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Stable chest pain is a common symptom with multiple potential causes. Non-invasive imaging has an important role in diagnosis and guiding management through the assessment of coronary stenoses, atherosclerotic plaque, myocardial ischaemia or infarction, and cardiac function. Computed tomography (CT) provides the anatomical evaluation of coronary artery disease (CAD) with the assessment of stenosis, plaque type and plaque burden, with additional functional information available from CT fractional flow reserve (FFR) or CT myocardial perfusion imaging. Stress magnetic resonance imaging, nuclear stress myocardial perfusion imaging, and stress echocardiography can assess myocardial ischaemia and other cardiac functional parameters. Coronary CT angiography can be used as a first-line test for many patients with stable chest pain, particularly those with low to intermediate pre-test probability. Functional testing may be considered for patients with known CAD, where the clinical significance is uncertain based on anatomical testing, or in patients with high pre-test probability. This practice recommendations document can be used to guide the selection of non-invasive imaging for patients with stable chest pain and provides brief recommendations on how to perform and report these diagnostic tests. KEY POINTS: The selection of non-invasive imaging tests for patients with stable chest pain should be based on symptoms, pre-test probability, and previous history. Coronary CT angiography can be used as a first-line test for many patients with stable chest pain, particularly those with low to intermediate pre-test probability. Functional testing can be considered for patients with known CAD, where the clinical significance of CAD is uncertain based on anatomical testing, or in patients with high pre-test probability. KEY RECOMMENDATIONS: Non-invasive imaging is an important part of the assessment of patients with stable chest pain. The selection of non-invasive imaging test should be based on symptoms, pre-test probability, and previous history. (Level of evidence: High). Coronary CT angiography can be used as a first line test for many patients with stable chest pain, particularly those with low to intermediate pre-test probability. CT provides information on stenoses, plaque type, plaque volume, and if required functional information with CT fractional flow reserve or CT perfusion. (Level of evidence: High). Functional testing can be considered for patients with known CAD, where the clinical significance of CAD is uncertain based on anatomical testing, or in patients with high pre-test probability. Stress MRI, SPECT, PET, and echocardiography can provide information on myocardial ischemia, along with cardiac functional and other information. (Level of evidence: Medium).
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OBJECTIVE: This work aimed to derive a machine learning (ML) model for the differentiation between ischemic cardiomyopathy (ICM) and non-ischemic cardiomyopathy (NICM) on non-contrast cardiovascular magnetic resonance (CMR). METHODS: This retrospective study evaluated CMR scans of 107 consecutive patients (49 ICM, 58 NICM), including atrial and ventricular strain parameters. We used these data to compare an explainable tree-based gradient boosting additive model with four traditional ML models for the differentiation of ICM and NICM. The models were trained and internally validated with repeated cross-validation according to discrimination and calibration. Furthermore, we examined important variables for distinguishing between ICM and NICM. RESULTS: A total of 107 patients and 38 variables were available for the analysis. Of those, 49 were ICM (34 males, mean age 60 ± 9 years) and 58 patients were NICM (38 males, mean age 56 ± 19 years). After 10 repetitions of the tenfold cross-validation, the proposed model achieved the highest area under curve (0.82, 95% CI [0.47-1.00]) and lowest Brier score (0.19, 95% CI [0.13-0.27]), showing competitive diagnostic accuracy and calibration. At the Youden's index, sensitivity was 0.72 (95% CI [0.68-0.76]), the highest of all. Analysis of predictions revealed that both atrial and ventricular strain CMR parameters were important for the identification of ICM patients. CONCLUSION: The current study demonstrated that using a ML model, multi chamber myocardial strain, and function on non-contrast CMR parameters enables the discrimination between ICM and NICM with competitive diagnostic accuracy. CLINICAL RELEVANCE STATEMENT: A machine learning model based on non-contrast cardiovascular magnetic resonance parameters may discriminate between ischemic and non-ischemic cardiomyopathy enabling wider access to cardiovascular magnetic resonance examinations with lower costs and faster imaging acquisition. KEY POINTS: ⢠The exponential growth in cardiovascular magnetic resonance examinations may require faster and more cost-effective protocols. ⢠Artificial intelligence models can be utilized to distinguish between ischemic and non-ischemic etiologies. ⢠Machine learning using non-contrast CMR parameters can effectively distinguish between ischemic and non-ischemic cardiomyopathies.
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OBJECTIVE: Our study aimed to explore with cardiovascular magnetic resonance (CMR) the impact of left atrial (LA) and left ventricular (LV) myocardial strain in patients with acute pericarditis and to investigate their possible prognostic significance in adverse outcomes. METHOD: This retrospective study performed CMR scans in 36 consecutive patients with acute pericarditis (24 males, age 52 [23-52]). The primary endpoint was the combination of recurrent pericarditis, constrictive pericarditis, and surgery for pericardial diseases defined as pericardial events. Atrial and ventricular strain function were performed on conventional cine SSFP sequences. RESULTS: After a median follow-up time of 16 months (interquartile range [13-24]), 12 patients with acute pericarditis reached the primary endpoint. In multivariable Cox regression analysis, LA reservoir and LA conduit strain parameters were all independent determinants of adverse pericardial diseases. Conversely, LV myocardial strain parameters did not remain an independent predictor of outcome. With receiving operating characteristics curve analysis, LA conduit and reservoir strain showed excellent predictive performance (area under the curve of 0.914 and 0.895, respectively) for outcome prediction at 12 months. CONCLUSION: LA reservoir and conduit mechanisms on CMR are independently associated with a higher risk of adverse pericardial events. Including atrial strain parameters in the management of acute pericarditis may improve risk stratification. CLINICAL RELEVANCE STATEMENT: Atrial strain could be a suitable non-invasive and non-contrast cardiovascular magnetic resonance parameter for predicting adverse pericardial complications in patients with acute pericarditis. KEY POINTS: ⢠Myocardial strain is a well-validated CMR parameter for risk stratification in cardiovascular diseases. ⢠LA reservoir and conduit functions are significantly associated with adverse pericardial events. ⢠Atrial strain may serve as an additional non-contrast CMR parameter for stratifying patients with acute pericarditis.
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A significant gap in exposure data for most livestock and zoonotic pathogens is common for several Latin America deer species. This study examined the seroprevalence against 13 pathogens in 164 wild and captive southern pudu from Chile between 2011 and 2023. Livestock and zoonotic pathogen antibodies were detected in 22 of 109 wild pudus (20.18%; 95% CI: 13.34-29.18) and 17 of 55 captive pudus (30.91%; 95% CI: 19.52-44.96), including five Leptospira interrogans serovars (15.38% and 10.71%), Toxoplasma gondii (8.57% and 37.50%), Chlamydia abortus (3.03% and 12.82%), Neospora caninum (0.00% and 9.52%), and Pestivirus (8.00% and 6.67%). Risk factors were detected for Leptospira spp., showing that fawn pudu have statistically significantly higher risk of positivity than adults. In the case of T. gondii, pudu living in "free-range" have a lower risk of being positive for this parasite. In under-human-care pudu, a Pestivirus outbreak is the most strongly suspected as the cause of abortions in a zoo in the past. This study presents the first evidence of Chlamydia abortus in wildlife in South America and exposure to T. gondii, L. interrogans, and N. caninum in wild ungulate species in Chile. High seroprevalence of livestock pathogens such as Pestivirus and Leptospira Hardjo in wild animals suggests a livestock transmission in Chilean template forest.
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(1) Objective: Myocarditis can be associated with ventricular arrhythmia (VA), individual non-invasive risk stratification through cardiovascular magnetic resonance (CMR) is of great clinical significance. Our study aimed to explore whether left atrial (LA) and left ventricle (LV) myocardial strain serve as independent predictors of VA in patients with myocarditis. (2) Methods: This retrospective study evaluated CMR scans in 141 consecutive patients diagnosed with myocarditis based on the updated Lake Louise criteria (29 females, mean age 41 ± 20). The primary endpoint was VA; this encompassed ventricular fibrillation, sustained ventricular tachycardia, nonsustained ventricular tachycardia, and frequent premature ventricular complexes. LA and LV strain function were performed on conventional cine SSFP sequences. (3) Results: After a median follow-up time of 23 months (interquartile range (18-30)), 17 patients with acute myocarditis reached the primary endpoint. In the multivariable Cox regression analysis, LA reservoir (hazard ratio [HR] and 95% confidence interval [CI]: 0.93 [0.87-0.99], p = 0.02), LA booster (0.87 95% CI [0.76-0.99], p = 0.04), LV global longitudinal (1.26 95% CI [1.02-1.55], p = 0.03), circumferential (1.37 95% CI [1.08-1.73], p = 0.008), and radial strain (0.89 95% CI [0.80-0.98], p = 0.01) were all independent determinants of VA. Patients with LV global circumferential strain > -13.3% exhibited worse event-free survival compared to those with values ≤ -13.3% (p < 0.0001). (4) Conclusions: LA and LV strain mechanism on CMR are independently associated with VA events in patients with myocarditis, independent to LV ejection fraction, and late gadolinium enhancement location. Incorporating myocardial strain parameters into the management of myocarditis may improve risk stratification.
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RATIONALE: To provide an overview of the current status of cardiac multimodality imaging practices in Europe and radiologist involvement using data from the European Society of Cardiovascular Radiology (ESCR) MRCT-registry. MATERIALS AND METHODS: Numbers on cardiac CT and MRI examinations were extracted from the MRCT-registry of the ESCR, entered between January 2011 and October 2023 (n = 432,265). Data collection included the total/annual numbers of examinations, indications, complications, and reporting habits. RESULTS: Thirty-two countries contributed to the MRCT-registry, including 29 European countries. Between 2011 and 2022, there was a 4.5-fold increase in annually submitted CT examinations, from 3368 to 15,267, and a 3.8-fold increase in MRI examinations, from 3445 to 13,183. The main indications for cardiac CT were suspected coronary artery disease (CAD) (59%) and transcatheter aortic valve replacement planning (21%). The number of patients with intermediate pretest probability who underwent CT for suspected CAD showed an increase from 61% in 2012 to 82% in 2022. The main MRI indications were suspected myocarditis (26%), CAD (21%), and suspected cardiomyopathy (19%). Adverse event rates were very low for CT (0.3%) and MRI (0.7%) examinations. Reporting of CT and MRI examinations was performed mainly by radiologists (respectively 76% and 71%) and, to a lesser degree, in consensus with non-radiologists (19% and 27%, respectively). The remaining examinations (4.9% CT and 1.7% MRI) were reported by non-radiological specialties or in separate readings of radiologists and non-radiologists. CONCLUSIONS: Real-life data on cardiac imaging in Europe using the largest available MRCT-registry demonstrate a considerable increase in examinations over the past years, the vast majority of which are read by radiologists. These findings indicate that radiologists contribute to meeting the increasing demands of competent and effective care in cardiac imaging to a relevant extent. CLINICAL RELEVANCE STATEMENT: The number of cardiac CT and MRI examinations has risen over the past years, and radiologists read the vast majority of these studies as recorded in the MRCT-registry. KEY POINTS: ⢠The number of cardiac imaging examinations is constantly increasing. ⢠Radiologists play a central role in providing cardiac CT and MR imaging services to a large volume of patients. ⢠Cardiac CT and MR imaging examinations performed and read by radiologists show a good safety profile.
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This position statement guides cardiovascular magnetic resonance (CMR) imaging program directors and learners on the key competencies required for Level II and III CMR practitioners, whether trainees come from a radiology or cardiology background. This document is built upon existing curricula and was created and vetted by an international panel of cardiologists and radiologists on behalf of the Society for Cardiovascular Magnetic Resonance (SCMR).
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Cardiologia , Competência Clínica , Consenso , Currículo , Educação de Pós-Graduação em Medicina , Imageamento por Ressonância Magnética , Humanos , Educação de Pós-Graduação em Medicina/normas , Imageamento por Ressonância Magnética/normas , Cardiologia/educação , Cardiologia/normas , Doenças Cardiovasculares/diagnóstico por imagem , Cardiologistas/educação , Cardiologistas/normas , Valor Preditivo dos Testes , Radiologistas/educação , Radiologistas/normas , Radiologia/educação , Radiologia/normas , Sociedades Médicas/normasRESUMO
The aim of the study was to compare carcass composition and physicochemical and sensory attributes of breast and leg meat from native Mexican guajolote (Meleagris g. gallopavo) as influenced by sex. For this, slaughter weight and carcass characteristics of male (n=8) and female (n=8) guajolotes raised traditionally under extensive systems with similar housing and feeding conditions were recorded. Also, physical characteristics, proximate composition, the fatty acid profile, and sensory attributes were determined in breast and leg meat using standard procedures. The results showed that males had higher (P<0.001) slaughter weight, hot and cold carcass weights, and dressing percentage, as well as carcass part weights, while females had higher (P<0.001) abdominal fat weights than males. The lightness (L*), yellowness (b*), and drip loss values of breast meat, as well as redness (a*) and water-holding capacity values of leg meat, were significantly (P<0.05) influenced by sex. Male breast meat had higher (P<0.05) moisture content, crude protein, erucic acid (C22:1n9), ∑ MUFAs (total monounsaturated fatty acids), ∑ UFAs (unsaturated fatty acids), ∑ DFAs (desirable fatty acids), ∑ UFAâ¯/â¯∑ SFA (total saturated fatty acid) ratio, ∑ PUFA (total polyunsaturated fatty acid)â¯/â¯∑ SFA ratio, and chewiness scores than females. Likewise, leg meat from males showed higher (P<0.05) ash content, myristic acid (C14:0), palmitic acid (C16:0), stearic acid (C18:0), oleic acid (C18:1n9c), palmitoleic acid (C16:1n7), ∑ SFAs, ∑ OFAs (odd fatty acids), thrombogenic index, and atherogenic index, whereas females had high fat content. In conclusion, it would be suggested that, from a nutritional point of view, the meat from male guajolotes was preferable to the meat from females.
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A variety of both acquired and congenital conditions can significantly affect the right ventricle, with a variety of potential origins that can have substantial clinical ramifications. These conditions can range from the impact of diseases like pulmonary arterial hypertension and ischaemic heart disease to valvular deficiencies resulting in heart failure. Moreover, the right ventricle response to factors like abnormal loading conditions, and its subsequent clinical effects, are influenced by factors such as age, disease progression, potential interventions, and their immediate and long-term clinical outcomes. Therefore, a readily available and reproducible non-invasive imaging assessment can aid in diagnosing the underlying condition of a dilated right ventricle, track its evolution, and help devising the most appropriate treatment strategy and optimal timing for its implementation throughout the patient's life.In this review, our primary focus will be on the non-invasive imaging with CT and MR of an enlarged right ventricle resulting from congenital causes and their treatment.
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Cardiopatias Congênitas , Insuficiência Cardíaca , Disfunção Ventricular Direita , Humanos , Ventrículos do Coração/diagnóstico por imagem , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/etiologia , Imageamento por Ressonância Magnética/efeitos adversos , Tomografia Computadorizada por Raios X/efeitos adversos , Disfunção Ventricular Direita/diagnóstico por imagem , Disfunção Ventricular Direita/etiologia , Disfunção Ventricular Direita/terapiaRESUMO
Bartonella spp. was screened in 155 rodents from Chile, mainly the invasive rats Rattus norvegicus and Rattus rattus. A total of 155 spleen and 50 blood samples were analyzed through real-time PCR for Bartonella spp. (nuoG gene). Positive samples were subjected to amplification of fragment of loci gltA, rpoB and ITS by conventional PCR (cPCR). Overall, 43 spleen samples (27.7%) and 6 rodent blood samples (12%) were positive for nuoG-Bartonella spp. Positive samples were found in R. norvegicus, R. rattus, Abrothrix olivacea and Oligoryzomys longicaudatus. Bartonella spp. DNA was amplified by cPCR in 16 samples, resulting in 21 sequences (6 gltA, 5 ITS and 10 rpoB). Sequencing and phylogenic analyses identified genotypes from Rattus spp., potentially belonging to Bartonella coopersplainsensis, Bartonella henselae, Bartonella tribocorum, and an undescribed Bartonella sp. From native rodents, one sequence was identified, being related B. machadoae. In conclusion, this work describes diverse and potentially zoonotic Bartonella spp. genotypes in Rattus spp. Additionally, this is the first report of Bartonella in O. longicaudatus, including a potentially novel Bartonella genotype or species.
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Infecções por Bartonella , Bartonella henselae , Bartonella , Ratos , Animais , Roedores , Infecções por Bartonella/epidemiologia , Infecções por Bartonella/veterinária , Infecções por Bartonella/diagnóstico , Chile/epidemiologia , Bartonella/genética , FilogeniaRESUMO
PURPOSE: Takotsubo cardiomyopathy (TTC) is a transient but severe acute myocardial dysfunction with a wide range of outcomes from favorable to life-threatening. The current risk stratification scores of TTC patients do not include cardiac magnetic resonance (CMR) parameters. To date, it is still unknown whether and how clinical, trans-thoracic echocardiography (TTE), and CMR data can be integrated to improve risk stratification. METHODS: EVOLUTION (Exploring the eVolution in prognOstic capabiLity of mUlti-sequence cardiac magneTIc resOnance in patieNts affected by Takotsubo cardiomyopathy) is a multicenter, international registry of TTC patients who will undergo a clinical, TTE, and CMR evaluation. Clinical data including demographics, risk factors, comorbidities, laboratory values, ECG, and results from TTE and CMR analysis will be collected, and each patient will be followed-up for in-hospital and long-term outcomes. Clinical outcome measures during hospitalization will include cardiovascular death, pulmonary edema, arrhythmias, stroke, or transient ischemic attack.Clinical long-term outcome measures will include cardiovascular death, pulmonary edema, heart failure, arrhythmias, sudden cardiac death, and major adverse cardiac and cerebrovascular events defined as a composite endpoint of death from any cause, myocardial infarction, recurrence of TTC, transient ischemic attack, and stroke. We will develop a comprehensive clinical and imaging score that predicts TTC outcomes and test the value of machine learning models, incorporating clinical and imaging parameters to predict prognosis. CONCLUSIONS: The main goal of the study is to develop a comprehensive clinical and imaging score, that includes TTE and CMR data, in a large cohort of TTC patients for risk stratification and outcome prediction as a basis for possible changes in patient management.
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INTRODUCTION: Neurofibromatosis type 1 (NF1) is an autosomal dominant cancer predisposition syndrome caused by pathogenic variants in NF1, which negatively regulates the RAS pathway. Knowledge of the genotype-phenotype correlation in this disease is an important tool for prognostic evaluation and early detection of malignant peripheral nerve sheath tumors (MPNST), present in approximately 10% of these patients. We present the case of a teenager with a left jaw MPNST and a previously unreported germline pathogenic variant on NF1. CASE PRESENTATION: An 11-year-old female with a NF1 clinical diagnosis was referred to our hospital with a MPNST in an advanced state. A previously unreported NF1 pathogenic variant was obtained (GRCh37: NM_182493.2 c.3299C>G, p.Ser1100*). Despite great efforts from the surgical and medical teams, the tumor progression couldn't be halted, resulting in the patient's death. DISCUSSION: As MPNSTs are refractory to current treatment regimens, early diagnosis, and development of new therapies, such as MEK inhibitors, is necessary for reducing morbidity and mortality within NF1 patients. This increases the importance of a more widespread genetic testing strategy. CONCLUSION: The report of a novel NF1 pathogenic variant in a patient with maternally inherited neurofibromatosis type 1 and a MPNST increases the knowledge of the genotype-phenotype correlation in the disease.
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Neoplasias de Bainha Neural , Neurofibromatose 1 , Neurofibrossarcoma , Feminino , Humanos , Genes da Neurofibromatose 1 , Células Germinativas/metabolismo , Herança Materna , Neoplasias de Bainha Neural/genética , Neoplasias de Bainha Neural/diagnóstico , Neurofibromatose 1/genética , Neurofibromatose 1/diagnóstico , Neurofibromatose 1/patologia , Neurofibrossarcoma/genética , CriançaRESUMO
Cardiac computed tomography (CT) and cardiac magnetic resonance imaging (MRI) are routine radiological examinations for diagnosis and prognosis of cardiac disease. The expected growth in cardiac radiology in the coming years will exceed the current scanner capacity and trained workforce. The European Society of Cardiovascular Radiology (ESCR) focuses on supporting and strengthening the role of cardiac cross-sectional imaging in Europe from a multi-modality perspective. Together with the European Society of Radiology (ESR), the ESCR has taken the initiative to describe the current status of, a vision for, and the required activities in cardiac radiology to sustain, increase and optimize the quality and availability of cardiac imaging and experienced radiologists across Europe. KEY POINTS: ⢠Providing adequate availability for performing and interpreting cardiac CT and MRI is essential, especially with expanding indications. ⢠The radiologist has a central role in non-invasive cardiac imaging examinations which encompasses the entire process from selecting the best modality to answer the referring physician's clinical question to long-term image storage. ⢠Optimal radiological education and training, knowledge of the imaging process, regular updating of diagnostic standards, and close collaboration with colleagues from other specialties are essential.
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Cardiopatias , Radiologia , Humanos , Radiologia/educação , Coração , Radiografia , Imageamento por Ressonância Magnética , Europa (Continente)RESUMO
Buffalo farming is an important livestock activity in Mexico. However, the low technological level of the farms makes it difficult to monitor the growth rates of the animals. The objectives of this study were to analyse the body measurements of 107 adult female Murrah buffaloes, to estimate the interrelationships between those measurements and body weight, and to develop equations to predict body weight (BW) using body measurements including withers at height (WH), rump height (RH), body height (BH), heart girth (HG), abdominal girth (AG), pelvic girth (PG), body length (BL), girth circumference (GC), diagonal body length (DBL), pelvic circumference (PC), and abdomen circumference (AC). The study was conducted on two commercial farms in southern Mexico. Pearson correlation and stepwise regression techniques were used for the data analysis. To find out the best regression models, we used model quality criteria such as coefficient of determination (R2), adjusted R2 (Adj.R2), root mean square error (RMSE), Mallow's Cp, Akaike's information criteria (AIC), Bayesian information criteria (BIC), and coefficient of variation (CV). Correlation results indicated that BW had a positive high correlation (P < 0.01) of all the measured traits. Model 4 (-780.56 + 311.76GC + 383.51DBL + 51.82PC + 47.65AC-106.78BL) was the best regression model with a higher R2 (0.87), Adj. R2 (0.86) smaller Cp (4.24), AIC (749.19), BIC (752.16), and RMSE (36.91). The current study suggests that GC, DBL, PC, AC, and BL might be used in combination to estimate BW of adult female Murrah buffaloes.
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Bison , Búfalos , Feminino , Animais , Teorema de Bayes , México , Peso Corporal , Análise de RegressãoRESUMO
The European Society of Cardiovascular Radiology (ESCR) is the European specialist society of cardiac and vascular imaging. This society's highest priority is the continuous improvement, development, and standardization of education, training, and best medical practice, based on experience and evidence. The present intra-society consensus is based on the existing scientific evidence and on the individual experience of the members of the ESCR writing group on carotid diseases, the members of the ESCR guidelines committee, and the members of the executive committee of the ESCR. The recommendations published herein reflect the evidence-based society opinion of ESCR. The purpose of this second document is to discuss suggestions for standardized reporting based on the accompanying consensus document part I. KEY POINTS: ⢠CT and MR imaging-based evaluation of carotid artery disease provides essential information for risk stratification and prediction of stroke. ⢠The information in the report must cover vessel morphology, description of stenosis, and plaque imaging features. ⢠A structured approach to reporting ensures that all essential information is delivered in a standardized and consistent way to the referring clinician.
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Doenças das Artérias Carótidas , Radiologia , Humanos , Consenso , Imageamento por Ressonância Magnética/métodos , Doenças das Artérias Carótidas/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodosRESUMO
The European Society of Cardiovascular Radiology (ESCR) is the European specialist society of cardiac and vascular imaging. This society's highest priority is the continuous improvement, development, and standardization of education, training, and best medical practice, based on experience and evidence. The present intra-society consensus is based on the existing scientific evidence and on the individual experience of the members of the ESCR writing group on carotid diseases, the members of the ESCR guidelines committee, and the members of the executive committee of the ESCR. The recommendations published herein reflect the evidence-based society opinion of ESCR. We have produced a twin-papers consensus, indicated through the documents as respectively "Part I" and "Part II." The first document (Part I) begins with a discussion of features, role, indications, and evidence for CT and MR imaging-based diagnosis of carotid artery disease for risk stratification and prediction of stroke (Section I). It then provides an extensive overview and insight into imaging-derived biomarkers and their potential use in risk stratification (Section II). Finally, detailed recommendations about optimized imaging technique and imaging strategies are summarized (Section III). The second part of this consensus paper (Part II) is focused on structured reporting of carotid imaging studies with CT/MR. KEY POINTS: ⢠CT and MR imaging-based evaluation of carotid artery disease provides essential information for risk stratification and prediction of stroke. ⢠Imaging-derived biomarkers and their potential use in risk stratification are evolving; their correct interpretation and use in clinical practice must be well-understood. ⢠A correct imaging strategy and scan protocol will produce the best possible results for disease evaluation.
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Aterosclerose , Doenças das Artérias Carótidas , Radiologia , Acidente Vascular Cerebral , Humanos , Consenso , Tomografia Computadorizada por Raios X/métodos , Doenças das Artérias Carótidas/diagnóstico por imagem , Imageamento por Ressonância Magnética , Padrões de ReferênciaRESUMO
Climate change, competent vectors, and reservoir animals are the main factors for developing vector-borne zoonotic diseases. These diseases encompass a significant and widespread category of pathogens (e.g., viruses, bacteria, protozoa, and helminths) transmitted by blood-feeding arthropods, including ticks, fleas, lice, triatomines, mosquitoes, sandflies, and blackflies. In Chile, several studies have explored the role of dogs as reservoirs of vector-borne pathogens; however, there is a lack of research investigating the presence of pathogens in arthropods. Specifically, within the order Diptera, limited knowledge exists regarding their roles as carriers of pathogens. This study aimed to examine the presence of zoonotic filarial nematodes in mosquitoes and dogs within a previously unstudied semi-rural area of Central Chile. Two hundred samples of dog blood and seven hundred and twenty-four mosquitoes were collected during 2021-2022 and studied for filarial nematodes by PCR. The prevalence of microfilaremic dogs detected by Knott's test was 7.5%, with Acanthocheilonema reconditum being the only species identified. Aedes (Ochlerotatus) albifasciatus was the most abundant mosquito species collected, and 15 out of 65 pools were positive for filarial nematodes. Among these pools, 13 tested positive for Acanthocheilonema reconditum, and two tested positive for Setaria equina through PCR. Additionally, five Culex pipiens specimens were positive for Acanthocheilonema reconditum. Despite the absence of zoonotic filarial species, these findings underscore the significance of monitoring pathogens in mosquitoes and animal hosts and continued research into the dynamics of vector-borne diseases, particularly in unexplored regions.
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Cardiovascular diseases (CVDs), particularly ischemic heart disease (IHD) and stroke, present epidemiologically in a different way among sexes. The reasons of these sex-based differences should be delved into sex-specific cardiovascular (CV) risk factors and different mechanisms of atherosclerotic progression. Imaging techniques of both carotid and coronary atherosclerotic plaques represent a tool to demonstrate sex-related features which might be used to further and better assess CV risk of male and female population. The aim of this review is to evaluate current knowledge on sex-specific qualitative and quantitative plaque features of coronary and carotid atherosclerosis. We also discuss the clinical implication of a sex-based plaque phenotype, evaluated with non-invasive imaging techniques, such as CT-angiography and MRI-angiography, to stratify CV risk.