Interdisciplinary recommendation on imaging procedures for ischemic heart disease
Whether patients suffer from acutely or chronically narrowed coronary vessels – quantitative imaging techniques are indispensable when it comes to detecting and treating circulatory disorders of the heart muscle or preventing them in time.
An interdisciplinary team, in which scientists from the German Centre for Cardiovascular Research (DZHK) also played a leading role, has now for the first time determined which method is best suited for patients with different clinical pictures in order to measure the heart’s blood supply.
The researchers have published the results as a joint consensus statement in Nature Reviews Cardiology.
The core of the work is a table with specific recommendations for action, which clearly shows which quantitative imaging methods are appropriate for each patient and the clinical picture at hand.
"What is special about this table is that scientists from different disciplines, namely cardiologists, physiologists, nuclear medicine specialists, physicists and radiologists, have compiled this table for the available imaging methods," says Professor Marc Dewey, DZHK scientist and Deputy Director of the Department of Radiology at the Mitte campus of Charité – Universitätsmedizin Berlin.
"Until now, there have only been guidelines of individual professional associations or individual techniques have been the focus of attention."
New findings on the method of choice
The advantages and disadvantages of the different techniques were discussed by the scientists using a systematic, multi-stage evaluation procedure. For some forms of disease, it became clear that one method is superior to all others, while for others, several are possible. "These findings have not been seen before and I hope that they will change clinical practice," says Dewey.
For example, patients who also suffer from cardiac heart failure benefit most from magnetic resonance imaging (MRI) because, in addition to the blood flow, the heart function can also be assessed - and whether connective tissue has replaced the heart muscle (fibrosis).
Invasive flow measurements are very well suited for patients with known coronary heart disease (CHD) or a high probability of CHD. Positron emission tomography (PET) provides the most accurate absolute quantification and is therefore particularly suitable for patients with CHD of multiple vessels.
Scintigraphy, on the other hand, is the most widely available procedure, and thanks to new technologies, quantification is now also possible. Echocardiography is the method of choice when doctors want to visualize the blood flow in the heart of bedridden patients, as it allows them to perform the examination at the bedside.
Computed tomography (CT) can also measure the blood flow and is the only method that enables the simultaneous analysis of possible coronary stenosis and plaques.
"Our consensus document helps to select the best possible diagnostic strategy and could therefore help to develop individualized suggestions for subsequent therapy," says Dewey. He also believes that it is important to give patients access to this chart to enable them to bring in their own wishes and ideas.
The Berlin radiologist expects the recommendations to remain valid for four to five years before they have to be revised in view of the constantly advancing technologies. He and his colleagues are open to new developments and members. So far, their team has been made up of European scientists, but colleagues from Asia or the USA are also welcome.
In this respect, their publication could also be seen as a call for all those who wish to participate in this decision-making process in the future, for instance for getting involved in the next topic, coronary arteries. The second meeting of the Quantitative Cardiac Imaging Study Group on March 9, 2021 in Berlin will be the starting point for this.
Prof. Dr. med. Marc Dewey, Deputy Director of the Department of Radiology at the Mitte Campus of Charité - Universitätsmedizin Berlin, Mitte Campus, marc.dewey(at)charite.de
Original work: Clinical quantitative cardiac imaging for the assessment of myocardial ischaemia
Marc Dewey, Maria Siebes, Marc Kachelrieß, Klaus F. Kofoed, Pál Maurovich-Horvat, Konstantin Nikolaou, Wenjia Bai, Andreas Kofle, Robert Manka, Sebastian Kozerke, Amedeo Chiribiri, Tobias Schaeffter, Florian Michallek, Frank Bengel, Stephan Nekolla, Paul Knaapen, Mark Lubberink, Roxy Senior, Meng-Xing Tang, Jan J. Piek, Tim van de Hoef, Johannes Martens and Laura Schreiber & on behalf of the Quantitative Cardiac Imaging Study Group. Nat Rev Cardiol (2020). DOI:10.1038/s41569-020-0341-8
Christine Vollgraf | idw - Informationsdienst Wissenschaft
Magnetic nanopropellers deliver genetic material to cells
08.05.2020 | Max-Planck-Institut für Intelligente Systeme
Development of new system for combatting COVID-19 that can be used for other viruses
08.04.2020 | University of Texas Medical Branch at Galveston
Microelectronics as a key technology enables numerous innovations in the field of intelligent medical technology. The Fraunhofer Institute for Biomedical Engineering IBMT coordinates the BMBF cooperative project "I-call" realizing the first electronic system for ultrasound-based, safe and interference-resistant data transmission between implants in the human body.
When microelectronic systems are used for medical applications, they have to meet high requirements in terms of biocompatibility, reliability, energy...
Thomas Heine, Professor of Theoretical Chemistry at TU Dresden, together with his team, first predicted a topological 2D polymer in 2019. Only one year later, an international team led by Italian researchers was able to synthesize these materials and experimentally prove their topological properties. For the renowned journal Nature Materials, this was the occasion to invite Thomas Heine to a News and Views article, which was published this week. Under the title "Making 2D Topological Polymers a reality" Prof. Heine describes how his theory became a reality.
Ultrathin materials are extremely interesting as building blocks for next generation nano electronic devices, as it is much easier to make circuits and other...
Scientists took a leukocyte as the blueprint and developed a microrobot that has the size, shape and moving capabilities of a white blood cell. Simulating a blood vessel in a laboratory setting, they succeeded in magnetically navigating the ball-shaped microroller through this dynamic and dense environment. The drug-delivery vehicle withstood the simulated blood flow, pushing the developments in targeted drug delivery a step further: inside the body, there is no better access route to all tissues and organs than the circulatory system. A robot that could actually travel through this finely woven web would revolutionize the minimally-invasive treatment of illnesses.
A team of scientists from the Max Planck Institute for Intelligent Systems (MPI-IS) in Stuttgart invented a tiny microrobot that resembles a white blood cell...
By studying the chemical elements on Mars today -- including carbon and oxygen -- scientists can work backwards to piece together the history of a planet that once had the conditions necessary to support life.
Weaving this story, element by element, from roughly 140 million miles (225 million kilometers) away is a painstaking process. But scientists aren't the type...
Study co-led by Berkeley Lab reveals how wavelike plasmons could power up a new class of sensing and photochemical technologies at the nanoscale
Wavelike, collective oscillations of electrons known as "plasmons" are very important for determining the optical and electronic properties of metals.
19.05.2020 | Event News
07.04.2020 | Event News
06.04.2020 | Event News
25.05.2020 | Medical Engineering
25.05.2020 | Information Technology
25.05.2020 | Information Technology