Advances in Clinical Cardiovascular Imaging, Echocardiography & Interventions (ACCI-EI): A Textbook of Cardiology Navin C Nanda, HK Chopra, Jagat Narula
INDEX
Page numbers followed by b refer to box, f refer to figure, fc refer to flowchart, and t refer to table.
A
Abdominal bruit 105
Aberrant origin 877
ABPM See Ambulatory blood pressure monitoring
Abscess, myocardial 359
Abundant fibrinous strands 764
ACE inhibitors 86, 582
Acebutolol 74, 100
Acetylcholine 333
Acetylcholine-induced spasm of coronary arteries 1172
Acquired aortic pathology 879
Acquired immunodeficiency syndrome 1165, 1166
Acquired pericardial diseases 778
Acquired valvular dysfunction 492
Acquisition system 1136
Acrylamide-based formulation 1010
Acupuncture mapping, classical five-element 617
Acute coronary events, global registry of 188, 305
Acute infarction, detection of 136
Acute myocardial infarction
clinical manifestations of 368
complications of 132
diagnosis of 277fc
Acute pulmonary embolism, effect of 831fc
Acyanotic cardiac lesions 1030
Adenosine 129, 333, 335, 390
stress 289
normal 133
triphosphate 322, 1162
Adiponectin 114
Adipose tissue 1116
Adrenal hyperplasia, congenital 105
Adrenergic nervous system 114
Adrenocortical incidentalomas 113
Adrenomedullin 113, 114
Adriamycin 1151
Advance echocardiographic parameters 41
Advanced cardiac life support 363
Advanced diastolic indices 44
Advanced fibrotic atrial cardiomyopathy 600
Advanced restrictive cardiomyopathy 713f
AF See Atrial fibrillation
Agatston score 1100f
Air embolism 758
Airway 1109
Akinesis 325
Alanine aminotransferase 1160
Alberta stroke
program early computed tomography score
protocol early CT score 993
Albumin 335
Aldosterone 114
antagonists 581
Aldosteronism, primary 65
Alirocumab 1158
Allopurinol 32
Alpha-receptor blocking 74
Alprostadil 964
Ambient cisterns, bilateral 1003f
Ambulatory blood pressure monitoring 58, 60f, 61
advantages of 59b
clinical indications of 59, 59b
day-night blood pressure changes 59
interpretation of 60
limitations of 59, 60b
normality for 59
American Association of Clinical Endocrinologists 1158
American College of Cardiology 113, 145, 284, 332, 335, 496, 545, 546, 823, 947, 981, 1097, 1101, 1118, 1157, 1214, 1273
clinical expert consensus document 209
foundation 144, 410
guidelines 417, 1099
American College of Endocrinology Recommendations 1158
American College of Roentgenology 1101
American Diabetes Association 1101
American Heart Association 13, 113, 144, 145, 284, 335, 417, 496, 535, 546, 645, 947, 981, 998, 1097, 1099, 1101, 1118
classification of cardiomyopathies 137
guidelines 609, 610, 823, 995, 1117
recommendations 1157
task force 1214
American Society of Anesthesiologists 1147
American Society of Echocardiography 18, 30, 64, 84, 89, 157, 325, 349, 353, 681, 697, 1084, 1245, 1247f, 1288
American Society of Nuclear Cardiology 243
Amino acid
polypeptide 1115
sulfur-containing 1176
Aminophylline 336
Amiodarone 582, 703
AML See Anterior mitral leaflet
Amlodipine 100
Amplatzer cardiac plug 597f
Amyloid 117, 729
heart disease 716
light-chain 744
Amyloidosis 139, 679f, 707, 716, 728, 734, 734f
diagnosis 729
transthyretin-related 732
treatment 734
Anaerobic glycolysis 330
Anasarca 722
Anderson-Fabry disease 140, 678, 722
Anecdotal data 607
Aneurysm
coiling of 1008f
formation in basal lateral wall 312f
morphology, depiction of 1004
obliteration 1007
of Valsalva 821, 822f
sac 1010
Angina 332
microvascular 336
pectoris 1164
unstable 180, 187, 378, 401, 1157, 1169, 1170f,
Angiogenesis markers 114
Angiographic studies 129
Angiography
aortic arch 948f
procedure 948
pulmonary 1057f
thermal 1233
Angioplasty
duplex guided 957f
subintimal 955
Angiosarcoma 1188, 1196, 1198
Angioscopy 1102
Angiotensin receptor-neprilysin inhibitor, role of 81
Angiotensin-converting enzyme 82, 100, 145, 161, 336
inhibitor 38, 100, 171, 303, 443, 581, 652
Angiotensin-receptor
blocker 38, 100, 161, 171, 300, 303, 443, 581, 652, 1110
neprilysin inhibitor 86, 161
Angle of implantation 1276
Angle-independent technique 1039
Ankle swelling 127
Ankle-brachial index 923, 924
Annular abscess 516
Annular segments 52
Annuloplasty rings 457
Annulus 1276
paradoxus 788
reversus 788, 789
sizing 362, 448
Anomalous origin 6f
congenital 1050
of coronary arteries 389
Anomalous pulmonary venous connection 1049
Anterior mitral leaflet, base of 429
Anterior tibial arteries, bilateral 941f
Anterior wall myocardial infarction 197, 198f, 284f
acute 269f, 311f
Anteroseptal segment 1040f
Anthracycline 137, 121, 141
agents 1242
treatment 679
Antianginal therapies 335
Antiarrhythmic defibrillators 163
Antiarrhythmic drug 703, 977
Anticoagulation 837
Antihypertensive
classes of 100
treatment 100f
Antioxidant 114
enzyme 1176
properties 74
Antiplatelet 303
actions 1176
therapy, dual 1022
Antithrombotic properties 1176
Aorta 6f, 347f, 487f, 590, 1220
abdominal 878, 947, 949
branches, lateral 877
fusiform aneurysm of 880f
infrarenal 887
anatomy of 877f
arch of 888f
ascending 436, 874f, 878, 887, 1065, 1071,
dimensions 439
coarctation of 105, 888, 889f, 1048, 1060
descending 884, 887
distal descending 878
horizontality of 1279
mild coarctation of 1058f
normal anatomy of 877
pathology of 1222
proximal
ascending 69
descending 440, 878, 1058f
severe coarctation of 1048f
Aortic aneurysm 367, 879, 954f, 1213
abdominal 879, 881f, 881t, 950f
ascending 869f
complications of 880
treatment of 881
Aortic annuloplasty, subcommissural 1220
Aortic annulus 437f, 1272
graphical depiction of 1272f
Aortic arch 878, 878f, 947, 948
transverse 869f, 870f
Aortic artery pathologies 3
Aortic atheroma 873
complex 570
Aortic bifurcation 877
Aortic calcifications, detection of 879
Aortic coarctation 1058
Aortic cusp 490, 627f
Aortic dilatation 878
Aortic disease 10, 867, 877
Aortic dissection 360, 367, 374, 379, 412, 870, 870f, 871f, 874f, 879, 882, 974, 1089, 1207f, 1208f, 1228, 1277
classification of 882, 882t
clinical features 882
computed tomography angiography 882
echocardiography features of 371b
imaging in 882
pathophysiology 882
treatment 883
Aortic end of stent 1021
Aortic injuries, grading of 888
Aortic insufficiency 1206f, 1207f
acute 371
Aortic intramural hematoma 871
acute 885f
Aortic isthmus 879
Aortic leiomyosarcoma 875f
Aortic measurements 878
Aortic outflow 440
Aortic pathology, assessment of 458
Aortic periannular abscess 816f
Aortic position 518f
Aortic pressure, peak of 431
Aortic prosthesis 506t
Aortic prosthetic heart valve regurgitation, severe 510t
Aortic regurgitation 123, 344, 355, 435, 439, 440, 442444, 447, 680, 883, 1220f
acute severe 371
assessment of 439
chronic severe 680
echocardiographic evaluation of 439
grading of 441
grading severity of 443t
jet
moderate 1059f
quantification of 440
lesions and management 1220t
management of 443
pathological 538
prognosis of 444f
severe 716f, 816f, 901
severity during surgery, assessment of 1219
Aortic root 439, 878
abscess 825
dilatation 69
dimensions 523
vegetation 512f
with systole, reduced motion of 647f
Aortic sinus 437f
dilatation of 436
Aortic stenosis 344, 439, 446, 680, 1269, 1270, 1271f, 1272
echocardiography in 427
assessment of severity 430
special considerations 435
special procedures 434
types of 429
low gradient 680, 1274
severity of 430t
subtypes of 1274t
supravalvular 1059f
types of 1274
with aortic regurgitation 436f
with mitral
regurgitation 436f
stenosis 436f
Aortic stented bioprosthesis 506
Aortic syndrome, acute 367, 370, 882, 882t, 1222
Aortic transection 872
Aortic trauma 887
imaging 888
magnetic resonance imaging 888
Aortic tumors 873
Aortic ulcer, penetrating 879, 885, 886f
Aortic valve 344, 347f, 355, 356, 358f, 361, 696f, 1077, 1090f, 1148, 1270
assessment of 458
disease 439, 684
failure of 1077
implantation, percutaneous 7
infective endocarditis of 816f
normal 708f
pathology 1218
planimetry of 433, 434f
repair 1220
replacement 123, 444, 446, 826f, 1206f, 1207
stenosis 356, 1031
tracing 431f
three-dimensional echocardiography of 434f
transesophageal echocardiography
evaluation of 356
vegetation 359f
Aortic vein 356f
Aortic velocity, inspiratory decrease of 766f
Aortic wall 887
Aortitis 886, 1139
Aorto-duodenal fistula 881
Aortofemoral bifurcation 1275f
Aortomitral assessment 458
Aorto-ostial lesion visualization 210
Aortopulmonary window 1030
Aperture arc ranges, moment of 21
Apical endocardium 1040
Apical endomyocardium 140
Apical five-chamber 375
Apical four-chamber 375, 511
view 312f, 548f
Apical hyperkinesia 1075
Apical rotation pattern 1039
Apical three-chamber 375
Apnea 1031
Apolipoprotein 1156, 1157
A 114
Apoptosis, myocardial 128
Arginine vasopressin 113, 114
Arrhythmia 72, 54, 133, 389, 392, 492, 661, 729, 974, 981, 1183
risk of 117
surgery 495
Arrhythmogenic right ventricular
cardiomyopathy 138, 634, 976, 976f
dysplasia 634, 974, 976, 976f
Arterial bypass grafts 942
Arterial compliance 98
Arterial disease 916, 947
Arterial function 72, 73
Arterial narrowing, assessment of severity of 919t
Arterial pressure, inspiratory reduction of 761
Arterial resistances, systemic 1092
Arterial return cannula 1077
Arterial spin labeling perfusion 998
Arterial supply of conduction system 195f
Arterial switch operation 1063
Arterial thromboembolism 1246
Arterial trunk, common 1030
Arterial waveforms 917
Arteriogenic abnormalities 966
Arteriolar arteriogenic dysfunction 964
Arteriovenous access 956
Arteriovenous fistula 921, 942f, 974f
Arteriovenous grafts 921
Arteriovenous malformation 947, 1000, 1006, 1014
Arteritis 541, 879
Artery
hypertension, severe pulmonary 547
left 1220
main 394f
normal 248f
subclavian 888, 1045
Arthritis, rheumatoid 137, 332
Arthroscopic knee surgery 832
Artificial intelligence 1145
Ascending aorta, measurement of 437f
ASO See Arterial switch operation
Aspartate aminotransferase 1160
Aspirin, use of 379
Atenolol 336
Atherogenic oxycholesterol 1176
Atheromatous plaque 1102
Atherosclerosis 215, 1176, 1177
progression of 211, 1113
Atherosclerotic cardiovascular disease 1155, 1158, 1159
burden of 1155
management of 1155
spectrum of 1108
Atherosclerotic disease 105
Atherosclerotic plaque characteristics 1300
Atherosclerotic ulcer 872
penetrating 882
Atherothrombosis 1113
intervention 1159
Athlete heart 702
Athletic performance 1165, 1166
Atorvastatin 336, 1158
Atresia, pulmonary 1017, 1018, 1023, 1024f, 1025f
Atria, dilated 730
Atrial abnormalities 1137
Atrial amyloid, isolated 729
Atrial appendage 570f
Atrial compensation 710
Atrial contraction velocity 578
Atrial electromechanical action 690, 690f
Atrial fibrillation 49, 54, 55f, 66, 158, 359, 561, 563, 564f, 570, 571f, 572f, 584586, 600602, 602f, 603, 604f, 605, 607, 616, 638, 647f, 684, 711, 714, 851, 974, 977f, 987, 1040, 1119
ablation for 582, 625f
cardioversion in 54, 572, 572f
detection 1146
development of 683
electrophysiology mapping in 616
etiology of 562
implication of nonvalvular 609
management of 562f
permanent 603
risk of 38
role of echocardiography in 584
stroke prevention in 359
Atrial filling 709
velocity 710
Atrial flutter 35
Atrial function 50, 50t, 681
sequence of 50f
Atrial myocardial speckles, assessment of 56
Atrial myxoma 974
Atrial pressure, mean right 158
Atrial pump, ejection force of 37
Atrial remodeling mechanisms 35
Atrial retrograde velocity 74
Atrial septal aneurysm 1143f
Atrial septal defect 344, 355, 855, 361, 557, 1018, 1018f, 1048, 1063, 1063f
closure 362
enlarging 1018
occluder device 823f
Atrial septal pouch 344
Atrial structural deformations, causes of 49f
Atrial switch operation 1047
Atrial systolic
electromechanical action 690
opening of valve 789
Atrial wall, level of right 50
Atrioventricular block 974
Atrioventricular canal 484
Atrioventricular delay 667
Atrioventricular dyssynchrony 665, 670
hallmark of 711
Atrioventricular groove 380
Atrioventricular inflow velocities 786
Atrioventricular nodal reentry tachycardia 974
Atrioventricular optimization 692
Atrioventricular orifices, large 709
Atrioventricular reentrant tachycardia 974
Atrioventricular septal defect 1049
Atrioventricular valve
flow 770
regurgitation 711, 715
replacement 715
Atrium, common 1017
Autoimmune disorders 813
Automated functional imaging 1288
Avalanche photodiode 18
Avalon cannula 1077, 1077f
AVMs See Arteriovenous malformations
Axial computed tomography
angiogram image 841f
image 842f
scan 841f
Axillary vein 932f
compressibility of 932f
Doppler of 932f
Axium 1010
Axonal injuries 1127
Axons 1127
reaching 1127
B
Baby stents 1011
Baffle obstruction, systemic 1047
Balanced steady-state free precession technique 11
Balloon angioplasty 887, 957f
Balloon atrial septostomy 1017, 1018f
form of 1018
Balloon dilation 1024f
Balloon expandable valve 1277
Balloon inflation, serves for 1011
Balloon mitral valvotomy 543, 553f, 556f, 557
echocardiography
after 556
during 553
Balloon mitral valvuloplasty 417, 419f, 470
role of echocardiography in 557t
Balloon remodelling technique 1010, 1011f
Balloon support 1283, 1284
Balloon valvoplasty 362, 496
Balloon valvotomy 543
Balloon valvuloplasty 1031
Bare metal stent 230
Barlow's disease 347f
Baroreceptor activation therapy 165
Barrel vascular remodeling device 1012
Basal ganglia 997
Beam-hardening artifacts 392
Bedside echocardiography 758
Bendroflumethiazide 102, 103
Bentall procedure 439, 444
Benzocaine 352
Benzodiazepine 352
Benzothiadiazine dioxide scaffold 98
Bernoulli equation 431
modified 149
Beta-2-adrenergic receptor activation 1029
Beta-blocker 32, 72, 76, 100, 145, 303, 306, 335, 581, 582, 683
effect of 305t
in hypertension, effect of 74
treatment, effect of 75
Biatrial atrial overload 724
Biatrial dilatation 580, 580f
Biatrial enlargement, moderate 786
Biatrial overload 744
Bicaval dual-lumen cannula 1078f
Bicuspid aortic valve 347f, 429, 522, 523, 888, 1059, 1059f, 1279
classification of 1279
Bidirectional Glenn's shunt 715
Bifurcation angle 236
Bifurcation device 1012
Bifurcation lesion 235, 239
assessment 238fc
treatment algorithm for 236f
Bile acid sequestrants 1160
Bileaflet prolapse 1216
Biliary tract 1166
Bioactive coils 1010
Bioenergy enzyme 1162
Bioprosthetic prosthetic heart valve vegetations 512f
Bioprosthetic pulmonary valves, implanted 1060
Bioprosthetic valves 456, 1283
Biphasic pattern 918f
Biplanar systems 1006
Biplane method of discs 35f
Biplane neuro cath lab 1007f
Biplane Simpson's method 67f, 155f
Bisoprolol 75, 146
Bitemporal hemianopia 106
Biventricular interactions 1091
Biventricular pacing devices 690
Biventricular repair 1023
Black blood imaging 878
Blalock-Taussig shunt 1018
modified 1045
Blood
coagulation 608f
dark 10, 523
flow, pulmonary 1045
loss, periprocedural 296
oxygen level 1128, 1299, 1304
pressure 32, 58, 60f, 61, 72, 99, 101, 979, 1109
control in diabetes 1110
elevated 1109
monitoring, home 58
sugar, control of 1110
urea nitrogen 106, 122
velocity 915
vessel
endothelium of 81
layers of 224f
tunica intima 224f
tunica media 224f
wall boundary 878
Bloody effusion 772
Blue toe syndrome 947
Blunt chest injury 483
Blunt injury 370
BMV See Balloon mitral valvuloplasty
Body
mass index 797
size indexation 30
surface area 30, 65, 427, 500, 506, 549
tissues 1163
Bone
fracture 832
tumor of 947
Bortezomib-based regimens 734
Bovine trunk 877
Brachial artery 948
normal ultrasound of 923f
Brachiocephalic trunk 887
Brachydactyly syndrome 105
Bradyarrhythmia 974
Bradycardia 303
Bradykinins 1027
Brain natriuretic peptide 154, 188, 189, 744, 1242
N-terminal prohormone of 154
Brain networks 1129
Brainstem 997
Brazilian Society of Cardiology 1101
Breast cancer 780, 1245f
metastatic 618
recurrent 618
Breathing 1109
Breathlessness 127
Brodmann area 6 1130
Bronchial arteries 8
Bronchospasm 303
Brown tumors 108
Brugada syndrome 634, 973, 974, 977, 977f
Buerger's disease 927
Bulb, posterior portion of 895f
Bulky leaflets 1281
Bull's eye 435f
map 698f
of global longitudinal strain 1039f, 1040f
plot 732, 1288
of longitudinal strain imaging 1291f
Bundle branch block, left 122, 162, 194, 289, 293, 654, 665, 973
Buspirone 106
Bypass angioplasty revascularization investigation 2 diabetes 291
Bypass graft revascularization 955
Bypass surgery with chest pain 391f
C
CABG See Coronary artery bypass graft
Cadmium-zinc-telluride 241
Calcific pericardium 5f
Calcified leaflet, heavily 1277
Calcified nodules 249
Calcium 1032
channel
antagonist 100
blockers 100, 335, 582
high burden of 385
ion 1028
mass score 1099
scoring 259, 385, 1138
volume score 1099
Calmodulin-dependent pathway 333
Caloric origin 778
CAMP See Cyclic adenosine monophosphate
Canaan score 551
Canadian implantable defibrillator study 163
Cancer 1166
chemotherapy-related left ventricular
dysfunction, types of 1242t
drug-associated cardiotoxicity 141
therapy
cardiovascular toxicity of 1242t
consequence of 137
Carbamazepine 106
Carbon dioxide paradoxical embolism 1151
Carbonic anhydrase isozymes 98
Carbonic anhydrase, multiple isoforms of 103
Carbonyl proteins 114
Carcinoid 483, 492
disease 483
syndrome 484, 486
Cardiac abnormalities 144
in severe sepsis 1092t
Cardiac allograft
rejection, acute 743
vasculopathy 141, 1227, 1229f
imaging 1229f
Cardiac amyloid 121
classification of 729t
Cardiac amyloidosis 678, 721, 732f734f
diagnosis of 729
diagnostic feature of 732f
Cardiac and pericardial masses 1198t
Cardiac arrest
intraoperative 1151
study hamburg 163
Cardiac biomarker 401
values 378
Cardiac catheterization 516, 725, 733, 1055
Cardiac chamber 751, 761, 785
quantification 115
Cardiac computed tomography 6b, 271, 395f, 410, 412, 457, 458, 514, 776, 1139t, 1191, 1192
acquisition and interpretation of 4fc
angiogram 800f
angiography 378, 1138
basic concepts of 3
basics of 3
disadvantages of 516
gated 4, 5
interpretation of 5
nongated 8
types of 4
Cardiac constriction, inferior vena cava signs of 788f
Cardiac contractility modulation 164
Cardiac cycle 3, 5, 90, 647f, 667
phases of 49
Cardiac death 1173
Cardiac device-related infective endocarditis 821
Cardiac disease
advanced primary 726
advanced secondary 726
diagnostic evaluation of 3
Cardiac dysfunction, stress-induced 1163
Cardiac dyssynchrony, assessment of 670
Cardiac electrophysiology procedures 1138
Cardiac emergencies 1209
Cardiac fibrosis index 1039, 1041
Cardiac function 11
evaluation of 1086t
Cardiac hemangiomas 1187
Cardiac imaging 448, 491, 1146
radiopharmaceuticals 23
Cardiac involvement, prevalence of 139
Cardiac lymphoma, primary 360
Cardiac magnetic resonance 29, 35, 90, 94, 115, 117, 330, 344, 409, 491, 492, 652, 732f, 744, 1144, 1192, 1289
diagnostic indication 409
imaging 89, 128, 322, 359, 410, 458, 522524, 529, 588, 598, 695, 724, 725, 732, 737, 778f, 804f, 1058, 1060, 1065, 1102, 1138, 1227
basics of 10
limitations of 529
scan 800
technique 523
measurements 94f
Cardiac malformations, congenital 1064
Cardiac manifestations 1183
Cardiac masses 140, 359, 360t, 1191, 1198t
magnetic resonance evaluation of 1191
Cardiac mechanical dyssynchrony, assessment of 670, 673
Cardiac mitral regurgitation, clinical application of 130
Cardiac morbidity, causes of 776
Cardiac motion
correction sequence 257f
of translation 51
Cardiac multidetector computed tomography 825
Cardiac myocytes 128
hypertrophy of 74
Cardiac natriuretic peptides 113, 114
Cardiac output 667, 714, 831, 852, 1083, 1092
measuring 861
Cardiac overload 1120
Cardiac placental growth factor 114
Cardiac procedures, percutaneous 356
Cardiac quantitative softwares 670
Cardiac radionuclide imaging 410
Cardiac resynchronization 135, 162
therapy 116, 122, 161, 162, 633, 646, 652, 654,
current indications 162
echocardiography guided 162
implantation 667
recommendations 162
Cardiac rhythm 1137
Cardiac sarcoidosis 634, 740f, 741
Cardiac segmentation, automatic 393
Cardiac single-photon emission computed tomography system 18
Cardiac structure 10
Cardiac surgery 392f, 1044
modern 1212
postoperative 763
Cardiac sympathetic denervation 633
Cardiac syncope 980
Cardiac tamponade 757f, 761, 785, 883, 1071, 1088, 1089f
evaluation of 760
sign of 756f
Cardiac thrombi 349
Cardiac tissue 74
injury, radiation-induced 742fc
Cardiac transplantation 653, 714, 1119
Cardiac trauma 1213
Cardiac troponin 188, 401, 1243
levels, normal 405
Cardiac tumor 483, 1087, 1183
benign 1184
primary 1183
benign 360
secondary malignant 1188
Cardiac valve 116, 490
disease, obstructive 973, 974
Cardiac viability study 21
Cardiac volume, total 762
Cardiaq device 460
Cardioembolic cerebrovascular stroke 600
Cardioembolic stroke 38
group 37
Cardiogenic shock 145, 204, 1033, 1083, 1091
Cardiology, telemedicine in 1134
Cardiomyocyte
hypertrophy 40
metabolism 400
Cardiomyopathy 15, 135, 141, 645, 790, 1037, 1174
after cancer treatment 716
classification of 137
dilated 124, 137, 138f, 140, 181, 469, 634, 643,
hypertrophic 1040
infilterative 684
multisite stimulation in 162
noncompaction 722, 744
nonischemic 10, 135, 136, 136fc, 140f, 141,
dilated 661
peripartum 1151
primary 137, 137b
radiation-induced 741
secondary 137, 137b, 140
speckle-tracking in 1038
spectrum 722
Cardiopulmonary
bypass 460, 1223, 1223fc
use of 1070
resuscitation 362, 363t
Cardiothoracic surgery 1228
Cardiotoxic chemotherapy 141, 1243t, 1247f
Cardiotoxic effects of anthracyclines 743
Cardiotoxicity 679, 1151, 1242, 1247
development of 679
high risk for 1247
low risk of 1247
Cardiovascular accident 99
Cardiovascular biomarkers 145
Cardiovascular biomedicine 1145, 1145f
Cardiovascular death 95, 760
Cardiovascular disease 61, 78, 98, 102, 400, 1159, 1166
clinical features of 1177
pathogenesis of 102
pathophysiology of 81
risk factors 27
risk of 964
treatment of 1166
Cardiovascular epidemiology 1097, 1104
Cardiovascular event 105
primary prevention of 1118
risk of 95
Cardiovascular failure, common cause of 1090
Cardiovascular health study cohort 31
Cardiovascular imaging 407, 1243
Cardiovascular magnetic resonance 120, 125, 129, 131, 135137, 140f, 141, 516, 855, 1299, 1304
clinical applications of 132
four-chamber 138f, 238f
imaging 136
role of 135
limitations of 133
perfusion imaging 1302
Cardiovascular morbidity 49
Cardiovascular mortality 32, 605
Cardiovascular outcomes, composite major 95
Cardiovascular pathology 1147
Cardiovascular risk factors 683
Cardiovascular system 72
Cardioversion ablation 603
Cardioverter defibrillator, internal 135
Carditis 536
accurate diagnosis of 540, 542
echocardiographic features of 536b
subclinical 535
Cardius 3 camera 19
Carotid anatomy 924f
Carotid angioplasty, duplex assisted 955
Carotid arterial anatomy 895
Carotid artery 898f, 901f, 949f
bulb, common 1099f
common 79, 893, 894, 896, 898f, 1098
disease 915
external 894, 924
for stenosis, ultrasound evaluation of 893
internal 79, 894, 926f, 896, 900f, 917f, 988,
left internal 899f, 924f
lumen, internal 901f
on duplex examination
external 924t
internal 924t
right-sided 897f
stenosis 899f, 958f
assessment of internal 896t
stent, internal 900f
stenting 995
duplex assisted internal 957
Carotid bulb 79
left 924f
Carotid disease 947
Carotid duplex 926
precautions in 926
scan 958f
ultrasound 894
Carotid intima media thickness 78, 1098, 1098f, 1109, 1177
common 1098
Carotid method, common 893
Carotid ratio 925
Carotid stenosis, indices of 925
Carotid studies 948
Carotid transesophageal and transpharyngeal echocardiographic examination 897
Carotid ultrasound 893
three-dimensional 897
two-dimensional 896
Carpentier's classification 439, 440t, 1215f
of valvular dysfunction 468
Carpentiers’ triad 468
Carvedilol 74, 146
prospective randomised cumulative survival
Catecholaminergic polymorphic ventricular tachycardia 634
Catecholamines 113
Catheter angiography 889
Catheter-based technique 1104
Catheterization 1045
Cavernoma 1000
appearance of 1001f
Cavernosal arteries 965f
Cavernosal sinusoids 963f
CDS See Clip-delivery system
Ceasing inotropes 1089
Celiac artery, origin of 881
Celiac trunk, branches 877
Cellular necrosis 128
Central cyanosis 954f
Central nervous system 81, 1006
Central venous
catheters 821
lines 832
pressure 1086, 1091, 1093
Cerebellar hematomas 999
Cerebellum 1127
Cerebra ischemia, mechanical embolus removal in 988
Cerebral amyloid angiopathy 999, 1000
Cerebral aneurysms, treatment of 1007
Cerebral artery
aneurysms, anterior 1012
middle 988, 994, 1000
Cerebral blood
flow 988, 996
volume 996
Cerebral thromboembolism, acute 988
Cerebral venous thrombosis 999, 1000
Cerebrospinal fluid 1000
Cerebrovascular accident 105, 124, 896, 993, 1179
Cesium iodide activated 18
Cetacaine 352
Chamber collapse 767
Chemotherapy 171
induced cardiomyopathy 652, 684
malignancy 832
related cardiac dysfunction 1241
Cheshire cat tamponade 757
Chest
discomfort, noncardiac 367
evaluation of 8
pain 256f, 367, 373, 374, 378, 399, 401, 407,
acute 378, 387f, 410412, 779
causes of 367
emergency echocardiographic
evaluation of 373
emergency imaging in 367
stable 260t
syndrome, evaluation of 411
radiation 789
radiograph 723, 1030, 1227
trauma, assessment of 367
wall 370
Chiari network 821
Chitra valve 470
Chlorothiazide 1032
Chlorpromazine 964
Chlorthalidone 98, 102, 103
inhibits 103
Cholesterol
crystals 250f
elevation 1109
levels 1156
Chordae tendineae, absence of 701
Chordal rupture 205
Chordal techniques 455
Chorea 536
Chronic heart failure, beta-blocker in 146t
Chronic ischemia, evaluation of 293fc
Chylous pericardial effusion 754, 755f
Cine angiography 1233
Cine fluoroscopy 514
Cine imaging 128
Cine sequences 524
Cinefluoroscopy 515f
Cingulate cortex, anterior 1126
Circumferential strain 654, 1038
Circumflex artery 1149f
branch of 1234f
left 316, 380, 382f, 383f, 385f, 393
Cisplatin 137
Claustrophobia 90, 133
Clinic blood pressure monitoring 61
Clip delivery system 480
Clopidogrel 306
and metoprolol in myocardial infarction
trial 307
Clot burden quantification 840, 842
Clot burden score 995
Clozapine 106
CMR See Cardiovascular magnetic resonance
CNS See Central nervous system
Coagulation markers 114
Coagulopathy 999
Cobalt chromium 500
Cocaine-induced cardiac toxicity 140
Coil design, facet of 1010
Cold pressor testing 333
Collateral flow 1050
Collateral vessels 1048
Color Doppler 537, 549
assessment 514
echocardiography 549, 550f, 697, 710
methods 484
parameters 509
ultrasound 968f
image 912f
Color flow Doppler 492, 1205f, 1207f
Color flow mapping 916
Color tissue Doppler imaging 666f
Commaneci device 1012, 1012f
Commissurotomy 551t
Common carotid artery
distal 925
left 924f, 897f
Communicating aneurysm 357f
Compensatory concentric hypertrophy 680
Complex clinical syndrome 1117
Compression test 934f
Computed tomography 21, 22, 255, 522, 797, 798, 809, 810, 954f, 989, 1183, 1192, 1227, 1229, 1229f
angiogram 840f
assessment of aortic dissection
rupture 873f
post-stent contrast-enhanced 942f
angiographic evaluation 839
angiography 107, 839, 880f, 882f, 889f, 893, 894, 938, 939, 942, 943, 951, 953, 989, 995
clinical role of 379
image 885f, 886f
protocol 878
role of 888
coronary angiogram 379
coronary angiography 6, 215, 240, 255, 257, 262, 408, 1275, 1302
evaluation 378
limitation 409
prognostic indication 408
dual energy 842f
findings 386
for prosthetic valve 515f
functional flow reserve 258, 1301
imaging 333, 335
myocardial perfusion 1301
imaging 1301
noncontrast 989, 993, 994, 1002f
perfusion 989
imaging 389
pulmonary angiogram 840f
images 841f
scan 777, 778f, 779f, 911, 1228
venogram 943f
venography 842, 943
Concentric hypertrophy group 37
Concentric left ventricular hypertrophy 31, 73f
Conceptualizing hemodynamics of tamponade 774f
Conduction defects 137
Conduction system abnormalities 1137
Congenital and acquired defects, enface planimetry of 344
Congenital aortic anomalies 888
differential diagnoses 889
management 889
Congenital heart disease, incidence of 1017
Connective tissue disorders 789
Conscious sedation 352
Consciousness, transient loss of 979
Constrictive pericardial diseases 785
Constrictive pericardial physiology 795
Constrictive pericarditis 141, 724, 724t, 776, 779, 780, 783, 785, 786f, 787, 787f, 789, 790, 790f794f, 800
diagnostic algorithm 791
limitations 791
pathophysiology 785
Contact pressure 761
Continuous wave 443, 492
Doppler 204, 547, 848, 859
beam 430
echocardiography 697
Contraction strain index 50
Contrast defect index 273, 277
Contrast delivery timing, optimization of 879
Contrast echocardiography 203, 408, 698, 861
diagnostic criteria 408
limitation 408
prognostic implication 408
Contrast enhanced computed tomography 939f
angiography 836f
Contrast enhanced echocardiography 368
Contrast enhanced magnetic resonance
angiography 878f
imaging 304
Contrast magnetic resonance
angiogram 940f
angiography 1057f
Contrast opacification, corrected 1302
Conventional angiography 946, 1233
indications of 947
Conventional computed tomography 817
Conventional coronary
angiogram 449
angiography 409
Conventional echocardiographic methods 95
Copeptin 114
Coronary abnormalities 1050
Coronary anatomy 379
Coronary angiogram 265, 1172
limitations of 247
Coronary angiography 210, 213, 215, 216, 218, 247, 317, 318f, 332, 409, 1103, 1171, 1228, 1275
computed tomographic 1098
limitations of 210t
quantitative 1179
Coronary angioplasty 253, 751
Coronary arterial
plaques, noninvasive imaging of 1309
wall, normal 209f
Coronary artery 79, 194, 195f, 317, 385f, 449, 879, 1119
anatomy of 381f, 405
bypass graft 131, 232f, 235, 265, 292, 293, 332,
surgery 232, 1164
calcification, degree of 1101t
calcium 5, 6, 1100
estimation of 1109
score 5, 219, 1099, 1101t
score, absolute 1101t
score, use of 1101t
disease 6, 31, 56, 72, 81, 94, 99, 115, 136, 174,
causes of 209
chronic 322
detection of 410t, 412f
diagnosis of 255
established 1121
evaluation of 259, 315
incidence of 1177
premature 1156
reporting and data system 259
severity of 235
distribution 368f
dominance 196
inadvertent puncture of 758
left 380, 1032, 1235
main 211, 286f, 317, 318f, 355
lesions, left main 285
myocardial distribution of 194
non-left main 212
obstruction 121
open occluded 306
perfusion, left 1032
proximal right 316
segmental evaluation of 315
simultaneous evaluation of 396
single 121
stenosis
chronic 128
left main 318
surgery study registry 332
visualizing 317
Coronary assessment 1050
Coronary atherosclerosis 208, 209
Coronary bifurcation lesions 235
Coronary blood flow 333
Coronary bypass
graft patency 321
surgery 1138
Coronary calcium score 1100f
Coronary cameral fistula 1050f
Coronary collaterals 318, 319f
Coronary computed tomography angiography 4, 7, 404, 1101
use of 404
Coronary cusp, left 1220
Coronary disease
microvascular 1303
obstructive 133
Coronary Doppler 315
Coronary flow
augmentation 333
normal 316f
reserve 74, 177, 319321, 332, 334
Coronary guidewire 1283, 1284
Coronary heart disease 100, 127, 194, 1097, 1177
risk of 1112
Coronary luminography 1103
Coronary magnetic resonance angiography 15
Coronary microcirculation 335
vasomotion abnormalities of 332
Coronary microvascular
disease 321
dysfunction 332, 335
pathophysiology of 333
Coronary motion artifacts 256
Coronary occlusion
acute 128, 129, 132, 139, 187, 194, 210, 215,
total 261
Coronary opacification, corrected 1302
Coronary ostia, low-lying 1281
Coronary ostial height 1277
Coronary physiology 251
Coronary revascularizations 1178
Coronary risk prediction tools, imaging-based 1098t
Coronary sinus 355, 659
left 1219
tributaries of 659
Coronary stenosis 260, 261
assessment of 392
Coronary stent
assessment 318
hardware 1021
Coronary syndrome, acute 369f, 1102
absence of 1170
classification of 194f
diagnosis of 407
evaluation of 180
Coronary vasospasm 140
Coronary veins, lack of suitable 660
Coronary venous system 1138
Coronary vessel remodelling, documentation of 211
Corpath robotic system 961f
Corpath system 960
Corpora cavernosa 968f
Corpous spongiosum 965f
Corpus callosum 1127
segmentation of 1128f
Corticosubcortical integration 1127
Craniotomy 1150
C-reactive protein 187, 188, 1112, 1113
and inflammation 1112f
high-sensitivity 1109, 1243
Creatine kinase 114, 189
levels 1160
muscle-brain 401
Creatine phosphokinase 188
Creatinine 114
Crista terminalis 1196
CRT See Cardiac resynchronization therapy
Cryoballoon ablation 638, 640
Cryoconsole 639f
Cryptogenic stroke 684
CT See Computed tomography
C-terminal provasopressin 114
Cumbersome methodology 29
Current cardioversion, external direct 614
Current-generation Fourier domain optical coherence tomography 238
Cushing's syndrome 105107, 140
CV disease See Cardiovascular disease
CVP See Central venous pressure
CVT See Cerebral venous thrombosis
Cyanosis 1030
Cyanotic cardiac defects 1030
Cyanotic congenital heart disease 1026
classification of 1017t
intervention of 1017
Cyanotic pulmonary overcirculation, forms of 1030
Cyclic adenosine monophosphate 1032, 1116
Cyclic guanosine monophosphate 336
concentrations of 82
elevation of 1116
Cyclophosphamide 137
Cystatin-C 114
D
DCM See Dilated cardiomyopathy
de Winter's T wave 199
Debakey classification 871
Deep dorsal arteries 965f
Deep vein thrombosis 831, 839, 927, 930, 1178
Deep venous
analysis 932f
system 934f
of arm 931f
of lower limbs 930f
Default mode network, activation of 1129
Deferoxamine 741
Defibrillator lead 483
Dehiscence 516
Dense fibrosis 925f
Denuded endothelium 226f
Deoxyhemoglobin 999
Deoxyribonucleic acid 1157
Depression 303, 1126
Descending artery
left anterior 291, 316
left main 316
Descending thoracic aneurysm, saccular aneurysm of 880f
Deterioration 325
Diabetes 563, 683, 1101
lipid lowering in 1110
mellitus 41, 101, 137, 171, 429, 600, 1158,
new onset 303
reducing cardiovascular risk in 1108
Diagnostic sensitivity 190
Diameter stenosis 334
Diastole, phases of 707
Diastolic atrioventricular valve regurgitation 716f
Diastolic dysfunction 40, 41, 44, 54, 72, 75f, 118, 495, 730
diagnosis and graduation of 45fc
echocardiographic measures of 711
of myocardium 711
patterns of 707, 710
severe 779
left ventricle 580f
stages of 36
surrogate measures of 117
Diastolic excursion 770
Diastolic filling
fraction 665
part of 785
time method 691
Diastolic flow 440, 766, 1085
Diastolic function 80, 84, 85, 266, 312, 1076
evaluation of 42
Diastolic heart failure 790
Diastolic mitral regurgitation 647, 661
Diastolic pressure, pulmonary arterial 158, 849
Diastolic pulmonary
pressures, elevated 493
venous flow 767
Diastolic stress
echocardiography 117
test 46, 1296f
Dietary sodium intake 41
Diffusion tensor imaging 1127, 1128
Diffusion-encoding gradients 1127
Diffusion-restricting
lesions, periphery of 997
parenchyma 997
Diffusion-weighted imaging 989, 996
Digirad cardius 3 XPO 19
Digital subtraction angiography 878, 893, 938, 940f, 942, 943, 946, 947, 949f951f, 989
technique 960
Digoxin 582
Dihydropyridine 100
calcium channel blockers 443
Dilated cardiomyopathy, causes of 646fc
Dimensionless index 433
Dipyridamole 129, 333
Dissect classification 884t
Dissection, interventional management of 885t
Distal aorta, severe angulation of 885
Distal aortic root, diameter of 69
Distal landing zone 885
Diuretic therapy 159f
Diverticulum 778
Dobutamine 333, 390, 435, 697, 1033
echocardiography 116
low-dose 326
infusion 12
mechanism of 324
stress cardiovascular magnetic resonance wall motion imaging 129
stress echocardiography 123, 277, 320, 322,
low-dose 322, 324, 325, 1269
method of 324
stress
function 411
low-dose 137
Dopamine 1033
Dopaminergic receptors 1033
Doppler assessment 512
of severity of tricuspid stenosis 488
Doppler echocardiography 649, 697
Doppler flow
patterns of remodeling 274
profile 965t
Doppler gradient 497
Doppler imaging strain analysis 330
Doppler scanning 916
Doppler study 537
Doppler tissue
imaging 1228
velocity imaging 326
Doppler ultrasonography 942
Doppler ultrasound 907, 915, 927
imaging 907
Doppler velocity
index 501, 503, 505f
measurements 1233
ratios 917
Doppler volumetric method 440
Double-lumen balloon 1011
Doxazosin 100
Doxorubicin 137, 1166
and cancer 1164
Drug
eluting stent 230
therapy 581
DSE See Dobutamine stress echocardiography
Duchenne's muscular dystrophy 140
Ductus venosus
constriction of 1027
leads 1027
Duke criteria 809
Duplex imaging 955
Dutch lipid clinic network score 1156
DVI See Doppler velocity index
DWI See Diffusion-weighted imaging
Dynamic susceptibility contrast perfusion 997
Dyskinesia 1040
Dyskinesis 325
Dyskinetic septal motion 1040
Dyslipidemia 429, 1109
Dysplasia 491
phlebectasic 933f
Dysplastic kidney 106
Dyspnea 699
acute 1117b
Dysrhythmia, paroxysmal 973
Dyssynchrony 116, 665, 1040
aspects of 656
assessment of 666, 668t
E
Early diastolic
medial mitral annular velocity 148f
mitral inflow velocity 564f
positive wave 593
velocity 578
Early gadolinium enhancement 130
Early repolarization syndrome 634
EBCT See Electron beam computed tomographic
Ebstein's anomaly 361, 484, 1017, 1031, 1051, 1051f, 1063, 1063f
Eccentric hypertrophy group 37
Eccentric neointimal hyperplasia 231f
ECG See Electrocardiography
Echo Doppler study 661
Echocardiogram, major advantage of 715
Echocardiographic assessment
advantages of three criteria for 1270t
disadvantages of three criteria for 1270t
Echocardiographic dyssynchrony 122
Echocardiographic evaluation of constrictive pericarditis, advances in 785
Echocardiographic guidance 553
Echocardiographic hemodynamic assessment 1092b
Echocardiographic parameters 1163
Echocardiographic signs, chronology of 771
Echocardiography 35, 41, 49, 117, 120, 154, 300, 310, 323, 329, 330, 368, 401, 457459, 463, 483, 500, 522, 536, 543, 567, 608, 690, 826, 862, 1137, 1137b, 1147, 1184, 1228, 1288
advances in 483
clinical usage of 1148
critical care 1070, 1079
derived parameters 150
examination, goals of 495
guideline 156
in infective endocarditis, limitations of 825
in intensive care unit, limitations of 1092
intraoperative 819, 1221
negating requirement of 612
perioperative 1147, 1148, 1150
preoperative 818
role of 367b, 479, 701, 818t, 833, 1071,
three-dimensional 29, 343, 420, 464, 465, 470,
transthoracic transthoracic 457
Echogenic calcified plaques, highly 210
ECMO See Extracorporeal membrane oxygenation
Edema, pulmonary 105
Edge-to-edge coaptation 479
EDV See End-diastolic volume
Egyptian eye 928
appearance 928f
Ehlers-Danlos syndrome 879
Ejection fraction 22f, 54, 94, 115, 120, 135, 144, 271, 277, 1269
measurement of 676
reduced 40, 117, 127
Elastic lamina
external 232f
internal 232f
Elastic membrane, external 209
Electrocardiogram 99, 101, 187, 724, 941, 979, 1137, 1140
limitations of 199
Electrocardiography 10, 51f, 199, 264, 289, 329, 334, 777, 798, 851, 973, 974, 1164, 1284
abnormal 367
Electrolyte imbalance 137
Electromagnetic flowmetry 1233
Electron beam computed tomographic 1098
Electronic health records 1135
ELISA method 1178
Embolic phenomenon 1183
Emergency
department, echocardiography in 372
neurological deficits 998
Emotional stress 915
Enalapril 336
End-arterectomy 995
End-diastolic
antegrade velocity 967f, 968
area 774f
diameter 89
velocity 896, 908f
volume 11, 94, 300, 858
wall thickness 277, 323
Endocardial borders 64, 90
Endocardial calcium 736f
Endocardial inflammation, stage of 735
Endocardial subsegments 130
Endocarditis 483, 492, 516, 813, 1213
complications of 516, 818t, 825
infective 357, 483, 809811, 811fc, 812, 818,
infective 811, 812, 814, 824f
multivalvular infective 819f
right-sided 821
Endocrine
abnormality 105
hypertension 107
Endoluminal flow-diversion devices 1013
Endomyocardial biopsy 725, 733, 744
Endomyocardial calcium 723
Endomyocardial fibroelastosis 137
Endomyocardial fibrosis 140, 140f, 483, 484, 715, 721, 724, 735, 737f, 744
clinical presentation 735
late phases of 715
treatment and prognosis 736
End-organ damage 81
Endothelial cell 1176
dysfunction 1176
Endothelial cytotoxicity 1176
Endothelial damage 132, 1176
Endothelial dependent vasodilation 1176
Endothelial derived peptides 114
Endothelial dysfunction 332, 966, 967f, 1164
Endothelial function assessment 333
Endothelial injury 1176
Endothelial-independent mechanisms 336
Endothelialized stent struts, completely 231f
Endothelin 81, 113
system 81
Endothelium 1176
derived vasoactive peptides 113
Endovascular aortic stent graft 105
Endovascular mechanical thrombectomy 990
Endovascular procedures 1006
Endovascular therapy 990, 1007
Endovascular valve edge-to-edge repair study 454
Endovenous laser therapy 955
End-systolic
area 858f
volume 11, 266, 277, 300, 858
Energy
primary source of 1169
sources of 1169
Enface projection 514
Enzyme methylenetetrahydrofolate reductase 1177
Eosinophilic cardiomyopathy 737
Eosinophilic heart disease 707
Epicardial border 90
Epicardial color Doppler scanning 1233
Epicardial coronary artery 332
normal 224f
Epicardial fat 777
thickness 980
Epicardial flow 282f
Epicardial layer of fat 799
Epicardial subsegments 130
Epicardial ultrasonography, high resolution 1235
Epicardial vasoconstriction, absence of 333
Epicardial vessels 336
Epicardium 764
Epinephrine 114, 181, 1033
infusion 1033
Epsilon wave 976f
Erectile dysfunction 963
arteriogenic etiology of 966f
color Doppler evaluation of 963
Erection hardness score 966, 966f, 967f, 968
Erythema marginatum 536
Esophageal diverticulum 352
Esophageal perforation 352
Esophageal stricture 352
Esophageal tumor 352
Esophagitis, active 352
Esophagus 897f
Estrogens 336
ESV See End-systolic volume
Ethyl alcohol 1014
European Association for Cardiothoracic Surgery 443t
European Association of Cardiovascular Imaging 30, 72, 84, 681
European Association of Echocardiography guidelines 349
European Atherosclerosis Society 1160
European Carotid Surgery Trial 926f
method 893
European Resuscitation Council 363
European Society of Cardiology 72, 145, 147, 158, 284, 335, 443t, 645, 703, 946, 982, 1101, 1157, 1160
guidelines 83, 751, 1117, 1159, 1160
European Society of Hypertension 72
guidelines 83
European System for Cardiac Operative Risk Evaluation 448
Eustachian valve 821
E-wave deceleration time 744
Exercise 435
echocardiography 442
stress echo 1292f
test 312f
stress strain echocardiography 1290
Exertional dyspnea 66
Exogenous catecholamines 1029
Extracardiac shunts 1049
Extracardiac structures, delineation of 7
Extracellular gadolinium 129
Extracellular matrix 218, 1029
quantification of 117
Extracellular volume 117
Extracorporeal circulation 1213
Extracorporeal membrane oxygenation 1069, 1070, 1070b, 1070f, 1071f, 1072, 1073, 1073f, 1074, 1077
complications of 1074, 1074f
in critical care 1070
initiation 1076t
system 1069f
types of 1070
Extraluminal structural information 335
Eyebrow sign 237
Ezetimibe 1157, 1160
F
FA See Femoral artery
Fabry's disease 137, 679f
fibrosis of 678
Familial dilated cardiomyopathy 652
Familial disorders 722
Familial hyperaldosteronism 105
Familial hypercholesterolemia 1156
diagnosis of 1157t
Faster scintillation crystals 23
Fasting lipid evaluation 1155
Fat imaging, dark 10
Fatal vascular emergency 1089
Fatigue 303
Fatty acid 1169
analogs 1309
binding protein 188, 190
metabolism 1169
Femoral artery 297, 920f, 1071f, 1073
common 885, 921f, 940f, 948, 956
Femoral vein 928f, 1071f, 1073
common 930f
Femoral venous route 1018
Femoro-jugular cannulation 1072f
Femoropopliteal aneurysm 947
Ferritin 114
Fetal
echocardiography 1044, 1144f
myocardial contractility 1029
Fever, rheumatic 484
FFR See Fractional flow reserve
Fibered coils 1010
Fibrin degradation product 833
Fibrinolytic functions 1176
Fibroatheroma 257
Fibroelastic disease 1217f
Fibrofatty
replacement of ventricular wall 138
volume 80
Fibroma 360, 1186, 1195, 1198
Fibromuscular dysplasia 105
Fibrosarcomas 1188
Fibrosis 128
stage of 735
subendocardial 140
Fibrotic endocardium 737f
Fibrous plaque 210
Film-based system
advantages of 1135t
disadvantages of 1135t
First-generation thrombectomy device 988
First-pass contrast-enhanced magnetic resonance imaging 13
Fish mouth appearance 547
Fisher grading system, modified 1000
Fistulae 817, 964, 966
FLAIR See Fluid attenuation inversion recovery
Flattened heart 802
Florid pulmonary edema 371
Flow convergence method 440, 441f
Flow disruptors 1013
Flow diverters 1012
Flow paradoxus 761, 765
across mitral valve 766f
across tricuspid valve 765f
Flow quantification imaging 14
Fluid
accumulation, pathological 761
attenuation inversion recovery 996, 997
dynamics, computational 7, 492
pressure 761
quantification of 763
Flumazenil 352
Fluorescence
coronary angiography 1235
imaging, intraoperative 1233
Fluorescent chromophore 113
Fluorodeoxyglucose 23, 733f, 744, 802, 810
labeled 219
Fluoro-D-glucose-positron emission tomography 809
Fluoroscopic guidance 660
Fluoroscopy 459
profiles tributaries of coronary sinus 660f
Fluoxetine 106
Flurodopamine 181
Fluvastatin 336
Foam sclerotherapy 955
Focal ulceration penetrating 885
Fogarty balloon 1018f
Folic acid 1177, 1178
Fontan operation 1050
Forced atrioventricular pacing 703
Foreign body artifact 1048
Fortis device 460
Fraction flow reserve, assessment of 243
Fractional anisotropy 1127f, 1128, 1173
Fractional flow reserve 227, 236, 238, 243, 334
computed tomography 258
limitations of 245
testing 244f
Fractional shortening 1040, 1084
Fracture 964
Framingham heart study 190
Framingham offspring study 1118
Framingham risk score 10971099
Frank rupture 883
Frank-Starling curve 1029
Free wall rupture 311, 368, 1084
French multicenter study 1121
Frequency mapping, dominant 617
Friedreich's ataxia 137
Frontal cortex, anterior inferior 993, 994f
Frozen elephant trunk repair 883
Functioning myocytes, lack of 12
Fusiform gyrus 1130
Fusion imaging 424, 424f
FV See Femoral vein
G
G protein isoform 1029
Gadolinium 528
based contrast agents 1056
chelated contrast agents 136
enhanced MR angiography 1057
enhancement 330
orthosilicate 23
Galectin 3 114
Gamma camera 399
basic components of 17
Gas discharge visualization 1131f
Gas-producing nanostructure 113
Geiger regions 19
Geller's syndrome 105
Gel-platinum hybrid coils 1010
Gemfibrozil 1166
Genes 695
Genetic testing 695
Giant intracavernous aneurysms 1007
Global circumferential strain 275, 276
Global function index 678
Global function, evaluation of 1040
Global left ventricular function 676
Global longitudinal strain 69, 75, 121, 124, 266, 275277, 419f, 435, 676, 1037, 1039, 1294
Global peak longitudinal systolic strain 860
Global strain values 1037
Glomerular filtration rate 1115, 1158
estimated 293, 941
Glomerulonephritis 105
chronic 106
GLS See Global longitudinal strain
Glucose 114
Glycated hemoglobin 1109
Glycogen storage disorders 137
Glycoproteins 1028
Gonadal arteries 877
Gordon's syndrome 105
Graft imaging, intraoperative 1232
Granular sparkling 731
Granulomatous myocardial disease 1139
Gray-scale median 896
analysis 924
Great arteries
congenitally corrected transposition of 1048
corrected transposition of 1017
dextro-transposition of 1047
transposition of 1017, 1018, 1047, 1047f,
with intact ventricular septum 1019t
Great blood vessels 776
Great saphenous
valve 955f
vein 920f, 927, 928, 928f, 934f
Great vessels, disease of 980
Guanidine, analog of 168
Guanosine
monophosphate 333
triphosphate, conversion of 333, 1115
Guanylate cyclase activation 336
Guglielmi detachable coil 1007
Guide extension catheter 1283, 1284
Guidewire placement 362
H
Hansen system 960
Harnessing quantitation advantage 1309
Hazy lesion 285f
HBPM See Home blood pressure monitoring
Head-up tilt test 979
Heart 780
attack trial, prevent 100
autonomic system of 167
block, complete 974
chambers 785
compressive disorder of 760
defects, congenital 349, 777, 1137
disease 412t
adult congenital 496
chronic 1166
clinical suspicion of 72
complex congenital 1049
congenital 4, 6, 7, 360, 361t, 363, 821, 1044, 1055, 1204
corrected congenital 634
cross-sectional imaging in
congenital 1044
hypertensive 72, 81, 563
interventions 424
ischemic 1178
left 483
multivalvular 15
radiation-induced 744
rheumatic 429, 436f, 446, 486, 535, 563, 1221f
specific congenital 1045
stable ischemic 130
structural 633, 634, 974, 980
disorders, congenital 3
distension of 760
dysfunction 1119
failure 35, 40, 54, 82, 94, 95, 98, 113, 115, 117, 127, 135, 145147, 154, 158, 161164, 167, 170, 174, 181, 182, 303, 481, 563, 577, 605, 633, 670, 683, 778, 817, 819, 855f, 1108, 1115, 1117, 1118, 1120, 1121, 1227
acute 147
assessment of 135
beta-blocker therapy in 144
biomarker in 114t, 150
cardiac ventricles of 1116
cardinal symptoms of 120
causes of 137
classic signs of 1030
classification of 145t
congenital 171
congestive 101, 123, 170, 306, 577, 600, 655, 817, 1163, 1164, 1242
development of 144f
device intervention in 161, 162
diagnostics, device-based 164
diuretics in 156
end-stage 161
etiology of 1030
hospitalization 561
monitor 164
national registry, acute decompensated 1119
neonatal 1027
noninvasive cardiac imaging in 155
nonischemic 176
risk evaluation in 116
role of echocardiography in 149
stages of 145t
symptomatic 72
symptomatic congestive 1037
syndrome of 1033
therapy 162
treatment of 1032
with preserved ejection fraction 145
with reduced ejection fraction 145
fatty acid binding protein 114
function of 562
mediastinal ratio 169
model for regurgitant volume 422f
muscle 1169
neonatal 1029
normal performance of 760
rate 255, 545, 664
irregular 392
multicycle reconstruction, higher 392
variability 164, 171
variable 392
related disorders 1126
sound
fourth 744
third 722, 744
subacute elastic compression of 760
systolic/diastolic functioning 1137
transplantation 664, 1213, 1227
valve 498
infectious growth around 1137
replacement 500t
Heart-to-mediastinum ratio 169f
derivation of 169f
Hemangioblastomas 999
Hemangioma 360, 1195, 1198
Hemangiomatosis, pulmonary capillary 848
Hematoma 772, 964
Hemochromatosis 137, 741
Hemodialysis access angioplasty, duplex guided 958f
Hemodynamic consequences 763
Hemodynamic deterioration 1071
Hemolysis 516, 1074
Hemopericardium 758
Hemoperitoneum 758
Hemorrhage 132f
nontraumatic
intracerebral 998
subarachnoid 999
subarachnoid 1000
Hemorrhagic stroke 998
Hemorrhagic transformation 996
of infarct 1000
Heparin induced thrombocytopenia 1074
Heparin sulfate antithrombin interactions 1176
Heparin, unfractionated 586
Hepatic cirrhosis, severity of 1119
Hepatic vein 786
Doppler 767f
Hepatic venous flow pattern 711f
Hepatocellular carcinomas 780
Heterogeneous
attenuation 108
phenotypes 41
Heterotaxy syndrome 1049f
Heterotopic cardiac transplant 1230
Heterotopic heart transplant, chest X-ray of 1230f
Heterozygous familial hypercholesterolemia 1159
HFPEF See Heart failure with preserved ejection fraction
HFREF See Heart failure with reduced ejection fraction
Hibernating myocardium 323
High-pressure gradient, differential diagnosis of 513
Hip replacement 832
Histone deacetylase, inhibitor of 582
Homocysteine 114, 11761178
high plasmatic level of 1179
imaging 1176
levels 1177, 1178, 1179
elevated 1179
metabolism 1176
regulates vascular tone 1176
serum 1178
Homogeneous restenotic tissue 231f
Hormone replacement 832
Hounsfield units 939, 1300
HT See Hemorrhagic transformation
Human brain 1127
Human heart disease 1162
Hybrid imaging test 329
Hydrochlorothiazide 94, 98
Hydroxyephedrine 181
Hyperaldosteronism, primary 105107
Hyperdense artery sign 994f
Hyperdense superior sagittal sinus 1002f
Hyperdynamic flow 513
anemia 513
AV fistula 513
fever 513
frequency 513
thyrotoxicosis 513
Hyperdynamic pulmonary flow 954f
Hyperechogenic endocardium 715
Hyperechogenic submitral structures 537
Hyperemia
myocardial 130
study 923
Hypereosinophilia syndrome 140, 744
Hyperglycemia 1109
Hyperhomocysteinemia 11761179
significant correlation of 1177
Hyperinsulinemia 1109
Hyperlipidemia 332
Hyperparathyroidism 105, 108
Hyperplasia, neointimal 230
Hypersensitive airway disease 290
Hypersensitivity 140
Hypertension 40, 41, 49, 49f, 63, 72, 73f, 74, 81, 83, 84, 94, 128, 135, 600, 683, 684, 915, 1000, 1150, 1163, 1164, 1246
detection 99
diagnosis of secondary 106
echocardiography in 27, 35, 83, 609
endpoint reduction in 65
evaluation of 83
secondary 105
management of 81, 85
masked 60
pregnancy induced 1151
prognosis of 98
pulmonary 8, 427, 448, 458, 483, 580, 580f,
arterial 838, 847, 852
role of echocardiography in 63
secondary 105, 106
severe pulmonary 755, 855f, 1088
symptomatic essential 1163
systemic 81, 429, 436, 884
tissue Doppler imaging in 50
treatment of 85
Hypertensive bleeding 1001f
Hyperthyroidism 105
Hypertrophic cardiomyopathy 117, 136, 137, 138f, 177, 527f, 563, 592, 634, 635, 678, 695, 696f, 701703, 714, 721, 732f, 744, 822, 824, 974, 1032, 1038, 1089, 1172
repair of 1213
Hypertrophic obstructive cardiomyopathy 824f, 974, 1205f, 1206, 1206f, 1207f
Hypertrophied septoparietal trabeculation 1060
Hypertrophy
asymmetric 28
dilated 73
hypertensive 1089
mixed 73
Hypodense areas 999
Hypokinesis 325
Hypoperfused myocardium 129
Hypoplasia 491
Hypoplastic left heart syndrome 1017
Hypotension 303
orthostatic 979, 980
Hypothyroidism 778
primary 105
Hypovolemia 1087f, 1089, 1148
Hypovolemic shock 1083, 1084
I
ICD See Implantable cardioverter defibrillators
ICH See Intracerebral hemorrhage
Idiopathic bleed 999
Idiopathic moderate effusions 758
Idiopathic restrictive cardiomyopathy 726
treatment 727
Idioventricular rhythm, accelerated 278
IHD See Ischemic heart disease
Iliac artery, external 949
Implantable cardiac defibrillator 671
Implantable cardioverter defibrillators 117, 161, 163, 164, 265, 275, 646, 661, 664, 701, 974, 976, 1045, 1173
Implantable defibrillator 163
Implantable hemodynamic monitors 164
Implantation, high 1281
In situ projections 514
In vitro experiments 102
In vitro validation 9092
Indocyanine green 1235
Infarcted area, size of 368
Infection 789, 879
acute 778
Infective endocarditis
complications of 814
diagnosis of 810t
Inferior wall myocardial infarction 196, 312f
acute 196, 312f
Inferolateral wall 672
Infiltrative diseases 678
Inflammatory cells, activity of 887
Inflammatory diseases 778
chronic 332
Inflammatory markers 1109
Infrainguinal arterial bypass grafts 956
Infrapopliteal arteries 922f
Infrapopliteal Doppler 921
Innominate artery 897f
Insonation, angle of 915
Inspiratory reduction 765
In-stent restenosis 229
Insular ribbon, lateral to 993
Insulin 114
resistance 332, 1109
Intact fibrous cap 252
Intact ventricular septum 1017, 1023
Intensive care unit 990
Interactions, drug 1166
Interatrial communication 1017
restrictive 1018f
Interatrial conduction time 690, 690f
Interatrial septum 355, 458, 553, 623f, 626, 730
tangential engagement of 624f
Interatrial shunt device 165
Intercirculatory mixing 1017
Interhemispheric fissure, anterior 1003f
Internal capsule, posterior limb of 993, 994f
Internal carotid artery, proximal part of 895f
International bodies 981
International Cooperative Pulmonary Embolism Registry 831, 836
International Subarachnoid Aneurysm Trial 1007
Internet of things devices 1139
Interstitial diseases 106
Interstitial fibrosis 115, 116
Interstitial matrix remodeling markers 114
Intervalvular fibrosa pseudoaneurysm 817
Interventricular dyssynchrony 665, 670
Interventricular mechanical delay 122, 668
Interventricular septal
movements 787
thickness 64f, 730, 1084
Interventricular septum 27, 355, 380, 458, 514, 787, 832, 835f, 1076
distal 310f
thickness 98
Intima media thickness
measuring effects on 79
normal 1099f
Intimal medial thickness 924
Intra-aortic balloon pump 1213
Intra-arterial therapy 988
Intracardiac defibrillator 702, 741, 744
Intracardiac echocardiography 420, 422, 424, 424f, 561, 572, 586, 588, 597, 622, 623f, 624, 624f, 625, 627f, 629f, 630f
catheter, fluoroscopic orientation of 622f
guidance 624f
role of 586, 621
Intracardiac masses, evaluation of 8, 349
Intracardiac pressures, abnormal 1151
Intracardiac repair 1061
Intracardiac shunt, indicator of 1150
Intracardiac structures, evaluation of 411
Intracavitary pressures 1091
Intracellular edema 128
Intracerebral hemorrhage 999, 1000, 1003f
etiology of 999
Intracoronary
Doppler wire 241
imaging, advent of 223
pressure wire 241
thermodilution 241
thermography 1104
Intracranial aneurysm 1003f, 1007
occlusion 1012
treatment of 1006
Intracranial bifurcation aneurysms 1012
Intracranial hemorrhage 279
Intracranial saccular aneurysm 999
Intraluminal support devices, generation of 1013
Intramural hematoma 367, 878, 882, 883
imaging 884
treatment and clinical outcome 885
Intramural mass, presence of 1084
Intramyocardial blood volume 333
Intraoperative echocardiography, indications for 1213t
Intrapericardial pressure 751, 760
Intraprocedural guidance 480
Intrapulmonary shunt 1150
Intrasaccular devices 1013
Intrathoracic
pressure 370
structures 765, 778
Intravascular gas-filled microbubbles 333
Intravascular ultrasound 78, 208, 211, 215, 217, 218, 223, 235, 235, 248f, 284, 286f, 955, 1098
basics of 208
clinical uses of 211
demonstrating stent thrombosis 212f
image, gray-scale 217f
left anterior descending on 285f
negative remodeling on 285f
role of 283
Intraventricular dyssynchrony 665, 666, 699, 1040f, 1041f
assessment of 699
Intrepid device 460
Invasive angiography 329
Invasive coronary angiography 240, 1299
Iodine perfusion map 390
Ion channel disorders 137
Iron overload 139
Ischaemic heart disease 1098
Ischemia 188, 1139
acute 128, 401, 404
chronic 291, 292, 677
evaluation 117
chronic 292t
modified albumin 114, 188
monitoring, perioperative 1148
producing lesions, assessment of 208, 211
related myocardial injury 1171
severe 1174
stress-induced 673
Ischemic attack, transient 608, 1158
Ischemic cardiomyopathy 136, 319, 673, 676, 678, 1032, 1086f
detection of 130
Ischemic cascade 264f, 400f
Ischemic coronary artery disease 328
Ischemic episode, transient stress-induced 1169
Ischemic equivalent, evaluation of 410
Ischemic heart
disease 3, 35, 130, 132, 135, 171, 180, 600, 683,
assessment of 1139
evidence of 1177
failure 127, 292
Ischemic memory 1169
Ischemic mitral regurgitation 301, 468
repair of 1216
Ischemic myocardium 1169
Ischemic penumbra 996
Ischemic remodeling 469
Ischemic stroke 37, 989, 990, 993
acute 989, 993, 994t, 998fc
Ischemic ventricular septal defect 267
Ishikawa's formula 691
Ismer's formula 691
Isodense, presence of 999
Isoenzymes 188
Isolated ventricular noncompaction 137
Isovolumetric relaxation 45, 49
time 75, 158, 578
Isovolumic contraction phase, onset of 709
Isovolumic contraction time 654, 859
Isovolumic relaxation 697
period 709
time 41, 149, 579, 654, 744, 771, 857
Ivabradine 336
IVC See Inferior vena cava
IVRT See Isovolumetric relaxation time
IVS See Interventricular septum
IVUS See Intravascular ultrasound
J
Jeopardized myocardium 1174
Joint commission international 289
Jones criteria 535
Journal of American College of Cardiology Cardiovascular Interventions 960
Jugular vein 932f
clot 932f
internal 1070f, 1078f
Jugular venous
distension 714
pressure 154, 722
pulse 849f
K
Kansas city cardiomyopathy questionnaire 1120
Kidney disease, chronic 36, 41, 105, 290, 563, 683, 744, 11571159, 1173
Killip classification 145t
Kissing sign 1148f
Klippel-Trenaunay syndrome 933
Knee replacement 832
Kussumaul's sign 722, 755f, 788
L
LAA See Left atrial appendage
Lactation, peripartum 832
Lactic-co-glycolic acid 1010
Lambl's excrescence 347f, 813
Laminin 1028
Lanthanum bromide 18
Laparoscopic surgery 1151
Late gadolinium 12
enhancement 116, 117, 125, 128, 130, 136,
cardiac magnetic resonance 678
magnetic resonance imaging 12
Late stage pericardial disease, radiologic feature of 786f
LBBB See Left bundle branch block
LCC See Left coronary cusp
LCX See Left circumflex artery
Lead endocarditis, transesophageal echocardiographic images of 823f
Leaflet
aneurysm 817
perforation 814
profile, high 1281
techniques 454
Lecompte maneuver 1047
Left atrial appendage 344, 349f, 360f, 352, 355, 356f, 543, 557, 569f, 572, 572f, 573f, 585f, 586, 586f, 588, 589f, 597, 597t, 598, 613f, 626, 1018
closure 362
Doppler evaluation of 591
echocardiographic 595
evaluation of 588
imaging of 588
function 597
assessment 591
peak ejection velocity 360
structure and function 568
thrombus 360
wall 593f
Left atrial enlargement 35
Left atrial function 45, 49, 579, 1039
assessment of 67, 564
impaired 41
Left atrial minimum volume 37
Left atrial pressure 45, 66fc, 155, 854f, 1047
Left atrial reservoir function 681
Left atrial size 563
Left atrial strain 49, 56, 683, 684, 1296
and diastolic function 683
evaluation 684
in atrial fibrillation, echocardiographic
evaluation of 600
measurement of 68f
waveform 567f
Left atrial systolic 690
Left atrial volume 35, 36f, 38f, 565f, 579, 584f, 697
estimation 38
index 123, 149, 277, 301
measurement of 36, 67f
Left atrial wall 53
segments 56
Left atrium 36, 50, 355, 437, 443, 569f, 572f, 613f, 626, 1073, 1076
ablation catheter in 625f
dilation 7
strain 118
Left carotid artery, duplex scans of 895f
Left main artery, trifurcation of 383f
Left main bifurcation lesion, treatment algorithm for 237fc
Left ventricle 27, 442, 443, 670, 744
diastolic dysfunction
echocardiographic parameters of 578
pathways of 40fc
dilated 73f
dysfunction 483
ejection fraction 272f, 1078
end-diastolic pressure, elevation of 42
evaluation of 154
filling
augment 1071
pressure 1092
function 7
and structure 309
internal dimension diastole 28
mass 29
index 29
measuring 1148
remodeling patterns 30
systolic function 1092
Left ventricular assist device 161, 1208
Left ventricular diastolic dysfunction 40, 63, 577, 577f, 578, 578f, 579, 579f, 697
diagnosis of 74t, 75
echocardiographic evaluation of 577
in hypertension 40
management of 581, 581t
pathophysiology of 577
Left ventricular diastolic dyssynchrony 673
Left ventricular diastolic function 41, 66, 562
abnormal values of 149t
assessment of 41, 564f, 585, 1039, 1246
grading 66fc
normal values of 149t
Left ventricular dilatation 664, 1092
Left ventricular dimension, assessment of 441
Left ventricular dysfunction 304, 1031
Left ventricular dyssynchrony 670, 673
assessment of 670
Left ventricular ejection fraction 68, 154, 124, 132, 145, 146, 155f, 167, 190, 264, 265, 271, 300, 325, 328, 408, 433, 435, 443, 453, 577, 646, 654, 664, 678, 691, 1037, 1084, 1121, 1173, 1241, 1271f, 1272, 1294
evaluation of 155f
measurement of 145
Left ventricular end-diastolic
area 1087, 1148, 1149
diameter 443
pressure 117, 696, 744
Left ventricular end-systolic diameter 443
Left ventricular filling pressure 40, 148, 762
Left ventricular free wall rupture 204, 205f
Left ventricular function 265, 328, 427, 437, 458, 730
postmyocardial infarction, diagnostic
modalities of 304
Left ventricular geometry 72
Left ventricular global diastolic function, assessment of 45
Left ventricular global longitudinal diastolic strain 42
Left ventricular hypertrophy 27, 31, 63, 65, 89, 95, 98101, 103, 437, 579, 744, 973, 999
assessment of 83
characterization of 63
detection of 63
diagnostic criterion 27
eccentric 31
effect on 85
evaluation 27
pattern of 65
prognostic implication of 30, 31, 98
regression 32, 99, 100, 100f
therapeutic implications 32
Left ventricular intraventricular dyssynchrony 666
Left ventricular mass 27, 32, 72, 83, 89, 94, 94f, 98
assessment 95
estimation of 64f
index 32, 35, 89, 149
measurement of 72, 89
three-dimensional 91f, 92f
Left ventricular midwall function 84
Left ventricular myocardial
dysfunction 1091
function 122f
Left ventricular myocardium 138f
Left ventricular noncompaction 121, 138, 652
Left ventricular outflow tract 8, 355, 361, 440, 697f, 770, 1057, 1149f, 1270, 1271f, 1277
abnormalities 427
calcification grading 1277
obstruction 203, 205
dynamic 1089
syndromes 1058
Left ventricular pseudoaneurysm 368
Left ventricular remodelling, development of 191
Left ventricular reverse remodeling 1038
Left ventricular segmentation 368f
Left ventricular strain 676
Left ventricular stroke volume 49
index 1269
Left ventricular systolic dysfunction 145, 570
Left ventricular systolic function 68, 368, 562, 1084
assessment of 1244
in hypertension 83
Left ventricular systolic
effect on 80
strain 84
Left ventricular thrombus 132, 203, 269
Left ventricular torsional deformation 1291
Left ventricular twist and untwisting 46
Left ventricular volume 115, 135
assessment of 271
Left ventriculogram 265f
Left vertebral artery, color Doppler of 908f
Leiomyosarcomas 105, 1188
Lentiform nucleus 993, 994f
Leptin 114
Lethal ventricular tachycardia 702
Libman-Sacks endocarditis 813
Liddle's syndrome 105
Life-saving emergency surgery 368
Lignocaine 352
spray and bite guard 353f
Limb ischemia 1074
critical 938, 947
Lipid core 1103
burden index 1104
Lipid evaluation
clinical therapeutic implication 1155
diagnosis 1155
implication 1155
prognostic
and clinical implications 1157
implication 1155
Lipid levels 1159
Lipid lowering treatment 100
Lipid management 1159t
Lipid soluble 1166
Lipid testing 1159
Lipoma 360, 1187, 1194, 1198
Lipoprotein 1109, 1156, 1178
cholesterol
high density 78
high low-density 1112
oxidized low-density 114
LIPV See Left inferior pulmonary vein
Lisinopril 100
Lithium 106
Liver
disease 36, 1150
enzyme 1160
hematoma 758
iron biopsy 12
transplant patients 1119
LMCA See Left main coronary artery
Lobar region 595
Loculated effusion 757
Loeffler's endocarditis 717f
Loeffler's syndrome 137
Loeys-Dietz syndrome 879
Löffler's endocardial disease 739f
Löffler's endocarditis 737, 738, 738f
clinical manifestations 737
diagnostic evaluation 737
treatment 738
Long QT syndrome 634, 976, 1137
Longitudinal strain 300, 744
Losartan 32
intervention 65
Low attenuation plaque 257, 1300
Low molecular weight heparin 586
Low pressure tamponade 757, 772
Low-density lipoprotein 102, 210, 211, 215, 1109, 1176
cholesterol 78, 1157, 1158
elevation of 1155
receptor 1157
Lower extremity 947
vessels 949
Lower limb 919
arteries, basic anatomy of 920f
perforators of 929f
veins 927
weakness 106
Lower thoracic-upper lumbar level 879
Lower-limb deep veins, bilateral normal 943f
LSPV See Left superior pulmonary vein
Lumbar puncture 1001
Lumen 210
cross-sectional area 209
volume 80
Luna aneurysm embolization system 1014
Lung 780
disease, chronic 483, 563
infections spreading 751
mass invading pericardium 780f
parenchyma 7, 8
bilateral 842f
perfusion measurements 840, 842
transplantation 1150
Lutetium oxyorthosilicate 23
LVDA See Left ventricular end-diastolic area
LVDD See Left ventricular diastolic dysfunction
LVEF See Left ventricular ejection fraction
LVH See Left ventricular hypertrophy
LVOT See Left ventricular outflow tract
Lymph nodes, mediastinal 888f
Lymphoma 780, 1188, 1196, 1198
M
M mode echocardiography 646
Macrophages 251
Macrovascular disease, progression of 1108
Magnesium 1032
Magnetic resonance
angiogram, noncontrast 941f
angiography 893, 894, 938, 940, 942, 943, 951,
images 1047f
role of 888
three-dimensional image 881f
coronary angiography 411, 1102
imaging 10, 106, 218, 219, 271, 312, 335, 448,
functional 1126
role of 1229
perfusion 996
spectroscopy 113, 135
venography 944
Main pulmonary artery 317t, 355, 376, 627, 855, 1057
Major adverse cardiac event 216, 245, 671
Malignant cardiac tumors, primary 360, 1187
Mammary artery, internal 1232, 1234f
Marfan's syndrome 1032
Mass dispersion index 698
Massive pulmonary embolism 832
Matrix 2 coil (stryker) 1010
Matrix metalloproteinase 114, 188
Matrix protein 1028
Maximal left atrial volume 36
Maximal normal aortic diameter 878t
Maximum intensity projection 6, 6f, 385, 385f, 878, 939
Maximum segmental dyssynchrony 666
Maximum stroke volume 661
May-Thurner syndrome 932
Maze procedure 496, 582
MCA See Middle cerebral artery
McConnell's sign 370, 834, 980
McGoon's ratio 1060
MDCT See Multidetector computed tomography
Mean diastolic gradient 547
Mean graft flow 1235
Mean transit time 996
Mechanical circulatory support devices 582
Mechanical dyssynchrony
presence of 665
primary 656
Mechanical valve
prosthesis 609
thrombus 359f
Mechanical ventilation 540f
Medial degeneration, congenital 879
Medial mitral annular
early diastolic tissue velocity 744
late diastolic tissue velocity 744
systolic tissue velocity 744
velocities, tissue Doppler imaging of 650f
Medial prefrontal cortex 1126
Median coronary artery calcium 256
Mediastinitis, acute 1228
Mediastinum 780
Medical Termination of Pregnancy Act 1261
Medical therapy 443
Medina embolic device 1014
Medtronic hall mitral 508f
Melanoma, malignant 780
Melphalan-prednisone 734
Membrane, pulmonary annular 1023
Mental stress 1126
Mesothelial cells 777
Mesothelioma 360
malignant 1188
Mesothelium 760
Metabolic stunning 1169
Metabolic syndrome 563, 1112, 1159
Meta-iodobenzylguanidine 117, 168, 179, 180
images, interpretation of 179
iodine 174
Metalloproteinases, tissue inhibitors of 114
Metanephrine level 108
Metastasis 1184, 1188, 1196, 1198
Metformin 404
Methemoglobin 999
Methotrexate 753
Methoxyisobutylisonitrile 289
Methylpentadecanoic acid 1169, 1173
imaging and technique 1170, 1172
Metoclopramide 352
Metolazone 1032
Metoprolol 74, 75, 306
European Trial 146
randomised intervention trial 146
MI See Myocardial infarction
Mickey mouse sign 919, 920f
Microalbuminuria 1157
Microbubble contrast agents 368
Microembolism 947
Microvascular angina, diagnosis of 334fc
Microvascular coronary artery disease, prognosis of 336
Microvascular dysfunction 334
Microvascular obstruction 130, 137
Microvascular occlusion 131
Micturating cystourethrography 106
Mid-esophageal four-chamber 511
Mid-esophageal inflow outflow view 511
Mid-myocardial replacement fibrosis 679f
Mid-regional proadrenomedulin 114
Mid-regional proatrial natriuretic peptide 114
Mild hypertension study, treatment of 100
Milrinone 1033
efficacy of 1033
Miniature transducer 78
Minimal incision valve surgery 446
Minimally invasive cardiac surgery 1223
Minimum systolic volume 667
Mitochondria
enzyme phosphate 1162
membrane integrity 115
Mitraclip device placement 348f
Mitraclip inside left atrium 481f
Mitraclip percutaneous therapy 481
Mitraclip system 454, 470
Mitraflex 455
Mitral annular
calcification, severe 457, 461
diastolic velocity, measurement of 85
plane systolic excursion 273
tissue 788
velocity 148, 148f
velocity, lateral 650f, 792f
Mitral annulus 711
tissue Doppler, lateral 43f
Mitral apparatus dysfunction 523
Mitral clipping evaluation 479
Mitral commissurotomy, percutaneous transvenous 549, 762
Mitral diastolic E wave 788
Mitral Doppler flow 75f
Mitral E velocity, peak acceleration of 158
Mitral early filling 709
Mitral inflow 42f, 66, 440
early diastolic velocity 66fc
estimation of 148f
late diastolic velocity 66fc
pattern 148f
pattern, assessment of 84
restrictive 313f
velocity 46, 578f, 579f, 709, 787
pattern 578f
wave duration 43f
Mitral insufficiency 1119
Mitral leaflet
anterior 540f, 541, 543, 551
separation index 547, 548f
Mitral propagation velocity 711f
Mitral prosthetic heart valve regurgitation, severe 508t
Mitral regurgitation 73f, 128, 312f, 344, 346f, 374f, 436, 448, 453, 454, 479, 525, 535, 538f, 539, 540f, 555f, 557, 607, 680, 697, 744, 1084, 1206f, 1221f
chronic severe 680
color Doppler evaluation of 73
diagnosis of 420
etiology of 479t
mild 454
moderate 454
moderate-to-severe 543
pathological 538
prevalence of 204
primary 479
secondary 1274
severe 269f, 421f, 454, 816f, 1091f
three-dimensional evaluation of 468
Mitral stenosis 344, 419f, 435, 453, 488, 546, 547, 548f, 557, 602, 1031, 1221
echocardiographic evaluation of 417
moderate-to-severe 610
rheumatic 357f, 543
severity 467, 546t
assessment of 545
stages and severity of 546t
three-dimensional evaluation of 467
valve 418f
Mitral valve 149, 344, 347f, 355, 356, 457, 464, 487f, 539, 626, 710, 756f, 1047, 1214
across 765
anterior
leaflet of 701
motion of 695
apparatus, evaluation of 549
area 481, 527, 546, 547, 548f, 557
measurements of 417
three-dimensional evaluation for 467
calculation of 548f
caseous necroses of 1196
degenerative pathology of 1217f
diagram 420f
disease 429, 435, 453, 461, 760
and interpretation 1214
primary 420
secondary 420
endocarditis of 815f
infective endocarditis of 816f
inflow velocities 41
interventions 470
intraoperative transesophageal
echocardiographic evaluation of 1214
leaflet 701
tips, level of 27
obstruction 1185f
prolapse 523, 525, 539
regurgitation, edge-to-edge repair of 470
repair 347, 480, 1214
mitral annulus for 356
transcatheter devices for 454t
replacement 456t
score of 418t
structural analysis of 1214
systolic anterior motion of 696f
thickened 537f
three-dimensional
acquisition of 466
evaluation of 466, 470
image of 421f
Mitral valvular dysfunction, classification of 469t
M-mode across mitral valve 1185f
M-mode echocardiography 544f, 695
Moderate intensity statin therapy 1158
Molecular imaging 118, 1304
Molecular interaction 113
Monoamine oxidase 168, 181
Monocyte chemoattractant protein-1 189
Monogenic primary renal tubular diseases 105
Monophasic arterial Doppler flow pattern 918f
Mosaic collateral flow 319f
Moving picture experts group 1138
Moya-moya disease 999
MPI See Myocardial perfusion imaging
MS See Mitral stenosis
MTT See Mean transit time
Mullin's sheath 630f
Multibeat 3D echocardiography 90
Multicenter automatic defibrillator implantation trial 122, 162
Multicenter InSync randomized clinical evaluation 162
Multidetector computed tomography 219, 378, 379, 588, 598, 725, 744, 776, 809, 810, 879, 953, 1044, 1098, 1272, 1275
angiography 258, 1101
Multimodality imaging 106, 1134
Multiorgan system failure 1031
Multiparametric echo-score 656
Multi-pinhole design 21
Multiplanar
imaging, curved 384
reconstruction technique 346f
reformation 384, 939, 989
Multiple detector scanners 107
Multiple endovascular stroke trials 990f
Multiple risk factor intervention trial 1177
Multipolar catheter 639f
Multislice computed tomography 1138
Multivessel
coronary artery disease 99
disease 133, 671, 1104, 1179
Mural calcium deposition 887
Mural thrombus, presence of 879
Muscle
cells, loss of smooth 216
rupture, functional 311
Muscular dystrophy 1165, 1166
Mustard procedure 1047
Myalgia 79
Mycotic aneurysm 818, 999
Myectomy status postmitral valve repair 1207
Myeloperoxidase 114, 188
placental growth factor matrix
metalloproteinase 188
Myocardial abnormalities 10
Myocardial blood 389
flow 240, 258, 368
quantification of 240, 241
Myocardial capillary bed 131, 132
Myocardial cell membrane 399
Myocardial contractile dysfunction 128
Myocardial contraction 1028
Myocardial contrast echocardiography 273, 330, 333, 335
Myocardial contusion 370
Myocardial damage 680
Myocardial deformation 1037
measurements 45
Myocardial density 63, 89
Myocardial diastolic function, tissue Doppler assessment of 85
Myocardial disarray 701
Myocardial disease 66fc, 980, 1137
evidence of 41
Myocardial disorders, primary 707
Myocardial dysfunction
detection of 1038
develops 680
Myocardial early diastolic velocity 74
Myocardial edema 130, 141, 1304
area of 133
assessment 128
presence of 129
Myocardial fiber
arrangement 1040
disarray, pattern of 430
Myocardial fibrosis 115, 128, 1038
detection of 1038
Myocardial flow reserve 240, 241
Myocardial function 40
Myocardial infarction 12, 81, 95, 101, 117, 130f, 136, 189, 194, 203, 215, 276, 284f, 286f, 293, 296, 300, 323, 345, 480, 744, 769, 778, 883, 896, 973, 974f, 1108, 1209, 974f, 1085f, 1294f
acute 124, 128, 146, 187, 199, 203, 204, 271,
and cardiac surgery 1164
anteroseptal 310f
echocardiographic features of 375b
mapping of 1304
mechanical complications of 368
related complications 1149
risk of 1138
risk scores 188
trial 306
Myocardial involvement 799
Myocardial iron
deposition 139
evaluation 136
Myocardial ischemia 128, 243, 369f, 389, 677, 788, 1032
acute 129f, 378, 677
and infarction 182, 974
detection of 1137
anterolateral 175f
assessment of 1149
asymptomatic 240
chronic 677
in left anterior descending territory 312f
Myocardial metabolism 1309
Myocardial microvasculature 131
Myocardial molecular imaging 1169
Myocardial necrosis 188
Myocardial oxygen consumption 1033
Myocardial performance index 120, 859, 859f
Myocardial perfusion 136, 178f, 258, 281f, 282f, 330, 1303f, 1308
abnormality 1179
imaging
acute rest 399
role of 288
reserve 13
single-photon emission computed
tomography 670, 1178
assessment of 115, 135
common interpretations of 292
evaluation of 258
radiotracers for 1307
imaging 13, 17, 174, 175f, 180, 241, 242, 258,
Myocardial region of interest, correct tracing of 1041
Myocardial revascularization 130
Myocardial scar 116
Myocardial segment 696
Myocardial strain 1244
estimation, three-dimensional 1291
imaging 684
Myocardial structure 136
Myocardial stunning 322, 328
Myocardial sympathetic nerve terminal, physiology of 168f
Myocardial thickness 1084
Myocardial tissue 117
characterization 12
Myocardial torsion 1039
Myocardial triglyceride accumulation 118
Myocardial ultrastructure 73
Myocardial viability 115, 313, 328, 1104, 1139
assessment of 135, 136, 322, 326, 328,
radiotracers for 1308
Myocardial volume 90
Myocardial wall
motion abnormalities, evaluation of 272
of left ventricular, anterior 132f
thickness 331
Myocarditis 12, 133, 137, 139, 634
acute 139f
detection of 136
Myocardium 717f, 1029, 1169
actively relaxes 709
and coronary circulation 335
fibrosis of 40
function of 709
neonatal 1028
postinterventional functional
recovery of 1171
presence of 129
scarred 673
sparkling appearance of 731f
stunning of 128
types of 323fc
typical ground-glass appearance of 696f
Myocyte apoptosis 115
Myocyte hypertrophy 115, 730
Myocyte injury markers 114
Myocyte mass 63
Myofibroblast proliferation 115
Myogenic abnormalities 966
Myoglobin 189
Myopathy, mitochondrial 137
Myopericarditis 801
Myosin light-chain kinase I 114
Myxoma 360, 1184, 1185f, 1192, 1198
right atrial 1204f
Myxomatous degeneration 1217f
Myxomatous disease 522
N
N terminal 744
N-13 ammonia 330
Naloxone 352
Napkin ring sign 257, 1300
Narrow sinotubular junction 1277
National Accreditation Board for Hospitals and Healthcare Providers 289
National Cardiovascular Data Registry 332
National Cholesterol Education Program 1114, 1155
Adult Treatment Panel III 1112
National Consumer Disputes Redressal Commission 1256
National Health and Nutritional Examination Studies 99
National Institute for Health and Care Excellence Guidelines 1159
National Institute of Health Stroke Scale 988, 989
Native valve 457
evaluation 356
Natriuretic peptide 81, 114, 189, 1120, 1121
B-type 1115, 1117, 1118, 1120, 1121
measurement 127
indication of 1118t
receptor-C functions 1115
system 81
role of 81
target 1120t
fixed 1121t
NCC See Non-coronary cusp
NE See Norepinephrine
Near infrared spectroscopy 215, 218, 1104
Nebivolol 74, 75
Necrosis
markers 114
stage of 735
Necrotic core 1103
Necrotic tissue volumes 80
Negative diastolic stress test 46
Negative predictive value 374, 401, 655
Neoangiogensis 251
Neoatherosclerosis 230
Neonatal cardiovascular physiology 1027
Neonatal rat ventricular myocardium 1029
Neoplasia 789
Neoplasms
benign 1192
malignant 1196
Neoplastic disease 778
Neoprotein 114
Neovascularization 1103
Nephrogenic systemic fibrosis 1056
Nephropathy
obstructive 106
reflex 106
Nephrosclerosis 106
Neprilysin 81
inhibitors 82
Nervous system, sympathetic 81
NET See Norepinephrine transporter
Neuroblastoma 1031
Neurocatheterization laboratory, evolution of 1006
Neuroendovascular procedures 1006
Neurofibromatosis 108
Neurons communicate via dendrites 1127
Neurosurgery 362, 1150
Neurotransmitters 21
New York Heart Association 85, 117, 145, 146, 167, 505, 691, 1120, 1163, 1164
classification 145t
Nicorandil 336
Nifedipine 336
Ninety minute door-to-balloon time 298
Nitinol 500
Nitrates 335
Nitric oxide 74, 1027, 1176
bioavailability of 41
donors 582
synthase 333
No reflow phenomenon 267, 284
No stent frame 1281
homograft 1281
stentless valves 1281
Nodules, subcutaneous 536
Nonbacterial thrombotic endocarditis 813
Noncardiac surgery 362, 1147, 1148, 1151
Non-coronary cusp 627, 1220
Non-coronary sinus 1219
Nonculprit vessel angioplasty 285
Noninvasive coronary computed tomographic angiography 243
Noninvasive technique 219
Nonischemic Cardiomyopathy Treatment Evaluation Trial, defibrillators in 163
Non-Q wave infarction 180
Non-ST elevation myocardial
infarction 194, 276
ischemia 378
Non-ST-segment elevation
acute coronary syndromes,
management of 405
myocardial infarction 187
Nontransmural infarction 116
Nontumoral masses 1196
Non-vitamin-K oral anticoagulant 572, 607, 608, 611
effect 607
therapy 612
Noonan syndrome 496
Norepinephrine 114, 167, 168f, 1031
transporter 168f, 181
North American Symptomatic Carotid Endarterectomy Trial 893, 926f
Novel echocardiographic technologies 698
Novel imaging technique 391
Novel innovative device therapy 164
NSF See Nephrogenic systemic fibrosis
N-terminal B-type natriuretic peptide 1120
N-terminal probrain natriuretic peptide 188, 1243
Nuclear
cardiology 516
imaging 219, 329, 825, 1098, 1104
diagnostic indication 409
ischemic memory imaging 409
prognostic indication 409
medicine 18
noninvasive technique of 21
scintigraphy 106, 1045
Nutritional deficiency 137
O
Obesity 41, 133, 563, 915
related left ventricular hypertrophy 30
Obstetric surgery 1151
Obstructive pulmonary disease, chronic 256f, 290
OCT See Optical coherence tomography
Oligemia, benign 988
Omapatrilat 82
Oncosurgery 1151
Open heart surgery 446
Operation theatre, echocardiography in 1223
Optical coherence tomography 78, 210t, 215, 217, 218, 223, 225f, 226f, 227, 229, 230, 231f, 232f, 237, 238, 247, 248f, 253, 284, 955, 961, 1102, 1103
guided vascular interventions 961
imaging 224f, 224fc, 227
representation of 224f
Oral contraceptive therapy 832
Organic mitral regurgitation 347, 479
Orifice mitral valve, double 479f
Oropharynx anesthesia 352
Ortho/para iodophenyl-pentadecanoic acid 1309
Orthopedic surgery 1150
Osteoprotegerin 114
Outflow tract obstructions 713
Oxidative metabolism 330
Oxidative stress 32, 114, 190, 332
markers 114
Oxygen saturation 1140
Oxyhemoglobin 999
P
Pacemaker 483
infections 1139
Packing density 1010
and hydrocoil 1010
PACS See Peak atrial contraction strain
Paget-Schroetter syndrome 933, 934f
Pain
chronic 1126
relief of 284
Palpography 217
PALS See Peak atrial longitudinal strain
Pan-diastolic motion 788
Pannus 517, 518t
formation 516
Papaverine 964
Papillary fibroelastoma 360, 1187, 1187f, 1194, 1198
Papillary muscle 205, 458, 701, 1148f
dysfunction 312f
endocardium excluding 29
infarction 523
rupture 204, 267, 311, 374, 374f, 368, 1216
Paradoxical low-flow low-gradient 1272
Paraganglioma 105, 1195, 1198
Paramagnetic core 113
Paraoxonase-1 114
Parasagittal lobar bleedings, bilateral 1002f
Parasternal long axis 154, 373, 375, 867
Parasternal short axis 154, 373, 867
Paravalvular aortic regurgitation 348f, 510
Paravalvular leak 511, 1283
Paravalvular regurgitation 1221
Parenchyma 8
Parietal cortex 993
Parietal pericardium 760, 764, 777, 793f
Parkinson's disease 1165, 1166
Paroxysmal atrial fibrillation 640
Paroxysmal supraventricular tachycardia 974
Pascal repair system 455
PASP See Pulmonary artery systolic pressure
Patchy distribution 136
Patchy subepicardial enhancement 139
Patent ductus arteriosus 855, 888, 948, 1017, 1021, 1030
stenting 1018, 1020f, 1021
Patent foramen ovale 355, 362
restrictive 1017
Patient remote monitoring system 1140, 1145f
PBMC See Percutaneous balloon mitral commissurotomy
PCI See Percutaneous coronary intervention
PCPW See Pulmonary capillary wedge pressure
PCSK9 inhibitor 1157, 1160
alirocumab 1158
PCWP See Pulmonary capillary wedge pressure
PDA See Posterior descending artery
Peak aortic valve velocity 1271f
Peak atrial contraction strain 52, 54f, 566
Peak atrial longitudinal strain 52, 54f, 55f, 67, 565
Peak circumferential strain 123f
Peak systolic velocity 107, 681, 894, 896, 908f, 919, 919f, 956, 966, 966f, 967f, 968
Peak tricuspid regurgitation
jet velocity 66
measurement of 41
Peak velocities
diastolic 767
systolic 767
Pectinate muscle 613f
Pediatric cardiology 1044
Pelvic arteries
caliber of 885
patency of 885
Penile Doppler study 963, 964f
analysis of 968t
Penile fractures 967
Penile hematoma 968
Penile Mondor's disease 968
Penile trauma 964
Penumbra 988
aspiration device 988
pivotal stroke trial 988
Percutaneous balloon
atrial septostomy 1077
mitral commissurotomy 361
Percutaneous catheter-directed reperfusion techniques 837
Percutaneous coronary
angioplasty 283
intervention 208, 211, 212, 212t, 216, 223,
indications of 235
primary 133, 264, 271
Percutaneous pulmonic valve implantation 494
Percutaneous transluminal
coronary angioplasty 272, 762, 1173
septal myocardial ablation 695
Perforator veins 927, 929
Perfusion mismatch, autonomic 182
Perfusion-weighted imaging 989
Periannular abscess, echocardiographic features of 815
Pericardial calcification 800
Pericardial cavity 751, 764
Pericardial conditions, congenital 803
Pericardial constriction 117
Pericardial cyst 778, 803, 1196
Pericardial defect, congenital 777
Pericardial disease 458, 751, 760, 776, 780, 797, 798t, 799
diagnosis of 799
tamponade 974
Pericardial disorders 751
Pericardial diverticula 804
Pericardial effusion 368, 371, 372, 374, 424f, 556f, 751, 754f, 764, 778, 801
asymptomatic 751
causes of 753
diagnostic criteria 751
estimation of 752
identification of 367
limitations 758
management 758
minimal 772
presence of 751, 840
prognosis 758
recurrence of 758
small 730, 752
Pericardial fluid 751, 762, 764, 765
Pericardial involvement 1246
Pericardial masses 780
Pericardial neoplasms 802
Pericardial pathology 753
Pericardial recesses 762
Pericardial space 709
Pericardial syndrome 799
Pericardial tamponade 367, 371, 379, 754, 755, 802
echocardiographic features of 372b
Pericardial tapping 790
Pericardial thickening, noncalcified 780f
Pericardiectomy 790
Pericardiocentesis, complications of 758
Pericarditis 799, 1137
acute 779
rheumatic 753
Pericardium 117, 770, 776, 780
absence of 760
anatomy of 776
assessment of 776
congenital absence of 778, 778f, 804
multimodality imaging of 776
physiology of 776
primary tumors of 780
thickening of 778f
Perihematoma edema 999
Periodontal disease 1165, 1166
Peripheral arterial
disease 923, 938, 942t, 943, 946, 953, 1158
assessment for 924t
diagnosing 923
evaluation of 943fc
Doppler after endovascular surgery 927
system 940f
Peripheral deep venous system, evaluation of 943
Peripheral eccentric thrombus 841f
Peripheral occlusive vascular disease 1108
Peripheral pulmonary artery stenosis 849
Peripheral vascular disease 915, 946
causes of 915t
Peripheral vascular interventions
advanced image-guided 953
duplex guided 955
image-guided 960
role of intravascular ultrasound in 958
Peripheral vasoconstriction 1030
Peripheral vasodilation 1031
Peripheral venous disease 946, 951
Peripheral vessels, disorder of 116
Periprocedural complications 661
Periprocedural imaging 1281
Perivalvular extension 819
Perivalvular involvement and abscess 814
Perivascular fibrosis 74
Permanent pacemaker implantation, predictors of 1282
Peyronie's disease 964, 966
PFO See Patent foramen ovale
Phase histogram bandwidth 670
Phentolamine 964
Phenylephrine 181
Pheochromocytoma 105108, 137
Phosphodiesterase inhibitors 1029
Photomultiplier tube 17, 18, 18f, 19f, 2123
basic principle of 22
instrument's design 22
Photon detectors 17
Photoplethysmography 1146
Phrenic nerve 661
injury 638
stimulation 660
PHV See Prosthetic heart valve
Picture archiving and communication system 1134, 1135
Pipeline embolization device 1012
Plain chest radiographs, domain of 1055
Plan transcatheter aortic valve replacement 1269
Planar reformation, curved 879, 939
Planimetry 547
Plaque
analysis software 393
burden 1104
characterization 257
erosion 249, 250f, 284, 1103
imaging 1098, 1102
morphology 79
classification of 225f
rupture 248, 249f, 252
vulnerability, new biomarker of 190
Plasma
brain natriuretic peptide 37, 725
homocysteine levels 1177, 1179
isoprostanes 114
malondialdehyde 114
total homocysteine levels 1177
Plasmatic ultrafiltrate 777
Plasminogen activator inhibitor-1, expression of 1113
Platelet
accumulation 1176
activation 188, 1176
adhesion, inhibits 1176
rich thrombus formation 1176
Plethora 786
Pleural effusion
large left-sided 764
left-sided 752
PLV See Posterior left ventricle
PML See Posterior mitral leaflet
PMT See Photomultiplier tube
Poly acid 1010
Polyarteritis 105
Polyarthralgia 536
Polyarthritis 536, 541
Polycontrast interference photography 1131
Polycystic kidney disease 106
autosomal dominant 105
Polyglycolic acid 1010
Polypoidal myxoma 1185f
Polyvinyl alcohol 1014
Popliteal artery 920f, 922f, 955
Popliteal fossa 920f
Popliteal vein 920f
Position-sensitive
avalanche photodiode 19
photomultiplier tube 18f, 19f
Positive diastolic stress test 46
Positive predictive value 401, 655
Positron emission tomography 17, 21, 107, 116, 174, 181, 219, 240, 242, 271, 322, 323, 326, 330, 334, 448, 740, 744, 810, 1104, 1139
quantification 241
tracers 400
Positron emitting radionuclides 21
Post-balloon atrial septostomy 1019f
Postcapillary pulmonary hypertension 853
Postcardiac surgery 773, 779, 785
Postcardiac transplantation 141
Postcoronary artery bypass graft 7
surgery subset 232
Postdegenerative mitral valve repair 1217
Posterior and superior transseptal puncture site 480f
Posterior cingulate cortex 1126
Posterior circulation stroke 990
Posterior descending artery 315, 317, 385f
Posterior left ventricle 385f
Posterior mitral leaflet 541, 544f
Posterior septum 701
Posterior temporal cortex 993
Posterior wall
myocardial infarction 198
thickness 64f, 89, 98
Posteromedial papillary muscles 1148
Postgadolinium injection, four-chamber 129f
Postgadolinium enhanced cardiovascular magnetic resonance 140f
Postinfarction ventricular septal
defects 1084
rupture 204
Postmyocardial infarction 132, 374f, 661, 1294
Postnatal circulation 1027
Postpercutaneous coronary intervention subset 229
Post-Rastelli procedure 1064f
Post-ST-elevation myocardial infarction 313f
Post-stenotic internal carotid artery 893
Potassium, urinary loss of 1032
Pre-conception and Prenatal Diagnostic Techniques (Prohibition of Sex Selection) Act 1253, 1257
Pre-extracorporeal membrane oxygenation assessment 1071, 1073
Pregangrenous limb, assessment of 927
Pregnancy 1165, 1166
lactation 832
Prenatal diagnostic techniques 1260
Pressure
half-time 507
overload 1030
pulmonary 1076
arterial 158, 847, 849f, 852, 854f
volume, abnormal 577f
wire technique 244f
Previous surgical bioprosthetic valves 457
Priapism 964, 967
Prima 1120
Proarrhythmia, drug-induced 974
Progetto Ipertensione Umbria Monitoraggio Ambulatoriale 101
Prohibition of Sex Selection Rules 1253, 1260
Proinflammatory bioactive coil arose 1010
Prominent pectinate muscles 594f
Prophylactic defibrillator implantation 163, 678
Proprotein convertase subtilisin 216
Prostaglandin injection 1021
Prosthetic aortic regurgitation, severity of 509
Prosthetic aortic valve
function 503f
regurgitation 509
Prosthetic heart valve 498, 500
endocarditis 512f
mitral regurgitation 509f, 510f
types of 498
Prosthetic mitral valve
function 504f
Doppler parameter of 507t
regurgitation 507
three-dimensional evaluation of 470
Prosthetic tricuspid regurgitation 513
Prosthetic valve 357, 502f
complications of 516
dehiscence of 817
dysfunction 367
echocardiographic evaluation of 498
endocarditis 820
transesophageal echocardiography evaluation of 820f
evaluation 1221
regurgitation, evaluation of 506
thrombus 517
types of 499f, 499t
Prosthetic valvular regurgitation 344
Proteasome inhibitors 734
Protein kinase
activates 333
G, level of 41
ProtekDuo veno-venous cannula 1070f
Proteoglycans, complex of 1028
Prothrombin time 1166
Proximal aorta, severe angulation of 885
Proximal isovelocity surface area 440, 442, 489
Proximal structures, involvement of 1204f
PS See Pulmonary stenosis
Pseudoaneurysm 132, 269, 311, 375, 817, 887, 919, 1228
sac 921f
thrombin injection of 955
Pseudoinfarction pattern 729
Pseudonormal mitral inflow pattern 712f
Pseudonormalization 710
PSPMT See Position-sensitive photomultiplier tube
Pulmonary annulus, balloon dilation of 1023
Pulmonary arterial pressure
derivation of mean 852f
determination of 158
Pulmonary artery 6f, 276, 396, 590, 711, 789f, 836f, 841f, 856, 1032, 1045, 1050, 1076
assessment of 8
bifurcation of 835f
branches, distal 1044
branching pattern of 1058
catheter 1213
derivation of 852f
diameters, enlarged 840
diastolic pressure 852f
evidence of 1150
hypertension 557
left 376, 627
normal right 1046f
ostial stenosis, mild left 1046f
pathologies 3
pressure 120, 148, 834f, 850
systolic pressure 546, 547, 850
wedge pressure 847
Pulmonary atresia, assessment of 1024f
Pulmonary blood flow
excessive 1030
obstructed 1030
Pulmonary capillary wedge pressure 54, 516, 563, 1083, 1093, 1121
Pulmonary edema, acute 145
Pulmonary embolism 367, 370, 379, 412, 839, 974, 1151, 1178
acute 375, 376f, 831, 833, 834f, 835f, 837f, 839, 841f, 1087
chronic 840
echocardiographic signs of 370b
risk factors for 832t
submassive 832
Pulmonary flow, augmentation of 765
Pulmonary hypertension
causes of 855
diagnosis of 848
Pulmonary insufficiency, congenital forms of 1031
Pulmonary obstructive disease, severe 330
Pulmonary prosthetic heart valve 514
obstruction 514
regurgitation 514
Pulmonary regurgitation 490, 491, 851f
echocardiographic assessment of 491
fraction 528f
Pulmonary stenosis
assessment of 1022f
critical 1018
supravalvular 1060
Pulmonary thromboembolism, acute 835
Pulmonary trunk 613f, 1065
Pulmonary valve 344, 357, 627, 1024f
anatomy 490
assessment 491
balloon dilation 1018, 1019, 1023
M-mode echocardiogram of 789
perforation 1023, 1024f, 1025f
stenosis 495, 1031
syndrome 1031
Pulmonary vascular
anatomy, determining 1058
markings 1030
resistance 831, 852, 853, 854f, 857f, 1027
tone 1033
Pulmonary vein 355, 356f, 539, 711, 765, 766, 1050
assessment of 8
confluences of 67
drainage of 1025
isolation 362, 638
left inferior 626, 627f
left superior 626
visualization of 624
Pulmonary velocity 766f
Pulmonary veno-occlusive disease 848
Pulmonary venous
blood flow 586f
connections 1204
Doppler flow 42, 43
flow 148, 581, 766
assessment 567
derived atrial reverse 75
inflow pattern 148
mapping 3, 8
Pulmonary-to-systemic-flow ratio, calculation of 1057
Pulmonic regurgitation, common etiologies of 491
Pulmonic valve stenosis, dome-type 495
Pulsatility index 1235
Pulse Doppler 433
echocardiography 697
Pulse pressure 61, 98
Pulse tissue Doppler
evaluation 792f
tracing 792f
Pulse wave 42, 442
Doppler 668, 916, 917
echocardiography 667
evaluation 148
tracing 571f
Pulsus paradoxus 766f, 771, 772
echocardiographic equivalents of 770
Pump failure 188
Pump function failure 1083
Punishment Under Pre-conception and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Act 1259
Pure aortic regurgitation 1280
PV See Pulmonary valve 344
Pyramidal volume data, three-dimensional 90
Pyrexia 779
Q
QRS complex 665
Quadricuspid valves 491
Quiescent interval steady state 941
Quinapril 336
R
Radial artery 296, 948
occlusion 297
Radial strain 125, 659
delay parameters 655
imaging 660t
measures radial deformation of
myocardium 1037
normal 1038f
Radiation
and contrast dose reduction strategies 843
dose 259, 392
exposure and risks with CT 379
Radical semiquinone intermediate 1162
Radio waves 10
Radiofrequency
ablation 603, 621, 625, 640, 640t
procedures, guided 572
use of 1023
analysis 217
catheter ablation 584
Radioisotopes 23
Radionuclide 23, 107, 113, 167, 177, 399
imaging 733
use of 176
voiding cystourethrogram 106
Radiopharmaceuticals, use of 1307
Radiosurgery 1014
Radiosynthesis 23
Railway track sign 840f
Raised arterial pressure, presence of 1029
Ramus intermedius 383f
Randomized control trials 444
Rankin score, modified 988, 990
Ranolazine 336
Rastelli operation 1063
Raynaud's disease 927
Raynaud's phenomenon 927
RBCs See Red blood cells
RCA See Right coronary artery
RCC See Right coronary cusp
Reactive hyperemia induction maneuver 910
Red blood cells 225f, 484, 999
Regional left ventricular function 677
Regional tamponade 770f, 772
Regional wall motion
abnormalities 374, 407, 448, 1084
assessment of 677
presence of 401
analysis 368, 1288
Regurgitant fraction 440, 443, 508, 509
Regurgitant lesions, severity of 665
Regurgitant orifice area, effective 442, 443, 484, 509
Regurgitant valve lesions 344
Regurgitant volume 440, 442, 443, 508
calculation of 421
Regurgitation
mild pulmonic 491
physiological 506
Rehabilitation, community-based 1101
Remodeling techniques 1010
Renal and liver insufficiency 778
Renal angle bruit 106
Renal artery 877, 949, 950f
stenosis 105
Renal cell carcinoma 780
Renal disease, end-stage 12, 31, 99, 956, 1172
Renal dysfunction, severe 90
Renal failure 684
Renal function
evaluate 106
markers 114
Renal parenchymal diseases 106
Renin secreting tumors 105
Renin-angiotensin aldosterone system 32, 81, 113, 114
activation of 300
blockers 105
chronic activation of 41
drug targeting 99
pathogenic role of 65
suppression of 1115
Renin-angiotensin receptor blockers 683
Renovascular hypertension 105, 106
Reservoir 49
function 51f
wave approach 328
Residual coronary disease 133
Residual stenosis, severity of 1019
Resistive index 967f, 968
Respiratory distress syndrome, acute 1070
Respiratory failure 832
Rest-dipyridamole stress 176f
Restrictive cardiomyopathy 137, 563, 707, 708f, 709f, 711, 711f, 721, 724726, 744, 790, 793f
classification of 725, 726t
clinical presentation 722
differential diagnosis 725
drug-induced 743
epidemiology 721
evaluation 723
genetics 721
limitations 717
prognostic implications 714
therapeutic implications 715
types of 726t
Reticular veins 927
Revascularization, planning of 1171
Rhabdomyoma 360, 1186, 1195
Rhabdomyosarcoma 1188, 1196, 1198
Rheumatic fever, acute 535, 536, 536b, 539, 541
Rheumatic mitral stenosis, diagnosis of 543
Rheumatic pathology 1216
Right atrial inversion index 755, 767
Right atrial pressure 158t, 1084
limitation of 1088t
Right atrium 355, 590, 800, 1071, 1073, 1078
Right coronary
angiogram 1290f
artery 6f, 196f, 257f, 259f, 278, 311, 315316, 355, 380, 382f, 383f, 385f, 1032, 1149f, 1235
cusp 1220
sinus 1219
Right heart 361
assessment 1246
catheterization 850
failure 779
filling 765
obstructive defects 1060
Right inferior pulmonary vein 626
Right pulmonary artery 376, 627, 836f, 874, 877, 1150f
Right superior pulmonary vein 43f, 626, 627, 627f
Right ventricle 1064, 1076
collapse 371f
failure, echocardiographic features of 1075
inversion 755
isovolumic acceleration 860f
pseudoaneurysm 758
systolic function 1092
evaluation of 158
systolic pressure 849f
Right ventricular dependent coronary circulation 1023
Right ventricular diastolic inversion 755
Right ventricular dilatation 311f, 1045
Right ventricular dysfunction 831
pathophysiology of 832fc
Right ventricular end-diastolic pressure 744
Right ventricular endomyocardial fibrosis 717f
Right ventricular function 266, 458, 692
assessment of 1039
Right ventricular hypertrophies 855
Right ventricular hypokinesis 370
Right ventricular infarction 206, 310
Right ventricular myocardial biopsy 701
Right ventricular myocardial infarction 196, 310, 311f
Right ventricular outflow tract 355, 490, 514, 626, 627, 756, 849, 852f, 873f, 1045
diastolic inversion of 756f
tract obstruction 1019
tract stenting 1022
Right ventricular pressure 495
Right ventricular strain 681, 842, 1294
Right ventricular systolic 495, 681
function 665
pressure 311, 744
Right ventricular wall inversion 767
RIPV See Right inferior pulmonary vein
Ritter's formula 691
Ritter's method 691
Rivaroxaban 610
Robotic peripheral vascular interventions 960
ROI See Reactive oxygen intermediate
Ross surgery 1213
Rosuvastatin 79, 1158
evaluation of 79
RSPV See Right superior pulmonary vein
Rugger-Jersey spine 108
RVMI See Right ventricular myocardial infarction
RVOT See Right ventricular outflow tract
S
SAH See Subarachnoid haemorrhage
Sahaja yoga 1129
Saphenofemoral junction 928, 955f
color mode of 928f, 929f
longitudinal view of 928f
Saphenous vein
graft 232, 232f, 1232
small 920f, 927, 928, 929f
Sarcoidosis 115, 139, 707, 716, 739
diagnosis 739
treatment 740
Sarcolemma 115
SAVR See Surgical aortic valve replacement
Scanogram 383
Scepter balloon catheter 1011
SCORE See Systematic coronary risk evaluation
SDI See Systolic dyssynchrony index
SEC See Spontaneous echocardiographic contrast
Second cardiac insufficiency bisoprolol study 146
Sedation 1055
Segment stenosis score 1300
Senning atrial baffle procedure 1047
Senning procedure 1047
Septal bounce 780, 787, 791f
Septal bulge 770
Septal endocardium 1270f
Septal hypertrophy, asymmetrical 696, 696f, 975f
Septal hypokinesia 1040
Septal mitral annulus tissue Doppler 43f
Septal motion, abnormal 779, 788
Septal movement 788
Septal myomectomy 695
Septal posterior wall mechanical delay 668
Septal puncture
guided 622
needle 624f
tailor site of 623f
Septal shudder and bounce 786
Septal tricuspid leaflet 355
Septal wall, stretch in 657
Septum, regional motion of 1040
Serum cardiac biomarkers 401
Sestamibi scintigraphy 108
Several paired lumbar arteries 877
Sgarbossa's criteria 199f
Shallow sinus 1277
Shock 1083
distributive 1083, 1090
etiology of 367
hemodynamic of 1093t
in intensive care unit
diagnostic criterion 1083
echocardiographic evaluation of 1083
obstructive 1083, 1087
septic 1090, 1091f
Short QT syndrome 634
Short-tau inversion recovery 133, 798, 878
Shunt
left to right 483
types of 1048
Siderosis 1303
Sildenafil 336
Simple test 1178
Simpson's method 64, 67, 90
Simpson's rule 11
Single disc tilting valve 470
Single echocardiographic sign 774
Single photon emission computed tomography 17, 23, 129, 174, 175f, 215, 240, 275, 293, 312, 323, 333, 744, 810, 1169, 1173
Single ventricle syndromes 1064
Single vessel disease 386f
Sinoatrial nodal branch 383f
Sinotubular junction 877, 1220, 1276f
Sinus node dysfunction 974
Sinus of Valsalva 822f, 1059, 1219f, 1276f, 1281
aneurysm of 815
dimensions 1273f
height 1279
size 1277
Sinus rhythm 571f
after cardioversion 603
maintenance of 603
Sinus size 1276
Sinus venosus 359f, 1048
Situs solitus 1064
Sleep apnea, obstructive 563
Small vessel
assessment 889
coronary artery disease 332
tests for 333
treatment of 335
disease 333, 551
Smooth muscle cell proliferation 1176
S-nitrosohomocysteine 1176
S-nitrosothiols 1176
Social media, use of 1263
Society of Cardiovascular Anesthesiologists 353, 1147
Society of Thoracic Surgeons Score 448
Sodium
glucose cotransporter inhibitors 1110
iodide 18
Soft-tissue, tumor of 947
Soluble guanylate cyclase 333
Speckle-tracking 1040
echocardiography 42, 44, 68f, 84, 122, 275, 326, 435, 564, 650, 651f, 676, 794f, 1037, 1039, 1244, 1288, 1291
imaging 275
radial strain 125
SPECT See Single photon emission computed tomography
Spectral Doppler 492
parameters 510, 513
Spectrum dynamics 21
Sphericity index, three-dimensional 272f
Spinal cord
injury 832
stimulation 165
Spiral catheter, guide placement of 627f
Spontaneous circulation, signs of 362
Spontaneous echocardiographic
contrast 570, 607, 613f
shadow 611
Spotty calcification 1300f
Stable angina, chronic 288, 1171, 1290, 1291
Standard treadmill protocols 46
Staphylococcus aureus 809, 810, 812
bacteremia 812
Starbrite 1120
Starr-Edward mitral 508f
Starr-Edward valve 470
Statins 78
effect of 78
pleiotropic effects of 80
therapy, efficacy of 80
Steady-state free precession 136
angiography 941
axial image 1065f
images 1064f
sequence 798, 1057
Steep learning curve 298
ST-elevation acute coronary syndrome, acute 297
ST-elevation myocardial infarction
complications of 267, 310
echocardiography after 265
electrocardiography imaging in 194
emerging biomarker of 189
management of 1137
Stem bronchus 371
STEMI See ST-segment elevation myocardial infarction
Stenosis 490, 959
calculation of 926f
criteria of 926
congenital fixed 429
degree of 926t
moderate 506
pulmonary 344, 711, 1017
arterial 1060
pulmonic 496
severe 506
left main 318f
subaortic 1058
sub-infundibular 1060
supravalvar 1022
Stenotic tricuspid valve
anatomy, assessment of 488
orifice 488f
Stent 1011
assisted coiling, technique of 1011
evaluation 942
expansion, optimization of 959
failure 252
frame, internal 1281
graft
deployment 883
function 881
placement 881
low-profile 1011
planning software 393
pulmonary end of 1021
thrombosis 208, 212, 247
Stethoscope 58
STIR See Short-tau inversion recovery
Stoke volume 433
Storage system 1136
Strain 654
analysis, use of 117
and strain rate imaging 600
delay index 657
echocardiography aids 731
imaging 417, 420, 422
two-dimensional 698
rate 1037
imaging 593
Streptococcus bovis 818
Streptococcus pneumoniae 1112
Stress
cardiomyopathy 139
echocardiography 130, 325t, 405, 434, 442,
computerized tomography 447
diagnostic implication 408
prognostic implication 408
strain imaging 408
end-systolic volume 1179
myocardial perfusion imaging 129, 405
test postpercutaneous coronary
intervention 311
thallium 330
myocardial perfusion scan 175f
wall motion imaging 129
Stretch resistance 1010
String sign 926f
Stroke 35, 37, 81, 95, 684, 987, 1110, 1178
computed tomography angiography 995
computed tomography perfusion 996
trials 997
volume 11, 1033, 1078, 1084, 1091, 1092
volume 853
volume measurements 121
volume, measurement of 1092f
ischemic 988
mechanism of 987
ST-segment elevation myocardial infarction 185, 187, 194, 223, 227, 227fc, 232, 250, 252, 264, 265, 269, 276, 279, 297, 304, 309, 310f, 326, 378
chest pain in 188f
complications 203
diagnosis of 264
management of 264
pathophysiology of 283
Subaortic stenosis
congenital 429
dynamic 429
tunnel type of 429
Subclavian artery
left 879, 885
proximal 911f
part of 909f
Subclavian steal syndrome 907, 908, 909f
Subclavian vein, thrombosed 934f
Subclinical myocardial dysfunction, detection of 1038
Subendocardial attenuation density 390
Subendocardial perfusion 1302
Subendocardium 13, 680
Subendothelial function 74
Subperiosteal resorption 108
Subvalvular apparatus 417, 468
Sudden cardiac death 127, 138, 146, 163, 215, 272, 701, 973
prevention of 702
risk 698
markers for 702
stratification for 702
Sudden death 1040
prevent 703
prevention 701
risk 95
calculator 703
Suicidal right ventricle 497
Sullivan extent score 1179
Sullivan method 1179
Superficial dorsal vein 968f
Superficial femoral
artery 920f, 921, 951f, 955, 956f
vein 943f
Superficial veins 927, 930
small 927f
Superior longitudinal fasciculus 1128
Superior pulmonary veins 799
Superior vena cava 361f, 627, 799, 861, 1058f, 1071f, 1072, 1073, 1076, 1077
Supraaortic stenosis 1059
Supraceliac clamping 1150
Supraventricular tachyarrhythmias, history of 703
Surgical aortic valve replacement 362, 446, 1272
Surgical repair, potential risk factors for 1216
Surrogate endpoints 118
SV See Sinus venosus
SVC See Superior vena cava
SVR See Systemic vascular resistance
Swedish National Diabetes Database 1110
Swinging heart 756, 771, 771f
Sylvian fissures, bilateral 1003f
Syncope 973, 979, 974b, 975f
anatomic causes of 973
cardiac causes of 974b
classification of 979
echocardiography in 981
evaluation of 981
neurogenic 979
reflex 979, 980
role of echocardiography in 980
Syphilis 879
Systematic coronary risk
estimation 1097, 1157, 1158
evaluation 1097
Systemic lupus erythematosus 137, 332
Systemic venous
congestion 714
flow 766
Systolic anterior motion 205, 701, 1203, 1205f
Systolic blood pressure 81, 443
intervention trial 1110
Systolic dysfunction 664
severe left ventricle 313f
Systolic dyssynchrony index 668
three-dimensional-based 124
Systolic flow, dominant 767f
Systolic function 85, 441, 697
tissue Doppler assessment of 84
Systolic heart failure 120
evaluation 120
nonischemic 163
Systolic hypertension 82, 100
Systolic intraventricular dyssynchrony 699
Systolic pressure, pulmonary arterial 158
Systolic strain, types of 1038
Systolic ventricular function 715f
T
Tachyarrhythmia 974
specific 974
Tachycardia 137, 390, 513, 1089
clinical signs of 779
supraventricular 974
Tachypnea 1030
Takayasu arteritis 105, 886, 886t, 887f, 908
active 887
chronic stage 887
imaging findings 886
management 887
types 886
Takotsubo cardiomyopathy 139, 332, 1172
Tamponade
classic signs of 769
diagnosis of 767
echocardiographic features of 762
physiology of 761
signs of 764
symptoms of 764
TAPSE See Tricuspid annular plane systolic excursion
TAVR See Transcatheter aortic valve replacement
Tc99m dimercaptosuccinic acid 106
Tc99m perfusion agents 400
Tc99m sestamibi 401
myocardial imaging 1170
Tc99m tetrofosmin imaging 1170
TDI See Tissue doppler imaging
TEE See Transesophageal echocardiography
Tei index 833, 859
Teichholz method 155
Telangiectasia 927f
veins 927
Telemedicine 1134
Teleradiology applications 1139
Telmisartan 74
Temporal cortex, anterior 993
Tendyne valve 460
Tenecteplase 279f, 280
Tension pneumothorax 367, 379, 1090
Teratoma 360
Tetralogy of Fallot 492, 528f, 1018, 1019, 1023, 1045, 1060
component of 1060
TGA See Transposition of great arteries
Thallium 18
doped sodium iodide 17
Thallium-201 1307
study 673
Thermal coronary angiography 1235
Thermography 1104
Thiamine deficiency 140
Thiazide 103
diuretics 102
like diuretic 100
Thin-cap fibroatheroma 216, 218f, 229, 250f, 257, 260, 284, 1299
Thoracic aneurysm, descending 878, 879, 881
Thoracic aorta 877, 947, 948
aneurysm of descending 948f
descending 626, 752f, 870f, 874f, 875f, 877
evaluation of 367
Thoracic aortic aneurysm 869, 879, 881
causes 879
epidemiology 879
measurements 879
types 879
Thoracic artery, left internal 233
Thoracic impedance 164
Thoracoabdominal aneurysms 879
classification of 879t
Three-dimensional echocardiography
advantages of 343t
disadvantages of 343t
live/real-time 869
Three-hydroxy-3-methyl-glutaryl-coenzyme 1166
Thrombectomy
devices
second generation 988
third-generation 988
intention for 990
Thromboangiitis obliterans 927, 947
Thromboembolic pulmonary hypertension, chronic 8, 831, 857f, 858f
Thromboembolism 516, 1074, 1228
pulmonary 483
risk of 567
Thrombolysis 837
in myocardial infarction 265, 271, 278280, 280f, 281f, 296, 378
Thrombolytic therapy 283
Thrombomodulin 1176
protein C 1176
Thrombosis 516, 735
Thrombus 284, 360, 517, 518f, 835f, 1189
dissolution, evidence of 611
formation 310, 1050
in plaque cavity 249f
in pulmonary artery 376f
small 813
Thyroid
abnormalities 108
disorders 137
dysfunction 108
Tiara device 460
Tibial artery 922f
revascularization 955
Tilting transducer down 627f
TIMI See Thrombolysis in myocardial infarction
Tissue
characterization 72, 73, 528
Doppler imaging 42, 43, 46, 50, 51f, 52f, 78, 122, 155, 585, 588, 592, 594, 649, 666, 668, 698, 1084, 1244
methods 859f
systolic velocity 860f
Doppler interrogation 860
factor pathway 1176
necrosis, biomarkers of 190
phase mapping 117
type plasminogen activator 278, 280
velocity
assessment of 593f
imaging 723, 730
Tombstone morphology 199
Tomographic slices 464
Torsades de pointes 977f
Total anomalous pulmonary venous connection 1017, 1025, 1030
Total coronary occlusion, detection of 318
Total internal carotid artery block, syndrome of 926
Total occlusion, chronic 208, 212, 318, 956, 1023
TR See Tricuspid regurgitation
Transatlantic inter-society consensus 956
Transcatheter aortic valve
implantation 7, 351, 529, 1283
replacement 362, 444, 446, 448, 456, 1272, 1279, 1283
situations 1279
Transcatheter heart valve 1273
Transcatheter mitral valve
interventions imaging evaluation 453
repair 453
techniques 454
replacement 456, 461, 461t
techniques 456
Transcatheter procedures 350
Transcatheter valve 499
factors 1281
Transcathether mitral valve replacement 459
Transcutaneous aortic valve replacement 510
Transcutaneous electrical nerve stimulation application 336
Transeptal puncture 362
Transesophageal echo 834, 836f, 861
Transesophageal echocardiogram 265, 479, 607, 815f, 1203
live three-dimensional 347f
Transesophageal echocardiography 205, 352, 357, 368, 434, 434f, 439, 447, 454, 457, 465, 498, 551, 561, 570, 570f, 572f, 573f, 585, 586, 589, 591, 596, 651, 812, 820f, 855, 1044, 1076, 1085, 1149f, 1150, 1150f, 1151, 1184, 1187f, 1212, 1269
advantages of 351b
clinical applications of 356b
contraindications of 351, 352b
disadvantages of 351b
during cardiopulmonary resuscitation 362
in critical care 362
indications 351
intraoperative 1147, 1203
perioperative 1147, 1148
probe 352, 353f
handle 353f
movements of 353f
procedure 352
role of 573f
specific indications of 356
three-dimensional 124, 465, 348f
two-dimensional 344, 870f, 875f, 1076f
Transesophageal three-dimensional echocardiographic reconstruction 874f
Transfemoral intervention 296
Transgastric
basal short axis 1215f
short-axis 1148, 1149
Transient apical ballooning 1172
Transit time flowmetry 1233
technique 1233f
Transluminal attenuation gradient 259, 335, 1302
Transmitral Doppler inflow 42
Transmitral early diastolic velocity 74
Transmitral flow deceleration time 563
Transmitral velocities 765
Transmittal flow, pulse wave Doppler of 667
Transmural perfusion 390
gradient 13
Transmural scar, areas of 129
Transpharyngeal echocardiographic examination 898f
Transprosthetic velocity and pressure gradient 501
Transradial intervention approach 296
Trans-septal puncture 351, 480, 552, 556f, 557
Transthoracic Doppler echocardiography 335
Transthoracic echocardiogram 480, 491, 607, 813, 855
Transthoracic echocardiographic images 824
Transthoracic echocardiography 315, 317, 319, 351, 368, 401, 427, 448, 507, 509, 584, 585, 585f, 586, 588, 778, 809, 812, 822f, 1044, 1073, 1184, 1085, 1089
guided early cardioversion 586fc
short-axis 585f
two-dimensional 344, 535, 867f870f
Transthoracic images, two-dimensional 868f
Transthoracic parasternal short axis 552f
Trastuzumab 121
therapy 679
Trauma 778
Traumatic injuries 887
Treadmill test 289, 311, 1169
Trickle sign 926f
Tricuspid annular
plane systolic excursion 124, 273, 311f, 647, 648f, 661, 681, 859, 860f, 1076
systolic excursion 267
Tricuspid aortic valve 5f
normal 429
Tricuspid atresia 1023, 1030
with pulmonary atresia 1025
with restrictive atrial septal defect 1023
Tricuspid flow during inspiration 1089
Tricuspid prosthetic valve 511
obstruction 513f
Tricuspid regurgitation 344, 370, 448, 483, 493, 513, 557, 645, 722, 744, 788, 848, 852f, 853f, 854f, 1031, 1045, 1060, 1075, 1076, 1088, 1186f, 1221
evaluation of 484, 485
normal 1221
pathophysiology of 1221, 1221f
pressure gradient 850f
rheumatic 486f
severe 1024f
spectral waveform 852
velocity 149, 849f, 852f, 859f
vena contracta 346f
Tricuspid stenosis 344, 483, 486, 488t
assessment of 486
Tricuspid valvar dysplasia 1031
Tricuspid valve 344, 357, 483, 489, 590, 765, 1051f, 1078, 1221
anatomy 483, 485, 486
disease 453
causes of 483b
function 347, 1048
normal 486f
regurgitation and stenosis, evaluation of 483
stenosis, rheumatic 488f
Tricyclic antidepressants 106
Triglycerides 78
levels 1155
Triphasic inflow pattern 713f
Triphasic waveform 918f
Triple vessel disease 388f, 1292f
Triple-rule out 883
Troponin 405
negative chest pain 133
True bifurcation lesion 236
Truncated ellipsoid method 29
Truncus arteriosus 1017
Tsunami warning to zebra line 1108
TTE See Transthoracic echocardiography
Tubercular aneurysm 887
Tubercular aortitis 887
imaging 887
pathology and presentation 887
Tubercular pseudoaneurysm 888f
Tuberculosis 785, 800
Tumors 813, 1205
benign 1188t, 1193t
malignant 1188t, 1193t
necrosis factor alpha 114
secondary 360
Tunica adventitia 224
Tunica albuginea, midshaft echogenic 968f
Tunica intima 224
Tunica media 224
Two-chamber cardiovascular magnetic resonance 138f
Two-dimensional echocardiography 29, 78, 301, 344, 535, 589, 647, 696, 752f, 753f, 812, 867
Two-dimensional speckle tracking 1297
echocardiography 676, 723, 730, 1037, 1042
limitations of 1041
strain 681
Tyrosine kinase inhibitors 1242
U
Ulcer, penetrating 367
Ultrasonography 942
diagnostic 951
duplex 106
Ultrasound
assisted catheter-directed thrombolysis 837
duplex 893, 916
Umbilical placental blood flow 1027
Uncinated fasciculus 1128
United States Food and Drug Administration 161, 479
Unstable coronary disease 194
Upper limb 921
arteries, anatomy of 923f
veins 930
Uremic pericarditis 785
Urinary bladder 168
Urine
biopyrrins 114
isoprostanes 114
Urocortins 113
USG See Ultrasonography
V
Vagal nerve stimulation 165
Valsalva maneuver 697, 710, 929f
Valsartan
heart failure trial 301, 1119
plus 82
Valvar insufficiency, forms of 1032
Valvar pulmonary stenosis, severe 715f
Valvar regurgitation 1031
Valvar stenosis 1022
Valvar support evaluation 523
Valvar surgeries 362
Valve
abnormality 1246
anatomy 1276
area 433
assessment 136
after mitraclip deployment 481
calcification 1276
degeneration 516
dehiscence 359
disease 483
evaluation of 7
fracture 1281
hemodynamics 546
in-ring 456
in-valve 456, 1281
procedures 1279
leaflet morphology 523
morphology 442, 523
presence of leaflet fibrosis 523
study of 439
perforation 359
replacement therapy 135
stenotic orifice of 488f
surgery 1203
types of 447
Valvular aortic stenosis 1058
Valvular assessment 1076
Valvular dysfunction 818, 819, 1065
acute 367, 370
late 516
Valvular endocarditis, assessment of 8
Valvular function 136
quantification of 421
Valvular heart disease 128, 135, 140, 522, 523t, 563, 634, 679, 684, 1214
assessment of 350, 524
evaluation of 367
Valvular imaging, goals of 522
Valvular insufficiency 1031
Valvular lesions 1092
Valvular orifice area, effective 501
Valvular pathology 570, 1076, 1084
Valvular prolapse 344
Valvular pulmonic stenosis 495
Valvular regurgitation 128
acute 359, 371
assessment of 528, 1218t
mild 730
severity of 14
Valvular repair 1213
Valvular stenosis
assessment of 527
causes of 1059
orifice planimetry 344
Valvular thickening with regurgitation 731
Valvular vegetations 1196
Valvulitis, rheumatic 538b
Varicose veins, radiofrequency ablation of 955
Vascular access planning 1274
Vascular adaptation 98
Vascular disease 10, 1176
Vascular endothelial
cells 128
function 1164
Vascular flow, loss of 996
Vascular function, markers of 114
Vascular hypertension 105, 107
Vascular malformations 999
Vascular manifestations 729
Vascular occlusion 105
Vascular origin 993
Vascular remodelling 230
Vascular resistance, systemic 1090, 1093
Vascular smooth muscle 102
cells 1176
endothelial receptors 333
Vascular surgery 1150
Vascular tone, loss of 1083
Vascular trauma 947
Vascular ultrasound and terminology 915
Vasculitides 999
Vasodilatory capacity, impaired 701
Vasopressin infusion 1033
Vasospastic angina 180, 1169, 1171, 1174
Veins
deep 930t
subclavian 934f
superficial 930t
systemic 765
Velocity time integral 326, 431, 660, 765, 1084
Velocity transmitral atrial velocity 75
Vena cava
diameter, inferior 158, 1086
measurement, inferior 158
plethora, inferior 756, 771
Vena contracta 442, 443, 484, 492, 507
dimensions 346f
three-dimensional 421f
width, measuring 440
Venoarterial extracorporeal membrane oxygenation 1071, 1074, 1075f
Venoatrial junction orifices 709
Venoocclusive disorder 964
Venous competence, assessment of 929
Venous compression syndromes 932
Venous interventions for varicose veins, Doppler technique in 933
Venous thromboembolism 831, 832
Venous thrombosis 964
Venovenous extracorporeal membrane oxygenation 1076f, 1078
Ventricles
dysfunction, severe right 1084
large 1042
reciprocal filling of 769, 770f
Ventricular acidic fibroblast growth factor 1028
Ventricular and atrial strain evaluation, left and right 676
Ventricular arrhythmias 131, 171, 494, 661, 678
Ventricular assist device 664, 1070, 1227
Ventricular contraction and relaxation 1028
Ventricular diastolic filling 787
Ventricular dimensions 1078
Ventricular dysfunction 1150
Ventricular dyssynchrony 162
presence of 664
Ventricular ejection fraction, lower post-stress left 1179
Ventricular end-systole 67
Ventricular fibrillation 661
Ventricular filling 761
pressures, elevation of 710
velocity 74
Ventricular free wall rupture 267
Ventricular function 11, 135, 1065
Ventricular hypertrophy 1137
Ventricular interaction 762
Ventricular myocardium causes 790
Ventricular paced rhythm 199
Ventricular pre-excitation 401
syndromes 977
Ventricular relaxation, enhancement of 1115
Ventricular septal defect 311, 344, 361, 374, 787, 822f, 855, 888, 1018, 1045, 1048, 1057, 1064, 1085
Ventricular septal rupture 204, 204f, 268f, 312f, 344, 368
Ventricular septum 1023
proximal 699
Ventricular strain 45
Ventricular systole, initial 767
Ventricular tachycardia 633, 661, 744, 973, 974, 976f
nonsustained 163
storm 631, 633
causes of 634t
Ventricular thrombus 131
Ventricular volumes
assessment of 7
reduction of 769
Ventricular wall, asynchrony of 11
Ventriculo-arterial matching 72, 73
Verapamil 336
Vertebral artery 907, 908f, 911f, 912f
anatomical parts of 908f
basic anatomy of 908f
disease, color Doppler evaluation of 907
pulse Doppler of 908f
stenosis 911
venous fistula 911
Vertebral vein 912f
Vertical vein stenting 1025
Vessel
disease 924, 941
measurements tools 393
occlusion, large 993, 994
perforation 1074
wall morphology 959
Vijaya's echo criteria, application of 538
Vijaya's echo score 539t
Vipassana 1129
Viral fevers 753
Viral pericarditis 785
Vis-a-vis scar location 661
Vitamin
B6 treatment 1176
K anticoagulants 607
Vitreoretinopathy, proliferative 493
Volume rendered technique 888f, 939f
von Hippel-Lindau syndrome 108
von-Willebrand factor 1176
Vulnerable plaque 188, 215, 250, 257, 1102, 1299
detection of 210
VV-ECMO See Venovenous extracorporeal membrane oxygenation
W
Wall motion
abnormality 324f, 371
score index 226, 266, 272, 277, 300, 1294
Weaning from venoarterial-extracorporeal membrane oxygenation 1078, 1079
White blood imaging 11, 878
White coat
effect 60
hypertension 60
reverse 60
Wilkin's score 551
Wilm's tumor 1031
WISE See Women's ischemia syndrome evaluation
Wolff-Parkinson-White syndrome 289, 290, 401, 973
Women's ischemia syndrome evaluation 332, 336
Woven endobridge device 1013
X
Xylocaine spray 465
Y
Yu index 666, 668
Z
Zen meditation 1129
Zotarolimus-eluting stents 232
×
Chapter Notes

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1Basics
  1. Basics of Cardiac Computed Tomography
  2. Basics of Cardiac Magnetic Resonance Imaging
  3. New Cardiac Cameras: Single-photon Emission Computed Tomography and Positron Emission Tomography2

Basics of Cardiac Computed TomographyCHAPTER 1

Priya Jagia,
Kartik Ganga,
Arun Sharma
 
INTRODUCTION
Diagnostic evaluation of cardiac diseases has become very advanced with the advent of cardiac computed tomography (CT). CT is now an indispensable component in the armamentarium of currently available imaging techniques. At present, CT scan can be used as a primary or complementary investigative modality for a variety of cardiac diseases, including ischemic heart disease, congenital heart disorders, aortic and pulmonary artery pathologies, and for pulmonary venous mapping. CT now contributes to screening, diagnosis, treatment optimization, and follow-up of patient with diverse cardiovascular diseases.
 
BASIC CONCEPTS OF CARDIAC COMPUTED TOMOGRAPHY WITH TECHNICAL DEVELOPMENTS
Technically, a basic CT scanner measures the attenuation of multiple X-ray beams passing through different sequential sections of the body from a multitude of different angles. Using these values, pictures of the internal organs are reconstructed. Classically, CT requires at least 180° of gantry rotation to perform image formation. Initial generation CT scanners required 1–5 seconds (s) to acquire a single slice. Rotation speed of up to 0.3–0.4 s per rotation provided by current generation CT scanners allows for increased temporal resolution.1 Though, adequate, for most organ systems, it is still not optimal for cardiac CT as heart exhibits a fast complex three-dimensional (3D) motion, which varies from patient to patient and also within the cardiac cycle. For images in cardiac CT to be of diagnostic utility, cardiac CT has to provide images of the heart that are motion free and that correspond to a specific phase of the cardiac cycle. This goal is achieved by synchronizing data acquisition with the cardiac cycle. This synchronization is done using the concurrent acquisition of the electrocardiography (ECG) signal and overcomes the problem of cardiac motion making quantitative data calculation, such as ejection fractions and volumetric assessments possible. In the quest for further reducing scan times and improving temporal resolution, a new concept that simultaneously utilizes two X-ray sources—dual source CT (DSCT)—was introduced. These scanners require only a 90° rotation to acquire sufficient data and hence exhibit a high temporal resolution in the order of 50–60 ms.2 Moreover, current CT systems are capable of providing a 3D isotropic acquisition, thereby improving spatial resolution for accurate depiction of smaller cardiac structures, including coronaries. The newer third-generation DSCT scanners provide excellent image quality over a wide range of body sizes and heart rates at lower radiation doses than the previous generation CT scanners. Faster gantry rotation time combined with larger Z-axis volume coverage per rotation combine to enable single-heart beat acquisitions in most patients with heart rates of up to 75–80 beats/min.2 Generally, cardiac CT requires intravenous injection of iodinated contrast agent, with the exception of CT calcium scoring which achieves CT acquisition without contrast. Low contrast protocols described in various studies result in significant reduction in contrast medium requirements, without any difficulties in contrast medium timing or unsatisfactory vessel enhancement.34
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Flowchart 1: Classification and uses of cardiac CT.
(CT: computed tomography)
Recent advancements in multislice CT technology have made coronary computed tomography angiography (CTA) a very useful modality in imaging the coronaries with submillisievert doses using very low contrast load, which is of paramount importance in patients with reduced renal functions (Flowchart 1).4
 
Types of Cardiac Computed Tomography (Flowchart 2)
Depending on the area of interest, cardiac CT can be broadly divided into ECG-gated and non-ECG-gated CTs.
Electrocardiography-gated CTs are primarily used for coronary artery assessment. However, they can also be useful in valvular assessment, congenital heart disease (CHD) evaluation, and functional cardiac assessment. Non-ECG-gated CTs are useful in morphological assessment of the pulmonary arteries and veins, pericardial assessment, and anatomical assessment of CHD and valves where functional indices are not required.
 
Gated Cardiac Computed Tomographies
The least amount of cardiac movement is during the end-systole and end-diastole of a particular cardiac cycle. This phase, however, varies with increasing heart rate which narrows the acquisition window. Therefore, motion-free imaging is usually best acquired in these phases. With higher heart rates, however, this dictum no longer applies, and it is advisable to acquire data in all the phases of the cardiac cycle for better visualization of cardiac and coronary morphology. Two gating techniques are utilized: (1) retrospective gating and (2) prospective gating.
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Flowchart 2: Acquisition and interpretation of cardiac CT.
(CT: computed tomography)
Retrospective gating: This is achieved by gating the acquisition with the cardiac cycle with acquisition throughout all the phases of cardiac cycle. Data from several consecutive cardiac cycles is continuously acquired with simultaneous ECG recording, leading to generation of true 3D data set, consisting of overlapping axial imaging slices. Any cardiac phase can, therefore, be reconstructed, but this occurs at the expense of a relatively high radiation dose.5 Since data from all the cardiac phases are available, ventricular functions (ejection fraction) and volumetric assessment can be performed. This scan is less sensitive to 5the changes of heart rate during the scan. The images can also be retrospectively analyzed and missed or extra beats can be excluded for analysis during ECG correction.
Prospective gating: This is a sequential CT scan which uses step and shoot technique to overcome the motion of the heart enabling data acquisition in only a certain phase of the cardiac cycle. If only morphological assessment is required, such as only coronary artery imaging, prospectively triggered sequences can be used. Using these sequences, preselection of a fraction of the RR interval width is done, and this allows imaging during a predefined cardiac phase (usually mid-diastole, when there is least cardiac motion—at approximately 75% of the cardiac cycle). With this scan, estimation of the next RR interval is of paramount importance and hence can be performed only in patients with regular heart rates. This type of scan is associated with lower radiation exposure to the patient as compared to retrospectively gated scans but does not allow ventricular functional analysis.6
 
Acquisition and Interpretation of Cardiac Computed Tomography (Flowchart 2)
For cardiac CT acquisition, injection of contrast is done via an automatic injector which injects the contrast intravenously at a high flow rate (3–5 mL/s in adults and 1–3 mL/s in children/infants). The scan is usually programmed to begin automatically once the contrast reaches its peak value in the vessel of interest (for coronaries and aorta—vessel of interest is the proximal descending thoracic aorta; for pulmonary arteries—vessel of interest is the main pulmonary artery; for CHD evaluation—scan is triggered manually when all the chambers of the heart are optimally opacified). After the data is acquired, the images are reviewed on the CT workstation using a variety of postprocessing techniques (described in Figures 1 to 5) to reach a diagnosis (Table 1).7,8
 
Uses of Gated Cardiac Computed Tomography (Box 1)
 
Coronary Artery Calcium Scoring
It involves prospectively gated noncontrast cardiac CT acquisition for the assessment of coronary artery calcium (CAC). It identifies and characterizes the location as well as burden of coronary artery disease (CAD) by detecting calcium within plaques. Calcium being defined as areas with greater than 130 HU, these coronary calcifications are usually automatically detected and color-coded. Semi-quantification of coronary calcium is expressed by the Agatston score, which uses the plaque size, density, and a weighting factor to calculate a value ranging from 0 (absence of detectable calcium) to over 1,000 (indicating extensive coronary calcification).
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Fig. 1: Axial section showing thickened calcific pericardium causing constriction of bilateral ventricles. Also noted is mild bilateral pleural effusion (arrows).
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Fig. 2: 3D MPR showing calcified thickened tricuspid aortic valve in three different planes. (3D: three-dimensional; MPR: multiplanar reconstruction)
An elevated CAC score has consistently been associated with increased mortality and adverse cardiovascular events, independent of other risk factors. CAC score has been found to be superior to well-established cardiovascular risk factor models for predicting silent myocardial ischemia and short-term outcomes.9 However, the association between CAC score and the extent of coronary atherosclerosis is not linear as severe coronary stenosis can occur at sites with limited calcium deposition and vice versa. Thus, CAC scoring is better used as a risk stratification tool to identify high-risk asymptomatic patients who might benefit from further investigations rather than being a diagnostic test for obstructive CAD.6
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Fig. 3: MIP showing anomalous origin of RCA with interarterial course between aorta and pulmonary artery (arrow). (MIP: maximum intensity projection; RCA: right coronary artery)
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Fig. 4: Curved MPR showing the entire extent of the coronary arterial tree in one image (arrow). (MPR: multiplanar reconstruction)
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Fig. 5: VRT image of a child with truncus arteriosus showing a common arterial trunk arising from the left ventricle. (VRT: volume-rendered reconstruction)
Table 1  
Axial data set
“Raw” images with thin-section volumetric data (see Fig. 1)
3D multiplanar reconstruction (MPR)
Thin-section volumetric data with reconstructed sagittal and coronal views (see Fig. 2)
Maximum intensity projections (MIP)
Thick-section images with accentuated intensity of contrast (Fig. 3)
Curved MPR
Displays vessel in a user-determined curved surface as a single image (Fig. 4)
Volume-rendered reconstruction (VRT)
3D illustration of volumetric CT data for display from any desired perspective (Fig. 5)
Endoluminal views
VRT technique that simulates an endoscopic examination by locating a point of view from inside hollow structures (Fig. 6)
(3D: three-dimensional; CT: computed tomography)
 
Computed Tomography Coronary Angiography for Native Coronaries (Figs. 3 and 4)
Unlike the CAC scan, this scan requires intravenous injection of iodinated contrast. CTCA has a high sensitivity and specificity for diagnosing coronary stenosis. CTCA allows identification of coronary atherosclerotic plaques in the absence of calcium or stenosis, thus permitting visualization of early subclinical atherosclerosis. Studies have demonstrated excellent diagnostic accuracy of CTCA for the detection of coronary stenosis, with a sensitivity of 786–99%, specificity of 92–98%, and negative predictive value of 92–100%.10 The high negative predictive value which approaches 100% is the main advantage of this technique. It can provide detailed information on coronary artery anatomy and assess both coronary artery atherosclerosis as well as luminal stenosis. In view of its high negative predictive value and high sensitivity, CTCA is the most beneficial in symptomatic patients with low to intermediate pretest probability of obstructive CAD.11 Moreover, CTCA can be useful for plaque characterization as studies have shown that plaques with spotty calcification, positive remodeling, or those with a lipid-rich core have a higher (95%) risk of rupture.12 It is also extremely beneficial in identifying the anomalous origin, course, and termination of the coronary arteries (Fig. 4) and is the investigation of choice for the same. CTCA also allows for noninvasive evaluation of hemodynamics in the coronary arterial tree. Using computational fluid dynamics, “three-vessel” fractional flow reserve (CT-FFR) can be calculated from already acquired coronary CTA data with no need for additional imaging or vasodilators. CT-FFR, therefore, can help in assessing the exact area of blockage and its impact on the flow which may guide treatment strategies.13
 
Coronary Computed Tomography Angiography for Graft and Stents
Computed tomography coronary angiography is the recommended investigation of choice for graft patency in postcoronary artery bypass grafting (CABG) patients with acute chest pain. It is also used for the follow-up of asymptomatic patients in whom CABG has been performed more than 5 years ago. Studies have shown a high sensitivity and specificity each ranging more than 95% with positive predictive value of more than 92–94% and negative predictive value to the tune of almost 99%, in the evaluation of stenosis/occlusion of grafts.14 Patency of coronary stents too can be evaluated with CTCA. However, CTCA is most useful if the diameter of the stent is more than 3 mm. CT has shown high diagnostic accuracy (sensitivity—91%, specificity—91%, positive predictive value—68%, and negative predictive value—98%) for in stent restenosis of stents greater than 3 mm diameter. Thicker stent material and strut thickness may also affect the accuracy of CTCA adversely.15
 
Assessment of Ventricular Volumes, Wall Thickness, and Mass
Magnetic resonance imaging (MRI) is the investigation of choice for functional assessment. But CT may be an equally accurate investigation with less inter- and intraobserver variability. This information is exclusively available with retrospectively gated acquisitions. Not only is the cardiac and coronary morphology assessed but cardiac functional assessment can also be performed with a single contrast-enhanced retrospective ECG-gated examination. Ejection fraction, end-systolic and end-diastolic volumes, stroke volumes, and cardiac output can be calculated.16 Left ventricular regional function can also be displayed on color-coded maps of wall motion and wall thickness for better assessment of wall-motion abnormalities.
 
Role of Computed Tomography in Congenital Heart Disease (see Fig. 5)
Though echocardiography (ECHO) remains the investigation of choice in these patients, cardiac CT may be used as a problem-solving tool, especially where only morphological information is required. Moreover, delineation of extracardiac structures, including pulmonary arteries, aortopulmonary collaterals, and aortic arch anatomy and associated anomalies, may be better evaluated with CT.17 Simultaneous assessment of the airway and skeletal abnormalities may influence management options. Techniques such as ECG-gated ultrahigh pitch [fast low-angle shot (FLASH) sequences], ECG padding/pulsing (giving full radiation dose only for a part of the cardiac cycle), using prospective ECG gating, help in radiation dose reduction in this population. Moreover, postoperative evaluation of complications is also better done by CT since it facilitates global and rapid simultaneous assessment of the chest and pleural spaces, airways, lung parenchyma, and vasculature.18
 
Evaluation of Valves
Earlier used primarily to identify valvular calcifications, CT can now depict subtle valvular anatomy and also evaluate valve function. It plays a role in both preoperative evaluation and postsurgical assessment. Another advantage of CT is that the coronary arteries can also be simultaneously evaluated in the same study.
 
For Morphological and Functional Valvular Assessment
Computed tomography offers excellent morphological assessment of valve leaflets, apposition zones, chordae commissures, and papillary annulus muscles during all the phases of the cardiac cycle.19 In mitral/aortic stenosis, CT helps in anatomical localization of the stenosis (valvular or subvalvular), presence of calcification (see Fig. 2), and the ancillary information, such as degree of left atrium (LA) dilation, left ventricle (LV) function, and coronary artery status, which can help in deciding management. CT plays a very important role in preoperative assessment for transcatheter aortic valve implantation (TAVI) (percutaneous aortic valve implantation). It can evaluate the aortic root dimensions (for accurate sizing purposes), coronary ostia takeoff as well as LV [specifically left ventricular outflow tract (LVOT)] assessment.8
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Fig. 6: Endoluminal view showing prosthetic heart valves with tissue discontinuity at the mitral annulus suggesting dehiscence (arrow).
CT can also be useful in morphological assessment of the tricuspid valve morphology, especially in the cases, such as Ebstein's anomaly where the displacement of the septal leaflet and redundancy of the anterior leaflet can be depicted in detail. Congenital pulmonary valve abnormalities, such as valvular stenosis or agenesis, can be assessed on CT. Excellent visualization of valve prostheses with minimal streak artifacts can be obtained by CT. Even bioprosthetic valves can be evaluated to assess for leaflet degeneration and dysfunction. Postoperative complications, such as pseudoaneurysms, abscess, paravalvular leaks, and valve dehiscence, can be identified and assessed by CT, providing both anatomic and dynamic information important for redo surgery (Fig. 6).
 
For Assessment of Valvular Endocarditis
Cardiac CT can demonstrate valvular vegetations, with a sensitivity and specificity of 97% and 88%, far superior to ECHO. On CT, vegetations appear as low-attenuation masses attached to the leaflets.20 CT is especially helpful in assessing peri- and paravalvular complications, such as abscess, pseudoaneurysm formation, or remote complications, such as septic emboli to the lungs.
 
Evaluation of Intracardiac Masses
Cardiac CT is often used concomitantly with ECHO and MRI in the evaluation of cardiac masses.21 Cardiac MRI is the investigation of choice for cardiac masses due to its superior soft-tissue characterization and high temporal resolution. Cardiac CT can be used in patients who cannot undergo an MRI or as an alternative modality. In addition, CT is superior to MRI for the assessment of calcification of the masses. Apart from characterization, CT enables complete evaluation of the chest and lung parenchyma, vascular anatomy, and also allows exclusion of obstructive CAD as a preoperative requisite in older patients.
 
Pericardial Assessment
Computed tomography enables imaging of the entire pericardium with high spatial and temporal resolution and is an important modality in the diagnostic workup of pericardial diseases (see Fig. 1). Moreover, it is the gold standard to visualize calcified pericardium. Although MRI is best suited for pericardial assessment, CT can help in the initial characterization of pericardial effusion (by using HUs to differentiate between transudative and effusive exudate), identifying inflammatory pericarditis (by visualization of enhancing pericardium), assessing constriction (using functional CT), and in characterization of a pericardial mass (enhancement, presence of calcium/fat).22
 
Uses of Nongated Cardiac Computed Tomography
 
Assessment of Pulmonary Veins: Pulmonary Venous Mapping
Preprocedural CT is helpful for morphological assessment of the pulmonary veins and LA, especially to assess the presence of additional pulmonary veins (e.g. middle lobe vein). This information is vital to the electrophysiologist who is attempting to perform a percutaneous ablation of an arrhythmic focus. Volume- and surface-rendered reconstructions allow for a quick overview of the pulmonary anatomy, thus providing the electrophysiologist with a roadmap prior to the intervention. CT is also useful in identifying postprocedural complications commonly associated with percutaneous ablation, such as pulmonary vein stenosis. For this purpose, however, ECG-gated study is performed for better visualization of the stenosis.23
 
Assessment of Pulmonary Arteries
For evaluation of patients with pathologies of the pulmonary arteries, CT is routinely used.24,25 Noncontrast study is performed when the assessment of lung parenchyma is the objective. Contrast-enhanced CT may be performed (often with a pulmonary angiography protocol) when chronic thromboembolic pulmonary hypertension (CTEPH) or other parenchymal causes of pulmonary hypertension is suspected. Based on the assessment of pulmonary arteries, heart, parenchyma, and bronchial arteries, the proper etiology of pulmonary hypertension may be identified which helps in planning treatment.9
 
CONCLUSION
Cardiac CT has assumed a wider role in the diagnostic workup of major cardiac pathologies. This has become possible due to continuously evolving technical refinements, such as recent third-generation multislice CT with dual source-dual energy acquisitions, cardiac gating, advanced postprocessing options, and radiation dose reduction strategies. It has now become possible to obtain reproducible functional information in addition to the morphological assessment of cardiac pathologies, thereby influencing the treatment strategies. It is the investigation of choice in emergency settings and in critically ill patients.
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