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Reviewer acknowledgment 2015

Contributing reviewers The Editors of Cardiovascular Ultrasound would like to thank all of our reviewers who have contributed to the journal in Volume 13 (2015) and whose valuable support is fundamental to its success.

The risk of cumulative radiation exposure in chest imaging and the advantage of bedside ultrasound

The increasing use and complexity of imaging techniques have not been matched by increasing awareness and knowledge by prescribers and practitioners. Imaging examinations that expose to ionizing radiation provide immense benefits when appropriate, yet they may result in an increased incidence of radiation-induced cancer in the long-term. The radiation issue is relevant not only...

Reviewer acknowledgement 2014

Contributing reviewers The Editors of Cardiovascular Ultrasound would like to thank all of our reviewers who have contributed to the journal in Volume 12 (2014) and whose valuable support is fundamental to its success.

Dual imaging stress echocardiography versus computed tomography coronary angiography for risk stratification of patients with chest pain of unknown origin

Background Dual imaging stress echocardiography, combining the evaluation of wall motion and coronary flow reserve (CFR) on the left anterior descending artery (LAD), and computed tomography coronary angiography (CTCA) are established techniques for assessing prognosis in chest pain patients. In this study we compared the prognostic value of the two methods in a cohort of...

The Radiation Issue in Cardiology: the time for action is now

The "radiation issue" is the need to consider possible deterministic effects (e.g., skin injuries) and long-term cancer risks due to ionizing radiation in the risk-benefit assessment of diagnostic or therapeutic testing. Although there are currently no data showing that high-dose medical studies have actually increased the incidence of cancer, the "linear-no threshold" model in...

The beneficial effects of TAVI in mitral insufficiency

Background Previous studies have suggested that concomitant mitral regurgitation (MR) is a risk factor for acute transcatheter aortic valve implantation (TAVI) failure, but may improve afterwards. Aim of this study was to assess the prevalence, clinical meaning and modifications of MR in patients undergoing TAVI. Methods In a retrospective, two-center (Potenza-San Carlo and Roma...

Transplant of stunned donor hearts rescued by pharmacological stress echocardiography: a “proof of concept” report

Background Due to the shortage of donor hearts, the criteria for acceptance have been considerably expanded. Hearts with regional or global left ventricular dysfunction are excluded from donation, but stress echo might be useful to identify patients with reversible wall motion abnormalities, potentially eligible for donation. Methods Six marginal candidate donors (mean age, 40...

The true cost of cardiovascular imaging: focusing on downstream, indirect, and environmental costs

To develop a more realistic assessment of costs, herein named “true” costs, the extra-cancer from medical radiation, environmental damage from imaging paraphernalia and radioactive wastes must be included as long-term costs from imaging examinations. It is urgent to define the “true” costs across imaging modalities as it interferes on physicians’ decision to request an exam and...

Medium-term outcome of recipients of marginal donor hearts selected with new stress-echocardiographic techniques over standard criteria

Background Heart transplantation is limited by severe donor organ shortage. Regardless of the changes made in the acceptance of marginal donors, any such mechanism cannot be considered successful unless recipient graft survival rates remain acceptable. A stress echo-driven selection of donors has proven successful in older donors with normal left ventricular resting function and...

Stress echo 2020: the international stress echo study in ischemic and non-ischemic heart disease

Background Stress echocardiography (SE) has an established role in evidence-based guidelines, but recently its breadth and variety of applications have extended well beyond coronary artery disease (CAD). We lack a prospective research study of SE applications, in and beyond CAD, also considering a variety of signs in addition to regional wall motion abnormalities. Methods In a...

Trends of Increasing Medical Radiation Exposure in a Population Hospitalized for Cardiovascular Disease (1970–2009)

Background High radiation doses employed in cardiac imaging may increase cancer frequency in exposed patients after decades. The aim of this study was to evaluate the relative trends in medical radiation exposure in a population hospitalized for cardiovascular disease. Methods and Results An observational single-center study was conducted to examine 16,431 consecutive patients...

Inappropriateness of Cardiovascular Radiological Imaging Testing; A Tertiary Care Referral Center Study

Aims Radiological inappropriateness in medical imaging leads to loss of resources and accumulation of avoidable population cancer risk. Aim of the study was to audit the appropriateness rate of different cardiac radiological examinations. Methods and Principal Findings With a retrospective, observational study we reviewed clinical records of 818 consecutive patients (67±12 years...

Economic and biological costs of cardiac imaging

Medical imaging market consists of several billion tests per year worldwide. Out of these, at least one third are cardiovascular procedures. Keeping in mind that each test represents a cost, often a risk, and a diagnostic hypothesis, we can agree that every unnecessary and unjustifiable test is one test too many. Small individual costs, risks, and wastes multiplied by billions of...

Abnormal shortened diastolic time length at increasing heart rates in patients with abnormal exercise-induced increase in pulmonary artery pressure

Rosa Sicari 0 Elisabetta Bianchini 0 Eugenio Picano 0 0 National Research Council, Institute of Clinical Physiology , Pisa , Italy Background: The degree of pulmonary hypertension is not independently

Myocardial contractility in the stress echo lab: from pathophysiological toy to clinical tool

Up-regulation of Ca2+ entry through Ca2+ channels by high rates of beating is involved in the frequency-dependent regulation of contractility: this process is crucial in adaptation to exercise and stress and is universally known as force-frequency relation (FFR). Disturbances in calcium handling play a central role in the disturbed contractile function in myocardial failure...

Left atrial dysfunction detected by speckle tracking in patients with systemic sclerosis

Background Cardiac involvement is a relevant clinical finding in systemic sclerosis (SSc) and is associated with poor prognosis. Left atrial (LA) remodeling and/or dysfunction can be an early sign of diastolic dysfunction. Two-dimensional speckle tracking echocardiography (STE) is a novel and promising tool for detecting very early changes in LA myocardial performance. Aim To...

The association of micronucleus frequency with obesity, diabetes and cardiovascular disease

Obesity and metabolic syndrome (MetS) are serious and growing health care problems worldwide, leading an increased risk for type 2 diabetes (T2D) and cardiovascular disease (CVD). Over the past decade, emerging evidence has shown that an increased chromosomal damage, as determined by the cytokinesis-block micronucleus (CBMN) assay, is correlated to the pathogenesis of metabolic...

WEB downloadable software for training in cardiovascular hemodynamics in the (3-D) stress echo lab

When a physiological (exercise) stress echo is scheduled, interest focuses on wall motion segmental contraction abnormalities to diagnose ischemic response to stress, and on left ventricular ejection fraction to assess contractile reserve. Echocardiographic evaluation of volumes (plus standard assessment of heart rate and blood pressure) is ideally suited for the quantitative and...