A decision by Ab Klink, Minister of Public Health, Wellbeing and Sports, to increase the number of balloon angioplasty facilities in hospitals to 30, has prompted the NVVC - the Dutch cardiologists association - to express concern that there will be too many centres and too few patients, and specialists will not be able to maintain the level of skills for this procedure.
Ongoing refinement of modern helical multi-slice CT (MSCT) scanners offers the opportunity for very high temporal and spatial resolution thin-slice data set acquisition. The reconstruction techniques offered (multisegment reconstruction) result in improved temporal resolution down to 40-200 ms and thus also reducing motion artifacts. The SURECardio software package makes possible optimum studies…
The aortocoronary bypass is an important surgical method for multivessel coronary revascularization, especially in the presence of complex lesions and in diabetic patients. It is can improve the prognosis of patients with three vessel disease and with left ventricular dysfunction1 . With regard to the type of graft used, bypasses are split into venous and arterial types. The use of venous…
Coronary stenting is the most common way of treating symptomatic ischaemic cardiopathy and stenosis of venous bypasses. Restenosis actually occurs in 30% of patients treated with non-medicated stents while "drug eluting" stents have reduced the incidence of restenosis by approximately a quarter and have proved particularly effective in diabetic patients and in the treatment of lesions…
Tissue Doppler Imaging (TDI) is an emergingnon-invasive ultrasound technique that makes it possible to measure velocities at any point of the ventricular wall during the cardiac cycle. Over the last ten years, TDI has been proposed as a feasible and useful imaging tool that provides information on regional wall motion dynamics.
The evaluation of the size and function of the left ventricle in patients with suspected heart disease is a central diagnostic problem. In contrast to other methods of evaluating left-ventricular function (e.g., angiocardiography, right-sided heart catheterization, radionuclide ventriculography or MRI), transthoracic echocardiography is a widespread and readily available procedure that is not…
Along with a high local resolution, the cardiac CT imaging also requires a high time resolution where the image data acquisition must be synchronised with the cardiac cycle by means of parallel ECG recording, and the measuring volume must be acquired in a single breathhold cycle. The multi-slice CT copes well with these requirements as it allows for acquiring continuous volume data sets of the…
Impairment of left ventricular relaxation may lead to pulmonary congestion and symptoms of heart failure even in patients with preserved systolic function. Doppler echocardiography has become the non-invasive method of choice for the assessment of both systolic and diastolic dysfunction. However, Doppler-derived parameters such as mitral inflow velocity, deceleration time and isovolumic…
It has long been known that remaining at high altitudes leads to an increase in pulmonary arterial pressure caused by hypoxia. Its effects on cardiac function have also been considered well documented. The increase in pressure in the pulmonary circulation causes an enlargement of the right ventricle and thereby causes a displacement of the left ventricle that is accompanied by a relaxation…
Further developments in computer and detection technology over the last few months and years have made it possible to overcome, to a large degree, the previously limitations of medical computer tomography in spatial and temporal resolution, and thus to permit “detail-true” representation of the beating heart. The diagnostic workflow and computer-tomographic diagnosis of the heart using the…
Because of the rapid technical and scientific development over the past few years, multislice computer tomography of the heart has become increasingly established in the clinical routine. This requires, among other things, knowledge of the anatomy of the coronary arteries, the meaningful evaluation of the calcium score and the appropriate reproduction of the function of the left ventricle.
In the last 10 years, small animal models have played an important role in cardiological research. These research models are especially important since today various cardiac illness entities can be investigated in transgene animal models. Because of the animals ease of handling and fast generation time, research projects with rats and mice are particularly interesting. Until the 1980s,…
Arteriosclerosis is well known as a vascular disease and cardiovascular risk factor. In its generalised form it affects not only the peripheral vessels (pelvis, legs) but also the coronary vessels and the carotid arteries. Arteriosclerosis is primarily a manifestation of advancing age, hence it is often accompanied by other diseases of the lungs and the heart as well as by metabolic diseases…
Ultrasound contrast agents (USCA) or echo enhancers consist of minute gas containing microbubbles that have a high reflectivity when exposed to an ultrasound field. The history of USCA started in the mid of the 1960s. The cardiologist Joyner performed echo cardiography during the injection of saline solution into the aortic root via a catheter. During the injection he observed bright signals on…
What is an “open foramen ovale”? The open foramen ovale medical abbreviation PFO for “patent foramen ovale”) is a usually small, only a few millimeter thick, membrane-covered slit in the septum between the atria of the heart. It is a remnant from human embryonic development that usually closes during the newborn period; however, in 10-25% of newborns a small opening remains that generally…
It has long been known that hypoxia at high altitudes leads to an increase of pulmonaryarterial pressure. For sensitive persons, one crucial factor for the development of HAPE is the overwhelming rise in pressure in the pulmonary circulation. Using right heart catheterization average pulmonary-arterial pressures of 60 mmHg were encountered in earlier studies of HAPE patients. A pressure increase…
A wearable cardiac telemedicine system based on Bluetooth technology could text the local hospital if a patient is about to have a heart attack, according to a publication of two Indian researchers of the Sathyabama University in Tamil Nadu, who developed the system.
The following two articles look at the advantages of a new ultrasound technique in prenatal diagnostics: Advanced Dynamic Flow (ADF). While the authors use ADF for different purposes - K. S. Heling applies ADF for general vascular imaging and R. Schmitz focuses on fetal liver tumours and a fetal aneurysm in the vein of Galen - they both arrive at remarkably similar conclusions. But read for…
Spiral computed tomography first allowed the seamless acquisition of entire volumina without first separating them into individual slices. With the newest generation of MSCT devices having the 16-slice technology, short gantry rotation time of < 0.5 seconds, and a high performance processor, it is now possible to acquire large amounts of data in a short period of time with high spatial and…
Besides sophisticated imaging technologies, biomarkers are the key to molecular medicine. Therefore, the development of new and more specific biomarkers is the primary aim of researchers around the world and - since this June - it is also the aim of the new founded European Institute of Molecular Imaging, a cooperation project of the University Münster, Germany and Siemens Medical Solutions.…
In recent years, Cardiac Resynchronization Therapy (CRT) has become increasingly important in the treatment of patients with impaired left ventricular contraction. Since this patient group is growing constantly experts estimate that by 2010 about 10 million people in Europe will be suffering from heart failure. Especially the “baby-boomers”, born just after World War II and in 2010 about…
Pediatric cardiovascular disorders are extremely complex in nature and present with a widely variable array of abnormal anatomy. Imaging these disorders presents a unique set of challenges for the cardiovascular team. Complex anatomical variations require detailed volumetric image interpretation with high spatial and temporal resolution. In addition, the patients are invariably young. They may…
In the last 25 years, fetal echocardiography has become established as an integral component of prenatal medicine. Structural heart defects are found in approx. 0.8% of all foetuses. They are consequently comparatively frequent and head the list of isolated fetal organ malformations. Routine screening of the four-chamber view and the outflow tract allows the experienced investigator to detect…
Among invasive cardiac catheterization diagnostic methods selective coronary angiography is the gold standard for directly visualizing the coronary system. It allows a definitive and precise diagnosis of coronary heart disease and thus serves as the rational basis for further revascularization procedures.
Dyssynchrony Imaging (DI), Toshiba's novel Doppler technology, is used as a quantitative clinical tool for rapid assessment of dyssynchrony in patients with suspected myomechanical dysfunction. From the parasternal short axis view, DI is applied by Toshiba's exclusive “angle-correction” technology and in apical views by standard Doppler imaging. Thus, DI permits evaluation of virtually all…
