简介：Positronemissiontomography(PET)isapowerfulnoninvasiveimagingtoolforphenotypingpatientsatriskoforwithknowncoronaryarterydisease(CAD).Oneofthekeyadvantagesoverotherimagingmodalitiesisitsuniqueabilitytoquantifyphysiologicprocesses,includingmyocardialbloodflow(inmillilitersperminutepergramofmyocardium),metabolism,andcardiacreceptors,anditshighsensitivityfordelineatingandquantifyingmoleculartargetsinvivousingtargetedimagingprobes.CardiacPET/CToffersopportunityforacomprehensivenoninvasiveevaluationoftheconsequencesofatherosclerosisinthecoronaryarteriesandthemyocardium.

简介：Inthelastseveralyears,therateofinnovationincardiacimagingtechniqueshasacceleratedsignificantly.Advanceshavebeenseeninall4majormodalities;echocardiography,nuclear(positronemissiontomography(PET)andsinglephotonemissioncomputedtomography(SPECT),cardiacmagneticresonanceimaging(CMR),andcomputedtomographicangiography(CTA).ThisissueofCardiovascularInnovationsandApplicationswillhighlightmanyoftheseadvances.

简介：RecentnovelapproachesinmyocardialperfusionsinglephotonemissionCT(SPECT)havebeenfacilitatedbynewdedicatedhigh-efficiencyhardwarewithsolid-statedetectorsandoptimizedcollimators.Newprotocolsincludeverylow-dose(1mSv)stress-only,two-positionimagingtomitigateattenuationartifacts,andsimultaneousdual-isotopeimaging.Attenuationcorrectioncanbeperformedbyspecializedlow-dosesystemsorbypreviouslyobtainedCTcoronarycalciumscans.HybridprotocolsusingCTangiographyhavebeenproposed.Imagequalityimprovementshavebeendemonstratedbynovelreconstructionsandmotioncorrection.FastSPECTacquisitionfacilitatesdynamicflowandearlyfunctionmeasurements.Imageprocessingalgorithmshavebecomeautomatedwithvirtuallyunsupervisedextractionofquantitativeimagingvariables.Thisautomationfacilitatesintegrationwithclinicalvariablesderivedbymachinelearningtopredictpatientoutcomeordiagnosis.Inthisreview,wedescribenewimagingprotocolsmadepossiblebythenewhardwaredevelopments.WealsodiscussseveralnovelsoftwareapproachesforthequantificationandinterpretationofmyocardialperfusionSPECTscans.

简介：Cardiaccatheterizationandpercutaneouscoronaryinterventionplayanimportantroleinthemanagementofcoronaryarterydisease.Althoughthetransfemoralapproachhasbeenthetraditionallydominantmethod,therehasbeenanincreasedutilizationofthetransradialapproach.Multipleobservationalstudiesandrandomizedclinicaltrialshaveshownfewerbleedingcomplications,reducedmorbidityandmortality,improvedqualityoflife,andbettereconomicoutcomeswhenthetransradialapproachisutilizedwhencomparedtothetransfemoralapproach.Despiteitsmanybenefits,utilizationofthisapproachincertaincountriesincludingtheUnitedStateshasbeenlessthanoptimalduetoaloweradoptionratesmostlydrivenbylackoftrainingopportunitiesanddecreasedawarenessofclinicalbenefitsofthetransradialapproach.Inthisreview,thehistory,observationaltrends,efficacy,andtechnicalaspectsoftransradialcardiaccatheterizationandpercutaneouscoronaryinterventionarediscussed.

简介：Recentdevelopmentsinthenovelimagingtechnologyofcardiaccomputedtomography(CT)notonlypermitdetailedassessmentofcardiacanatomybutalsoprovideinsightintocardiovascularphysiology.Foremost,coronaryCTangiography(CCTA)enablesdirectnoninvasiveexaminationofbothcoronaryarterystenosesandatheroscleroticplaquecharacteristics.CalculationofcomputationalfluiddynamicsbycardiacCTallowsthenoninvasiveestimationoffractionalflowreserve,whichincreasesthediagnosticaccuracyfordetectionofhemodynamicallysignificantcoronaryarterydisease.Inaddition,acombinationofmyocardialCTperfusionandCCTAcanprovidesimultaneousanatomicalandfunctionalassessmentofcoronaryarterydisease.Finally,detailedanatomicalevaluationofatrial,ventricular,andvalvularanatomyprovidesdiagnosticinformationandguidanceforproceduralplanning,suchasfortranscatheteraorticvalvereplacement.TheclinicalapplicationsofcardiacCTwillbeextendedwiththedevelopmentofthesenovelmodalities.

简介：BackgroundDeepsternawoundinfection(DSWI)aftermediansternotomyforcardiacsurgeryisoneofthemostcomplexandpotentiallylife-threateningcomplications.ItsverydifficulttotreatDSWI,andthereislackofagreementregardingthebesttherapystrategy.Thus,weaimedtosummarizeourexperiencesofsurgicaltreatmentforDSWI,inwhichsatisfactoryclinicalresultswereobtained.MethodsWeretrospectivelyanalyzed17caseswhosufferedfromDSWIaftercardiacsurgeryinourdepartmentfromJanuary2010toJune2015.Therewere8maleand9femalepatientswiththeiraverageageof62.7±9.5years(range42~75years).Allpatientsreceivedreservationofpartofsternumcombinedwithvacuum-assistedsuctiondrainageandbilateralpectoralismajormyocutaneousadvancementflaps.ResultsTheaverageintervalbetweencardiacsurgeryanddiagnosedDSWIwas10.9±6.5days(range5~21days).Timeofvacuum-assistedsuctiondrainagewas11.6±4.8days(range5~15days)andwoundhealingtimewas27.3±7.2days(range23~35days).Allpatientshadanuneventfulpostoperativerecoveryandgoodwoundhealing.Follow-uptimewas33.7±13.3months(range8~74months).Norecurrentinfectionwasobserved.ConclusionsReservationofpartofsternumcombinedwithvacuum-assistedsuctiondrainageandbilateralpectoralismajormyocutaneousadvancementflapsisasimpleandeffectivesurgicalstrategyforthetreatmentofDSWIaftercardiacsurgery.

简介：Cardiologistswhoseepatientsonageneralcardiologyservicearebeginningtoseeanincreasingnumberofpatientswhohavereceivedaprimarypreventionimplantablecardiacdefibrillator(ICD)buthaveneverhaditfire.ThereareadditionallyanumberofpatientswhohaveinappropriatefiringofICDs.Inappropriateshocksoccurinupto40%ofpatientswithanICD.Themaincauseissupraventriculartachyarrhythmia,includingsinustachycardia,atrialfibrillation,andotherrapidsupraventriculararrhythmias.

简介：Cardiacmagneticresonance(CMR)imagingplaysanimportantroleinthediagnosisandmanagementofcardiovasculardiseases.Thestate-of-the-artCMRimaginghasmanyadvantagesincardiacimaging,includingexcellentspatialandtemporalresolution,unrestrictedimagingfield,noexposuretoionizingradiation,excellenttissuecontrast,anduniquemyocardialtissuecharacterization.ClinicalCMRimagingisusedduringthecardiovasculardiagnosticworkupintheUnitedStatesandsomeEuropeancountries.UseofCMRimagingisemerginginhospitalsinChinaandhasapromisingfuture.Thisreviewbrieflydescribesthereal-worldclinicalapplicationofCMRimaginginChinaanddiscussobstaclesforitsfuturedevelopment.

简介：Whenmanyolder(seasoned)physicianstrained,moderncardiovascularimaginge.g.cardiacultrasound,nuclearstudies,computedtomography,cardiacMRdidnotexist.Non-invasiveimagingstudiesthatwereavailabletousincludedtheECG,stressexercisetesting,andchestX-ray.Invasivestudiessuchashemodynamicsandangiographyweretheonlyphysiologicandanatomicstudiesavailable.Thustherewereveryfewimagingstudiesusedforclinicaldecisionmakingtoconfirmthediagnosis,estimateprognosis,orplantherapyofthecardiaccondition.Thebestofthesewascardiaccatheterizationwithventricularandcoronaryangiographyinadultpatientsandmeasurementofintracardiacpressure,oximetryandangiographyinpatientswithcongenitalheartdisease.Thisisstillthecasein2016withmanymoreimagesadded.

简介：Segmentingwholeheartfromcardiaccomputedtomography(CTimagescanprovideanimportantbasisfortheevaluationofcardiacfunctionandhelpimprovetheaccuracyofclinicaldiagnosis.Manualsegmentationisthemostaccuratemethodforcardiacsegmentation.Butitistimeconsumingandnotsufficientlyreproducible.However,cliniciansstillrelyonthismethodinpracticalapplications.Soafullyautomaticmethodisneededtoimprovethesegmentationefficiency.Thispapeproposesaregistration-basedautomaticapproachforthree-dimensional(3DsegmentationofcardiacCTimages.TheproposedmethodutilizesthesimilarityocardiacCTimagesbetweendifferentindividuals,andusesregistrationtoachievethesegmentation.Affinetransformationisfirstlyimplementedtoachieveglobalcoarseregistration.Then,cubicB-splinesareusedtorefinethelocaldetailsinlocallyaccurateregistration.Mutualinformation(Ml)isusedasthesimilaritymeasure,andadaptivestochasticgradientdescent(ASGD)astheoptimizationalgorithm.Oumethodisappliedtothedual-sourcecardiacCTimagestosegmentwholeheartExperimentalresultsshowthattheproposedmethodcanautomaticallysegmentwholeheartfromcardiacCTimages.

简介：Background:Ketamineisappliedwidelyforsedationduringcardiaccatheterizationinspontaneouslybreathingchildrenwithcongenitalheartdisease(CHD).However,arareandunreportedrespiratorycomplication,transientandreversibleatelectasisoflungs(TRAL),wasidentified.Purpose:ThestudywasperformedtoinvestigateretrospectivelytheprevalenceandclinicalcharacteristicsofTRALafterketaminesedationinpediatriccardiaccatheterization.Methods:Fourthousandfourhundredandseventy-foursickchildrenweresedatedwithketamine,andpediatriccardiaccatheterizationwascarriedoutunderspontaneousbreathing.TRALwasdetectedin33children(17M/16F,agewas2.1±1.7years)byretrospectiveanalysis.Theclinicalandradiographiccharacteristicswererecordedbefore,duringandafterTRAL.Results:Inpediatriccardiaccatheterization,theprevalenceofTRALwas0.74%afterketaminesedation.TRALoccurredin23childrenwithcyanoticCHD,and10withacyanoticCHD.AllTRALshadcommonclinicalandradiographicfeatures:thediffuseopacityofbilaterallungsdevelopedrapidly(identifiedunderX-rayfluoroscopy),associatedwithdecreaseinlungvolume,andthenthedecreaseinSpO2(94.2±9.2%vs.59.4±2.2%,P<0.05),andheartrates(143.5±14.3bpmvs.58.3±9.7bpm,P<0.05)followedquickly.TRALwasrelievedbysupportiveoxygenin32children(23withfacemask,and9withendotrachealintubation),andthedurationofTRALwas1.6±0.5minutes.However,TRALcausedthedeathofonechild.Conclusions:TRALisarareandurgentrespiratorycomplicationafterketaminesedation,andthemechanismisunclear.RapidanddiffuseopacityofbilaterallungsistheearliestsignofTRALinpediatriccardiaccatheterization,andtheimmediatesupportiveoxygeniscrucial.