Changing Paradigms in the Diagnosis of Ischemic Heart Disease by Multimodality Imaging.
Andrea BaggianoGianpiero ItalianoMarco GuglielmoLaura FusiniAndrea Igoren GuaricciRiccardo MaragnaCarlo Maria GiacariSaima MushtaqEdoardo ConteAndrea Daniele AnnoniAlberto FormentiMaria Elisabetta ManciniDaniele AndreiniMark RabbatEugenio PicanoGianluca PontonePublished in: Journal of clinical medicine (2022)
Coronary artery disease (CAD) represents the most common cardiovascular disease, with high morbidity and mortality. Historically patients with chest pain of suspected coronary origin have been assessed with functional tests, capable to detect haemodynamic consequences of coronary obstructions through depiction of electrocardiographic changes, myocardial perfusion defects or regional wall motion abnormalities under stress condition. Stress echocardiography (SE), single-photon emission computed tomography (SPECT), positron emission tomography (PET) and cardiovascular magnetic resonance (CMR) represent the functional techniques currently available, and technical developments contributed to increased diagnostic performance of these techniques. More recently, cardiac computed tomography angiography (cCTA) has been developed as a non-invasive anatomical test for a direct visualisation of coronary vessels and detailed description of atherosclerotic burden. Cardiovascular imaging techniques have dramatically enhanced our knowledge regarding physiological aspects and myocardial implications of CAD. Recently, after the publication of important trials, international guidelines recognised these changes, updating indications and level of recommendations. This review aims to summarise current standards with main novelties and specific limitations, and a diagnostic algorithm for up-to-date clinical management is also proposed.
Keyphrases
- coronary artery disease
- positron emission tomography
- computed tomography
- left ventricular
- magnetic resonance
- cardiovascular events
- cardiovascular disease
- percutaneous coronary intervention
- pet ct
- coronary artery
- coronary artery bypass grafting
- high resolution
- pet imaging
- contrast enhanced
- magnetic resonance imaging
- image quality
- aortic stenosis
- clinical practice
- healthcare
- dual energy
- pulmonary embolism
- machine learning
- heart failure
- working memory
- left atrial
- heat stress
- risk factors
- metabolic syndrome
- pulmonary hypertension
- solid state
- photodynamic therapy
- atrial fibrillation
- catheter ablation