Ischemic Heart Disease: New Insights from Imaging Diagnostic Techniques
1IRCCS, Milano, Italy
2University Hospital Policlinico of Bari, Bari, Italy
3Federico II University Hospital, Naples, Italy
4Fondazione G. Monasterio CNR Regione, Pisa, Italy
5Careggi Hospital, Florence, Italy
Ischemic Heart Disease: New Insights from Imaging Diagnostic Techniques
Description
Ischemic heart disease is the leading cause of death and disability in the USA and other Western countries, and thus its prevention is important for ethical and economic reasons. It is also known that sudden cardiac death or acute coronary syndromes are frequently the first manifestation of previously subclinical atherosclerosis. Although traditional risk charts may provide risk stratification in the overall population, their capability to predict the first cardiac event at the individual patient level is limited.
Considerable progress has been made over the last 10 years in the field of noninvasive coronary imaging. In particular, coronary computed tomography angiography is an emerging noninvasive technique for the evaluation of coronary artery disease. The anatomic evaluation of coronary vessels by this technique has the potential to noninvasively characterize coronary atherosclerotic plaques at high risk of acute coronary syndrome. The diagnostic role of coronary computed tomography angiography in symptomatic patients is delineated but it is still unknown in asymptomatic individuals with significant atherosclerosis due to a paucity of data.
In parallel, for many years invasive coronary angiography was considered the reference standard and myocardial revascularization was guided exclusively by visual assessment of coronary stenoses without taking into consideration their functional significance. Previous studies suggested that despite the fact that severe coronary lesions are more likely to cause ischemia, there may be a mismatch between the anatomic severity of lesions and the presence of myocardial ischemia that would benefit from intervention.
Several functional imaging techniques including stress echocardiography, single-photon emission computed tomography, stress cardiac magnetic resonance, and positron emission tomography may be used to reveal the presence of coronary artery disease and guide the use of invasive coronary angiography. More recently, fractional flow reserve derived from coronary computed tomography angiography and stress myocardial computed tomography perfusion has emerged to provide both anatomical and functional evaluation of coronary artery disease simultaneously.
We invite authors to contribute original research articles as well as review articles related to imaging of stable ischemic heart disease, coronary artery disease, and diagnostic techniques. In order to underscore new insights from any imaging diagnostic techniques, we encourage highlighting aspects of diagnostic accuracy, prognosis, and technological advances.
Potential topics include but are not limited to the following:
- Noninvasive evaluation of coronary atherosclerotic plaques
- Screening of coronary artery disease in asymptomatic high-risk patients
- Diagnosis of significant coronary artery disease in symptomatic patients
- New technologies for the quantification of ischemic myocardium
- Diagnostic strategies as a gatekeeper to invasive coronary angiography
- Prognostic value of advanced imaging techniques in infarcted myocardium