Chẩn đoán hình ảnh tim mạch có gì mới trong năm 2015 2016

Cardiovascular Imaging: Year-in-Review 2015-2016 Adj Ass Prof Ong Hean Yee MBBCh BAO, ASCeXAM, FRCP, FESC Senior Consultant and Head of Department Department of Cardiology Khoo Teck Puat Hospital Disclosure Advisory Board Novartis, Boehringer Ingelheim, Bayer, Sanofi, Pfizer, Astra Zeneca Principle Investigator Novartis, Sanofi, Bayer, Astra Zeneca, Eli-Lilly, Amgen, Pfizer Sponsorship (2014-2015 only) Astra Zeneca, Bayer All Honorariums donated to Department Research and Training Fund Cardiovascular Imaging 2015-16 Focused Cardiac Ultrasound Cardiac CT Perfusion Therapeutic Ultrasound CAC - 15 year prediction High Risk Plaque Cardiovascular Imaging 2015-16 Focused Cardiac Ultrasound Cardiac CT Perfusion Therapeutic Ultrasound CAC - 15 year prediction High Risk Plaque Focused Cardiac Ultrasound J Am Soc Echocardiogr 2014; 27: 683, e1-e33 Focused Cardiac Ultrasound A&E ICU + J Am Soc Echocardiogr 2014; 27: 683, e1-e33 + Focused Cardiac Ultrasound Acac Emerg Med 2015; 22: 536–541 Focused Cardiac Ultrasound Ascending Aorta measurement in A+E vs CT Nazerian et al Acad Emerg Med 2015; 22: 536 Hypotension due to Cardiac Dysfunction vs Hypovelemia Jones AE et al Shock 2005; 24: 513-7 Screening for HCM in Sports Clinic Yim ES et al J Ultrasound Med 2013; 32: 333-8 Use of hand held echo machine in underpriviledged community Fedson S JASE 2003;16:901-5 Clinical Examination versus handheld machine Spencer KT JACC 2001;37:2013-8 Focused Cardiac Ultrasound A&E ICU + = ? J Am Soc Echocardiogr 2014; 27: 683, e1-e33 + 15 year warranty J Am Coll Cardiol Img 2015; Aug (8): 900-9 15 year warranty J Am Coll Cardiol Img 2015; Aug (8): 900-9 15 year warranty J Am Coll Cardiol Img 2015; Aug (8): 900-9 15 year warranty J Am Coll Cardiol Img 2015; Aug (8): 900-9 Cardiovascular Imaging 2015-16 Focused Cardiac Ultrasound Cardiac CT Perfusion Therapeutic Ultrasound CAC - 15 year prediction High Risk Plaque High Risk Plaques J Carvdiovasc Computed Tomography 2015; 9: 538-545 J Am College Cardiol 2015; 66: 337-46 High Risk Plaques Falk and Fuster Circulation 1992, 92, (3): 657 High Risk Plaques Falk and Fuster Circulation 1992, 92, (3): 657 High Risk Plaques / Stenosis PR (Positive Remodelling) (Remodeling Index > 1.1) LAP (Low Attenutation Plague) (< 30 Hounsfield Unit) Significant Stenosis (> 70% luminal stenosis) Motoyama JACC 2007; 50: 319–26 High Risk Plaques Motoyama et al J Am College Cardiol 2015; 66: 337-46 High Risk Plaques Significant Stenosis Only High Risk Plaque Only Motoyama JACC 2015; 66: 337-46 HR 2.89 HR 13.13 High Risk Plaque Definition Low Attenuation 1.1) Spotty Calcium 9-90mm3 with >130 HU Plaque Length 13.8 mm Plague Volume 15 mm3 if < 30 HU 52 mm3 if < 60 HU ROMICAT II JCCT 2015; 9: 538-545 High Risk Plaque Definition ROMICAT II JCCT 2015; 9: 538-545 High Risk Plaque Definition ROMICAT II JCCT 2015; 9: 538-545 Thank You Focused Cardiac Ultrasound Cardiac CT Perfusion Therapeutic Ultrasound CAC - 15 year prediction High Risk Plaque ... Availability Cons Contrast Nephropathy Radiation (12-15 mSV) Functional vs Anatomy  Underestimation  and  Oveestimation  Topol Nissen Circulation 1995; 92: 2333-2342 Revascularisation by Anatomy