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Rofo 2023; 195(06): 506-513
DOI: 10.1055/a-1999-7271
Review

Myocardial Evaluation in Patients with Aortic Stenosis by Cardiac Computed Tomography

Beurteilung des Myokards bei Patienten mit Aortenstenose durch kardiale Computertomografie
Francisco F. Gama
1   Cardiology, Hospital Centre of West Lisbon Campus Hospital of Santa Cruz, Lisboa, Portugal
2   Cardiac Imaging, Barts Health NHS Trust, London, United Kingdom of Great Britain and Northern Ireland
,
Kush Patel
2   Cardiac Imaging, Barts Health NHS Trust, London, United Kingdom of Great Britain and Northern Ireland
,
Jonathan Bennett
2   Cardiac Imaging, Barts Health NHS Trust, London, United Kingdom of Great Britain and Northern Ireland
,
Nikoo Aziminia
2   Cardiac Imaging, Barts Health NHS Trust, London, United Kingdom of Great Britain and Northern Ireland
,
Francesca Pugliese
2   Cardiac Imaging, Barts Health NHS Trust, London, United Kingdom of Great Britain and Northern Ireland
,
Thomas Treibel
2   Cardiac Imaging, Barts Health NHS Trust, London, United Kingdom of Great Britain and Northern Ireland
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Abstract

Background Aortic valve stenosis (AVS) is one of the most prevalent pathologies affecting the heart that can curtail expected survival and quality of life if not managed appropriately.

Current Status Cardiac computed tomography (CT) has long played a central role in this subset, mostly for severity assessment and for procedural planning. Although not as widely accepted as other imaging modalities for functional myocardial assessment [i. e., transthoracic echocardiogram (TTE), cardiac magnetic resonance (CMR)], this technique has recently increased its clinical application in this regard.

Future Outlook The ability to provide morphological, functional, tissue, and preprocedural information highlights the potential of the “all-in-one” concept of cardiac CT as a potential reality for the near future for AVS assessment. In this review article, we sought to analyze the current applications of cardiac CT that allow a full comprehensive evaluation of aortic valve disease.

Key Points: 

  • Noninvasive myocardial tissue characterization stopped being an exclusive feature of cardiac magnetic resonance.

  • Emerging acquisition methods make cardiac CT an accurate and widely accessible imaging modality.

  • Cardiac CT has the potential to become a "one-stop" exam for comprehensive aortic stenosis assessment.

Citation Format

  • Gama FF, Patel K, Bennett J et al. Myocardial Evaluation in Patients with Aortic Stenosis by Cardiac Computed Tomography. Fortschr Röntgenstr 2023; 195: 506 – 513

Zusammenfassung

Hintergrund Die Aortenklappenstenose (AVS) ist eine der häufigsten Erkrankungen des Herzens, die bei unzureichender Behandlung die Lebenserwartung und Lebensqualität beeinträchtigen kann.

Aktueller Stand Die kardiale Computertomografie (CT) spielt auf diesem Gebiet seit langem eine zentrale Rolle, vor allem zur Einschätzung des Schweregrads und zur Planung von Eingriffen. Obwohl diese Technik zur Beurteilung der Myokardfunktion nicht so weit verbreitet ist wie andere bildgebende Verfahren [z. B. transthorakales Echokardiogramm (TTE), kardiale Magnetresonanztomografie (CMR)], wird sie in letzter Zeit verstärkt in der klinischen Praxis eingesetzt.

Zukunftsperspektiven Die Fähigkeit, präoperationell Informationen über Morphologie, Funktion und das Gewebe zu liefern, unterstreicht das Fähigkeit der kardialen CT als „All-in-One“-Konzept, das zur Beurteilung der AVS möglicherweise in naher Zukunft realisiert wird. In diesem Übersichtsartikel haben wir versucht, die aktuellen Anwendungen der kardialen CT zu analysieren, die eine vollständige und umfassende Beurteilung der Erkrankungen der Aortenklappen ermöglichen.

Kernaussagen: 

  • Die nicht-invasive Charakterisierung des Myokardgewebes ist nicht mehr ausschließlich der kardialen Magnetresonanz vorbehalten.

  • Neue Aquisitionsmethoden machen die kardiale CT zu einer genauen und allgemein zugänglichen Bildgebungsmodalität.

  • Die kardiale CT hat das Potenzial, sich zu einer „One-Stop“-Untersuchung für eine umfassende Beurteilung der Aortenstenose zu entwickeln.

Key words

aortic valve - ultrasound computed tomography (US/CT) - tissue characterization


Publikationsverlauf

Eingereicht: 14. September 2022

Angenommen: 01. Dezember 2022

Artikel online veröffentlicht:
28. Februar 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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