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Purpose: To quantitatively investigate the effect of myocardial bridge (MB) in the left anterior descending artery (LAD) on the fractional flow reserve (FFR). Materials and Methods: Three‐hundred patients with LAD MB who had undergone coronary artery CT angiography (CCTA) were retrospectively enroled, and 104 normal patients were enroled as the control. The CCTA‐derived fractional flow reserve (FFRCT) was measured at the LAD 10 mm proximal (FFR1) and 20–40 mm distal (FFR3) to the MB and at the MB location (FFR2). Results: FFR2 and FFR3 of the MB (with BM only) and MBLA (with both MB and atherosclerosis) groups were significantly (p < 0.01) lower than those of the control. The FFR3 distal to the MB was significantly lower (p < 0.01) than that of the control. The FFRCT of the whole LAD in the MBLA group was significantly (p < 0.05) lower than that of the MB and control group (p < 0.05). MB length (OR 1.061) and MB muscle index (odds ratio or OR 1.007) were two risk factors for abnormal FFRCT, and MB length was a significant independent risk factor for abnormal FFRCT (OR = 1.077). LAD stenosis degree was a risk factor for abnormal FFRCT values (OR 3.301, 95% confidence interval [CI] 1.441–7.562, p = 0.005) and was also a significant independent risk factor (OR = 3.369, 95% CI: 1.392–8.152; p = 0.007) for abnormal FFRCT. Conclusion: MB significantly affects the FFRCT of distal coronary artery. For patients with MB without atherosclerosis, the MB length is a risk factor significantly affecting FFRCT, and for patients with MB accompanied by atherosclerosis, LAD stenotic severity is an independent risk factor for FFRCT. [ABSTRACT FROM AUTHOR]

Introduction: This study was performed to explore the diagnostic value of cardiac computed tomography angiography (CCTA) for endothelial insufficiency (EIS) of a left atrial appendage (LAA) disc‐like occluder. Methods: Fifty‐nine patients with nonvalvular atrial fibrillation who underwent placement of an LAA disc‐like occluder (LAmbre; Lifetech Scientific) in our hospital were retrospectively analyzed. Patients who were found to have contrast agent entering the LAA at the 3‐month postoperative CCTA examination underwent Hounsfield unit (HU) measurement of the LAA and construction of a three‐dimensional (3D) model of the device for preliminary discernment between peri‐device leakage (PDL) and EIS. These patients were then further examined by transesophageal echocardiography (TEE) to check for concordance with the computed tomography (CT) findings. According to the CT and TEE results, all patients were divided into the PDL group, total endothelialization group, and EIS group. The endothelial conditions and other implantation‐related results were also tracked at the 6‐month follow‐up. Results: All 59 patients underwent successful implantation of the LAmbre LAA closure device with no severe adverse events during the procedure. Thirty‐five patients were found to have contrast agent entering the LAA at the 3‐month postoperative CCTA follow‐up. Based on the CT HU measurement and the 3D construction analysis results, these 35 patients were divided into the PDL group (19 patients) and the EIS group (16 patients). In the PDL group, the contrast agent infiltrated from the shoulder along the periphery of the occluder on two‐dimensional (2D) CT images, and the 3D model showed a gap between the LAA and the device cover. However, the CCTA images of the other 16 patients in the EIS group showed that the contrast agent in the occluder on the 2D CTA images and 3D construction model confirmed the absence of a gap between the LAA and the device cover. TEE confirmed all of the CT results. The 6‐month follow‐up results showed that 14 of 19 patients in the EIS group achieved total endothelialization, whereas this number in the PDL group was only five of 19 patients. Conclusion: CCTA can replace TEE for examination of the endothelialization status, and patients with EIS have a higher chance of endothelialization than patients with PDL. [ABSTRACT FROM AUTHOR]

The diagnosis of acute myocarditis often involves several noninvasive techniques that can provide information regarding volumes, ejection fraction, and tissue characterization. In particular, echocardiography is extremely helpful for the evaluation of biventricular volumes, strain and ejection fraction. Cardiac magnetic resonance, beyond biventricular volumes, strain, and ejection fraction allows to characterize myocardial tissue providing information regarding edema, hyperemia, and fibrosis. Contemporary cardiac computed tomography angiography (CCTA) can not only be extremely important for the assessment of coronary arteries, pulmonary arteries and aorta but also tissue characterization using CCTA can be an additional tool that can explain chest pain with a diagnosis of myocarditis. [ABSTRACT FROM AUTHOR]

Transthoracic echocardiography is the imaging modality of choice for the detection of coronary artery aneurysms (CAAs) in Kawasaki disease. However, cardiac computed tomography angiography is useful in the diagnosis of distal CAAs. [ABSTRACT FROM AUTHOR]

Aim The energy loss coefficient ( ELCo) has been suggested as a more accurate indicator of aortic stenosis ( AS) severity as compared to transthoracic echocardiography ( TTE) aortic valve area ( AVA). There are little data regarding the optimal location for aortic area (Aa) measurement needed for ELCo calculation and the agreement of ELCo with direct anatomical AVA measurement. The aim of this study was to determine the optimal site of Aa measurement for calculation of the ELCo, using cardiac computed tomography angiography ( CCTA) AVA planimetry as the reference standard. Methods We analyzed 69 patients with AS who underwent both CCTA and TTE. ELCo and CCTA planimetry AVA were compared using multiple sites for CCTA Aa measurement (sinus, sinotubular junction, or ascending aorta). Results CCTA AVA was 0.96±0.46 cm2. ELCo was 0.95±0.43 cm2 using sinotubular junction Aa, 0.92±0.41 cm2 using sinus Aa, and 0.91±0.4 cm2 using the ascending aorta ( P=.84, P=.13, and P=.08 compared to CCTA AVA). There was good agreement between CCTA AVA and ELCo using all Aa locations (0.89-0.90). On subgroup analysis of 16 patients most likely to be affected by pressure recovery (aortic diameter<3 cm and AVA ≥1 cm2), ELCo using the sinotubular junction Aa showed the best agreement with CCTA AVA as compared to the other Aa locations (0.84 vs 0.75-0.77). Conclusions ELCo using Aa measurement at the sinotubular junction showed the best agreement with CCTA AVA. We therefore recommend using the sinotubular junction Aa for ELCo calculation. [ABSTRACT FROM AUTHOR]

Background and Aim of the Study: Review how advanced imaging techniques and a multidisciplinary heart team approach are used to evaluate complex cardiac structural pathology., Methods: Single-center retrospective case series., Results and Conclusions: Cardiac computed tomography angiography in addition to transthoracic and transesophageal echocardiography impacts pre-procedural planning and procedural success., (© 2022 Wiley Periodicals LLC.)

Objectives Cardiac computed tomography angiography ( CCTA) is a commonly used diagnostic test for coronary artery disease. Despite its considerable clinical value, few studies have explored the psychological value of CCTA from the perspective of patients undergoing testing. This study aimed to investigate the patient-perceived value of diagnostic CCTA testing, specifically in relation to patients' perceptions of their heart health and health behaviours. Design The study used a qualitative methodology incorporating thematic analysis before and after testing. Methods Semi-structured interviews were conducted before and after the receipt of CCTA test results among 13 non-acute patients attending a heart clinic in New Zealand for diagnostic CCTA. Data analysis followed a thematic analysis approach applied at each interview time point. Results Three themes were identified from the pre-diagnostic interviews: expectations that testing would facilitate heart-related understanding; the role of CCTA as an essential requirement for considering the use of cardiac medication; and awareness of the importance of heart-healthy behaviours. Post-diagnostic interview analysis identified four themes: positive psychological responses to cardiac diagnosis; perceived value of viewing scan images; the potential impact of testing on health behaviour intentions; and patients' reflections on the procedure. Conclusions These results suggest that CCTA has the potential to meet knowledge-gaining expectations that patients bring to clinic and may increase motivation of health-protective behaviours. Diagnostic CCTA may therefore provide an ideal opportunity to address patients' illness understanding and behavioural intentions. The effective utilization of scan images as a supplement to consultation may enhance such practice objectives and warrants further investigation. Statement of contribution What is already known on this subject? Cardiac computed tomography angiography ( CCTA) is an advanced diagnostic test that is particularly useful for early diagnosis of coronary artery disease., Cardiac computed tomography angiography is able to produce highly detailed images of the formation and build-up of calcium deposits in coronary vasculature, thus providing a window into an otherwise unseen disease process., Although CCTA is increasingly utilized by clinicians, little is known about its psychological value for cardiac patients undergoing the test., What does this study add? Cardiac computed tomography angiography testing can be a potentially important experience for cardiac patients in understanding their cardiac health., Cardiac computed tomography angiography could provide an opportune time to address patients' health behaviour intentions and treatment beliefs., Effective utilization of CCTA scan images in consultation may help to enhance consultation objectives. [ABSTRACT FROM AUTHOR]