.Y.Y.C.); Yong Loo Lin School of Medicine (P.C., L.L.S.T., C.C.O., Y.J.F.K., A.F.H.L., M.Y.Y.C.) and Department of Biomedical Engineering (L.Z.), National University of Singapore, Singapore; and Department of Diagnostic Imaging, National University Hospital, Singapore (L.L.S.T., C.C.O.)
| | - Jiang Ming Fam
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Dr, 169609 Singapore (C.W., S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); The Second Affiliated Hospital of Nanchang University, Nanchang, China (C.W., Q.W.); Duke-NUS Medical School, Singapore (S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); Department of Cardiology, National University Heart Centre, Singapore (P.C., A.F.H.L., M.Y.Y.C.); Yong Loo Lin School of Medicine (P.C., L.L.S.T., C.C.O., Y.J.F.K., A.F.H.L., M.Y.Y.C.) and Department of Biomedical Engineering (L.Z.), National University of Singapore, Singapore; and Department of Diagnostic Imaging, National University Hospital, Singapore (L.L.S.T., C.C.O.)
| | - Lynette Li San Teo
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Dr, 169609 Singapore (C.W., S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); The Second Affiliated Hospital of Nanchang University, Nanchang, China (C.W., Q.W.); Duke-NUS Medical School, Singapore (S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); Department of Cardiology, National University Heart Centre, Singapore (P.C., A.F.H.L., M.Y.Y.C.); Yong Loo Lin School of Medicine (P.C., L.L.S.T., C.C.O., Y.J.F.K., A.F.H.L., M.Y.Y.C.) and Department of Biomedical Engineering (L.Z.), National University of Singapore, Singapore; and Department of Diagnostic Imaging, National University Hospital, Singapore (L.L.S.T., C.C.O.)
| | - Chee Yang Chin
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Dr, 169609 Singapore (C.W., S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); The Second Affiliated Hospital of Nanchang University, Nanchang, China (C.W., Q.W.); Duke-NUS Medical School, Singapore (S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); Department of Cardiology, National University Heart Centre, Singapore (P.C., A.F.H.L., M.Y.Y.C.); Yong Loo Lin School of Medicine (P.C., L.L.S.T., C.C.O., Y.J.F.K., A.F.H.L., M.Y.Y.C.) and Department of Biomedical Engineering (L.Z.), National University of Singapore, Singapore; and Department of Diagnostic Imaging, National University Hospital, Singapore (L.L.S.T., C.C.O.)
| | - Ching Ching Ong
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Dr, 169609 Singapore (C.W., S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); The Second Affiliated Hospital of Nanchang University, Nanchang, China (C.W., Q.W.); Duke-NUS Medical School, Singapore (S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); Department of Cardiology, National University Heart Centre, Singapore (P.C., A.F.H.L., M.Y.Y.C.); Yong Loo Lin School of Medicine (P.C., L.L.S.T., C.C.O., Y.J.F.K., A.F.H.L., M.Y.Y.C.) and Department of Biomedical Engineering (L.Z.), National University of Singapore, Singapore; and Department of Diagnostic Imaging, National University Hospital, Singapore (L.L.S.T., C.C.O.)
| | - Lohendran Baskaran
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Dr, 169609 Singapore (C.W., S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); The Second Affiliated Hospital of Nanchang University, Nanchang, China (C.W., Q.W.); Duke-NUS Medical School, Singapore (S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); Department of Cardiology, National University Heart Centre, Singapore (P.C., A.F.H.L., M.Y.Y.C.); Yong Loo Lin School of Medicine (P.C., L.L.S.T., C.C.O., Y.J.F.K., A.F.H.L., M.Y.Y.C.) and Department of Biomedical Engineering (L.Z.), National University of Singapore, Singapore; and Department of Diagnostic Imaging, National University Hospital, Singapore (L.L.S.T., C.C.O.)
| | - Yung Jih Felix Keng
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Dr, 169609 Singapore (C.W., S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); The Second Affiliated Hospital of Nanchang University, Nanchang, China (C.W., Q.W.); Duke-NUS Medical School, Singapore (S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); Department of Cardiology, National University Heart Centre, Singapore (P.C., A.F.H.L., M.Y.Y.C.); Yong Loo Lin School of Medicine (P.C., L.L.S.T., C.C.O., Y.J.F.K., A.F.H.L., M.Y.Y.C.) and Department of Biomedical Engineering (L.Z.), National University of Singapore, Singapore; and Department of Diagnostic Imaging, National University Hospital, Singapore (L.L.S.T., C.C.O.)
| | - Adrian Fatt Hoe Low
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Dr, 169609 Singapore (C.W., S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); The Second Affiliated Hospital of Nanchang University, Nanchang, China (C.W., Q.W.); Duke-NUS Medical School, Singapore (S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); Department of Cardiology, National University Heart Centre, Singapore (P.C., A.F.H.L., M.Y.Y.C.); Yong Loo Lin School of Medicine (P.C., L.L.S.T., C.C.O., Y.J.F.K., A.F.H.L., M.Y.Y.C.) and Department of Biomedical Engineering (L.Z.), National University of Singapore, Singapore; and Department of Diagnostic Imaging, National University Hospital, Singapore (L.L.S.T., C.C.O.)
| | - Mark Yan-Yee Chan
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Dr, 169609 Singapore (C.W., S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); The Second Affiliated Hospital of Nanchang University, Nanchang, China (C.W., Q.W.); Duke-NUS Medical School, Singapore (S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); Department of Cardiology, National University Heart Centre, Singapore (P.C., A.F.H.L., M.Y.Y.C.); Yong Loo Lin School of Medicine (P.C., L.L.S.T., C.C.O., Y.J.F.K., A.F.H.L., M.Y.Y.C.) and Department of Biomedical Engineering (L.Z.), National University of Singapore, Singapore; and Department of Diagnostic Imaging, National University Hospital, Singapore (L.L.S.T., C.C.O.)
| | - Aaron Sung Lung Wong
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Dr, 169609 Singapore (C.W., S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); The Second Affiliated Hospital of Nanchang University, Nanchang, China (C.W., Q.W.); Duke-NUS Medical School, Singapore (S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); Department of Cardiology, National University Heart Centre, Singapore (P.C., A.F.H.L., M.Y.Y.C.); Yong Loo Lin School of Medicine (P.C., L.L.S.T., C.C.O., Y.J.F.K., A.F.H.L., M.Y.Y.C.) and Department of Biomedical Engineering (L.Z.), National University of Singapore, Singapore; and Department of Diagnostic Imaging, National University Hospital, Singapore (L.L.S.T., C.C.O.)
| | - Siang Jin Terrance Chua
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Dr, 169609 Singapore (C.W., S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); The Second Affiliated Hospital of Nanchang University, Nanchang, China (C.W., Q.W.); Duke-NUS Medical School, Singapore (S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); Department of Cardiology, National University Heart Centre, Singapore (P.C., A.F.H.L., M.Y.Y.C.); Yong Loo Lin School of Medicine (P.C., L.L.S.T., C.C.O., Y.J.F.K., A.F.H.L., M.Y.Y.C.) and Department of Biomedical Engineering (L.Z.), National University of Singapore, Singapore; and Department of Diagnostic Imaging, National University Hospital, Singapore (L.L.S.T., C.C.O.)
| | - Qinghua Wu
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Dr, 169609 Singapore (C.W., S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); The Second Affiliated Hospital of Nanchang University, Nanchang, China (C.W., Q.W.); Duke-NUS Medical School, Singapore (S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); Department of Cardiology, National University Heart Centre, Singapore (P.C., A.F.H.L., M.Y.Y.C.); Yong Loo Lin School of Medicine (P.C., L.L.S.T., C.C.O., Y.J.F.K., A.F.H.L., M.Y.Y.C.) and Department of Biomedical Engineering (L.Z.), National University of Singapore, Singapore; and Department of Diagnostic Imaging, National University Hospital, Singapore (L.L.S.T., C.C.O.)
| | - Swee Yaw Tan
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Dr, 169609 Singapore (C.W., S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); The Second Affiliated Hospital of Nanchang University, Nanchang, China (C.W., Q.W.); Duke-NUS Medical School, Singapore (S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); Department of Cardiology, National University Heart Centre, Singapore (P.C., A.F.H.L., M.Y.Y.C.); Yong Loo Lin School of Medicine (P.C., L.L.S.T., C.C.O., Y.J.F.K., A.F.H.L., M.Y.Y.C.) and Department of Biomedical Engineering (L.Z.), National University of Singapore, Singapore; and Department of Diagnostic Imaging, National University Hospital, Singapore (L.L.S.T., C.C.O.)
| | - Soo Teik Lim
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Dr, 169609 Singapore (C.W., S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); The Second Affiliated Hospital of Nanchang University, Nanchang, China (C.W., Q.W.); Duke-NUS Medical School, Singapore (S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); Department of Cardiology, National University Heart Centre, Singapore (P.C., A.F.H.L., M.Y.Y.C.); Yong Loo Lin School of Medicine (P.C., L.L.S.T., C.C.O., Y.J.F.K., A.F.H.L., M.Y.Y.C.) and Department of Biomedical Engineering (L.Z.), National University of Singapore, Singapore; and Department of Diagnostic Imaging, National University Hospital, Singapore (L.L.S.T., C.C.O.)
| | - Liang Zhong
- From the National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Dr, 169609 Singapore (C.W., S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); The Second Affiliated Hospital of Nanchang University, Nanchang, China (C.W., Q.W.); Duke-NUS Medical School, Singapore (S.L., R.S.T., J.M.F., C.Y.C., L.B., Y.J.F.K., A.S.L.W., S.J.T.C., S.Y.T., S.T.L., L.Z.); Department of Cardiology, National University Heart Centre, Singapore (P.C., A.F.H.L., M.Y.Y.C.); Yong Loo Lin School of Medicine (P.C., L.L.S.T., C.C.O., Y.J.F.K., A.F.H.L., M.Y.Y.C.) and Department of Biomedical Engineering (L.Z.), National University of Singapore, Singapore; and Department of Diagnostic Imaging, National University Hospital, Singapore (L.L.S.T., C.C.O.)
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Dundas J, Leipsic JA, Sellers S, Blanke P, Miranda P, Ng N, Mullen S, Meier D, Akodad M, Sathananthan J, Collet C, de Bruyne B, Muller O, Tzimas G. Artificial Intelligence-based Coronary Stenosis Quantification at Coronary CT Angiography versus Quantitative Coronary Angiography. Radiol Cardiothorac Imaging 2023; 5:e230124. [PMID: 38166336 DOI: 10.1148/ryct.230124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
Purpose To evaluate the performance of a new artificial intelligence (AI)-based tool by comparing the quantified stenosis severity at coronary CT angiography (CCTA) with a reference standard derived from invasive quantitative coronary angiography (QCA). Materials and Methods This secondary, post hoc analysis included 120 participants (mean age, 59.7 years ± 10.8 [SD]; 73 [60.8%] men, 47 [39.2%] women) from three large clinical trials (AFFECTS, P3, REFINE) who underwent CCTA and invasive coronary angiography with QCA. Quantitative analysis of coronary stenosis severity at CCTA was performed using an AI-based coronary stenosis quantification (AI-CSQ) software service. Blinded comparison between QCA and AI-CSQ was measured on a per-vessel and per-patient basis. Results The per-vessel AI-CSQ diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 80%, 88%, 86%, 65%, and 94%, respectively, for diameter stenosis (DS) 50% or greater; and 78%, 92%, 91%, 47%, and 98%, respectively, for DS 70% or greater. The areas under the receiver operating characteristic curve (AUCs) to predict DS of 50% or greater and 70% or greater on a per-vessel basis were 0.92 (95% CI: 0.88, 0.95; P < .001) and 0.93 (95% CI: 0.89, 0.97; P < .001), respectively. The AUCs to predict DS of 50% or greater and 70% or greater on a per-patient basis were 0.93 (95% CI: 0.88, 0.97; P < .001) and 0.88 (95% CI: 0.81, 0.94; P < .001), respectively. Conclusion AI-CSQ at CCTA demonstrated a high diagnostic performance compared with QCA both on a per-patient and per-vessel basis, with high sensitivity for stenosis detection. Keywords: CT Angiography, Cardiac, Coronary Arteries Supplemental material is available for this article. Published under a CC BY 4.0 license.
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Affiliation(s)
- James Dundas
- From the Department of Medicine and Radiology, University of British Columbia, Vancouver, British Columbia, Canada (J.D., J.A.L., P.B., G.T.); Cardiovascular Translational Laboratory, Centre for Heart Lung Innovation & Providence Research, Vancouver, British Columbia, Canada (S.S.); HeartFlow, Mountain View, Calif (P.M., N.N., S.M.); Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.M., J.S.); Interventional Cardiology Department, Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France (M.A.); OLV Clinic, Cardiovascular Center Aalst, Aalst, Belgium (C.C., B.d.B.); and Department of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland (O.M., G.T.)
| | - Jonathon A Leipsic
- From the Department of Medicine and Radiology, University of British Columbia, Vancouver, British Columbia, Canada (J.D., J.A.L., P.B., G.T.); Cardiovascular Translational Laboratory, Centre for Heart Lung Innovation & Providence Research, Vancouver, British Columbia, Canada (S.S.); HeartFlow, Mountain View, Calif (P.M., N.N., S.M.); Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.M., J.S.); Interventional Cardiology Department, Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France (M.A.); OLV Clinic, Cardiovascular Center Aalst, Aalst, Belgium (C.C., B.d.B.); and Department of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland (O.M., G.T.)
| | - Stephanie Sellers
- From the Department of Medicine and Radiology, University of British Columbia, Vancouver, British Columbia, Canada (J.D., J.A.L., P.B., G.T.); Cardiovascular Translational Laboratory, Centre for Heart Lung Innovation & Providence Research, Vancouver, British Columbia, Canada (S.S.); HeartFlow, Mountain View, Calif (P.M., N.N., S.M.); Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.M., J.S.); Interventional Cardiology Department, Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France (M.A.); OLV Clinic, Cardiovascular Center Aalst, Aalst, Belgium (C.C., B.d.B.); and Department of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland (O.M., G.T.)
| | - Philipp Blanke
- From the Department of Medicine and Radiology, University of British Columbia, Vancouver, British Columbia, Canada (J.D., J.A.L., P.B., G.T.); Cardiovascular Translational Laboratory, Centre for Heart Lung Innovation & Providence Research, Vancouver, British Columbia, Canada (S.S.); HeartFlow, Mountain View, Calif (P.M., N.N., S.M.); Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.M., J.S.); Interventional Cardiology Department, Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France (M.A.); OLV Clinic, Cardiovascular Center Aalst, Aalst, Belgium (C.C., B.d.B.); and Department of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland (O.M., G.T.)
| | - Patricia Miranda
- From the Department of Medicine and Radiology, University of British Columbia, Vancouver, British Columbia, Canada (J.D., J.A.L., P.B., G.T.); Cardiovascular Translational Laboratory, Centre for Heart Lung Innovation & Providence Research, Vancouver, British Columbia, Canada (S.S.); HeartFlow, Mountain View, Calif (P.M., N.N., S.M.); Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.M., J.S.); Interventional Cardiology Department, Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France (M.A.); OLV Clinic, Cardiovascular Center Aalst, Aalst, Belgium (C.C., B.d.B.); and Department of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland (O.M., G.T.)
| | - Nicholas Ng
- From the Department of Medicine and Radiology, University of British Columbia, Vancouver, British Columbia, Canada (J.D., J.A.L., P.B., G.T.); Cardiovascular Translational Laboratory, Centre for Heart Lung Innovation & Providence Research, Vancouver, British Columbia, Canada (S.S.); HeartFlow, Mountain View, Calif (P.M., N.N., S.M.); Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.M., J.S.); Interventional Cardiology Department, Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France (M.A.); OLV Clinic, Cardiovascular Center Aalst, Aalst, Belgium (C.C., B.d.B.); and Department of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland (O.M., G.T.)
| | - Sarah Mullen
- From the Department of Medicine and Radiology, University of British Columbia, Vancouver, British Columbia, Canada (J.D., J.A.L., P.B., G.T.); Cardiovascular Translational Laboratory, Centre for Heart Lung Innovation & Providence Research, Vancouver, British Columbia, Canada (S.S.); HeartFlow, Mountain View, Calif (P.M., N.N., S.M.); Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.M., J.S.); Interventional Cardiology Department, Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France (M.A.); OLV Clinic, Cardiovascular Center Aalst, Aalst, Belgium (C.C., B.d.B.); and Department of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland (O.M., G.T.)
| | - David Meier
- From the Department of Medicine and Radiology, University of British Columbia, Vancouver, British Columbia, Canada (J.D., J.A.L., P.B., G.T.); Cardiovascular Translational Laboratory, Centre for Heart Lung Innovation & Providence Research, Vancouver, British Columbia, Canada (S.S.); HeartFlow, Mountain View, Calif (P.M., N.N., S.M.); Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.M., J.S.); Interventional Cardiology Department, Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France (M.A.); OLV Clinic, Cardiovascular Center Aalst, Aalst, Belgium (C.C., B.d.B.); and Department of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland (O.M., G.T.)
| | - Mariama Akodad
- From the Department of Medicine and Radiology, University of British Columbia, Vancouver, British Columbia, Canada (J.D., J.A.L., P.B., G.T.); Cardiovascular Translational Laboratory, Centre for Heart Lung Innovation & Providence Research, Vancouver, British Columbia, Canada (S.S.); HeartFlow, Mountain View, Calif (P.M., N.N., S.M.); Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.M., J.S.); Interventional Cardiology Department, Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France (M.A.); OLV Clinic, Cardiovascular Center Aalst, Aalst, Belgium (C.C., B.d.B.); and Department of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland (O.M., G.T.)
| | - Janarthanan Sathananthan
- From the Department of Medicine and Radiology, University of British Columbia, Vancouver, British Columbia, Canada (J.D., J.A.L., P.B., G.T.); Cardiovascular Translational Laboratory, Centre for Heart Lung Innovation & Providence Research, Vancouver, British Columbia, Canada (S.S.); HeartFlow, Mountain View, Calif (P.M., N.N., S.M.); Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.M., J.S.); Interventional Cardiology Department, Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France (M.A.); OLV Clinic, Cardiovascular Center Aalst, Aalst, Belgium (C.C., B.d.B.); and Department of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland (O.M., G.T.)
| | - Carlos Collet
- From the Department of Medicine and Radiology, University of British Columbia, Vancouver, British Columbia, Canada (J.D., J.A.L., P.B., G.T.); Cardiovascular Translational Laboratory, Centre for Heart Lung Innovation & Providence Research, Vancouver, British Columbia, Canada (S.S.); HeartFlow, Mountain View, Calif (P.M., N.N., S.M.); Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.M., J.S.); Interventional Cardiology Department, Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France (M.A.); OLV Clinic, Cardiovascular Center Aalst, Aalst, Belgium (C.C., B.d.B.); and Department of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland (O.M., G.T.)
| | - Bernard de Bruyne
- From the Department of Medicine and Radiology, University of British Columbia, Vancouver, British Columbia, Canada (J.D., J.A.L., P.B., G.T.); Cardiovascular Translational Laboratory, Centre for Heart Lung Innovation & Providence Research, Vancouver, British Columbia, Canada (S.S.); HeartFlow, Mountain View, Calif (P.M., N.N., S.M.); Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.M., J.S.); Interventional Cardiology Department, Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France (M.A.); OLV Clinic, Cardiovascular Center Aalst, Aalst, Belgium (C.C., B.d.B.); and Department of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland (O.M., G.T.)
| | - Olivier Muller
- From the Department of Medicine and Radiology, University of British Columbia, Vancouver, British Columbia, Canada (J.D., J.A.L., P.B., G.T.); Cardiovascular Translational Laboratory, Centre for Heart Lung Innovation & Providence Research, Vancouver, British Columbia, Canada (S.S.); HeartFlow, Mountain View, Calif (P.M., N.N., S.M.); Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.M., J.S.); Interventional Cardiology Department, Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France (M.A.); OLV Clinic, Cardiovascular Center Aalst, Aalst, Belgium (C.C., B.d.B.); and Department of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland (O.M., G.T.)
| | - Georgios Tzimas
- From the Department of Medicine and Radiology, University of British Columbia, Vancouver, British Columbia, Canada (J.D., J.A.L., P.B., G.T.); Cardiovascular Translational Laboratory, Centre for Heart Lung Innovation & Providence Research, Vancouver, British Columbia, Canada (S.S.); HeartFlow, Mountain View, Calif (P.M., N.N., S.M.); Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.M., J.S.); Interventional Cardiology Department, Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France (M.A.); OLV Clinic, Cardiovascular Center Aalst, Aalst, Belgium (C.C., B.d.B.); and Department of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland (O.M., G.T.)
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Bombardieri AM, Albers GW, Rodriguez S, Pileggi M, Steinberg GK, Heit JJ. Percutaneous cervical sympathetic block to treat cerebral vasospasm and delayed cerebral ischemia: a review of the evidence. J Neurointerv Surg 2023; 15:1212-1217. [PMID: 36597947 DOI: 10.1136/jnis-2022-019838] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 11/26/2022] [Indexed: 12/12/2022]
Abstract
Delayed cerebral ischemia (DCI) affects 30% of patients following aneurysmal subarachnoid hemorrhage (aSAH) and is a major driver of morbidity, mortality, and intensive care unit length of stay for these patients. DCI is strongly associated with cerebral arterial vasospasm, reduced cerebral blood flow and cerebral infarction. The current standard treatment with intravenous or intra-arterial calcium channel antagonist and balloon angioplasty or stent has limited efficacy. A simple treatment such as a cervical sympathetic block (CSB) may be an effective therapy but is not routinely performed to treat vasospasm/DCI. CSB consists of injecting local anesthetic at the level of the cervical sympathetic trunk, which temporarily blocks the innervation of the cerebral arteries to cause arterial vasodilatation. CSB is a local, minimally invasive, low cost and safe technique that can be performed at the bedside and may offer significant advantages as complementary treatment in combination with more conventional neurointerventional surgery interventions. We reviewed the literature that describes CSB for vasospasm/DCI prevention or treatment in humans after aSAH. The studies outlined in this review show promising results for a CSB as a treatment for vasospasm/DCI. Further research is required to standardize the technique, to explore how to integrate a CSB with conventional neurointerventional surgery treatments of vasospasm and DCI, and to study its long-term effect on neurological outcomes.
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Affiliation(s)
- Anna Maria Bombardieri
- Anesthesiology and Perioperative Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Gregory W Albers
- Neurology, Stanford University School of Medicine, Stanford, California, USA
| | - Samuel Rodriguez
- Anesthesiology and Perioperative Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Marco Pileggi
- Neuroradiology, Lugano Regional Hospital Civico and Italiano Sites, Lugano, Switzerland
| | | | - Jeremy J Heit
- Radiology, Neuroadiology and Neurointervention Division, Stanford University, Stanford, California, USA
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17
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Dodd WS, Dayton O, Lucke-Wold B, Reitano C, Sorrentino Z, Busl KM. Decrease in cortical vein opacification predicts outcome after aneurysmal subarachnoid hemorrhage. J Neurointerv Surg 2023; 15:1105-1110. [PMID: 36456184 DOI: 10.1136/jnis-2022-019578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/20/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND The pathophysiology of brain injury after aneurysmal subarachnoid hemorrhage (aSAH) remains incompletely understood. Cerebral venous flow patterns may be a marker of hemodynamic disruptions after aneurysm rupture. We hypothesized that a decrease in venous filling after aSAH would predict cerebral ischemia and poor outcome. OBJECTIVE To examine the hypotheses that venous filling as measured by the cortical venous opacification score (COVES) would (1) decrease after aSAH and (2) that decreased COVES would be associated with higher rates of hydrocephalus, vasospasm, delayed cerebral iscemia (DCI), and poor functional evaluation at outcome. METHODS In this retrospective observational cohort study of consecutive patients with aSAH admitted to our tertiary care center between 2016 and 2018, we measured the COVES at admission and at subsequent CT angiography (CTA). We collected clinical variables and compared hydrocephalus, vasospasm, DCI, and outcome at discharge in patients with decrease in COVES with patients with stable COVES. RESULTS A total of 22 patients were included in the analysis. COVES decreased from first CTA to second CTA in 11 (50%) patients, by an average of 1.1 points (P=0.01). Patients whose COVES decreased between admission and follow-up imaging were more likely to develop DCI (58% vs 0%, P=0.03) and have a poor outcome at discharge (100% vs 55%, P=0.03) than patients who had no change in COVES. aSAH severity was not associated with initial COVES, and there was no association between change in COVES and development of hydrocephalus or vasospasm. CONCLUSIONS Development of decreased venous filling on CTA is associated with poor outcome after aSAH. This association suggests that venous hemodynamics may be reflective of, or contribute to, the pathophysiological mechanisms of brain injury after aSAH. Larger prospective studies are necessary to substantiate our findings.
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Affiliation(s)
- William S Dodd
- College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Orrin Dayton
- Department of Radiology, University of Florida, Gainesville, Florida, USA
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Christian Reitano
- Department of Radiology, University of Florida, Gainesville, Florida, USA
| | - Zachary Sorrentino
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Katharina M Busl
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
- Department of Neurology, University of Florida, Gainesville, Florida, USA
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18
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Hirschfeld CB, Dorbala S, Shaw LJ, Villines TC, Choi AD, Better N, Cerci RJ, Karthikeyan G, Vitola JV, Williams MC, Al-Mallah M, Berman DS, Bernheim A, Biederman RW, Bravo PE, Budoff MJ, Bullock-Palmer RP, Chen MY, DiLorenzo MP, Doukky R, Ferencik M, Geske JB, Hage FG, Hendel RC, Koweek L, Murthy VL, Narula J, Rodriguez Lozano PF, Shah NR, Shah A, Soman P, Thompson RC, Wolinsky D, Cohen YA, Malkovskiy E, Randazzo MJ, Lopez-Mattei J, Parwani P, Shetty M, Pascual TNB, Pynda Y, Dondi M, Paez D, Einstein AJ. Cardiovascular Testing in the United States during the COVID-19 Pandemic: Volume Recovery and Worldwide Comparison. Radiol Cardiothorac Imaging 2023; 5:e220288. [PMID: 37908554 PMCID: PMC10613928 DOI: 10.1148/ryct.220288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 06/27/2023] [Accepted: 08/08/2023] [Indexed: 11/02/2023]
Abstract
Purpose To characterize the recovery of diagnostic cardiovascular procedure volumes in U.S. and non-U.S. facilities in the year following the initial COVID-19 outbreak. Materials and Methods The International Atomic Energy Agency (IAEA) coordinated a worldwide study called the IAEA Noninvasive Cardiology Protocols Study of COVID-19 2 (INCAPS COVID 2), collecting data from 669 facilities in 107 countries, including 93 facilities in 34 U.S. states, to determine the impact of the pandemic on diagnostic cardiovascular procedure volumes. Participants reported volumes for each diagnostic imaging modality used at their facility for March 2019 (baseline), April 2020, and April 2021. This secondary analysis of INCAPS COVID 2 evaluated differences in changes in procedure volume between U.S. and non-U.S. facilities and among U.S. regions. Factors associated with return to prepandemic volumes in the United States were also analyzed in a multivariable regression analysis. Results Reduction in procedure volumes in April 2020 compared with baseline was similar for U.S. and non-U.S. facilities (-66% vs -71%, P = .27). U.S. facilities reported greater return to baseline in April 2021 than did all non-U.S. facilities (4% vs -6%, P = .008), but there was no evidence of a difference when comparing U.S. facilities with non-U.S. high-income country (NUHIC) facilities (4% vs 0%, P = .18). U.S. regional differences in return to baseline were observed between the Midwest (11%), Northeast (9%), South (1%), and West (-7%, P = .03), but no studied factors were significant predictors of 2021 change from prepandemic baseline. Conclusion The reductions in cardiac testing during the early pandemic have recovered within a year to prepandemic baselines in the United States and NUHICs, while procedure volumes remain depressed in lower-income countries.Keywords: SPECT, Cardiac, Epidemiology, Angiography, CT Angiography, CT, Echocardiography, SPECT/CT, MR Imaging, Radionuclide Studies, COVID-19, Cardiovascular Imaging, Diagnostic Cardiovascular Procedure, Cardiovascular Disease, Cardiac Testing Supplemental material is available for this article. © RSNA, 2023.
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Affiliation(s)
- Cole B. Hirschfeld
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Sharmila Dorbala
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Leslee J. Shaw
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Todd C. Villines
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Andrew D. Choi
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Nathan Better
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Rodrigo J. Cerci
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Ganesan Karthikeyan
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - João V. Vitola
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Michelle C. Williams
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Mouaz Al-Mallah
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Daniel S. Berman
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Adam Bernheim
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Robert W. Biederman
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Paco E. Bravo
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Matthew J. Budoff
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Renee P. Bullock-Palmer
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Marcus Y. Chen
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Michael P. DiLorenzo
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Rami Doukky
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Maros Ferencik
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Jeffrey B. Geske
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Fadi G. Hage
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Robert C. Hendel
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Lynne Koweek
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Venkatesh L. Murthy
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Jagat Narula
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Patricia F. Rodriguez Lozano
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Nishant R. Shah
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Amee Shah
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Prem Soman
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Randall C. Thompson
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - David Wolinsky
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Yosef A. Cohen
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Eli Malkovskiy
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Michael J. Randazzo
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Juan Lopez-Mattei
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Purvi Parwani
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Mrinali Shetty
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Thomas N. B. Pascual
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Yaroslav Pynda
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Maurizio Dondi
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Diana Paez
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
| | - Andrew J. Einstein
- From the Division of Cardiology, Weill Cornell Medicine and
NewYork-Presbyterian Hospital, New York, NY (C.B.H.); Departments of Medicine
and Radiology, Brigham and Women’s Hospital, Boston, Mass (S.D.);
Blavatnik Family Women’s Health Research Institute, Mount Sinai Medical
Center, New York, NY (L.J.S.); Division of Cardiovascular Medicine, Department
of Medicine, University of Virginia, Charlottesville, Va (T.C.V.); The George
Washington University School of Medicine, Washington, DC (A.D.C.); Cabrini
Health, Royal Melbourne Hospital and University of Melbourne, Melbourne,
Australia (N.B.); Quanta Diagnostico por Imagem, Curitiba, Brazil (R.J.C.,
J.V.V.); Department of Cardiology, All India Institute of Medical Sciences, New
Delhi, India (G.K.); BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, Scotland (M.C.W.); Houston Methodist DeBakey Heart and
Vascular Center, Houston, Tex (M.A.M.); Departments of Imaging, Medicine, and
Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (D.S.B.);
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School
of Medicine at Mount Sinai, New York, NY (A.B.); Division of Cardiology, Centre
for Cardiac MRI, Allegheny Health Network, Allegheny General Hospital,
Pittsburgh, Pa (R.W.B.); Division of Cardiovascular Medicine, Department of
Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pa (P.E.B.); Lundquist Institute at Harbor-UCLA, Torrance, Calif (M.J.B.);
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ
(R.P.B.P.); National Heart, Lung, and Blood Institute, National Institutes of
Health, Bethesda, Md (M.Y.C.); Division of Cardiology, Department of Pediatrics,
Columbia University Vagelos College of Physicians and Surgeons and
NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY
(M.P.D., A.S.); Division of Cardiology, Cook County Health, Chicago, Ill (R.D.);
Knight Cardiovascular Institute, Oregon Health & Science University,
Portland, Ore (M.F.); Department of Cardiovascular Diseases, Mayo Clinic,
Rochester, Minn (J.B.G.); University of Alabama at Birmingham and Birmingham
Veterans Affairs Medical Center, Birmingham, Ala (F.G.H.); Section of
Cardiology, Deming Department of Medicine, Tulane University School of Medicine,
New Orleans, La (R.C.H.); Duke University Medical Center, Durham, NC (L.K.);
Division of Cardiovascular Medicine, Department of Internal Medicine, University
of Michigan, Ann Arbor, Mich (V.L.M.); Division of Cardiology, Mount Sinai
Heart, Icahn School of Medicine at Mount Sinai, New York, NY (J.N.); Department
of Medicine, Cardiovascular Division, University of Virginia Health System,
Charlottesville, Va (P.F.R.L.); Division of Cardiology, Department of Medicine,
Brown University Alpert Medical School, Providence, RI (N.R.S.); Division of
Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa (P.S.); St
Luke’s Mid America Heart Institute, Kansas City, Mo (R.C.T.); Cleveland
Clinic Florida, Weston, Fla (D.W.); Technion Israel Institute of Technology,
Haifa, Israel (Y.A.C., A.J.E.); Seymour, Paul, and Gloria Milstein Division of
Cardiology, Columbia University Irving Medical Center and New York-Presbyterian
Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (E.M., A.J.E.);
Department of Medicine, Columbia University Irving Medical Center and New
York-Presbyterian Hospital, New York, NY (M.J.R.); Lee Health Heart &
Vascular Institute, Fort Myers, Fla (J.L.M.); Department of Cardiology, Loma
Linda University Health, Loma Linda, Calif (P.P.); University of Chicago
(NorthShore), NorthShore University Health System, Evanston, Ill (M.S.);
Department of Science and Technology, Philippine Nuclear Research Institute,
Quezon City, Philippines (T.N.B.P.); International Atomic Energy Agency, Vienna,
Austria (Y.P., M.D., D.P.); and Department of Radiology, Columbia University
Irving Medical Center and New York-Presbyterian Hospital, New York, NY
(A.J.E.)
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Gulsin GS, Tzimas G, Holmes KR, Takagi H, Sellers SL, Blanke P, Koweek LMH, Nørgaard BL, Jensen J, Rabbat MG, Pontone G, Fairbairn TA, Chinnaiyan KM, Douglas PS, Huey W, Matsuo H, Sand NPR, Nieman K, Bax JJ, Amano T, Kawasaki T, Akasaka T, Rogers C, Berman DS, Patel MR, De Bruyne B, Mullen S, Leipsic JA. Impact of Coronary CT Angiography-derived Fractional Flow Reserve on Downstream Management and Clinical Outcomes in Individuals with and without Diabetes. Radiol Cardiothorac Imaging 2023; 5:e220276. [PMID: 37908552 PMCID: PMC10613926 DOI: 10.1148/ryct.220276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 06/21/2023] [Accepted: 09/01/2023] [Indexed: 11/02/2023]
Abstract
Purpose To compare the clinical use of coronary CT angiography (CCTA)-derived fractional flow reserve (FFR) in individuals with and without diabetes mellitus (DM). Materials and Methods This secondary analysis included participants (enrolled July 2015 to October 2017) from the prospective, multicenter, international The Assessing Diagnostic Value of Noninvasive CT-FFR in Coronary Care (ADVANCE) registry (ClinicalTrials.gov identifier, NCT02499679) who were evaluated for suspected coronary artery disease (CAD), with one or more coronary stenosis ≥30% on CCTA images, using CT-FFR. CCTA and CT-FFR findings, treatment strategies at 90 days, and clinical outcomes at 1-year follow-up were compared in participants with and without DM. Results The study included 4290 participants (mean age, 66 years ± 10 [SD]; 66% male participants; 22% participants with DM). Participants with DM had more obstructive CAD (one or more coronary stenosis ≥50%; 78.8% vs 70.6%, P < .001), multivessel CAD (three-vessel obstructive CAD; 18.9% vs 11.2%, P < .001), and proportionally more vessels with CT-FFR ≤ 0.8 (74.3% vs 64.6%, P < .001). Treatment reclassification by CT-FFR occurred in two-thirds of participants which was consistent regardless of the presence of DM. There was a similar graded increase in coronary revascularization with declining CT-FFR in both groups. At 1 year, presence of DM was associated with higher rates of major adverse cardiovascular events (hazard ratio, 2.2; 95% CI: 1.2, 4.1; P = .01). However, no between group differences were observed when stratified by stenosis severity (<50% or ≥50%) or CT-FFR positivity. Conclusion Both anatomic CCTA findings and CT-FFR demonstrated a more complex pattern of CAD in participants with versus without DM. Rates of treatment reclassification were similar regardless of the presence of DM, and DM was not an adverse prognostic indicator when adjusted for diameter stenosis and CT-FFR.Clinical trial registration no. NCT 02499679Keywords: Fractional Flow Reserve, CT Angiography, Diabetes Mellitus, Coronary Artery Disease Supplemental material is available for this article. See also the commentary by Ghoshhajra in this issue.© RSNA, 2023.
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Affiliation(s)
- Gaurav S. Gulsin
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Georgios Tzimas
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Kenneth-Royce Holmes
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Hidenobu Takagi
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Stephanie L. Sellers
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Philipp Blanke
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Lynne M. H. Koweek
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Bjarne L. Nørgaard
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Jesper Jensen
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Mark G. Rabbat
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Gianluca Pontone
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Timothy A. Fairbairn
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Kavitha M. Chinnaiyan
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Pamela S. Douglas
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Whitney Huey
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Hitoshi Matsuo
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Niels P. R. Sand
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Koen Nieman
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Jeroen J. Bax
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Tetsuya Amano
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Tomohiro Kawasaki
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Takashi Akasaka
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Campbell Rogers
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Daniel S. Berman
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Manesh R. Patel
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Bernard De Bruyne
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Sarah Mullen
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
| | - Jonathon A. Leipsic
- From the Department of Medicine and Radiology, University of British
Columbia, 1081 Burrard St, Vancouver, BC, Canada V6T 1Z3 (G.S.G., G.T., K.R.H.,
H.T., S.L.S., P.B., J.A.L.); Department of Cardiovascular Sciences, University
of Leicester and the NIHR Biomedical Research Centre, Glenfield Hospital,
Leicester, UK (G.S.G.); Department of Heart Vessels, Cardiology Service,
Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
(G.T.); Centre for Heart Lung Innovation, University of British Columbia and St
Paul’s Hospital, Vancouver, BC, Canada (S.L.S., J.A.L.); Division of
Cardiology, Department of Medicine, Duke University Medical Center, Duke
Clinical Research Institute, Duke University School of Medicine, Durham, NC
(L.M.H.K., M.R.P.); Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark (B.L.N., J.J.); Department of Cardiology, Loyola University of
Chicago, Chicago, Ill; (M.G.R.); Department of Cardiology, Edward Hines Jr VA
Hospital, Hines, Ill (M.G.R.); Department of Cardiology, Centro Cardiologico
Monzino, Milan, Italy (G.P.); Department of Cardiology, University of Liverpool,
Liverpool Heart and Chest Hospital, Liverpool, UK (T.A.F.); Department of
Cardiology, Beaumont Health, Royal Oak, Mich (K.M.C.); Duke Clinical Research
Institute, Duke University School of Medicine, Durham, NC (P.S.D.); Department
of Cardiology, Gifu Heart Center, Gifu, Japan (H.M.); Cardiac Research Unit,
Institute of Regional Health Research, University Hospital of SouthWest DK,
University of Southern Denmark, Odense, Denmark (N.P.R.S.); Department of
Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
(K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the
Netherlands (J.J.B.); Department of Cardiology, Aichi Medical University, Aichi,
Japan (T. Amano); Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(T.K.); Department of Cardiovascular Medicine, Wakayama Medical University,
Wakayama, Japan (T. Akasaka); HeartFlow Inc, Redwood City, Calif (W.H., C.R.,
S.M.); Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart
Institute, Los Angeles, Calif (D.S.B.); and Cardiovascular Center Aalst,
OLV-Clinic, Aalst, Belgium (B.D.B.)
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20
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Cole TS, Rudy RF, Faridmoayer E, Gandhi S, Cavallo C, Catapano JS, Jadhav AP, Lawton MT, Albuquerque FC, Ducruet AF. Relationship between cerebral vasospasm vascular territory and functional outcome after aneurysmal subarachnoid hemorrhage. J Neurointerv Surg 2023; 15:958-963. [PMID: 36379702 DOI: 10.1136/jnis-2022-019016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 10/17/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Vasospasm following aneurysmal subarachnoid hemorrhage (SAH) contributes significant morbidity and mortality after brain aneurysm rupture. However, the association between vascular territory of vasospasm and clinical outcome has not been studied. We present a hypothesis-generating study to determine whether the location of vasospasm within the intracranial circulation is associated with functional outcome after SAH. METHODS A retrospective analysis of a prospective, intention-to-treat trial for aneurysmal SAH was performed to supplement trial outcomes with in-hospital angiographic imaging and treatment variables regarding vasospasm. The location of vasospasm and the position on the vessel (distal vs proximal) were evaluated. Modified Rankin scale (mRS) outcomes were assessed at discharge and 6 months, and predictive models were constructed. RESULTS A total of 406 patients were included, 341 with follow-up data at 6 months. At discharge, left-sided vasospasm was associated with poor outcome (odds ratio (OR), 2.37; 95% CI, 1.25 to 4.66; P=0.01). At 6 months, anterior cerebral artery (ACA) vasospasm (OR, 3.87; 95% CI, 1.29 to 11.88; P=0.02) and basilar artery (BA) vasospasm (OR, 6.22; 95% CI, 1.54 to 27.11; P=0.01) were associated with poor outcome after adjustment. A model predicting 6-month mRS score and incorporating vasospasm variables achieved an area under the curve of 0.85 and a net improvement in reclassification of 13.2% (P<0.01) compared with a previously validated predictive model for aneurysmal SAH. CONCLUSIONS In aneurysmal SAH, left-sided vasospasm is associated with worse discharge functional status. At 6 months, both ACA and BA vasospasm are associated with unfavorable functional status.
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Affiliation(s)
- Tyler S Cole
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Robert F Rudy
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Erfan Faridmoayer
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Sirin Gandhi
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Claudio Cavallo
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Joshua S Catapano
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Ashutosh P Jadhav
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Michael T Lawton
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Felipe C Albuquerque
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Andrew F Ducruet
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
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21
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Ding H, Zhao P, Lv H, Li X, Qiu X, Dai C, Xu N, Wang G, Yang Z, Gong S, Jin L, Wang Z. A new method for assessing transverse sinus stenosis with CT venography based on the venous trans-stenotic pressure gradient. J Neurointerv Surg 2023; 15:1034-1038. [PMID: 36207111 PMCID: PMC10511954 DOI: 10.1136/jnis-2022-019270] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/12/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND Evaluation of the transverse sinus stenosis (TSS) is essential for TSS-related diseases. OBJECTIVE To investigate a new method for the quantitative assessment of TSS based on the correlation between TSS and trans-stenotic pressure gradient (TPG). METHODS Patients with unilateral pulsatile tinnitus with or without idiopathic intracranial hypertension were retrospectively included. All patients underwent CT venography and venous manometry and were confirmed to have TSS. The cross-sectional diameter/area of TSS, the poststenotic and prestenotic segments, and the superior sagittal sinus (SSS) were measured. The degree of TSS was calculated by dividing the diameter/area of TSS by the diameter/area of the poststenotic segment (M1/M2), prestenotic segment (M3/M4), and SSS (M5/M6). Partial correlation analysis (controlling for the effect of age, sex, outflow laterality, and contralateral stenosis) was performed to evaluate the correlation between M1-M6 and the TPG. Receiver operating characteristic curve analysis of M1-M6 for diagnosing a significant TPG (≥8 mm Hg) was performed. RESULTS Ninety-nine patients met the inclusion criteria. The partial correlation coefficients between M1-M6 and the TPG were 0.60, 0.61, 0.43, 0.48, 0.39, and 0.54, respectively. The areas under the curve (AUCs) of M1-M6 for diagnosing a significant TPG were 0.81, 0.86, 0.68, 0.69, 0.64, and 0.72, respectively. The AUC of M2 was significantly larger than that of M3 (P=0.002), M4 (P<0.001), M5 (P=0.001), and M6 (P<0.001). CONCLUSIONS Quantitatively assessing TSS by taking the ratio of the cross-sectional area of TSS to that of the poststenotic segment might be a more efficient method for predicting the TPG.
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Affiliation(s)
- Heyu Ding
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, Beijing, China
| | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, Beijing, China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, Beijing, China
| | - Xiaoshuai Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, Beijing, China
| | - Xiaoyu Qiu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, Beijing, China
| | - Chihang Dai
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, Beijing, China
| | - Ning Xu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, Beijing, China
| | - Guopeng Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, Beijing, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, Beijing, China
| | - Shusheng Gong
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, Beijing, China
| | - Long Jin
- Department of Intervention, Beijing Friendship Hospital, Capital Medical University, Beijing, Beijing 100050, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, Beijing, China
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22
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Hang Y, Wang CD, Ni H, Cao Y, Zhao LB, Liu S, Shi HB, Jia Z. Alberta Stroke Program Early CT Score and collateral status predict target mismatch in large vessel occlusion with delayed time windows. J Neurointerv Surg 2023; 15:876-880. [PMID: 35790373 DOI: 10.1136/neurintsurg-2022-018960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/12/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND The Alberta Stroke Program Early CT Score (ASPECTS) and collateral score (CS) are two readily available imaging metrics for the evaluation of acute ischemic stroke (AIS) with large vessel occlusion (LVO). OBJECTIVE To investigate the predictive value of the ASPECTS combined with CS in detecting patients with CT perfusion (CTP) target mismatch in delayed time windows. METHODS One hundred and sixty-four patients with LVO-AIS were included. ASPECTS was assessed on non-contrast CT (NCCT). CS was evaluated on single-phase CT angiography (sCTA). Target mismatch was defined as a CTP core volume ≤70 mL, mismatch ratio ≥1.8, and absolute mismatch volume ≥15 mL. Spearman correlation analysis and receiver operating characteristic curve analyses were performed. RESULTS The median NCCT ASPECTS of the 164 patients was 8 (IQR 6-9), median sCTA-CS was 2 (IQR 1-2), and median CTP core volume was 8 mL (IQR 0-29.5). There was a strong correlation between NCCT ASPECTS and CTP core volume (rs=-0.756, p<0.0001) and a moderate correlation between the sCTA-CS and CTP core volume (rs=-0.450, p<0.0001). Integrating NCCT ASPECTS and sCTA-CS provided a higher area under the curve (AUC) for predicting target mismatch (AUC=0.882; sensitivity, 89.1%; specificity, 77.8%; p<0.001). CONCLUSIONS NCCT ASPECTS had a strong correlation with CTP core volumes in patients with LVO-AIS in delayed time windows. Combining NCCT ASPECTS with sCTA-CS resulted in a more accurate prediction of target mismatch. If a CTP scan is not available, NCCT ASPECTS combined with sCTA-CS may guide clinicians in making treatment decisions.
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Affiliation(s)
- Yu Hang
- Department of Interventional Radiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China
| | - Chen Dong Wang
- Department of Interventional Radiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China
| | - Heng Ni
- Department of Interventional Radiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China
| | - Yuezhou Cao
- Department of Interventional Radiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China
| | - Lin Bo Zhao
- Department of Interventional Radiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China
| | - Sheng Liu
- Department of Interventional Radiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China
| | - Hai-Bin Shi
- Department of Interventional Radiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China
| | - Zhenyu Jia
- Department of Interventional Radiology, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China
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23
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Steiger K, Singh R, Fox WC, Koester S, Brown N, Shahrestani S, Miller DA, Patel NP, Catapano JS, Srinivasan VM, Meschia JF, Erben Y. Procedural, workforce, and reimbursement trends in neuroendovascular procedures. J Neurointerv Surg 2023; 15:909-913. [PMID: 35961665 DOI: 10.1136/jnis-2022-019297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/07/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND This study aims to define the proportion of Medicare neuroendovascular procedures performed by different specialists from 2013 to 2019, map the geographic distribution of these specialists, and trend reimbursement for these procedures. METHODS The Medicare Provider Utilization Database was queried for recognized neuroendovascular procedures. Data on specialists and their geographic distribution were tabulated. Reimbursement data were gathered using the Physician Fee Schedule Look-Up Tool and adjusted for inflation using the United States Bureau of Labor Statistics' Consumer Price Index Inflation calculator. RESULTS The neuroendovascular workforce in 2013 and 2019, respectively, was as follows: radiologists (46% vs 44%), neurosurgeons (45% vs 35%), and neurologists (9% vs 21%). Neurologists increased proportionally (p=0.03). Overall procedure numbers increased across each specialty: radiology (360%; p=0.02), neurosurgery (270%; p<0.01), and neurology (1070%; p=0.03). Neuroendovascular revascularization (CPT 61645) increased in all fields: radiology (170%; p<0.01), neurosurgery (280%; p<0.01), neurology (240%; p<0.01); central nervous system (CNS) permanent occlusion/embolization (CPT61624) in neurosurgery (67%; p=0.03); endovascular temporary balloon artery occlusion (CPT61623) in neurology (29%; p=0.04). In 2019, radiologists were the most common neuroendovascular specialists everywhere except in the Northeast where neurosurgeons predominated. Inflation adjusted reimbursement decreased for endovascular temporary balloon occlusion (CPT61623, -13%; p=0.01), CNS transcatheter permanent occlusion or embolization (CPT61624, -13%; p=0.02), non-CNS transcatheter permanent occlusion or embolization (CPT61626, -12%; p<0.01), and intracranial stent placement (CPT61635, -12%; p=0.05). CONCLUSIONS The number of neuroendovascular procedures and specialists increased, with neurologists becoming more predominant. Reimbursement decreased. Coordination among neuroendovascular specialists in terms of training and practice location may maximize access to acute care.
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Affiliation(s)
- Kyle Steiger
- Division of Vascular and Endovascular Surgery, Mayo Clinic in Florida, Jacksonville, Florida, USA
| | - Rohin Singh
- Neurosurgery, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | | | - Stefan Koester
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Nolan Brown
- Neurosurgery, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | | | - David A Miller
- Radiology, Mayo Clinic in Florida, Jacksonville, Florida, USA
| | - Naresh P Patel
- Neurosurgery, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | | | | | - James F Meschia
- Neurology, Mayo Clinic in Florida, Jacksonville, Florida, USA
| | - Young Erben
- Division of Vascular and Endovascular Surgery, Mayo Clinic in Florida, Jacksonville, Florida, USA
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Baek JH, Kim BM, Kim DJ, Heo JH, Nam HS, Kim YD, Rho MH, Chung PW, Won YS, Chung Y. Preprocedural determination of an occlusion pathomechanism in endovascular treatment of acute stroke: a machine learning-based decision. J Neurointerv Surg 2023; 15:e2-e8. [PMID: 35710314 DOI: 10.1136/neurintsurg-2022-018946] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/17/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To evaluate whether an occlusion pathomechanism can be accurately determined by common preprocedural findings through a machine learning-based prediction model (ML-PM). METHODS A total of 476 patients with acute stroke who underwent endovascular treatment were retrospectively included to derive an ML-PM. For external validation, 152 patients from another tertiary stroke center were additionally included. An ML algorithm was trained to classify an occlusion pathomechanism into embolic or intracranial atherosclerosis. Various common preprocedural findings were entered into the model. Model performance was evaluated based on accuracy and area under the receiver operating characteristic curve (AUC). For practical utility, a decision flowchart was devised from an ML-PM with a few key preprocedural findings. Accuracy of the decision flowchart was validated internally and externally. RESULTS An ML-PM could determine an occlusion pathomechanism with an accuracy of 96.9% (AUC=0.95). In the model, CT angiography-determined occlusion type, atrial fibrillation, hyperdense artery sign, and occlusion location were top-ranked contributors. With these four findings only, an ML-PM had an accuracy of 93.8% (AUC=0.92). With a decision flowchart, an occlusion pathomechanism could be determined with an accuracy of 91.2% for the study cohort and 94.7% for the external validation cohort. The decision flowchart was more accurate than single preprocedural findings for determining an occlusion pathomechanism. CONCLUSIONS An ML-PM could accurately determine an occlusion pathomechanism with common preprocedural findings. A decision flowchart consisting of the four most influential findings was clinically applicable and superior to single common preprocedural findings for determining an occlusion pathomechanism.
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Affiliation(s)
- Jang-Hyun Baek
- Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Neurology, Severance Stroke Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Byung Moon Kim
- Interventional Neuroradiology, Department of Radiology, Severance Stroke Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dong Joon Kim
- Interventional Neuroradiology, Department of Radiology, Severance Stroke Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ji Hoe Heo
- Department of Neurology, Severance Stroke Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyo Suk Nam
- Department of Neurology, Severance Stroke Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Dae Kim
- Department of Neurology, Severance Stroke Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Myung Ho Rho
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Pil-Wook Chung
- Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yu Sam Won
- Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yeongu Chung
- Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Arrarte Terreros N, Bruggeman AA, Kappelhof M, Tolhuisen ML, Brouwer J, Hoving JW, Konduri PR, van Kranendonk KR, Dutra BG, Alves HC, Dippel DW, van Zwam WH, Beenen LF, Yo LS, van Bavel E, Majoie CB, Marquering HA. Thrombus imaging characteristics within acute ischemic stroke: similarities and interdependence. J Neurointerv Surg 2023; 15:e60-e68. [PMID: 35835463 PMCID: PMC10715487 DOI: 10.1136/jnis-2022-019134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/23/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND The effects of thrombus imaging characteristics on procedural and clinical outcomes after ischemic stroke are increasingly being studied. These thrombus characteristics - for eg, size, location, and density - are commonly analyzed as separate entities. However, it is known that some of these thrombus characteristics are strongly related. Multicollinearity can lead to unreliable prediction models. We aimed to determine the distribution, correlation and clustering of thrombus imaging characteristics based on a large dataset of anterior-circulation acute ischemic stroke patients. METHODS We measured thrombus imaging characteristics in the MR CLEAN Registry dataset, which included occlusion location, distance from the intracranial carotid artery to the thrombus (DT), thrombus length, density, perviousness, and clot burden score (CBS). We assessed intercorrelations with Spearman's coefficient (ρ) and grouped thrombi based on 1) occlusion location and 2) thrombus length, density and perviousness using unsupervised clustering. RESULTS We included 934 patients, of which 22% had an internal carotid artery (ICA) occlusion, 61% M1, 16% M2, and 1% another occlusion location. All thrombus characteristics were significantly correlated. Higher CBS was strongly correlated with longer DT (ρ=0.67, p<0.01), and moderately correlated with shorter thrombus length (ρ=-0.41, p<0.01). In more proximal occlusion locations, thrombi were significantly longer, denser, and less pervious. Unsupervised clustering analysis resulted in four thrombus groups; however, the cohesion within and distinction between the groups were weak. CONCLUSIONS Thrombus imaging characteristics are significantly intercorrelated - strong correlations should be considered in future predictive modeling studies. Clustering analysis showed there are no distinct thrombus archetypes - novel treatments should consider this thrombus variability.
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Affiliation(s)
- Nerea Arrarte Terreros
- Department of Biomedical Engineering and Physics, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Agnetha Ae Bruggeman
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Manon Kappelhof
- Department of Biomedical Engineering and Physics, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Manon L Tolhuisen
- Department of Biomedical Engineering and Physics, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Josje Brouwer
- Department of Neurology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Jan W Hoving
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Praneeta R Konduri
- Department of Biomedical Engineering and Physics, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Katinka R van Kranendonk
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Bruna G Dutra
- Department of Biomedical Engineering and Physics, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Heitor Cbr Alves
- Department of Biomedical Engineering and Physics, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | | | - Wim H van Zwam
- Department of Radiology and Nuclear Medicine, Maastricht UMC, Maastricht, The Netherlands
| | - Ludo Fm Beenen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Lonneke Sf Yo
- Department of Radiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
| | - Ed van Bavel
- Department of Biomedical Engineering and Physics, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Charles Blm Majoie
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Henk A Marquering
- Department of Biomedical Engineering and Physics, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
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26
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Barkovich EJ, Batheja V, Hong T, Rao J, Javan R. Pearls and pitfalls in emergency CT neuroangiography through the lens of bias and error. Emerg Radiol 2023; 30:525-537. [PMID: 37291368 DOI: 10.1007/s10140-023-02143-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 05/16/2023] [Indexed: 06/10/2023]
Abstract
Computed tomography angiography (CTA) of the head and neck is central in emergency department (ED) evaluation of clinically suspected acute stroke and intracranial hemorrhage. Timely and accurate detection of acute findings is crucial for best clinical outcomes; missed or delayed diagnosis can be devastating. Our pictorial essay presents twelve CTA cases that provided significant diagnostic dilemmas to on-call trainees while reviewing current bias and error classifications in radiology. Among others, we discuss anchoring, automation, framing, satisfaction of search, scout neglect and zebra-retreat bias. Each imaging vignette depicts a potential diagnostic "pitfall" while introducing types of cognitive bias/error before concluding with a concrete "pearl" for CTA interpretation. We believe that familiarity with bias and error is particularly important in the ED setting where high case volume, high acuity and radiologist fatigue intersect. Particular attention to personal cognitive biases and these potential CTA pitfalls may help emergency radiologists transition from habit-driven pattern recognition to analytical thinking, ultimately improving diagnostic decision making.
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Affiliation(s)
- Emil Jernstedt Barkovich
- Dept of Radiology, George Washington University Hospital, 900 23rd St NW First Floor, Washington, DC, 20037, USA.
| | - Vivek Batheja
- George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC, 20052, USA
| | - Thomas Hong
- George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC, 20052, USA
| | - Jhanavi Rao
- Dept of Radiology, George Washington University Hospital, 900 23rd St NW First Floor, Washington, DC, 20037, USA
| | - Ramin Javan
- Dept of Radiology, George Washington University Hospital, 900 23rd St NW First Floor, Washington, DC, 20037, USA
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27
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Takafuji M, Kitagawa K, Mizutani S, Hamaguchi A, Kisou R, Iio K, Ichikawa K, Izumi D, Sakuma H. Super-Resolution Deep Learning Reconstruction for Improved Image Quality of Coronary CT Angiography. Radiol Cardiothorac Imaging 2023; 5:e230085. [PMID: 37693207 PMCID: PMC10485715 DOI: 10.1148/ryct.230085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/29/2023] [Accepted: 06/20/2023] [Indexed: 09/12/2023]
Abstract
Purpose To investigate image noise and edge sharpness of coronary CT angiography (CCTA) with super-resolution deep learning reconstruction (SR-DLR) compared with conventional DLR (C-DLR) and to evaluate agreement in stenosis grading using CCTA with that from invasive coronary angiography (ICA) as the reference standard. Materials and Methods This retrospective study included 58 patients (mean age, 69.0 years ± 12.8 [SD]; 38 men, 20 women) who underwent CCTA using 320-row CT between April and September 2022. All images were reconstructed with two different algorithms: SR-DLR and C-DLR. Image noise, signal-to-noise ratio, edge sharpness, full width at half maximum (FWHM) of stent, and agreement in stenosis grading with that from ICA were compared. Stenosis was visually graded from 0 to 5, with 5 indicating occlusion. Results SR-DLR significantly decreased image noise by 31% compared with C-DLR (12.6 HU ± 2.3 vs 18.2 HU ± 1.9; P < .001). Signal-to-noise ratio and edge sharpness were significantly improved by SR-DLR compared with C-DLR (signal-to-noise ratio, 38.7 ± 8.3 vs 26.2 ± 4.6; P < .001; edge sharpness, 560 HU/mm ± 191 vs 463 HU/mm ± 164; P < .001). The FWHM of stent was significantly thinner on SR-DLR (0.72 mm ± 0.22) than on C-DLR (1.01 mm ± 0.21; P < .001). Agreement in stenosis grading between CCTA and ICA was improved on SR-DLR compared with C-DLR (weighted κ = 0.83 vs 0.77). Conclusion SR-DLR improved vessel sharpness, image noise, and accuracy of coronary stenosis grading compared with the C-DLR technique.Keywords: CT Angiography, Cardiac, Coronary Arteries Supplemental material is available for this article. © RSNA, 2023.
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Affiliation(s)
- Masafumi Takafuji
- From the Department of Radiology, Mie University Graduate School of
Medicine, 2-174 Edobashi, Tsu 514-8507, Japan (M.T., K.K., H.S.); and
Departments of Radiology (M.T., S.M., A.H., R.K.) and Cardiology (K. Iio, K.
Ichikawa, D.I.), Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Kakuya Kitagawa
- From the Department of Radiology, Mie University Graduate School of
Medicine, 2-174 Edobashi, Tsu 514-8507, Japan (M.T., K.K., H.S.); and
Departments of Radiology (M.T., S.M., A.H., R.K.) and Cardiology (K. Iio, K.
Ichikawa, D.I.), Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Sachio Mizutani
- From the Department of Radiology, Mie University Graduate School of
Medicine, 2-174 Edobashi, Tsu 514-8507, Japan (M.T., K.K., H.S.); and
Departments of Radiology (M.T., S.M., A.H., R.K.) and Cardiology (K. Iio, K.
Ichikawa, D.I.), Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Akane Hamaguchi
- From the Department of Radiology, Mie University Graduate School of
Medicine, 2-174 Edobashi, Tsu 514-8507, Japan (M.T., K.K., H.S.); and
Departments of Radiology (M.T., S.M., A.H., R.K.) and Cardiology (K. Iio, K.
Ichikawa, D.I.), Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Ryosuke Kisou
- From the Department of Radiology, Mie University Graduate School of
Medicine, 2-174 Edobashi, Tsu 514-8507, Japan (M.T., K.K., H.S.); and
Departments of Radiology (M.T., S.M., A.H., R.K.) and Cardiology (K. Iio, K.
Ichikawa, D.I.), Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Kotaro Iio
- From the Department of Radiology, Mie University Graduate School of
Medicine, 2-174 Edobashi, Tsu 514-8507, Japan (M.T., K.K., H.S.); and
Departments of Radiology (M.T., S.M., A.H., R.K.) and Cardiology (K. Iio, K.
Ichikawa, D.I.), Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Kazuhide Ichikawa
- From the Department of Radiology, Mie University Graduate School of
Medicine, 2-174 Edobashi, Tsu 514-8507, Japan (M.T., K.K., H.S.); and
Departments of Radiology (M.T., S.M., A.H., R.K.) and Cardiology (K. Iio, K.
Ichikawa, D.I.), Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Daisuke Izumi
- From the Department of Radiology, Mie University Graduate School of
Medicine, 2-174 Edobashi, Tsu 514-8507, Japan (M.T., K.K., H.S.); and
Departments of Radiology (M.T., S.M., A.H., R.K.) and Cardiology (K. Iio, K.
Ichikawa, D.I.), Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Hajime Sakuma
- From the Department of Radiology, Mie University Graduate School of
Medicine, 2-174 Edobashi, Tsu 514-8507, Japan (M.T., K.K., H.S.); and
Departments of Radiology (M.T., S.M., A.H., R.K.) and Cardiology (K. Iio, K.
Ichikawa, D.I.), Matsusaka Municipal Hospital, Matsusaka, Japan
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Tomizawa N, Fujimoto S, Mita T, Takahashi D, Nozaki Y, Fan R, Kudo A, Kawaguchi Y, Takamura K, Hiki M, Kurita M, Kumamaru KK, Watada H, Minamino T, Aoki S. Coronary Artery Vorticity to Predict Functional Plaque Progression in Participants with Type 2 Diabetes Mellitus. Radiol Cardiothorac Imaging 2023; 5:e230016. [PMID: 37693191 PMCID: PMC10483244 DOI: 10.1148/ryct.230016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 07/07/2023] [Accepted: 07/20/2023] [Indexed: 09/12/2023]
Abstract
Purpose To investigate whether vorticity could predict functional plaque progression better than high-risk plaque (HRP) and lesion length (LL) in individuals with type 2 diabetes mellitus. Materials and Methods This single-center prospective study included 61 participants (mean age, 61 years ± 9 [SD]; 43 male participants) who underwent serial coronary CT angiography at 2 years, with 20%-70% stenosis at initial CT between October 2015 and March 2020. The number of the following HRP characteristics was recorded: low attenuation, positive remodeling, spotty calcification, and napkin-ring sign. Vorticity was calculated using a mesh-free simulation. A decrease in CT fractional flow reserve larger than 0.05 indicated functional progression. Models using HRP and LL and vorticity were compared using receiver operating characteristic curve analysis. Results Of the 94 vessels evaluated, 25 vessels (27%) showed functional progression. Vessels with functional progression showed higher vorticity at distal stenosis (984 sec-1; IQR: 730-1253 vs 443 sec-1; IQR: 295-602; P < .001) than vessels without progression. The area under the receiver operating characteristic curve of vorticity (0.91; 95% CI: 0.84, 0.97) was higher than that of HRP and LL (0.69; 95% CI: 0.56, 0.82; P < .01). Diagnostic accuracy of vorticity (85%; 80 of 94 vessels; 95% CI: 76, 92) was higher than that of HRP and LL (72%; 68 of 94 vessels; 95% CI: 62, 81; P = .004). Conclusion In participants with type 2 diabetes mellitus, vorticity at distal stenosis was a better predictor of functional plaque progression than HRP and LL.Keywords: Coronary Artery, Vorticity, Functional Plaque Progression, Type 2 Diabetes, Vasculature, CT Angiography, Computational Fluid Dynamics, Fractional Flow Reserve Supplemental material is available for this article. © RSNA, 2023.
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Affiliation(s)
- Nobuo Tomizawa
- From the Department of Radiology (N.T., R.F., K.K.K., S.A.),
Department of Cardiovascular Biology and Medicine (S.F., D.T., Y.N., A.K., Y.K.,
K.T., M.H., T. Minamino), and Department of Diabetes, Endocrinology, and
Metabolism (T. Mita, M.K., H.W.), Juntendo University Graduate School of
Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Shinichiro Fujimoto
- From the Department of Radiology (N.T., R.F., K.K.K., S.A.),
Department of Cardiovascular Biology and Medicine (S.F., D.T., Y.N., A.K., Y.K.,
K.T., M.H., T. Minamino), and Department of Diabetes, Endocrinology, and
Metabolism (T. Mita, M.K., H.W.), Juntendo University Graduate School of
Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Tomoya Mita
- From the Department of Radiology (N.T., R.F., K.K.K., S.A.),
Department of Cardiovascular Biology and Medicine (S.F., D.T., Y.N., A.K., Y.K.,
K.T., M.H., T. Minamino), and Department of Diabetes, Endocrinology, and
Metabolism (T. Mita, M.K., H.W.), Juntendo University Graduate School of
Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Daigo Takahashi
- From the Department of Radiology (N.T., R.F., K.K.K., S.A.),
Department of Cardiovascular Biology and Medicine (S.F., D.T., Y.N., A.K., Y.K.,
K.T., M.H., T. Minamino), and Department of Diabetes, Endocrinology, and
Metabolism (T. Mita, M.K., H.W.), Juntendo University Graduate School of
Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Yui Nozaki
- From the Department of Radiology (N.T., R.F., K.K.K., S.A.),
Department of Cardiovascular Biology and Medicine (S.F., D.T., Y.N., A.K., Y.K.,
K.T., M.H., T. Minamino), and Department of Diabetes, Endocrinology, and
Metabolism (T. Mita, M.K., H.W.), Juntendo University Graduate School of
Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Ruiheng Fan
- From the Department of Radiology (N.T., R.F., K.K.K., S.A.),
Department of Cardiovascular Biology and Medicine (S.F., D.T., Y.N., A.K., Y.K.,
K.T., M.H., T. Minamino), and Department of Diabetes, Endocrinology, and
Metabolism (T. Mita, M.K., H.W.), Juntendo University Graduate School of
Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Ayako Kudo
- From the Department of Radiology (N.T., R.F., K.K.K., S.A.),
Department of Cardiovascular Biology and Medicine (S.F., D.T., Y.N., A.K., Y.K.,
K.T., M.H., T. Minamino), and Department of Diabetes, Endocrinology, and
Metabolism (T. Mita, M.K., H.W.), Juntendo University Graduate School of
Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Yuko Kawaguchi
- From the Department of Radiology (N.T., R.F., K.K.K., S.A.),
Department of Cardiovascular Biology and Medicine (S.F., D.T., Y.N., A.K., Y.K.,
K.T., M.H., T. Minamino), and Department of Diabetes, Endocrinology, and
Metabolism (T. Mita, M.K., H.W.), Juntendo University Graduate School of
Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Kazuhisa Takamura
- From the Department of Radiology (N.T., R.F., K.K.K., S.A.),
Department of Cardiovascular Biology and Medicine (S.F., D.T., Y.N., A.K., Y.K.,
K.T., M.H., T. Minamino), and Department of Diabetes, Endocrinology, and
Metabolism (T. Mita, M.K., H.W.), Juntendo University Graduate School of
Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Makoto Hiki
- From the Department of Radiology (N.T., R.F., K.K.K., S.A.),
Department of Cardiovascular Biology and Medicine (S.F., D.T., Y.N., A.K., Y.K.,
K.T., M.H., T. Minamino), and Department of Diabetes, Endocrinology, and
Metabolism (T. Mita, M.K., H.W.), Juntendo University Graduate School of
Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Mika Kurita
- From the Department of Radiology (N.T., R.F., K.K.K., S.A.),
Department of Cardiovascular Biology and Medicine (S.F., D.T., Y.N., A.K., Y.K.,
K.T., M.H., T. Minamino), and Department of Diabetes, Endocrinology, and
Metabolism (T. Mita, M.K., H.W.), Juntendo University Graduate School of
Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Kanako K. Kumamaru
- From the Department of Radiology (N.T., R.F., K.K.K., S.A.),
Department of Cardiovascular Biology and Medicine (S.F., D.T., Y.N., A.K., Y.K.,
K.T., M.H., T. Minamino), and Department of Diabetes, Endocrinology, and
Metabolism (T. Mita, M.K., H.W.), Juntendo University Graduate School of
Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Hirotaka Watada
- From the Department of Radiology (N.T., R.F., K.K.K., S.A.),
Department of Cardiovascular Biology and Medicine (S.F., D.T., Y.N., A.K., Y.K.,
K.T., M.H., T. Minamino), and Department of Diabetes, Endocrinology, and
Metabolism (T. Mita, M.K., H.W.), Juntendo University Graduate School of
Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Tohru Minamino
- From the Department of Radiology (N.T., R.F., K.K.K., S.A.),
Department of Cardiovascular Biology and Medicine (S.F., D.T., Y.N., A.K., Y.K.,
K.T., M.H., T. Minamino), and Department of Diabetes, Endocrinology, and
Metabolism (T. Mita, M.K., H.W.), Juntendo University Graduate School of
Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Shigeki Aoki
- From the Department of Radiology (N.T., R.F., K.K.K., S.A.),
Department of Cardiovascular Biology and Medicine (S.F., D.T., Y.N., A.K., Y.K.,
K.T., M.H., T. Minamino), and Department of Diabetes, Endocrinology, and
Metabolism (T. Mita, M.K., H.W.), Juntendo University Graduate School of
Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
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29
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Sadeh-Gonik U, Budylev A, Krivitzky D, Molad J, Halevi H, Jonas-Kimchi T, Yashar H, Ben Assayag E, Seyman E. Circle of Willis integrity in acute middle cerebral artery occlusion: does the posterior communicating artery matter? J Neurointerv Surg 2023:jnis-2023-020326. [PMID: 37527929 DOI: 10.1136/jnis-2023-020326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/30/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Collateral circulation is an important determinant of outcome in people with acute ischemic stroke due to large vessel occlusion (LVO). OBJECTIVE To explore the impact of the circle of Willis (CW) anatomical characteristics ipsilateral to the occlusion site, particularly the posterior communicating artery (PComA) and the A1-portion of the anterior cerebral artery (A1-ACA), on stroke outcomes in a cohort of patients with LVO and middle cerebral artery (MCA) occlusion, undergoing endovascular thrombectomy (EVT). METHODS This is a retrospective cohort study performed in a comprehensive tertiary stroke center. The study population consisted of consecutive patients with LVO with proximal MCA occlusion (M1) between June 2016 and April 2021, undergoing EVT. Demographic, clinical, and imaging information was extracted from patient files. Patency and diameters of ipsilateral A1-ACA and PComA were manually measured on admission CT angiography images in the core laboratory. RESULTS One hundred and five patients with LVO comprised the study cohort, mean age 72.3 years, 43.8% were male, mean National Institutes of Health Stroke Scale score at admission 15.2. The cohort was grouped according to CW vessel characteristics. On univariate analysis, a well-developed PComA was associated with lower rates of hemorrhagic transformation (1.8% vs 14.3%, P=0.01) and a trend towards lower mortality rates (8.9% vs 20.4%, P=0.08).On multivariable regression analysis a well-developed PComA emerged as an independent predictor for survival (aOR=0.09, 95% CI 0.01 to 0.4 for survival at discharge, P=0.009, aOR=0.22, 95% CI 0.05 to 0.8 for survival at 90 days, P=0.02). CONCLUSIONS In a cohort of patients with LVO due to M1 occlusion undergoing EVT, a well-developed PComA was associated with significantly lower hemorrhagic transformation rates, a trend towards better functional outcomes, and independently predicted survival. Larger studies are needed to understand the differential effect of CW collateral conduits on stroke outcome and evaluate the practicality of incorporating such factors in the clinical decision-making process prior to EVT.
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Affiliation(s)
- Udi Sadeh-Gonik
- Department of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Anatoly Budylev
- Department of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - David Krivitzky
- Department of Stroke and Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Jeremy Molad
- Department of Stroke and Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Hen Halevi
- Department of Stroke and Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sagol School of Neuroscience Tel Aviv University, Tel-Aviv, Israel
- The Faculty of Medicine,Tel Aviv University, Tel-Aviv, Israel
| | - Tali Jonas-Kimchi
- Department of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Hila Yashar
- Department of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Einor Ben Assayag
- Department of Stroke and Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sagol School of Neuroscience Tel Aviv University, Tel-Aviv, Israel
- The Faculty of Medicine,Tel Aviv University, Tel-Aviv, Israel
| | - Estelle Seyman
- Department of Stroke and Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- The Faculty of Medicine,Tel Aviv University, Tel-Aviv, Israel
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Carvalho JG, Gho JMIH, Budde RPJ, Hofland J, Hirsch A. Multimodality Imaging of Cardiac Paragangliomas. Radiol Cardiothorac Imaging 2023; 5:e230049. [PMID: 37693206 PMCID: PMC10483254 DOI: 10.1148/ryct.230049] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 07/01/2023] [Accepted: 07/07/2023] [Indexed: 09/12/2023]
Abstract
Paragangliomas are rare neuroendocrine tumors of extra-adrenal autonomic paraganglia origin. Paragangliomas rarely involve the heart, and they account for less than 1% of primary cardiac tumors. Most cardiac paragangliomas are incidentally detected at echocardiography or CT or during the workup of symptomatic patients with high catecholamine levels. Paragangliomas are typically located around the great vessels, coronary arteries (atrioventricular groove), or the atria, which can be explained by the tumor origin from the paraganglia and the distribution of the cardiac plexus. At MRI, cardiac paragangliomas typically have low to intermediate signal on T1-weighted images and high signal on T2-weighted images. The tumors are strongly vascularized, with high uptake on first-pass perfusion images and a heterogeneous pattern on late gadolinium enhancement images. Functional imaging is indicated for diagnostic confirmation and to screen for additional tumor locations or metastatic disease. Surgical excision is the only curative treatment. Cardiac CT angiography or invasive angiography should be performed preoperatively to precisely delineate tumor vascularization. In particular, its relation with the coronary arteries should be determined, as paragangliomas can be perfused by the coronary arteries, posing additional surgical challenges and the need for coronary revascularization. This imaging essay reviews the characteristics of paragangliomas and the use of multimodality imaging for diagnosis and treatment. Keywords: CT Angiography, Molecular Imaging, MR Imaging, PET/CT, Cardiac, Heart, Neoplasms-Primary © RSNA, 2023.
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Affiliation(s)
| | - Johannes M. I. H. Gho
- From the Department of Radiology and Nuclear Medicine (J.G.C.,
J.M.I.H.G., R.P.J.B., A.H.) and Department of Cardiology (J.M.I.H.G., R.P.J.B.,
A.H.), Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40,
3015 GD Rotterdam, the Netherlands; and Department of Internal Medicine, Sector
Endocrinology, Erasmus MC Cancer Institute, University Medical Center Rotterdam,
Rotterdam, the Netherlands (J.H.)
| | - Ricardo P. J. Budde
- From the Department of Radiology and Nuclear Medicine (J.G.C.,
J.M.I.H.G., R.P.J.B., A.H.) and Department of Cardiology (J.M.I.H.G., R.P.J.B.,
A.H.), Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40,
3015 GD Rotterdam, the Netherlands; and Department of Internal Medicine, Sector
Endocrinology, Erasmus MC Cancer Institute, University Medical Center Rotterdam,
Rotterdam, the Netherlands (J.H.)
| | - Johannes Hofland
- From the Department of Radiology and Nuclear Medicine (J.G.C.,
J.M.I.H.G., R.P.J.B., A.H.) and Department of Cardiology (J.M.I.H.G., R.P.J.B.,
A.H.), Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40,
3015 GD Rotterdam, the Netherlands; and Department of Internal Medicine, Sector
Endocrinology, Erasmus MC Cancer Institute, University Medical Center Rotterdam,
Rotterdam, the Netherlands (J.H.)
| | - Alexander Hirsch
- From the Department of Radiology and Nuclear Medicine (J.G.C.,
J.M.I.H.G., R.P.J.B., A.H.) and Department of Cardiology (J.M.I.H.G., R.P.J.B.,
A.H.), Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40,
3015 GD Rotterdam, the Netherlands; and Department of Internal Medicine, Sector
Endocrinology, Erasmus MC Cancer Institute, University Medical Center Rotterdam,
Rotterdam, the Netherlands (J.H.)
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31
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Delora A, Hadjialiakbari C, Percenti E, Torres J, Alderazi YJ, Ezzeldin R, Hassan AE, Ezzeldin M. Viz LVO versus Rapid LVO in detection of large vessel occlusion on CT angiography for acute stroke. J Neurointerv Surg 2023:jnis-2023-020445. [PMID: 37355255 DOI: 10.1136/jnis-2023-020445] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 06/10/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND Endovascular thrombectomy improves outcomes and reduces mortality for large vessel occlusion (LVO) and is time-sensitive. Computer automation may aid in the early detection of LVOs, but false values may lead to alarm desensitization. We compared Viz LVO and Rapid LVO for automated LVO detection. METHODS Data were retrospectively extracted from Rapid LVO and Viz LVO running concurrently from January 2022 to January 2023 on CT angiography (CTA) images compared with a radiologist interpretation. We calculated diagnostic accuracy measures and performed a McNemar test to look for a difference between the algorithms' errors. We collected demographic data, comorbidities, ejection fraction (EF), and imaging features and performed a multiple logistic regression to determine if any of these variables predicted the incorrect classification of LVO on CTA. RESULTS 360 participants were included, with 47 large vessel occlusions. Viz LVO and Rapid LVO had a specificity of 0.96 and 0.85, a sensitivity of 0.87 and 0.87, a positive predictive value of 0.75 and 0.46, and a negative predictive value of 0.98 and 0.97, respectively. A McNemar test on correct and incorrect classifications showed a statistically significant difference between the two algorithms' errors (P=0.00000031). A multiple logistic regression showed that low EF (Viz P=0.00125, Rapid P=0.0286) and Modified Woodcock Score >1 (Viz P=0.000198, Rapid P=0.000000975) were significant predictors of incorrect classification. CONCLUSION Rapid LVO produced a significantly larger number of false positive values that may contribute to alarm desensitization, leading to missed alarms or delayed responses. EF and intracranial atherosclerosis were significant predictors of incorrect predictions.
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Affiliation(s)
- Adam Delora
- Emergency Medicine, HCA Houston, Kingwood, Texas, USA
| | | | - Eryn Percenti
- Internal Medicine, HCA Houston, Kingwood, Texas, USA
| | - Jordan Torres
- Internal Medicine, HCA Houston, Kingwood, Texas, USA
| | | | - Rime Ezzeldin
- Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Ameer E Hassan
- Department of Neurology, University of Texas Rio Grande Valley, Harlingen, Texas, USA
| | - Mohamad Ezzeldin
- Department of Clinical Sciences, College of Medicine, University of Houston, Houston, Texas, USA
- Neuroendovascular Surgery, HCA Houston, Houston, Texas, USA
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Lee H, Shim W, Jeong D, Kwon Y, Youn SW. Piecing Arterial Branching Pattern Together from Non-Contrast and Angiographic Brain Computed Tomography before Endovascular Thrombectomy for Acute Ischemic Stroke. J Clin Med 2023; 12:4051. [PMID: 37373744 DOI: 10.3390/jcm12124051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 05/31/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Predicting the unseen arterial course and branching pattern distal to vessel occlusion is crucial for endovascular thrombectomy in acute stroke patients. We investigated whether a comprehensive interpretation of NCT and CTA would enhance arterial course prediction more than either NCT or CTA interpretation alone. Among 150 patients who achieved post-thrombectomy TICI grades ≥ IIb for anterior circulation occlusions, we assessed visualization grade on both NCT and CTA by five scales at the thrombosed and the distal-to-thrombus segment, using DSA as the reference standard. The visualization grades were compared and related to various subgroups. The mean visualization grade of the distal-to-thrombus segment on NCT was significantly larger than that of CTA (mean ± SD, 3.62 ± 0.87 versus 3.31 ± 1.20; p < 0.05). On CTA, visualization grade of distal-to-thrombus segment in the good collateral flow subgroup was higher than that in the poor collateral flow subgroup (mean ± SD, 4.01 ± 0.93 versus 2.56 ± 0.99; p < 0.001). After the comprehensive interpretation of NCT and CTA, seventeen cases (11%) showed visualization grade of distal-to-thrombus segment upgrading. Tracing arterial course and piecing branching patterns together in distal-to-occlusion of stroke patients was feasible on the routine pre-interventional NCT and CTA, which may provide timely guidance during thrombectomy.
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Affiliation(s)
- Horyul Lee
- Department of Radiology, Daegu Catholic University Medical Center, Daegu 42472, Republic of Korea
| | - Woojin Shim
- Department of Radiology, Daegu Catholic University Medical Center, Daegu 42472, Republic of Korea
| | - Dongjun Jeong
- Department of Radiology, Daegu Catholic University Medical Center, Daegu 42472, Republic of Korea
| | - Younghoon Kwon
- Department of Cardiology, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - Sung Won Youn
- Department of Radiology, Daegu Catholic University Medical Center, Daegu 42472, Republic of Korea
- Department of Radiology, Daegu Catholic University Medical School, Daegu 42472, Republic of Korea
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Singh K, Narayanasamy S, Nagpal P, Priya S. Duplicated Internal Jugular and Innominate Vein: Unreported Association. Radiol Cardiothorac Imaging 2023; 5:e220302. [PMID: 37404796 PMCID: PMC10316288 DOI: 10.1148/ryct.220302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/25/2023] [Accepted: 04/14/2023] [Indexed: 07/06/2023]
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Mastrodicasa D, Aquino GJ, Ordovas KG, Vargas D, Fleischmann D, Abbara S, Hanneman K. Radiology: Cardiothoracic Imaging Highlights 2022. Radiol Cardiothorac Imaging 2023; 5:e230042. [PMID: 37404783 PMCID: PMC10316293 DOI: 10.1148/ryct.230042] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/07/2023] [Accepted: 05/08/2023] [Indexed: 07/06/2023]
Abstract
Since its inaugural issue in 2019, Radiology: Cardiothoracic Imaging has disseminated the latest scientific advances and technical developments in cardiac, vascular, and thoracic imaging. In this review, we highlight select articles published in this journal between October 2021 and October 2022. The scope of the review encompasses various aspects of coronary artery and congenital heart diseases, vascular diseases, thoracic imaging, and health services research. Key highlights include changes in the revised Coronary Artery Disease Reporting and Data System 2.0, the value of coronary CT angiography in informing prognosis and guiding treatment decisions, cardiac MRI findings after COVID-19 vaccination or infection, high-risk features at CT angiography to identify patients with aortic dissection at risk for late adverse events, and CT-guided fiducial marker placement for preoperative planning for pulmonary nodules. Ongoing research and future directions include photon-counting CT and artificial intelligence applications in cardiovascular imaging. Keywords: Pediatrics, CT Angiography, CT-Perfusion, CT-Spectral Imaging, MR Angiography, PET/CT, Transcatheter Aortic Valve Implantation/Replacement (TAVI/TAVR), Cardiac, Pulmonary, Vascular, Aorta, Coronary Arteries © RSNA, 2023.
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35
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Kanza RE, Heniche Y, Hubert J, Bérubé M. Segmental Lung Torsion. Radiol Cardiothorac Imaging 2023; 5:e220258. [PMID: 37404793 PMCID: PMC10316302 DOI: 10.1148/ryct.220258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 04/16/2023] [Accepted: 05/01/2023] [Indexed: 07/06/2023]
Abstract
The authors report an unusual case of segmental lung torsion detected at CT pulmonary angiography in a patient with dyspnea. This case highlights the importance for clinicians and radiologists to consider and be familiar with the diagnosis of lung torsion, a rare and potentially life-threatening pathologic condition that can be successfully treated with emergent surgery if detected early. Keywords: CT, CT Angiography, Pulmonary, Thorax, Lung, Emergency Radiology Supplemental material is available for this article. © RSNA, 2023.
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36
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Banerjee S, Pham T, Eastaway A, Auffermann WF, Quigley EP. The Use of Virtual Reality in Teaching Three-Dimensional Anatomy and Pathology on CT. J Digit Imaging 2023; 36:1279-1284. [PMID: 36717519 PMCID: PMC9886418 DOI: 10.1007/s10278-023-00784-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 02/01/2023] Open
Abstract
While radiological imaging is presented as two-dimensional images either on radiography or cross-sectional imaging, it is important for interpreters to understand three-dimensional anatomy and pathology. We hypothesized that virtual reality (VR) may serve as an engaging and effective way for trainees to learn to extrapolate from two-dimensional images to an understanding of these three-dimensional structures. We created a Google Cardboard Virtual Reality application that depicts intracranial vasculature and aneurysms. We then recruited 12 medical students to voluntarily participate in our study. The performance of the students in identifying intracranial aneurysms before and after the virtual reality training was evaluated and compared to a control group. While the experimental group's performance in correctly identifying aneurysms after virtual reality educational intervention was better than the control's (experimental increased by 5.3%, control decreased by 2.1%), the difference was not statistically significant (p-value of 0.06). Significantly, survey data from the medical students was very positive with students noting they preferred the immersive virtual reality training over conventional education and believed that VR would be a helpful educational tool for them in the future. We believe virtual reality can serve as an important tool to help radiology trainees better understand three-dimensional anatomy and pathology.
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Affiliation(s)
- Soham Banerjee
- Department of Radiology, Baylor College of Medicine, One Baylor Plaza BCM360, TX, Houston, USA.
| | - Theresa Pham
- Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | - Adriene Eastaway
- Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | | | - Edward P Quigley
- Department of Radiology, University of Utah, Salt Lake City, UT, USA
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37
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Ramos DDOS, Sarmet dos Santos AR, Vaz A, Ishikawa WY. Giant Congenital Coronary-Cameral Fistula. Radiol Cardiothorac Imaging 2023; 5:e220245. [PMID: 37124649 PMCID: PMC10141319 DOI: 10.1148/ryct.220245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/31/2023] [Accepted: 02/06/2023] [Indexed: 05/02/2023]
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Luo X, Wang J, Liang X, Yan L, Chen X, He J, Luo J, Zhao B, He G, Wang M, Zhu Y. Prediction of cerebral aneurysm rupture using a point cloud neural network. J Neurointerv Surg 2023; 15:380-386. [PMID: 35396332 DOI: 10.1136/neurintsurg-2022-018655] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/27/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Accurate prediction of cerebral aneurysm (CA) rupture is of great significance. We intended to evaluate the accuracy of the point cloud neural network (PC-NN) in predicting CA rupture using MR angiography (MRA) and CT angiography (CTA) data. METHODS 418 CAs in 411 consecutive patients confirmed by CTA (n=180) or MRA (n=238) in a single hospital were retrospectively analyzed. A PC-NN aneurysm model with/without parent artery involvement was used for CA rupture prediction and compared with ridge regression, support vector machine (SVM) and neural network (NN) models based on radiomics features. Furthermore, the performance of the trained PC-NN and radiomics-based models was prospectively evaluated in 258 CAs of 254 patients from five external centers. RESULTS In the internal test data, the area under the curve (AUC) of the PC-NN model trained with parent artery (AUC=0.913) was significantly higher than that of the PC-NN model trained without parent artery (AUC=0.851; p=0.041) and of the ridge regression (AUC=0.803; p=0.019), SVM (AUC=0.788; p=0.013) and NN (AUC=0.805; p=0.023) radiomics-based models. Additionally, the PC-NN model trained with MRA source data achieved a higher prediction accuracy (AUC=0.936) than that trained with CTA source data (AUC=0.824; p=0.043). In external data of prospective cohort patients, the AUC of PC-NN was 0.835, significantly higher than ridge regression (0.692; p<0.001), SVM (0.701; p<0.001) and NN (0.681; p<0.001) models. CONCLUSION PC-NNs can achieve more accurate CA rupture prediction than traditional radiomics-based models. Furthermore, the performance of the PC-NN model trained with MRA data was superior to that trained with CTA data.
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Affiliation(s)
- Xiaoyuan Luo
- Digital Medical Research Center and also with the Shanghai Key Laboratory of Medical Image Computing and Computer Assisted Intervention, Fudan University, Shanghai, China
| | - Jienan Wang
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Xinmei Liang
- Department of Radiology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Lei Yan
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - XinHua Chen
- Department of Neurosurgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Jian He
- Department of Nuclear Medicine, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Jing Luo
- Department of Neurosurgery, Anhui Medical University Affiliated First Hospital, Hefei, China
| | - Bing Zhao
- Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guangchen He
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Manning Wang
- Digital Medical Research Center and also with the Shanghai Key Laboratory of Medical Image Computing and Computer Assisted Intervention, Fudan University, Shanghai, China
| | - Yueqi Zhu
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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Arrarte Terreros N, Bruggeman AAE, van Voorst H, Konduri PR, Jansen IGH, Kappelhof M, Tolhuisen ML, Boodt N, Dippel DWJ, van der Lugt A, van Zwam WH, van Oostenbrugge RJ, van der Worp HB, Emmer BJ, Meijer FJA, Roos YBWEM, van Bavel E, Marquering HA, Majoie CBLM. Bifurcation occlusions and endovascular treatment outcome in acute ischemic stroke. J Neurointerv Surg 2023; 15:355-362. [PMID: 35318957 PMCID: PMC10086510 DOI: 10.1136/neurintsurg-2021-018560] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/03/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND A thrombus in the M1 segment of the middle cerebral artery (MCA) can occlude this main stem only or extend into the M1-M2 bifurcation. The occlusion pattern may affect endovascular treatment (EVT) success, as a bifurcated thrombus may be more prone to fragmentation during retrieval. OBJECTIVE To investigate whether bifurcated thrombus patterns are associated with EVT procedural and clinical outcomes. METHODS Occlusion patterns of MCA thrombi on CT angiography from MR CLEAN Registry patients were classified into three groups: main stem occlusion, bifurcation occlusion extending into one M2 branch, and bifurcation occlusion extending into both M2 branches. Procedural parameters, procedural outcomes (reperfusion grade and embolization to new territory), and clinical outcomes (24-48 hour National Institutes of Health Stroke Scale [NIHSSFU] score, change in NIHSS scores between 24 and 48 hours and baseline ∆ [NIHSS], and 90-day modified Rankin Scale [mRS] scores) were compared between occlusion patterns. RESULTS We identified 1023 patients with an MCA occlusion of whom 370 (36%) had a main stem occlusion, 151 (15%) a single branch, and 502 (49%) a double branch bifurcation occlusion. There were no statistically significant differences in retrieval method, procedure time, number of retrieval attempts, reperfusion grade, and embolization to new territory between occlusion patterns. Patients with main stem occlusions had lower NIHSSFU scores than patients with single (7 vs 11, p=0.01) or double branch occlusions (7 vs 9, p=0.04). However, there were no statistically significant differences in ∆ NIHSS or in 90-day mRS scores. CONCLUSIONS In our population, EVT procedural and long-term clinical outcomes were similar for MCA bifurcation occlusions and MCA main stem occlusions.
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Affiliation(s)
- Nerea Arrarte Terreros
- Department of Biomedical Engineering and Physics, Amsterdam UMC, location AMC, Amsterdam, The Netherlands .,Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Agnetha A E Bruggeman
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Henk van Voorst
- Department of Biomedical Engineering and Physics, Amsterdam UMC, location AMC, Amsterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Praneeta R Konduri
- Department of Biomedical Engineering and Physics, Amsterdam UMC, location AMC, Amsterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Ivo G H Jansen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Manon Kappelhof
- Department of Biomedical Engineering and Physics, Amsterdam UMC, location AMC, Amsterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Manon L Tolhuisen
- Department of Biomedical Engineering and Physics, Amsterdam UMC, location AMC, Amsterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Nikki Boodt
- Department of Neurology, Erasmus MC, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | | | - Aad van der Lugt
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Wim H van Zwam
- Department of Radiology, Maastricht UMC, Maastricht, The Netherlands
| | - Robert J van Oostenbrugge
- Department of Neurology, Maastricht UMC, Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht, University of Maastricht, Maastricht, Netherlands
| | - H Bart van der Worp
- Department of Neurology and Neurosurgery Brain Center, UMC Utrecht, Utrecht, The Netherlands
| | - Bart J Emmer
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | | | - Yvo B W E M Roos
- Department of Neurology, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Ed van Bavel
- Department of Biomedical Engineering and Physics, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Henk A Marquering
- Department of Biomedical Engineering and Physics, Amsterdam UMC, location AMC, Amsterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Charles B L M Majoie
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
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Khawaja R, Chawla A, Vargas D. Anterior Subtype of Partial Anomalous Left Pulmonary Artery. Radiol Cardiothorac Imaging 2023; 5:e220189. [PMID: 37274417 PMCID: PMC10233408 DOI: 10.1148/ryct.220189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 01/30/2023] [Accepted: 03/10/2023] [Indexed: 06/06/2023]
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Williams MC, Williams SE, Newby DE. Artificial Intelligence-based Text-to-Image Generation of Cardiac CT. Radiol Cardiothorac Imaging 2023; 5:e220297. [PMID: 37274418 PMCID: PMC10233407 DOI: 10.1148/ryct.220297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/17/2023] [Accepted: 02/28/2023] [Indexed: 06/06/2023]
Affiliation(s)
- Michelle C. Williams
- From the British Heart Foundation Centre for Cardiovascular Science,
University of Edinburgh, Chancellor’s Building, 49 Little France
Crescent, Edinburgh EH16 SUF, Scotland
| | - Steven E. Williams
- From the British Heart Foundation Centre for Cardiovascular Science,
University of Edinburgh, Chancellor’s Building, 49 Little France
Crescent, Edinburgh EH16 SUF, Scotland
| | - David E. Newby
- From the British Heart Foundation Centre for Cardiovascular Science,
University of Edinburgh, Chancellor’s Building, 49 Little France
Crescent, Edinburgh EH16 SUF, Scotland
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Bauer MJ, Nano N, Adolf R, Will A, Hendrich E, Martinoff SA, Hadamitzky M. Prognostic Value of Machine Learning-based Time-to-Event Analysis Using Coronary CT Angiography in Patients with Suspected Coronary Artery Disease. Radiol Cardiothorac Imaging 2023; 5:e220107. [PMID: 37124636 PMCID: PMC10141344 DOI: 10.1148/ryct.220107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 02/09/2023] [Accepted: 02/22/2023] [Indexed: 05/02/2023]
Abstract
Purpose To assess the long-term prognostic value of a machine learning (ML) approach in time-to-event analyses incorporating coronary CT angiography (CCTA)-derived and clinical parameters in patients with suspected coronary artery disease. Materials and Methods The retrospective analysis included patients with suspected coronary artery disease who underwent CCTA between October 2004 and December 2017. Major adverse cardiovascular events were defined as the composite of all-cause death, myocardial infarction, unstable angina, or late revascularization (>90 days after index scan). Clinical and CCTA-derived parameters were assessed as predictors of major adverse cardiovascular events and incorporated into two models: a Cox proportional hazards model with recursive feature elimination and an ML model based on random survival forests. Both models were trained and validated by employing repeated nested cross-validation. Harrell concordance index (C-index) was used to assess the predictive power. Results A total of 5457 patients (mean age, 61 years ± 11 [SD]; 3648 male patients) were evaluated. The predictive power of the ML model (C-index, 0.74; 95% CI: 0.71, 0.76) was significantly higher than the Cox model (C-index, 0.71; 95% CI: 0.68, 0.74; P = .02). The ML model also outperformed the segment stenosis score (C-index, 0.69; 95% CI: 0.66, 0.72; P < .001), which was the best performing CCTA-derived parameter, and patient age (C-index, 0.66; 95% CI: 0.63, 0.69; P < .001), the best performing clinical parameter. Conclusion An ML model for time-to-event analysis based on random survival forests had higher performance in predicting major adverse cardiovascular events compared with established clinical or CCTA-derived metrics and a conventional Cox model.Keywords: Machine Learning, CT Angiography, Cardiac, Arteries, Heart, Arteriosclerosis, Coronary Artery DiseaseSupplemental material is available for this article.© RSNA, 2023.
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Din M, Agarwal S, Grzeda M, Wood DA, Modat M, Booth TC. Detection of cerebral aneurysms using artificial intelligence: a systematic review and meta-analysis. J Neurointerv Surg 2023; 15:262-271. [PMID: 36375834 PMCID: PMC9985742 DOI: 10.1136/jnis-2022-019456] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/11/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Subarachnoid hemorrhage from cerebral aneurysm rupture is a major cause of morbidity and mortality. Early aneurysm identification, aided by automated systems, may improve patient outcomes. Therefore, a systematic review and meta-analysis of the diagnostic accuracy of artificial intelligence (AI) algorithms in detecting cerebral aneurysms using CT, MRI or DSA was performed. METHODS MEDLINE, Embase, Cochrane Library and Web of Science were searched until August 2021. Eligibility criteria included studies using fully automated algorithms to detect cerebral aneurysms using MRI, CT or DSA. Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis: Diagnostic Test Accuracy (PRISMA-DTA), articles were assessed using Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). Meta-analysis included a bivariate random-effect model to determine pooled sensitivity, specificity, and area under the receiver operator characteristic curve (ROC-AUC). PROSPERO CRD42021278454. RESULTS 43 studies were included, and 41/43 (95%) were retrospective. 34/43 (79%) used AI as a standalone tool, while 9/43 (21%) used AI assisting a reader. 23/43 (53%) used deep learning. Most studies had high bias risk and applicability concerns, limiting conclusions. Six studies in the standalone AI meta-analysis gave (pooled) 91.2% (95% CI 82.2% to 95.8%) sensitivity; 16.5% (95% CI 9.4% to 27.1%) false-positive rate (1-specificity); 0.936 ROC-AUC. Five reader-assistive AI studies gave (pooled) 90.3% (95% CI 88.0% - 92.2%) sensitivity; 7.9% (95% CI 3.5% to 16.8%) false-positive rate; 0.910 ROC-AUC. CONCLUSION AI has the potential to support clinicians in detecting cerebral aneurysms. Interpretation is limited due to high risk of bias and poor generalizability. Multicenter, prospective studies are required to assess AI in clinical practice.
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Affiliation(s)
- Munaib Din
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Siddharth Agarwal
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Mariusz Grzeda
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - David A Wood
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Marc Modat
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Thomas C Booth
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
- Department of Neuroradiology, King's College Hospital NHS Foundation Trust, London, UK
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Li Z, Zhang H, Yu L. Pseudoaneurysm of the Mitral-Aortic Intervalvular Fibrosa. Radiol Cardiothorac Imaging 2023; 5:e220217. [PMID: 36860842 PMCID: PMC9969213 DOI: 10.1148/ryct.220217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/08/2023] [Accepted: 01/30/2023] [Indexed: 02/18/2023]
Abstract
Supplemental material is available for this article.
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Affiliation(s)
- Zihao Li
- From the Department of Radiology, Qilu Hospital of Shandong University Dezhou Hospital (Dezhou People’s Hospital), No. 1166 Dongfanghong West Road, Decheng District, Dezhou, China 253000
| | - Hongwei Zhang
- From the Department of Radiology, Qilu Hospital of Shandong University Dezhou Hospital (Dezhou People’s Hospital), No. 1166 Dongfanghong West Road, Decheng District, Dezhou, China 253000
| | - Lina Yu
- From the Department of Radiology, Qilu Hospital of Shandong University Dezhou Hospital (Dezhou People’s Hospital), No. 1166 Dongfanghong West Road, Decheng District, Dezhou, China 253000
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Li Z, Zhang H, Yu L. Emphysematous Aortitis of the Abdominal Aorta. Radiol Cardiothorac Imaging 2023; 5:e220192. [PMID: 36860837 PMCID: PMC9969206 DOI: 10.1148/ryct.220192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 01/12/2023] [Accepted: 01/30/2023] [Indexed: 02/18/2023]
Abstract
Supplemental material is available for this article.
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Affiliation(s)
- Zihao Li
- From the Department of Radiology, Qilu Hospital of Shandong University Dezhou Hospital (Dezhou People’s Hospital), No. 1166 Dongfanghong West Road, Decheng District, Dezhou, China 253000
| | - Hongwei Zhang
- From the Department of Radiology, Qilu Hospital of Shandong University Dezhou Hospital (Dezhou People’s Hospital), No. 1166 Dongfanghong West Road, Decheng District, Dezhou, China 253000
| | - Lina Yu
- From the Department of Radiology, Qilu Hospital of Shandong University Dezhou Hospital (Dezhou People’s Hospital), No. 1166 Dongfanghong West Road, Decheng District, Dezhou, China 253000
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Schmidt JC, Huang DD, Fleming AM, Brockman V, Hennessy EA, Magnotti LJ, Schroeppel T, McFann K, Hamilton LD, Dunn JA. Missed blunt cerebrovascular injuries using current screening criteria - The time for liberalized screening is now. Injury 2023; 54:1342-1348. [PMID: 36841698 DOI: 10.1016/j.injury.2023.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 01/18/2023] [Accepted: 02/07/2023] [Indexed: 02/27/2023]
Abstract
Diagnostic Criteria Study BACKGROUND: The morbidity and mortality associated with ischemic stroke attributable to blunt cerebrovascular injury (BCVI) warrant aggressive screening. The Denver Criteria (DC) and Expanded Denver Criteria (eDC) have imprecise elements that can be difficult and subjective in application and can delay or prevent screening. We hypothesize these screening criteria lack adequate ability to consistently identify BCVI and that the use of a liberalized screening approach with CT angiography (CTA) is superior without increasing risk of acute kidney injury (AKI). METHODS This was a multi-institutional retrospective cohort study of trauma patients who presented between 2015-2020 with radiographically confirmed BCVI diagnosed using each institutions' liberalized screening protocol, defined as automatic CTA of the head and neck for all patients undergoing head and neck CT. Outcomes of interest included AKI, stroke, and death due to BCVI. Outcomes were reported as frequency, percent, and 95% confidence interval as calculated by the Clopper-Pearson method. Incidence of medical follow-up within 1 year of first medical visit was quantified as the median and inter-quartile range of days to follow-up visit. RESULTS We identified 433 BCVI patients with a mean age of 45.2 (standard deviation 18.9) years, 256 men and 177 women, 1.73 m (0.10) tall, and weighed 80.3 kg (20.3). Forty-one patients had strokes (9.5% [95% confidence interval 6.9, 12.6] and 12 patients (2.8% [1.4, 4.5]) had mortality attributable to BCVI. Of 433 total cases, 132 (30.5% [26.2, 35.1]) would have been missed by DC and 150 (34.6% [30.2, 39.3]) by eDC. Incidence of AKI in our BCVI population was 6 (1.4% [0.01, 3.0]). CONCLUSIONS BCVI would be missed over 30% of the time using the DC and eDC compared to liberalized use of screening CTA. Risk of AKI due to CTA did not occur at a clinically meaningful level, supporting liberal CTA screening.
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Affiliation(s)
- Julia C Schmidt
- UCHealth North Medical Center of the Rockies, 2500 Rocky Mountain Avenue, Loveland, CO 80538, USA
| | - Dih-Dih Huang
- University of Tennessee Health Sciences Center, Memphis, TN 38163, USA
| | - Andrew M Fleming
- University of Tennessee Health Sciences Center, Memphis, TN 38163, USA
| | - Valerie Brockman
- UCHealth Memorial Hospital Central, 1400 Boulder Street, Colorado Springs, CO 80909, USA
| | - Elizabeth A Hennessy
- UCHealth Memorial Hospital Central, 1400 Boulder Street, Colorado Springs, CO 80909, USA
| | - Louis J Magnotti
- University of Tennessee Health Sciences Center, Memphis, TN 38163, USA
| | - Thomas Schroeppel
- UCHealth Memorial Hospital Central, 1400 Boulder Street, Colorado Springs, CO 80909, USA
| | - Kim McFann
- UCHealth North Medical Center of the Rockies, 2500 Rocky Mountain Avenue, Loveland, CO 80538, USA
| | - Landon D Hamilton
- UCHealth North Medical Center of the Rockies, 2500 Rocky Mountain Avenue, Loveland, CO 80538, USA
| | - Julie A Dunn
- UCHealth North Medical Center of the Rockies, 2500 Rocky Mountain Avenue, Loveland, CO 80538, USA.
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Higashigaito K, Mergen V, Eberhard M, Jungblut L, Hebeisen M, Rätzer S, Zanini B, Kobe A, Martini K, Euler A, Alkadhi H. CT Angiography of the Aorta Using Photon-counting Detector CT with Reduced Contrast Media Volume. Radiol Cardiothorac Imaging 2023; 5:e220140. [PMID: 36860835 PMCID: PMC9969214 DOI: 10.1148/ryct.220140] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 12/04/2022] [Accepted: 12/14/2022] [Indexed: 01/27/2023]
Abstract
Purpose To develop and evaluate a low-volume contrast media protocol for thoracoabdominal CT angiography (CTA) with photon-counting detector (PCD) CT. Materials and Methods This prospective study included consecutive participants (April-September 2021) who underwent CTA with PCD CT of the thoracoabdominal aorta and previous CTA with energy-integrating detector (EID) CT at equal radiation doses. In PCD CT, virtual monoenergetic images (VMI) were reconstructed in 5-keV intervals from 40 to 60 keV. Attenuation of the aorta, image noise, and contrast-to-noise ratio (CNR) were measured, and subjective image quality was rated by two independent readers. In the first group of participants, the same contrast media protocol was used for both scans. CNR gain in PCD CT compared with EID CT served as the reference for contrast media volume reduction in the second group. Noninferiority analysis was used to test noninferior image quality of the low-volume contrast media protocol with PCD CT. Results The study included 100 participants (mean age, 75 years ± 8 [SD]; 83 men). In the first group (n = 40), VMI at 50 keV provided the best trade-off between objective and subjective image quality, achieving 25% higher CNR compared with EID CT. Contrast media volume in the second group (n = 60) was reduced by 25% (52.5 mL). Mean differences in CNR and subjective image quality between EID CT and PCD CT at 50 keV were above the predefined boundaries of noninferiority (-0.54 [95% CI: -1.71, 0.62] and -0.36 [95% CI: -0.41, -0.31], respectively). Conclusion CTA of the aorta with PCD CT was associated with higher CNR, which was translated into a low-volume contrast media protocol demonstrating noninferior image quality compared with EID CT at the same radiation dose.Keywords: CT Angiography, CT-Spectral, Vascular, Aorta, Contrast Agents-Intravenous, Technology Assessment© RSNA, 2023See also the commentary by Dundas and Leipsic in this issue.
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Affiliation(s)
- Kai Higashigaito
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
| | - Victor Mergen
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
| | - Matthias Eberhard
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
| | - Lisa Jungblut
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
| | - Monika Hebeisen
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
| | - Susan Rätzer
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
| | - Bettina Zanini
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
| | - Adrian Kobe
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
| | - Katharina Martini
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
| | - André Euler
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
| | - Hatem Alkadhi
- From the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland (K.H., V.M., M.E., L.J., S.R., B.Z., A.K., K.M., A.E., H.A.); and Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland (M.H.)
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Mastrodicasa D, Willemink MJ, Turner VL, Hinostroza V, Codari M, Hanneman K, Ouzounian M, Ocazionez Trujillo D, Afifi RO, Hedgire S, Burris NS, Yang B, Lacomis JM, Gleason TG, Pacini D, Folesani G, Lovato L, Hinzpeter R, Alkadhi H, Stillman AE, Chen EP, van Kuijk SMJ, Schurink GWH, Sailer AM, Bäumler K, Miller DC, Fischbein MP, Fleischmann D. Registry of Aortic Diseases to Model Adverse Events and Progression (ROADMAP) in Uncomplicated Type B Aortic Dissection: Study Design and Rationale. Radiol Cardiothorac Imaging 2022; 4:e220039. [PMID: 36601455 PMCID: PMC9806732 DOI: 10.1148/ryct.220039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 09/01/2022] [Accepted: 11/09/2022] [Indexed: 12/24/2022]
Abstract
Purpose To describe the design and methodological approach of a multicenter, retrospective study to externally validate a clinical and imaging-based model for predicting the risk of late adverse events in patients with initially uncomplicated type B aortic dissection (uTBAD). Materials and Methods The Registry of Aortic Diseases to Model Adverse Events and Progression (ROADMAP) is a collaboration between 10 academic aortic centers in North America and Europe. Two centers have previously developed and internally validated a recently developed risk prediction model. Clinical and imaging data from eight ROADMAP centers will be used for external validation. Patients with uTBAD who survived the initial hospitalization between January 1, 2001, and December 31, 2013, with follow-up until 2020, will be retrospectively identified. Clinical and imaging data from the index hospitalization and all follow-up encounters will be collected at each center and transferred to the coordinating center for analysis. Baseline and follow-up CT scans will be evaluated by cardiovascular imaging experts using a standardized technique. Results The primary end point is the occurrence of late adverse events, defined as aneurysm formation (≥6 cm), rapid expansion of the aorta (≥1 cm/y), fatal or nonfatal aortic rupture, new refractory pain, uncontrollable hypertension, and organ or limb malperfusion. The previously derived multivariable model will be externally validated by using Cox proportional hazards regression modeling. Conclusion This study will show whether a recent clinical and imaging-based risk prediction model for patients with uTBAD can be generalized to a larger population, which is an important step toward individualized risk stratification and therapy.Keywords: CT Angiography, Vascular, Aorta, Dissection, Outcomes Analysis, Aortic Dissection, MRI, TEVAR© RSNA, 2022See also the commentary by Rajiah in this issue.
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Orbuch R, Kondapi K, Ref JE, Avery RJ. Four-dimensional Flow in Pulmonary Artery Aneurysm with Localized Dissection. Radiol Cardiothorac Imaging 2022; 4:e220052. [PMID: 36601452 PMCID: PMC9806721 DOI: 10.1148/ryct.220052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 11/01/2022] [Accepted: 11/08/2022] [Indexed: 12/13/2022]
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Bhat S, Bir S, Schreve F, Bergin CJ, Jones PG, Waqanivavalagi SWFR. Ethnic Disparities in CT Aortography Use for Diagnosing Acute Aortic Syndrome. Radiol Cardiothorac Imaging 2022; 4:e220018. [PMID: 36601460 PMCID: PMC9806728 DOI: 10.1148/ryct.220018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 08/31/2022] [Accepted: 10/13/2022] [Indexed: 11/19/2022]
Abstract
Purpose To determine whether CT aortography was performed in proportion to patient risk for acute aortic syndrome (AAS) and incidence of AAS for different ethnic groups. Materials and Methods All atraumatic thoracic aorta CT aortographic examinations performed in adults (age > 15 years) suspected of having AAS between January 2009 and December 2019 at Auckland City Hospital (New Zealand) were included. Patients were risk stratified using the aortic dissection detection risk score (ADD-RS). The primary outcomes were the ratio of CT aortography rates to rates of positive CT aortographic examinations and the incidence of AAS. Population census data were used to determine age-standardized incidence of AAS in the emergency department (ED). Results In total, 1646 CT aortographic examinations were performed in 1543 patients (mean age, 62 years ± 16 [SD]; 877 male patients). Māori (34% [68 of 203]) and Pacific Islanders (35% [80 of 229]) were more likely to be at high risk of AAS (ADD-RS > 1) compared with patients from other ethnic groups (25% [308 of 1214]); in the ED catchment population, age-standardized AAS incidence was significantly higher in Māori (6.9 per 100 000 person-years [95% CI: 4.3, 10.4]) and Pacific Islanders (5.3 [95% CI: 3.4, 7.8]) than in other ethnic groups (2.3 [95% CI: 1.8, 2.8]). Despite this higher incidence, disproportionately fewer CT aortographic examinations were requested in the ED for Māori (9.2 CT aortographic examinations per AAS diagnosis) and Pacific Islanders (9.2 CT aortographic examinations per AAS diagnosis) compared with other ethnic groups (13.8 CT aortographic examinations per AAS diagnosis). Conclusion Māori and Pacific Islanders were at disproportionately higher risk of AAS but had fewer requested CT aortographic examinations compared with other ethnic groups. This increased risk of AAS in Pacific Islander and indigenous Māori patients should be considered by clinicians when investigating AAS.Keywords: Ethnicity, Māori, Pacific Islander, Aortic Dissection Detection Risk Score, Acute Aortic Syndrome, Aortic Dissection, CT Angiography Supplemental material is available for this article. © RSNA, 2022.
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