Article from Circulation

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McQuillen, Patrick S. MD
Magnetic Resonance Imaging in Congenital Heart Disease: What to Do With What We See and Don't See? [Editorial]
Circulation. 119(5):660-662, February 10, 2009.

Articles from Circulation

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Xie, Feng MD; Lof, John MS; Matsunaga, Terry PhD; Zutshi, Reena PhD; Porter, Thomas R.
Diagnostic Ultrasound Combined With Glycoprotein IIb/IIIa-Targeted Microbubbles Improves Microvascular Recovery After Acute Coronary Thrombotic Occlusions
Circulation.
Status
published online before print, 2 March 2009
Abstract
Background-: The high mechanical index (MI) impulses from a diagnostic ultrasound transducer may be a method of recanalizing acutely thrombosed vessels if the impulses are applied only when microbubbles are channeling through the thrombus.Methods and Results-: In 45 pigs with acute left anterior descending thrombotic occlusions, a low-MI pulse sequence scheme (contrast pulse sequencing) was used to image the myocardium and guide the delivery of high-MI (1.9 MI) impulses during infusion of either intravenous platelet-targeted microbubbles or nontargeted microbubbles. A third group received no diagnostic ultrasound and microbubbles. All groups received half-dose recombinant prourokinase, heparin, and aspirin. Contrast pulse sequencing examined replenishment of contrast within the central portion of the risk area and guided the application of high-MI impulses. Angiographic recanalization rates, resolution of ST-segment elevation on ECG, and wall thickening were analyzed. Pigs receiving platelet-targeted microbubbles had more rapid replenishment of the central portion of the risk area (80% versus 40% for nontargeted microbubbles; P=0.03) and higher epicardial recanalization rates (53% versus 7% for prourokinase alone; P=0.01). Replenishment of contrast within the risk area (whether with platelet-targeted microbubbles or nontargeted microbubbles) was associated with both higher recanalization rates and even higher rates of ST-segment resolution (82% versus 21% for prourokinase alone; P=0.006). ST-segment resolution occurred in 6 pigs (40%) treated with microbubbles who did not have epicardial recanalization, of which 5 had recovery of wall thickening.Conclusions-: Intravenous platelet-targeted microbubbles combined with brief high-MI diagnostic ultrasound impulses guided by contrast pulse sequencing improve both epicardial recanalization rates and microvascular recovery.

Computerized tomographic angiography...carotid artery bypass

Computerized tomographic angiography for preoperative assessment of the superficial temporal artery for external carotid artery to internal carotid artery bypass: a case report
Farsad K, Hayek R, Mamourian A, Friedman J
Cases Journal, 2008 1:119 ( 21 August 2008 )
[Abstract] [Provisional PDF]

Circulation - online articles

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Bluemke, David A. ; Achenbach, Stephan; Budoff, Matthew et al
Noninvasive Coronary Artery Imaging: Magnetic Resonance Angiography and Multidetector Computed Tomography Angiography: A Scientific Statement From the American Heart Association Committee on Cardiovascular Imaging and Intervention of the Council on Cardiovascular Radiology and Intervention, and the Councils on Clinical Cardiology and Cardiovascular Disease in the Young.
Publish Ahead of Print, published online before print, 27 June 2008

Sverdlov, Aaron L. ; Taylor, Karen ; Elkington, Andrew G. ; Zeitz, Christopher J. et al
Cardiac Magnetic Resonance Imaging Identifies the Elusive Perivalvular Abscess
Circulation. 118(1):e1-e3, July 1, 2008.

Politi, Luigi ; Monopoli, Daniel Enrique; Sgura, Fabio Alfredo ; Rossi, Rosario et al
Spontaneous Echocardiographic Wall Motion Abnormalities in Variant Angina
Source Circulation. 118(1):e4-e6, July 1, 2008

Coronary CT angiography

Sometimes, when assessing the value of a new medical technology, it's easy to get caught up in arcane statistics and lose sight of the ultimate goal: saving lives.
That's especially true with coronary CT angiography (CTA), an exciting new technology that's been generating controversy of late. At issue is whether coronary CTA's ability to detect potentially fatal heart disease before symptoms arise is worth the cost of integrating the technology into the healthcare system.
This week in our Cardiac Imaging Digital Community, we bring you a story that illustrates the lifesaving value of coronary CTA. Jim Pittman, an administrator at a Midwestern U.S. hospital, describes how his life was suddenly changed when he volunteered for a CTA exam originally intended to train technologists on a new 64-slice CT scanner.
Mr. Pittman's story alone isn't statistically significant, and by itself probably won't convince Medicare or any third-party payors to suddenly open the purse strings for coronary CTA reimbursement. But it is yet another example in a growing body of anecdotal evidence in support of the value of coronary CTA.
Learn about Mr. Pittman's story by clicking here, or visit our Cardiac Imaging Digital Community, at cardiac.auntminnie.com.