International Journal of Cardiovascular Practice

Review Article

The Assessment of left ventricular Function in MRI using the detection of myocardial borders and optical flow approaches: A Review

Narjes Benameur, Tarek Kraim, Younes Arous, Najemeddine Benabdallah

International Journal of Cardiovascular Practice, Vol. 2 No. 4 (2017), 27 August 2017, Page 73-75

The evaluation of left ventricular wall motion in Magnetic Resonance Imaging (MRI) clinical practice is based on a visual assessment of cine-MRI sequences. In fact, clinical interpreters (radiologists) proceed with a global visual evaluation of multiple cine-MRI sequences acquired in the three standard views. In addition, some functional parameters are quantified following a manual or a semi-automatic contouring of the myocardial borders. Although these parameters give information about the functional state of the left ventricle, they are not able to provide the location and the extent of wall motion abnormalities, which are associated with many cardiovascular diseases. In the past years, several approaches were developed to overcome the limitations of the classical evaluation techniques of left ventricular function. The aim of this article is to present an overview of the different methods and to summarize the relevant techniques based on myocardial contour detection and optical flow for regional assessment of left ventricular abnormalities.

Low dose radiation exposure and cardiovascular diseases: a review

Ling Gao, Chun-Yan Ding

International Journal of Cardiovascular Practice, Vol. 2 No. 4 (2017), 27 August 2017, Page 76-79

ICRP stated that particular attention should be paid to radiation effects in the cardiovascular system because of recent published observations of radiation effects in this systems occurring after much lower doses than reported previously (ICRP, 2007 and 2012). The review was based on scientific articles available in the open literature, major reviews by other organizations, in particular International Commission on Radiation Protection (ICRP, 118). In this review, we describe low-dose ionizing radiation effect, causes of cardiovascular diseases, relationship between low-dose ionizing radiation and cardiovascular diseases, as well as the importance and urgent of elucidate the relationship between low dose ionizing radiation and cardiovascular disease.

Original Articles

Updated Meta-Analysis of Randomized Trials Comparing Safety and Efficacy of Intraoperative Defibrillation Testing with No Defibrillation Testing On Implantable Cardioverter-Defibrillator Implantation

Carlo Bonanno, Antonio Rossillo, Mariemma Paccanaro, Angelo Ramondo, Antonio Raviele

International Journal of Cardiovascular Practice, Vol. 2 No. 4 (2017), 27 August 2017, Page 80-88

Introduction: There is an ongoing debate regarding the need to conduct intraoperative defibrillation testing (DFT) at the time of implantable cardioverter-defibrillator (ICD) implantation. To provide sufficiently strong evidence for the feasibility of omitting intraoperative DFT in clinical practice, we conducted a meta-analysis of randomized controlled trials (RCT) comparing patients with DFT and no-DFT.

Methods: We systematically searched Medline (via PubMed),, the Cochrane Central Register of Controlled Trials, and Embase for studies evaluating DFT vs. no-DFT on ICD implantation with regard to total mortality and arrhythmic death, efficacy of first and any appropriate shock in interrupting ventricular tachycardia (VT)/ventricular fibrillation (VF), and procedural adverse events. Effect estimates [risk ratio (RR) with 95% confidence intervals (CI)] were pooled using the random-effects model.

Results: Our meta-analysis included 4 RCTs comprising 3770 patients (1896 with DFT and 1874 without DFT). Total mortality (RR = 1.00, 95% CI 0.86–1.17; P = 0.98) and arrhythmic death (RR = 1.60, 95% CI 0.46-5.59: P = 0.46) were not statistically different. Both first (RR = 0.94, 95% CI 0.89–0.98; P = 0.004) and any appropriate ICD shock (RR = 0.97, 95% CI 0.95–1.00; P = 0.02) significantly increased the rate of VT/VF interruption in the group with no-DFT in comparison with DFT. Finally, the incidence of adverse events was lower in no-DFT patients (RR = 1.23; 95% CI 1.00–1.51; P = 0.05).

Conclusions: The practice of DFT (as opposed to no-DFT) did not yield benefits in mortality or the overall rate of conversion of VT/VT. Moreover, a slightly higher incidence of perioperative adverse events was observed in the DFT group.

Case report

Dilated Cardiomyopathy in Behcet's Disease in a Young Male Patient

Hamid Khederlou, Samin Taheri, Alireza Sadeghi, Amirhossein Moghtader Mojdehi

International Journal of Cardiovascular Practice, Vol. 2 No. 4 (2017), 27 August 2017, Page 89-92

Behcet’s disease is a multisystemic, inflammatory and chronic disorder characterized by recurrent oral aphthous ulcers and genital ulcers, uveitis and other manifestations, including systemic organ involvement. Cardiac involvement in Behcet’s disease is rarely however, it plays an important role in prognosis and increases mortality. We hereby have reported a case of Behcet's disease with dilated cardiomyopathy. He was presented with constitutional symptoms and also oral and genital aphthous ulcers, pseudofolliculitis, tachycardia, arthritis, splenomegaly, ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein) elevation and LV systolic dysfunction with LVEF=45% were found in evaluation. He was started on Azathioprine and Prednisolone.

A Mysterious Case of ST-Elevation Myocardial Infarction; an Old Man with Weight Loss and Dyspepsia

Morteza Safi, Isa Khaheshi, Mehdi Memaryan, Mohammadreza Naderian

International Journal of Cardiovascular Practice, Vol. 2 No. 4 (2017), 27 August 2017, Page 93-94

We present a 65-year-old man who developed retrosternal compressive chest pain. A 12-lead electrocardiography demonstrated ST-segment elevation in leads II, III and aVF. Emergent coronary angiography showed significant thrombus in the distal portion of the left main coronary artery. Abdomino-pelvic computed tomography scan, which was performed the next day, confirmed a pancreatic mass with peritoneal seedings, compatible with peritoneal carcinomatosis. This case underscores the importance of malignancies that may lead to a catastrophic ST-elevation myocardial infarction due to a hypercoagulable state and following thrombosis in the left main coronary artery.