Emerging Roles for Artificial Intelligence in Heart Failure Imaging.

Artificial intelligence (AI) applications are expanding in cardiac imaging. AI research has shown promise in workflow optimization, disease diagnosis, and integration of clinical and imaging data to predict patient outcomes. The diagnostic and prognostic paradigm of heart failure is heavily reliant on cardiac imaging. As AI becomes increasingly validated and integrated into clinical practice, AI influence on heart failure management will grow. This review discusses areas of current research and potential clinical applications in AI as applied to heart failure cardiac imaging.

Percutaneous VDD leadless pacer implant post recent bioprosthetic tricuspid valve replacement for infective endocarditis.

In January 2020, the first Medtronic VDD leadless pacemaker Micra AV was approved by FDA to treat patients with advanced AV block, based on the encouraging results from the Micra Atrial tRacking using a Ventricular accELerometer 2 (MARVEL 2). There is reassuring data about safety and short-term outcomes of traditional leadless pacemaker implant after recent surgical tricuspid valve replacement, but only few cases are reported in literature. No data was found regarding AV Micra implant safety and outcomes in patients following bioprosthetic tricuspid valve replacement as of today. Our patient is a 44-year-old gentleman with history of IV drug use who recently underwent tricuspid replacement with bioprosthesis for infective endocarditis complicated by postsurgical heart block, acute kidney insufficiency requiring hemodialysis, persistent bacteremia and candidemia, and progressive failure of the epicardial pacing wires. Given the elevated infective risk, the decision of attempting leadless pacer implant through the bioprosthetic valve was taken and our patient underwent successful Micra AV implant on postoperative day 30. To our knowledge, this is the first AV Micra placement following bioprosthetic tricuspid valve replacement. The uneventful procedure and the encouraging short-term device follow-up results seem to confirm the relative safety of this device in treating advanced atrioventricular conduction disorders in patients at elevated infective risk.

Artificial Intelligence Advancements in the Cardiovascular Imaging of Coronary Atherosclerosis.

Coronary artery disease is a leading cause of death worldwide. There has been a myriad of advancements in the field of cardiovascular imaging to aid in diagnosis, treatment, and prevention of coronary artery disease. The application of artificial intelligence in medicine, particularly in cardiovascular medicine has erupted in the past decade. This article serves to highlight the highest yield articles within cardiovascular imaging with an emphasis on coronary CT angiography methods for % stenosis evaluation and atherosclerosis quantification for the general cardiologist. The paper finally discusses the evolving paradigm of implementation of artificial intelligence in real world practice.

Hypercalcemia in Small Lymphocytic Lymphoma with an Elevated Parathyroid Hormone-Related Peptide Associated with Early Richter Transformation.

Hypercalcemia in malignancy is associated with multiple mechanisms and occurs in up to 20-30% of cancer patients. We report a case of small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) associated with hypercalcemia and an elevation in parathyroid hormone-related peptide (PTHrP) in the setting of a Richter transformation. Real-time reverse transcriptase PCR on lymph node biopsy specimens obtained before and after transformation showed an 8-fold increase in PTHrP mRNA levels and about 2-fold decrease in the levels of its cognate receptor PTHR1. The findings of this case suggest that parathyroid hormone-related peptide might be useful in monitoring a specific group of patients with SLL/CLL who develop hypercalcemia during the course of their disease and could suggest an autocrine-like mechanism involving PTHrP in Richter transformation.

Contemporary Cardiovascular Imaging Advancements and Social Media.

PURPOSE OF REVIEW: Social media (SoMe) as a means of knowledge dissemination has grown significantly in cardiovascular imaging in recent years. This media platform allows for a free exchange of ideas, the development of new communities, and the ability to disseminate advancements rapidly. While the social media platforms offer limitless potential, their public domain necessitates several important suggestions around best practices. RECENT FINDINGS: In cardiovascular imaging, specific hashtags have emerged to encompass the major modalities to include #EchoFirst, #YesCCT, #WhyCMR, and #CVNuc. Cardiovascular imaging journals have established major presences in the social media space as an avenue to present novel, high-quality, peer-reviewed content to new audiences. SUMMARY: This review paper aims to introduce basic concepts in social media and cardiovascular imaging while highlighting recent topics of high importance, influence, and attention in cardiovascular imaging to include the ISCHEMIA trial, COVID-19, structural imaging, and multimodality advances from throughout 2020.

Not Your Common Athletic Heart Problem: Using Coronary CTA to Visualize Spontaneous Coronary Artery Dissection.

A 19-year-old healthy male collegiate athlete presented with typical anginal symptoms after running a 5K race. He had complained of similar symptoms off and on for the past month. On presentation, troponin was 0.12 ng/ml (reference value < 0.01 ng/ml), which peaked at 17.7 ng/ml and CK-MB was 28.71 IU/L (reference value < 25 IU/L). ECG showed diffuse biphasic T-waves. Coronary computed tomography angiogram (cCTA) demonstrated a 1.5 cm dissection in the left anterior descending artery and a 1.9 × 1.8 cm attenuation defect in the left ventricular apex consistent with thrombus. Subsequent coronary catheterization confirmed dissection of the left anterior descending artery. Spontaneous coronary artery dissection (SCAD) is a rare phenomenon. Diagnosis can be made through noninvasive measures but is usually done through left heart catheterization. In young patients who present with an NSTEMI, clinical suspicion for SCAD among other conditions should be raised. Additionally, recognizing that complications such as intracardiac thrombi can occur in SCAD is critical in ensuring appropriate therapy.