Part 1: The Clinical Applications of Left Ventricular Myocardial Strain.

There is an increasing prevalence of cardiovascular disease and heart failure. Indices of left ventricular (LV) systolic function such as LV ejection fraction used to identify those at risk of adverse cardiac events such as heart failure may not be truly representative of LV systolic function in certain cardiac diseases. Given that LV ejection fraction reduction may represent more advanced irreversible stages of disease, measures of myocardial strain have emerged as a feasible and robust instrument for the early identification of heart disease and subtle LV systolic dysfunction. The purpose of this review was to provide an overview of myocardial strain concepts and emerging clinical applications of global longitudinal strain in cardio-oncology.

Use of Extracorporeal Membrane Oxygenation and Impella as Bridge to Surgery Through Imaging for Cardiogenic Shock.

Three-dimensional TEE, zoomed volume acquisition, oriented to the surgeon's view of the mitral valve. (A) The left atrial erspective demonstrates a flail A3 segment with a ruptured posteromedial papillary muscle (arrow). (B) Three-dimensional color Doppler demonstrates severe MR. (C, D) Three-dimensional transillumination; left atrial (left) and LV (right) perspective demonstrated. This technique was used to highlight the blood pool-tissue interface. The degree of transparency was adjusted to maximize the border definition between the ruptured posteromedial papillary muscle and blood pool and more clearly demonstrate the ruptured posteromedial papillary muscle (dashed arrow).

Transcatheter Mitral Valve Repair and Replacement: Current Evidence for Intervention and the Role of CT in Preprocedural Planning-A Review for Radiologists and Cardiologists Alike.

The mitral valve is a complex structure with a three-dimensional saddle shape annulus. Mitral regurgitation occurs from leaflet coaptation failure that is either primary (a problem with the leaflets) or secondary (chamber dilatation in the setting of cardiomyopathy). There has been an increase in focus on transcatheter mitral valve interventions, for both mitral repair and replacement. These technologies have rapidly developed to provide treatment for a substantial number of patients with severe symptomatic mitral regurgitation who are at too high of a risk to undergo open heart surgery. CT assessment of the mitral valve has developed with equal rapidity, with regard to preprocedural planning for transcatheter therapies. This review will provide an overview of mitral valve anatomy, an update on the current transcatheter repair and replacement therapies, as well as a focused overview of the role of multislice CT in mitral assessment prior to intervention. © RSNA, 2020.