๐น CT bifurcation score + subtended mass stratify which branches need protection.
๐น CT-fluoro overlay and AR/VR provide live guidance.
๐ Bottom line: Maximize PCI precision/efficiency by planning w/ CCTA; #IVUS/#OCT for optimization.
www.ahajournals.org/doi/10.1161/...
@uniofgalway ๐ฎ๐ช
๐น CT picks optimal views, predicts engagement, and helps right-size guides.
๐น Length, vessel geometry, calcium map, high-risk plaque โก๏ธ smarter prep (lithotripsy/atherectomy) and cleaner landing zones.
๐น CT-FFR and virtual stent planning predicts post-PCI FFR (P3 data).
CCTA isnโt just for diagnosis, itโs a PCI playbook.
Excellent new review details how #CCTA offers shorter cases, less contrast/radiation, fewer geographic misses, better stent sizing, and a reproducible workflow you can teach.
โ Coronary calcium scoring is a great way to risk stratify patients for the #1 cause of death, but many insurance plans still don't cover this test.
๐ Here's a new expert statement in @JACCJournals that calls on payers to provide coverage. The time is now for progress.
buff.ly/UCWJZG5
๐ค Young woman presents with chest pain. Diagnosis?
๐ Incredible #CardiacCT imaging @NorthwellHealth
#cardioSky
๐ฅ New review from @TheLancet on Dx of #CAD.
๐ Bottom line: The field continues to shift toward plaque-centric #CCTA, with functional tests layered on for ischemia, reflecting a more comprehensive approach to chronic CAD.
www.thelancet.com/journals/lan...
@drmarthagulati.bsky.social #CardioSky
๐ Incredible #CT images of #LVAD complications - just out in @JACCJournals.
๐ Thanks to the team at @inselgruppe.bsky.social for putting this together!
www.jacc.org/doi/10.1016/...
#cardiosky
www.jacc.org/doi/epdf/10....
@CardioOnc_MR_CT @RonBlankstein @hahn_rt
@ACCinTouch @American_Heart @SCCTorg @SCMRorg
#cardioSky
๐ฅ Hot off the press! 2025 CV Imaging Training Statement
๐ฃ๏ธ New "Advanced Imager" pathway with Level II-like competence in CT, MR, Echo, and Nuc
๐ Nice emphasis on cross-modality integration for CAD, sarcoid, amyloid, HCM pericardium, masses, structural, and ACHD
Link below๐
What is the unifying diagnosis?๐ซ
Incredible cardiac imaging happening @NorthwellHealth ๐
#cardioSky @SCMRorg
SSFP, LGE, T1, T2
๐จ New AHA statement on NOCA from @CardioMDPhD @lesleejshaw and others.
๐ AI plaque analysis improves risk discrimination and changes downstream management.
๐ @NorthwellHealth will be studying this as we prepare to roll out Plaque Analysis!
#CardioSky
www.ahajournals.org/doi/10.1161/...
๐ง Family: ECG+echo (CMR if equivocal); echo q1โ2y, CMR q2โ5y
๐งฉ Phenocopies: Amyloid (EF/GLS >4.1, high T1), Fabry (low T1, basal IL LGE), Athlete (balanced dilation, no LGE)
๐ค Future: AI, indexed wall thickness, DTI/FAPI
doi.org/10.1093/ehjc...
#CardioSky
๐ฆ Obstruction is dynamic: LVOTO >30 rest, >50 provoked
โณ Mid-cavity HCM = hourglass LV & apical aneurysm; doppler underestimates pressures
๐ซ๏ธ Ischemia w/o CAD is common: check CMR/PET for microvascular dysfunction
๐ Therapy monitoring: CMIs: start for EF โฅ55โ60%; hold <50%
๐งญ Diagnosis โ MWT โฅ15 mm alone: use phenotype, function, tissue characterization
๐ฅ LGE matters: ~65% have LGE; โฅ15% LV mass can up-class ICD risk
๐ฏ EF can mislead: track GLS for systolic dysfunction
๐ซ Diastolic assessment: EACVI/ASE 4-criteria + LA strain; exercise echo
๐ New #EACVI consensus statement on multimodality imaging for #HCM from @s_e_petersen @cardim_nuno. #Echo, #CMR, #CCT, and #PET each add unique value across diagnosis, symptoms, prognosis, screening, and treatment monitoring.
Key points๐
๐ CT perfusion can provide volumetric MBF maps that pair seamlessly with #CCTA for a single comprehensive exam. ?Could this offer a one-stop shop?
doi.org/10.1016/j.jc...
#cardiacimaging #cardioSky
๐งฑ Historically, there has been limited access to PET scans needed to quantify MBF. But this is changing.
๐ As described in this expert review, CT & MRI are now validated to deliver comprehensive/actionable reporting on MBF, bringing greater precision to the chest pain pathway.
๐ฅ Myocardial Blood Flow (#MBF) isn't just a #PET thing anymore. #CCT and #CMR are in the game.
๐ฆ Angina isn't always explained by epicardial stenoses. Quantification of MBF can detect other causes (#ANOCA), like microvascular disease, HCM, or transplant vasculopathy.
๐ If we start reporting even 3 of these opportunistic metrics (e.g. RV function, membranous septum length, frailty marker), we move CT-TAVR from procedural planning โ phenotyping platform.
#TAVR #StructuralHeart #cardioSky @danilorenzatti @CardioMDPhD
๐น Frailty on CT: psoas/skeletal muscle index + vertebral HU โ osteosarcopenia โ worse 1-year outcomes.
๐น CAD beyond โis there calcium?โ: better CCTA (PCCT) + CT-FFR can reduce the number of patients we send for invasive angio.
๐น Amyloid signal: CT-ECV (esp. with dual/spectral or photon-counting) โ separates AS remodeling from coexisting ATTR, which is not rare in this population.
๐น Fat: EAT / peri-coronary fat volume + attenuation โ inflammatory signature that tracks with MACE after TAVR.
๐น Conduction risk: membranous septum length, LVOT/root/mitral annular calcium โ helps predict whoโs heading for a PPM.
๐น Myocardial phenotype: full-cycle CT โ RV function (often missed on echo), CT-GLS, โcardiac damageโ staging โ all tied to mortality after TAVR.
Weโre doing CT before most TAVRs, but weโre only cashing in on the โplanningโ part. This review argues we should be squeezing the rest of the dataset for prognosis and longitudinal care.
www.journalofcardiovascularct.com/article/S193...
What else is sitting on those scans? ๐
๐ฅ Masterful review of the literature on CT-FFR in @journalCCT
www.journalofcardiovascularct.com/article/S193...
#CCTA + #CTFFR = anatomy + physiology in one stop ๐
Growing evidence to look at the translesional ฮFFR, not just the distal FFR value ๐บ
@PRodriguezMD #cardioSky #CAD #SCCT
๐ค Thought-provoking piece in @CircAHA from Kole & Joshi
๐ซ A growing group of patients with subclinical atherosclerosis falls in between traditional "primary" and "secondary" prevention. I've heard of "prevention 1.5" or "plaque-informed prevention." How about the following classification system?๐
๐ Spectral data paves the way for plaque phenotyping, perfusion mapping, myocardial characterization - a possible "one-stop" exam?
๐ค Still need: larger prospective clinical validation and cost-effectiveness data
๐ www.jacc.org/doi/10.1016/...
@ArthurShiyovich @RonBlankstein #cardioSky #CCTA
๐ฅ Just out in #JACC CVI: State-of-the-Art on Photon-Counting CT
๐ Why this technology is a game-changer:
โข๏ธ Better for patients: โฌ๏ธ radiation and โฌ๏ธ contrast
๐
Better for readers: spatial rez of 0.1mm + โฌ๏ธ blooming = stents and calcified plaques are clearer than ever before
โจ Beautiful #CMR pictures. Young patient with new chest pain. SSFP, T2W, and LGE.
#NorthwellHealth #cardiosky
๐ชฆ Ischemic heart disease remains the #1 cause of death worldwide
๐ฅ That's 8.9M premature deaths or 136M years of life lost in 2023 alone
๐ We need a better strategy to detect and prevent ischemic heart disease
๐ Thanks to GBD for another incredible report: www.thelancet.com/journals/lan...
#CCTA
๐ Key strategies include: prospective gating, reduced field of view, BMI-tailored kVp, elimination of redundant phases, and hands-on training for techs.
๐ฌ Here, Chazal et al describe how a multicenter CCTA program used these strategies to lower mean radiation dose by 23%! doi.org/10.1016/j.ja...