JW Jukema - Academia.edu (original) (raw)

Papers by JW Jukema

Netherlands Heart Journal, 2009

Netherlands Heart Journal, 2018

Introduction Optical coherence tomography (OCT) enables detailed imaging of the coronary wall, lu... more Introduction Optical coherence tomography (OCT) enables detailed imaging of the coronary wall, lumen and intracoronary implanted devices. Responding to the lack of specific appropriate use criteria (AUC) for this technique, we conducted a literature review and a procedure for appropriate use criteria. Methods Twenty-one of all 184 members of the Dutch Working Group on Interventional Cardiology agreed to evaluate 49 pre-specified cases. During a meeting, factual indications were established whereupon members individually rated indications on a 9-point scale, with the opportunity to substantiate their scoring. Results Twenty-six indications were rated 'Appropriate', eighteen indications 'May be appropriate', and five 'Rarely appropriate'. Use of OCT was unanimously considered 'Appropriate' in stent thrombosis, and 'Appropriate' for guidance in PCI, especially in distal left main coronary artery and proximal left anterior descending coronary artery, unexplained angiographic abnormalities, and use of bioresorbable vascular scaffold (BVS). OCT was considered 'Rarely Appropriate' on top of fractional flow reserve (FFR) for treatment indication, assessment of strut coverage, bypass anastomoses or assessment of proximal left main coronary artery. Conclusions The use of OCT in stent thrombosis is unanimously considered 'Appropriate' by these experts. Varying degrees of consensus exists on the appropriate use of OCT in other settings.

American Journal of Physiology-Heart and Circulatory Physiology, 2001

Conversion of conductance catheter data to absolute ventricular volumes requires assessment of pa... more Conversion of conductance catheter data to absolute ventricular volumes requires assessment of parallel conductance ( G P). We determined the accuracy of G P obtained by the hypertonic saline method ( G [Formula: see text]) compared with angiographically derived G P( G [Formula: see text]) and quantified the variabilities of G P for the dual-field conductance catheter method in nine anesthetized sheep studied at baseline, treated with dobutamine, and subjected to volume loading and β-blockade. G [Formula: see text] and G [Formula: see text] showed an excellent linear correlation ( G [Formula: see text] = 1.002 · G [Formula: see text] + 0.001 Ω−1, R 2 = 0.92), and Bland-Altman analysis yielded a nonsignificant bias and narrow limits of agreement (bias ± 2SD = 0.002 ± 0.112 Ω−1). Within-animal variability of G P was very similar with both methods and was due to changes in blood conductivity rather than geometrical changes. Variability between animals was significant (26.3% of mean for...

Netherlands Heart Journal, 2017

Recent years have brought a significant amount of new results in the field of atherosclerosis. A ... more Recent years have brought a significant amount of new results in the field of atherosclerosis. A better understanding of the role of different lipoprotein particles in the formation of atherosclerotic plaques is now possible. Recent cardiovascular clinical trials have also shed more light upon the efficacy and safety of novel compounds targeting the main pathways of atherosclerosis and its cardiovascular complications. In this review, we first provide a background consisting of the current understanding of the pathophysiology and treatment of atherosclerotic disease, followed by our future perspectives on several novel classes of drugs that target atherosclerosis. The focus of this update is on the pathophysiology and medical interventions of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) and lipoprotein(a) (Lp(a)).

Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation, 2011

This study aims to assess the cost-effectiveness of ezetimibe plus simvastatin (E/S) versus atorv... more This study aims to assess the cost-effectiveness of ezetimibe plus simvastatin (E/S) versus atorvastatin or simvastatin monotherapy as second-line treatment of primary hypercholesterolaemia from the Dutch healthcare perspective. The evaluation used a Markov model and patient data from the Dutch EASEGO study in which patients failing to reach goal low-density lipoprotein cholesterol levels on atorvastatin 10 mg or simvastatin 20 mg had their dose doubled or switched to ezetimibe 10 mg plus generic simvastatin 20 mg (E10/S20). The second scenario, based on Dutch guidelines, switched patients from simvastatin 40 mg to atorvastatin 40 mg, or ezetimibe 10 mg was added to simvastatin 40 mg (E10/S40). The key effectiveness input measure was change in total cholesterol/high-density lipoprotein ratio obtained from the EASEGO study. In conformity with published studies linking reduced lipid levels to reduced risk of cardiovascular events, the present model assumed that a lipid decrease with e...

Introduction. The FSAP-Marburg I polymorphism (1704G > A), which reduces FSAP activity, is associ... more Introduction. The FSAP-Marburg I polymorphism (1704G > A), which reduces FSAP activity, is associated with late complications of carotid stenosis in humans. Therefore, this study examines the influence of the Marburg I polymorphism and the closely linked Marburg II polymorphism (1280G > C) on various cardiovascular outcomes in two large independent study populations. Methods. The two Marburg polymorphisms in the HABP2 gene encoding FSAP were genotyped in a large population of elderly patients at risk for vascular disease (the PROSPER-study, n = 5804) and in a study population treated with a percutaneous coronary intervention (the GENDER-study, n = 3104). Results. In the PROSPER study, the Marburg I polymorphism was associated with an increased risk of clinical stroke (HR: 1.60, 95% CI: 1.13-2.28) and all-cause mortality (HR: 1.33, 95% CI: 1.04-1.71). In the GENDER study carriers of this variant seemed at lower risk of developing restenosis (HR: 0.59, 95% CI: 0.34-1.01). The Marburg II polymorphism showed similar but weaker results. Conclusion. The increase in stroke risk in Marburg I carriers could be due to differential effects on smooth muscle cells and on matrix metalloproteinases, thereby influencing plaque stability. The possible protective effect on restenosis could be the result of reduced activation of zymogens, which are involved in hemostasis and matrix remodeling.

Nephrology Dialysis Transplantation, 2014

Introduction and Aims: Dialysis patients have high mortality risk with cardiovascular mortality a... more Introduction and Aims: Dialysis patients have high mortality risk with cardiovascular mortality as an important cause of death. Chronic kidney disease specific risk factors implicated in these processes include chronic inflammatory state with up-regulation of inflammatory cytokines and altered growth factor levels, altered calcium/phosphate metabolism and coagulation as well as endothelial dysfunction. Alterations in the genetic profile of these processes in dialysis patients may further increase this dysbalance and enhance morbidity and mortality. The aim of this study was to investigate the association between SNPs involved in the abovementioned processes and cardiovascular and non-cardiovascular mortality in a large population of incident dialysis patients. Methods: We included 1330 incident dialysis patients in which 42 SNPs in 25 genes involved in vascular processes (endothelial function and vascular remodeling, growth factors, inflammation, coagulation, and calcium/phosphate metabolism) were genotyped. Cox regression analysis was used to investigate the effect of these SNPs on five-years mortality. Results: The mortality rate was 114 per 1000 person-years for the 1330 dialysis patients. Cardiovascular mortality accounted for 49,4% of these deaths, whereas 50,6% (240/474) were not cardiovascular related. We found that VEGF rs2010963 and TNF rs1799964 were protective for cardiovascular mortality in dialysis patients, whereas VEGF rs699947 was associated with increased risk of cardiovascular mortality (Table 1). In addition, MMP-1 rs11292517 and VDR rs2238135 were associated with decreased risk of non-cardiovascular mortality, while rs9804922 in an intergenic region on 12q23.2, CD180 rs5744478 and interleukin-6 rs1800795 were associated with an increased non-cardiovascular mortality risk (Table 2). No significant associations with mortality were observed with the other SNPs. Conclusions: In this large cohort of dialysis patients, we found that two SNPs involved in endothelial function and remodeling, three SNPs related to inflammatory processes, two SNPs in genes encoding for growth factors, and one SNP related to vitamin D metabolism were associated with mortality risk. This study provides further evidence for an important role of these processes in the comorbid conditions of dialysis patients. Future studies are warranted to unravel the underlying mechanisms responsible for the increased mortality in these patients.

Journal of Cardiovascular Magnetic Resonance, 2012

Background: The Bramwell-Hill model describes the relation between vascular wall stiffness expres... more Background: The Bramwell-Hill model describes the relation between vascular wall stiffness expressed in aortic distensibility and the pulse wave velocity (PWV), which is the propagation speed of the systolic pressure wave through the aorta. The main objective of this study was to test the validity of this model locally in the aorta by using PWV-assessments based on in-plane velocity-encoded cardiovascular magnetic resonance (CMR), with invasive pressure measurements serving as the gold standard. Methods: Seventeen patients (14 male, 3 female, mean age ± standard deviation = 57 ± 9 years) awaiting cardiac catheterization were prospectively included. During catheterization, intra-arterial pressure measurements were obtained in the aorta at multiple locations 5.8 cm apart. PWV was determined regionally over the aortic arch and locally in the proximal descending aorta. Subsequently, patients underwent a CMR examination to measure aortic PWV and aortic distention. Distensibility was determined locally from the aortic distension at the proximal descending aorta and the pulse pressure measured invasively during catheterization and non-invasively from brachial cuff-assessment. PWV was determined regionally in the aortic arch using through-plane and in-plane velocity-encoded CMR, and locally at the proximal descending aorta using in-plane velocity-encoded CMR. Validity of the Bramwell-Hill model was tested by evaluating associations between distensibility and PWV. Also, theoretical PWV was calculated from distensibility measurements and compared with pressure-assessed PWV. Results: In-plane velocity-encoded CMR provides stronger correlation (p = 0.02) between CMR and pressureassessed PWV than through-plane velocity-encoded CMR (r = 0.69 versus r = 0.26), with a non-significant mean error of 0.2 ± 1.6 m/s for in-plane versus a significant (p = 0.006) error of 1.3 ± 1.7 m/s for through-plane velocityencoded CMR. The Bramwell-Hill model shows a significantly (p = 0.01) stronger association between distensibility and PWV for local assessment (r = 0.8) than for regional assessment (r = 0.7), both for CMR and for pressureassessed PWV. Theoretical PWV is strongly correlated (r = 0.8) with pressure-assessed PWV, with a statistically significant (p = 0.04) mean underestimation of 0.6 ± 1.1 m/s. This theoretical PWV-estimation is more accurate when invasively-assessed pulse pressure is used instead of brachial cuff-assessment (p = 0.03). Conclusions: CMR with in-plane velocity-encoding is the optimal approach for studying Bramwell-Hill associations between local PWV and aortic distensibility. This approach enables non-invasive estimation of local pulse pressure and distensibility.

The International Journal of Cardiovascular Imaging, 2009

The International Journal of Cardiovascular Imaging, 2009

The International Journal of Cardiovascular Imaging, 2009

Recent years have witnessed a rapid development of multi-slice computed tomography (MSCT) technol... more Recent years have witnessed a rapid development of multi-slice computed tomography (MSCT) technology. The number of detector rows has increased from 4-slices to the current availability of 64-slice and even 320-slice systems. In addition, images are acquired with thinner slices and faster rotation times resulting in substantially improved image quality and diagnostic accuracy. Simultaneously, effective dose reduction acquisition techniques have been developed allowing considerable reduction of the radiation dose. Conceivably, these advancements may allow further expansion of the use of MSCT beyond the visual assessment of the presence or absence of significant coronary artery disease. Indeed, a particular advantage of the technique is that in addition to evaluation of the coronary arteries it also allows assessment of cardiac structures and function. The purpose of the current review is to discuss several novel applications of cardiac MSCT, including stenosis quantification, atherosclerotic plaque imaging and prognostification as well as imaging of left ventricular function, aortic and mitral valve anatomy using state-of-the-art technology.

The International Journal of Cardiovascular Imaging, 2010

The International Journal of Cardiovascular Imaging, 2010

The International Journal of Cardiovascular Imaging, 2009

The International Journal of Cardiovascular Imaging, 2011

The purpose of this study was to evaluate the performance of 320-row computed tomography angiogra... more The purpose of this study was to evaluate the performance of 320-row computed tomography angiography (CTA) in the identification of significant coronary artery disease (CAD) in patients presenting with acute chest pain and to examine the relation to outcome during follow-up. A total of 106 patients with acute chest pain underwent CTA to evaluate presence of CAD. Each CTA was classified as: normal, nonsignificant CAD (\50% luminal narrowing) and significant CAD (C50% luminal narrowing). CTA results were compared with quantitative coronary angiography. After discharge, the following cardiovascular events were recorded: cardiac death, non-fatal infarction, and unstable angina requiring revascularization. Among the 106 patients, 23 patients (22%) had a normal CTA, 19 patients (18%) had non-significant CAD on CTA, 59 patients (55%) had significant CAD on CTA, and 5 patients (5%) had non-diagnostic image quality. In total, 16 patients (15%) were immediately discharged after normal CTA and 90 patients (85%) underwent invasive coronary angiography. Sensitivity, specificity, and positive and negative predictive values to detect significant CAD on CTA were 100, 87, 93, and 100%, respectively. During mean follow-up of 13.7 months, no cardiovascular events occurred in patients with a normal CTA examination. In patients with non-significant CAD on CTA, no cardiac death or myocardial infarctions occurred and only 1 patient underwent revascularization due to unstable angina. In patients presenting with acute chest pain, an excellent clinical performance for the non-invasive assessment of significant CAD was demonstrated using CTA. Importantly, normal or non-significant CAD on CTA predicted a low rate of adverse cardiovascular events and favorable outcome during follow-up.

The International Journal of Cardiovascular Imaging, 2011

International Journal of Cardiology, 2013

European Heart Journal, 2010

This editorial refers to 'A variant at chromosome 9p21 is associated with recurrent myocardial in... more This editorial refers to 'A variant at chromosome 9p21 is associated with recurrent myocardial infarction and cardiac death after acute coronary syndrome: The GRACE Genetics Study' † , by I. Buysschaert et al. on page 1132

European Heart Journal, 2012

Netherlands Heart Journal, 2009

Netherlands Heart Journal, 2018

Introduction Optical coherence tomography (OCT) enables detailed imaging of the coronary wall, lu... more Introduction Optical coherence tomography (OCT) enables detailed imaging of the coronary wall, lumen and intracoronary implanted devices. Responding to the lack of specific appropriate use criteria (AUC) for this technique, we conducted a literature review and a procedure for appropriate use criteria. Methods Twenty-one of all 184 members of the Dutch Working Group on Interventional Cardiology agreed to evaluate 49 pre-specified cases. During a meeting, factual indications were established whereupon members individually rated indications on a 9-point scale, with the opportunity to substantiate their scoring. Results Twenty-six indications were rated 'Appropriate', eighteen indications 'May be appropriate', and five 'Rarely appropriate'. Use of OCT was unanimously considered 'Appropriate' in stent thrombosis, and 'Appropriate' for guidance in PCI, especially in distal left main coronary artery and proximal left anterior descending coronary artery, unexplained angiographic abnormalities, and use of bioresorbable vascular scaffold (BVS). OCT was considered 'Rarely Appropriate' on top of fractional flow reserve (FFR) for treatment indication, assessment of strut coverage, bypass anastomoses or assessment of proximal left main coronary artery. Conclusions The use of OCT in stent thrombosis is unanimously considered 'Appropriate' by these experts. Varying degrees of consensus exists on the appropriate use of OCT in other settings.

American Journal of Physiology-Heart and Circulatory Physiology, 2001

Conversion of conductance catheter data to absolute ventricular volumes requires assessment of pa... more Conversion of conductance catheter data to absolute ventricular volumes requires assessment of parallel conductance ( G P). We determined the accuracy of G P obtained by the hypertonic saline method ( G [Formula: see text]) compared with angiographically derived G P( G [Formula: see text]) and quantified the variabilities of G P for the dual-field conductance catheter method in nine anesthetized sheep studied at baseline, treated with dobutamine, and subjected to volume loading and β-blockade. G [Formula: see text] and G [Formula: see text] showed an excellent linear correlation ( G [Formula: see text] = 1.002 · G [Formula: see text] + 0.001 Ω−1, R 2 = 0.92), and Bland-Altman analysis yielded a nonsignificant bias and narrow limits of agreement (bias ± 2SD = 0.002 ± 0.112 Ω−1). Within-animal variability of G P was very similar with both methods and was due to changes in blood conductivity rather than geometrical changes. Variability between animals was significant (26.3% of mean for...

Netherlands Heart Journal, 2017

Recent years have brought a significant amount of new results in the field of atherosclerosis. A ... more Recent years have brought a significant amount of new results in the field of atherosclerosis. A better understanding of the role of different lipoprotein particles in the formation of atherosclerotic plaques is now possible. Recent cardiovascular clinical trials have also shed more light upon the efficacy and safety of novel compounds targeting the main pathways of atherosclerosis and its cardiovascular complications. In this review, we first provide a background consisting of the current understanding of the pathophysiology and treatment of atherosclerotic disease, followed by our future perspectives on several novel classes of drugs that target atherosclerosis. The focus of this update is on the pathophysiology and medical interventions of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) and lipoprotein(a) (Lp(a)).

Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation, 2011

This study aims to assess the cost-effectiveness of ezetimibe plus simvastatin (E/S) versus atorv... more This study aims to assess the cost-effectiveness of ezetimibe plus simvastatin (E/S) versus atorvastatin or simvastatin monotherapy as second-line treatment of primary hypercholesterolaemia from the Dutch healthcare perspective. The evaluation used a Markov model and patient data from the Dutch EASEGO study in which patients failing to reach goal low-density lipoprotein cholesterol levels on atorvastatin 10 mg or simvastatin 20 mg had their dose doubled or switched to ezetimibe 10 mg plus generic simvastatin 20 mg (E10/S20). The second scenario, based on Dutch guidelines, switched patients from simvastatin 40 mg to atorvastatin 40 mg, or ezetimibe 10 mg was added to simvastatin 40 mg (E10/S40). The key effectiveness input measure was change in total cholesterol/high-density lipoprotein ratio obtained from the EASEGO study. In conformity with published studies linking reduced lipid levels to reduced risk of cardiovascular events, the present model assumed that a lipid decrease with e...

Introduction. The FSAP-Marburg I polymorphism (1704G > A), which reduces FSAP activity, is associ... more Introduction. The FSAP-Marburg I polymorphism (1704G > A), which reduces FSAP activity, is associated with late complications of carotid stenosis in humans. Therefore, this study examines the influence of the Marburg I polymorphism and the closely linked Marburg II polymorphism (1280G > C) on various cardiovascular outcomes in two large independent study populations. Methods. The two Marburg polymorphisms in the HABP2 gene encoding FSAP were genotyped in a large population of elderly patients at risk for vascular disease (the PROSPER-study, n = 5804) and in a study population treated with a percutaneous coronary intervention (the GENDER-study, n = 3104). Results. In the PROSPER study, the Marburg I polymorphism was associated with an increased risk of clinical stroke (HR: 1.60, 95% CI: 1.13-2.28) and all-cause mortality (HR: 1.33, 95% CI: 1.04-1.71). In the GENDER study carriers of this variant seemed at lower risk of developing restenosis (HR: 0.59, 95% CI: 0.34-1.01). The Marburg II polymorphism showed similar but weaker results. Conclusion. The increase in stroke risk in Marburg I carriers could be due to differential effects on smooth muscle cells and on matrix metalloproteinases, thereby influencing plaque stability. The possible protective effect on restenosis could be the result of reduced activation of zymogens, which are involved in hemostasis and matrix remodeling.

Nephrology Dialysis Transplantation, 2014

Introduction and Aims: Dialysis patients have high mortality risk with cardiovascular mortality a... more Introduction and Aims: Dialysis patients have high mortality risk with cardiovascular mortality as an important cause of death. Chronic kidney disease specific risk factors implicated in these processes include chronic inflammatory state with up-regulation of inflammatory cytokines and altered growth factor levels, altered calcium/phosphate metabolism and coagulation as well as endothelial dysfunction. Alterations in the genetic profile of these processes in dialysis patients may further increase this dysbalance and enhance morbidity and mortality. The aim of this study was to investigate the association between SNPs involved in the abovementioned processes and cardiovascular and non-cardiovascular mortality in a large population of incident dialysis patients. Methods: We included 1330 incident dialysis patients in which 42 SNPs in 25 genes involved in vascular processes (endothelial function and vascular remodeling, growth factors, inflammation, coagulation, and calcium/phosphate metabolism) were genotyped. Cox regression analysis was used to investigate the effect of these SNPs on five-years mortality. Results: The mortality rate was 114 per 1000 person-years for the 1330 dialysis patients. Cardiovascular mortality accounted for 49,4% of these deaths, whereas 50,6% (240/474) were not cardiovascular related. We found that VEGF rs2010963 and TNF rs1799964 were protective for cardiovascular mortality in dialysis patients, whereas VEGF rs699947 was associated with increased risk of cardiovascular mortality (Table 1). In addition, MMP-1 rs11292517 and VDR rs2238135 were associated with decreased risk of non-cardiovascular mortality, while rs9804922 in an intergenic region on 12q23.2, CD180 rs5744478 and interleukin-6 rs1800795 were associated with an increased non-cardiovascular mortality risk (Table 2). No significant associations with mortality were observed with the other SNPs. Conclusions: In this large cohort of dialysis patients, we found that two SNPs involved in endothelial function and remodeling, three SNPs related to inflammatory processes, two SNPs in genes encoding for growth factors, and one SNP related to vitamin D metabolism were associated with mortality risk. This study provides further evidence for an important role of these processes in the comorbid conditions of dialysis patients. Future studies are warranted to unravel the underlying mechanisms responsible for the increased mortality in these patients.

Journal of Cardiovascular Magnetic Resonance, 2012

Background: The Bramwell-Hill model describes the relation between vascular wall stiffness expres... more Background: The Bramwell-Hill model describes the relation between vascular wall stiffness expressed in aortic distensibility and the pulse wave velocity (PWV), which is the propagation speed of the systolic pressure wave through the aorta. The main objective of this study was to test the validity of this model locally in the aorta by using PWV-assessments based on in-plane velocity-encoded cardiovascular magnetic resonance (CMR), with invasive pressure measurements serving as the gold standard. Methods: Seventeen patients (14 male, 3 female, mean age ± standard deviation = 57 ± 9 years) awaiting cardiac catheterization were prospectively included. During catheterization, intra-arterial pressure measurements were obtained in the aorta at multiple locations 5.8 cm apart. PWV was determined regionally over the aortic arch and locally in the proximal descending aorta. Subsequently, patients underwent a CMR examination to measure aortic PWV and aortic distention. Distensibility was determined locally from the aortic distension at the proximal descending aorta and the pulse pressure measured invasively during catheterization and non-invasively from brachial cuff-assessment. PWV was determined regionally in the aortic arch using through-plane and in-plane velocity-encoded CMR, and locally at the proximal descending aorta using in-plane velocity-encoded CMR. Validity of the Bramwell-Hill model was tested by evaluating associations between distensibility and PWV. Also, theoretical PWV was calculated from distensibility measurements and compared with pressure-assessed PWV. Results: In-plane velocity-encoded CMR provides stronger correlation (p = 0.02) between CMR and pressureassessed PWV than through-plane velocity-encoded CMR (r = 0.69 versus r = 0.26), with a non-significant mean error of 0.2 ± 1.6 m/s for in-plane versus a significant (p = 0.006) error of 1.3 ± 1.7 m/s for through-plane velocityencoded CMR. The Bramwell-Hill model shows a significantly (p = 0.01) stronger association between distensibility and PWV for local assessment (r = 0.8) than for regional assessment (r = 0.7), both for CMR and for pressureassessed PWV. Theoretical PWV is strongly correlated (r = 0.8) with pressure-assessed PWV, with a statistically significant (p = 0.04) mean underestimation of 0.6 ± 1.1 m/s. This theoretical PWV-estimation is more accurate when invasively-assessed pulse pressure is used instead of brachial cuff-assessment (p = 0.03). Conclusions: CMR with in-plane velocity-encoding is the optimal approach for studying Bramwell-Hill associations between local PWV and aortic distensibility. This approach enables non-invasive estimation of local pulse pressure and distensibility.

The International Journal of Cardiovascular Imaging, 2009

The International Journal of Cardiovascular Imaging, 2009

The International Journal of Cardiovascular Imaging, 2009

Recent years have witnessed a rapid development of multi-slice computed tomography (MSCT) technol... more Recent years have witnessed a rapid development of multi-slice computed tomography (MSCT) technology. The number of detector rows has increased from 4-slices to the current availability of 64-slice and even 320-slice systems. In addition, images are acquired with thinner slices and faster rotation times resulting in substantially improved image quality and diagnostic accuracy. Simultaneously, effective dose reduction acquisition techniques have been developed allowing considerable reduction of the radiation dose. Conceivably, these advancements may allow further expansion of the use of MSCT beyond the visual assessment of the presence or absence of significant coronary artery disease. Indeed, a particular advantage of the technique is that in addition to evaluation of the coronary arteries it also allows assessment of cardiac structures and function. The purpose of the current review is to discuss several novel applications of cardiac MSCT, including stenosis quantification, atherosclerotic plaque imaging and prognostification as well as imaging of left ventricular function, aortic and mitral valve anatomy using state-of-the-art technology.

The International Journal of Cardiovascular Imaging, 2010

The International Journal of Cardiovascular Imaging, 2010

The International Journal of Cardiovascular Imaging, 2009

The International Journal of Cardiovascular Imaging, 2011

The purpose of this study was to evaluate the performance of 320-row computed tomography angiogra... more The purpose of this study was to evaluate the performance of 320-row computed tomography angiography (CTA) in the identification of significant coronary artery disease (CAD) in patients presenting with acute chest pain and to examine the relation to outcome during follow-up. A total of 106 patients with acute chest pain underwent CTA to evaluate presence of CAD. Each CTA was classified as: normal, nonsignificant CAD (\50% luminal narrowing) and significant CAD (C50% luminal narrowing). CTA results were compared with quantitative coronary angiography. After discharge, the following cardiovascular events were recorded: cardiac death, non-fatal infarction, and unstable angina requiring revascularization. Among the 106 patients, 23 patients (22%) had a normal CTA, 19 patients (18%) had non-significant CAD on CTA, 59 patients (55%) had significant CAD on CTA, and 5 patients (5%) had non-diagnostic image quality. In total, 16 patients (15%) were immediately discharged after normal CTA and 90 patients (85%) underwent invasive coronary angiography. Sensitivity, specificity, and positive and negative predictive values to detect significant CAD on CTA were 100, 87, 93, and 100%, respectively. During mean follow-up of 13.7 months, no cardiovascular events occurred in patients with a normal CTA examination. In patients with non-significant CAD on CTA, no cardiac death or myocardial infarctions occurred and only 1 patient underwent revascularization due to unstable angina. In patients presenting with acute chest pain, an excellent clinical performance for the non-invasive assessment of significant CAD was demonstrated using CTA. Importantly, normal or non-significant CAD on CTA predicted a low rate of adverse cardiovascular events and favorable outcome during follow-up.

The International Journal of Cardiovascular Imaging, 2011

International Journal of Cardiology, 2013

European Heart Journal, 2010

This editorial refers to 'A variant at chromosome 9p21 is associated with recurrent myocardial in... more This editorial refers to 'A variant at chromosome 9p21 is associated with recurrent myocardial infarction and cardiac death after acute coronary syndrome: The GRACE Genetics Study' † , by I. Buysschaert et al. on page 1132

European Heart Journal, 2012