Review of the Literature
Multi-modality imaging: Bird’s eye view from the 2020 American Heart Association Scientific Sessions

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Abstract

This review summarizes key imaging studies that were presented at the American Heart Association Scientific Sessions 2020, which occurred virtually this year due to the pandemic, related to the fields of single-photon emission computed tomography, positron emission tomography, cardiac computed tomography, cardiac magnetic resonance, and echocardiography. The aim of this bird’s eye view is to inform readers of the various studies discussed at the meeting from these imaging modalities. Since there was no physical attendance this year, we find that a general overview of imaging will be especially useful. Further, we hope that the presentation of multiple imaging studies in a single synthesized review will stimulate new ideas for future research in imaging.

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.

References (47)

  • MasonSM et al.

    Assessment of cardiovascular events among symptomatic outpatients with suspected coronary artery disease who presented during COVID-19 pandemic

    Circulation

    (2020)
  • ShimizuM et al.

    Machine learning on dual-isotope myocardial semiconductor SPECT can predict cardiac prognosis in patients with congestive heart failure

    Circulation

    (2020)
  • NakajimaK et al.

    Machine learning-based risk model using 123 I-metaiodobenzylguanidine to differentially predict modes of cardiac death in heart failure

    J Nucl Cardiol

    (2020)
  • TamakiS et al.

    Usefulness of 2-year iodine-123 metaiodobenzylguanidine-based risk model for the post-discharge risk stratification in acute decompensated heart failure patients with preserved left ventricular ejection fraction

    Circulation

    (2020)
  • KadoyaY et al.

    Prognostic value of cardiac 123I-MIBG imaging for predicting cardiac events after transcatheter aortic valve replacement

    Circulation.

    (2020)
  • FukunagaH et al.

    Evaluation of left peri atrial cardiac sympathetic activity using Mibg scintigraphy before and after cryoballoon ablation of paroxysmal atrial fibrillation

    Circulation

    (2020)
  • SouzaAA et al.

    Intermuscular fat is independently associated with coronary microvascular dysfunction and adverse cardiovascular outcomes in patients with no obstructive CAD

    Circulation

    (2020)
  • WeberB et al.

    Specificity for inflammatory pathways and myocardial injury associated with coronary microvascular dysfunction in rheumatoid arthritis

    Circulation

    (2020)
  • BhattaruA et al.

    Association of serum leptin and abdominal aortic inflammation in rheumatoid arthritis

    Circulation

    (2020)
  • BoczarKE et al.

    Anti-inflammatory effect of rosuvastatin in patients with HIV infection: a randomized controlled FDG-PET study

    Circulation

    (2020)
  • KikoT et al.

    Prognostic value of simultaneous hybrid 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging in cardiac sarcoidosis

    Circulation

    (2020)
  • AbohashemS et al.

    Genetic susceptibility to stress associates with higher amygdalar activity and greater myocardial infarction risk

    Circulation

    (2020)
  • AbbasiT et al.

    Stress-related neurobiological activity contributes to the link between cardiovascular polygenic risk score and myocardial infarction

    Circulation

    (2020)
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