Review of the LiteratureMulti-modality imaging: Bird’s eye view from the 2020 American Heart Association Scientific Sessions
Section snippets
SPECT
Many exciting abstracts have been presented at AHA 2020 in the field of SPECT. Coronary artery disease (CAD) remains the leading cause of morbidity and mortality. Cardiac CT angiogram (anatomical definition) and stress SPECT myocardial perfusion imaging (MPI) (physiological evaluation) are two of the most commonly used non-invasive modalities to assess for CAD. However, significant coronary calcification and attenuation artifacts are common limitations for CT and SPECT, respectively, hence
PET
The field of cardiac PET imaging of inflammation remains a dynamic and evolving one. There seems to be a common pathway between inflammation, microvascular disease, and cardiovascular events. Souza et al.13 evaluated the association between intermuscular adipose tissue (IMAT) (often associated with inflammation and a key determinant in cardiometabolic disease), microvascular coronary dysfunction, and cardiovascular outcomes in 669 patients undergoing stress PET with normal perfusion and LVEF.
CMR
The utility of CMR was highlighted in one of the late breaking scientific sessions presented at AHA 2020 evaluating the etiology of myocardial infarction without obstructive coronary disease (MINOCA), a part of the Women’s Heart Attack Research Program (HARP) study. Reynolds et al.22 prospectively evaluated 145 women with MINOCA and showed that 62 of the 116 (53.4%) who had a CMR had myocardial edema or subendocardial LGE in a coronary distribution. Another 24 of 116 (20.7%) were found to have
Echocardiography
Numerous interesting abstracts were presented at AHA 2020. We will review here a few representative submissions.
Stress echocardiography has long been used for both establishing a diagnosis as well as risk stratification in patients with suspected and known CAD. Given the modality’s relatively low sensitivity, it is of clinical relevance to identify factors that will allow improved risk stratification even in the absence of regional wall motion and/or thickening abnormalities. Bou Chaya et al.30
CT
Multiple important studies, including a late breaking clinical trial, investigating the role of coronary computed tomography angiography (CCTA) and cardiac CT were presented at AHA 2020.
Dr. Gray from Edinburgh presented the results of the RAPID CTA trial (Early Coronary CT Angiography in Patients with Suspected or Provisionally Diagnosed Acute Coronary Syndrome) which was funded by the National Institute for health research in the United Kingdom.42 The study was a prospective, randomized, open
Disclosure
Dr. Al-Mallah reports research grant support from Siemens. Dr. Hage reports grant support from GE Healthcare. Drs. AlJaroudi, Pflederer, and Andrikopoulou report no disclosures.
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