Top

The International Journal of Cardiovascular Imaging

Published in:

01-04-2009 | Original Paper

Strain imaging in echocardiography: methods and clinical applications

Authors: Gillian C. Nesbitt, Sunil Mankad, Jae K. Oh

Published in: The International Journal of Cardiovascular Imaging | Special Issue 1/2009

Abstract

Echocardiography is the most common diagnostic method for assessing cardiac functions. However, echocardiographic measures are subjective, semi-quantitative, and relatively insensitive when detecting subtle perturbations in contractility. Furthermore, early detection of abnormalities is crucial and may often influence treatments and establish prognosis. Echocardiographic- and Doppler-derived strain and strain rate imaging are relatively newer and more comprehensive techniques. They characterize the mechanics of myocardial contraction and relaxation (deformation imaging) more precisely and find applications in many cardiac pathologies. They are especially useful for assessing longitudinal myocardial deformation, which is otherwise difficult to assess using standard echocardiographic visual inspection. This review describes the fundamental concepts of strain imaging derived from tissue Doppler and two-dimensional speckle tracking and investigates how these methods can be incorporated into echocardiographic examinations and highlights their clinical applications. The considerable potentiality of imaging modalities for numerous cardiac conditions is thereby shown.

Curtis JP, Sokol SI, Wang Y et al (2003) The association of left ventricular ejection fraction, mortality, and cause of death in stable outpatients with heart failure. J Am Coll Cardiol 42(4):736–742. doi:10.1016/S0735-1097(03)00789-7 PubMedCrossRef

Greenbaum RA, Ho SY, Gibson DG et al (1981) Left ventricular fibre architecture in man. Br Heart J 45(3):248–263. doi:10.1136/hrt.45.3.248 PubMedCrossRef

Pellikka PA, Nagueh SF, Elhendy AA et al (2007) American society of echocardiography recommendations for performance, interpretation and application of stress echocardiography. J Am Soc Echocardiogr 20(9):1021–1041. doi:10.1016/j.echo.2007.07.003 PubMedCrossRef

Hoffmann R, Lethen H, Marwick T et al (1996) Analysis of interinstitutional observer agreement in interpretation of dobutamine stress echocardiograms. J Am Coll Cardiol 27(2):330–336. doi:10.1016/0735-1097(95)00483-1 PubMedCrossRef

Gorcsan J 3rd, Deswal A, Mankad S et al (1998) Quantification of the myocardial response to low-dose dobutamine using tissue Doppler echocardiographic measures of velocity and velocity gradient. Am J Cardiol 81(5):615–623. doi:10.1016/S0002-9149(97)00973-9 PubMedCrossRef

Heimdal A, Stoylen A, Torp H et al (1998) Real-time strain rate imaging of the left ventricle by ultrasound. J Am Soc Echocardiogr 11(11):1013–1019. doi:10.1016/S0894-7317(98)70151-8 PubMedCrossRef

Mirsky I, Parmley WW (1973) Assessment of passive elastic stiffness for isolated heart muscle and the intact heart. Circ Res 33(2):233–243PubMed

Urheim S, Edvardsen T, Torp H et al (2000) Myocardial strain by Doppler echocardiography validation of a new method to quantify regional myocardial function. Circulation 102(10):1158–1164PubMed

Aurigemma GP, Douglas PS, Gaasch HW (2002) Quantitative evaluation of left ventricular structure, wall stress and systolic function. In: Otto CM (ed) The practice of clinical echocardiography. WB Saunders Company, Philadelphia, pp 65–87

10.

Stoylen A, Heimdal A, Bjornstad K et al (1999) Strain rate imaging by ultrasound in the diagnosis of regional dysfunction of the left ventricle. Echocardiography 16(4):321–329. doi:10.1111/j.1540-8175.1999.tb00821.x PubMedCrossRef

11.

Zerhouni EA, Parish DM, Rogers WJ et al (1988) Human heart: tagging with MR imaging—a method of noninvasive assessment of myocardial motion. Radiology 169(1):59–63PubMed

12.

Axel L, Dougherty L (1989) MR imaging of motion with spatial modulation of magnetization. Radiology 171(3):841–845PubMed

13.

Sutherland GR, Steward MJ, Groundstroem KW et al (1994) Color Doppler myocardial imaging: a new technique for the assessment of myocardial function. J Am Soc Echocardiogr 7:441–458PubMed

14.

Uematsu M, Miyatake K, Tanaka N et al (1995) Myocardial velocity gradient as a new indicator of regional left ventricular contraction: detection by a two-dimensional Doppler imaging technique. J Am Coll Cardiol 26(1):217–223. doi:10.1016/0735-1097(95)00158-V PubMedCrossRef

15.

Edvardsen T, Gerber BL, Garot J et al (2002) Quantitative assessment of intrinsic regional myocardial deformation by Doppler strain rate echocardiography in humans: validation against three-dimensional tagged magnetic resonance imaging. Circulation 106(1):50–56. doi:10.1161/01.CIR.0000019907.77526.75 PubMedCrossRef

16.

Amundsen BH, Helle-Valle T, Edvardsen T et al (2006) Noninvasive myocardial strain measurement by speckle tracing echocardiography: validation against sonomicrometry and tagged magnetic resonance imaging. J Am Coll Cardiol 47(4):789–793. doi:10.1016/j.jacc.2005.10.040 PubMedCrossRef

17.

Hanekom L, Cho GY, Leano R et al (2007) Comparison of two-dimensional speckle and tissue Doppler strain measurement during dobutamine stress echocardiography: an angiographic correlation. Eur Heart J 28(14):1765–1772. doi:10.1093/eurheartj/ehm188 PubMedCrossRef

18.

Perk G, Tunick PA, Kronzon I (2007) Non-Doppler two-dimensional strain imaging by echocardiography—from technical considerations to clinical applications. J Am Soc Echocardiogr 20(3):234–243. doi:10.1016/j.echo.2006.08.023 PubMedCrossRef

19.

Pirat B, Khoury DS, Hartley CJ et al (2008) A novel feature-tracking echocardiographic method for the quantitation of regional myocardial function: validation in an animal model of ischemia–reperfusion. J Am Coll Cardiol 51(6):651–659. doi:10.1016/j.jacc.2007.10.029 PubMedCrossRef

20.

Voigt JU, Arnold MF, Karlsson M et al (2000) Assessment of regional longitudinal myocardial strain rate derived from Doppler myocardial imaging indexes in normal and infarcted myocardium. J Am Soc Echocardiogr 13(6):588–598. doi:10.1067/mje.2000.105631 PubMedCrossRef

21.

Weidemann F, Wacker C, Rauch A et al (2006) Sequential changes of myocardial function during acute myocardial infarction, in the early and chronic phase after coronary intervention described by ultrasonic strain rate imaging. J Am Soc Echocardiogr 19(7):839–847. doi:10.1016/j.echo.2006.01.024 PubMedCrossRef

22.

Weidemann F, Jung P, Hoyer C et al (2007) Assessment of contractile reserve in patients with intermediate coronary lesions: a strain imaging study validated by invasive myocardial fractional flow reserve. Eur Heart J 28(12):1425–1432. doi:10.1093/eurheartj/ehm082 PubMedCrossRef

23.

Park TH, Nagueh SF, Khoury DS et al (2006) Impact of myocardial structure and function postinfarction on diastolic strain measurements: implications for assessment of myocardial viability. Am J Physiol Heart Circ Physiol 209(2):H724–H731

24.

Edvardsen T, Skulstad H, Aakhus S et al (2001) Regional myocardial systolic function during acute ischemia assessed by strain Doppler echocardiography. J Am Coll Cardiol 37(3):726–730. doi:10.1016/S0735-1097(00)01160-8 PubMedCrossRef

25.

Abraham TP, Nishimura RA, Holmes DR Jr et al (2002) Strain rate imaging for assessment of regional myocardial function: results from a clinical model of septal ablation. Circulation 105(12):1403–1406. doi:10.1161/01.CIR.0000013423.33806.77 PubMedCrossRef

26.

Armstrong G, Pasquet A, Fukamachi K et al (2000) Use of peak systolic strainas an index of regional myocardial function: comparison with tissue Doppler velocity during dobutamine stress and myocardial ischemia. J Am Soc Echocardiogr 13(8):731–737. doi:10.1067/mje.2000.105912 PubMedCrossRef

27.

Yip G, Khandheria B, Belohlavek M et al (2004) Strain echocardiography tracks dobutamine-induced decrease in regional myocardial perfusion in nonocclusive coronary stenosis. J Am Coll Cardiol 44(8):1664–1671. doi:10.1016/j.jacc.2004.02.065 PubMedCrossRef

28.

Hoffmann R, Altiok E, Nowak B et al (2002) Strain rate measurement by Doppler echocardiography allows improved assessment of myocardial viability in patients with depressed left ventricul function. J Am Coll Cardiol 39(3):443–449. doi:10.1016/S0735-1097(01)01763-6 PubMedCrossRef

29.

Hanekom L, Jenkins C, Jeffries L et al (2005) Incremental value of strain rate analysis as an adjunct to wall-motion scoring for assessment of myocardial viability by dobutamine echocardiography: a follow-up study after revascularization. Circulation 112(25):3892–3900. doi:10.1161/CIRCULATIONAHA.104.489310 PubMedCrossRef

30.

Zhang Y, Chan AK, Yu CM et al (2005) Strain rate imaging differentiates transmural from non-transmural myocardial infarction: a validation study using delayed-enhancement magnetic resonance imaging. J Am Coll Cardiol 46(5):864–871. doi:10.1016/j.jacc.2005.05.054 PubMedCrossRef

31.

Dandel M, Wellnhofer E, Lehmkuhl H et al (2006) Early detection of left ventricular wall motion alterations in heart allografts with coronary artery disease: diagnostic valvue of tissue Doppler and two-dimensional (2D) strain echocardiography. Eur J Echocardiogr 7:S127–S128. doi:10.1016/S1525-2167(06)60477-0 CrossRef

32.

Dandel M, Wellnhofer E, Hummel M et al (2003) Early detection of left ventricular dysfunction related to transplant coronary artery disease. J Heart Lung Transplant 22(12):1353–1364. doi:10.1016/S1053-2498(03)00055-X PubMedCrossRef

33.

Marciniak A, Eroglu E, Marciniak M et al (2007) The potential clinical role of strain and strain rate imaging in diagnosing acute rejection after heart transplantation. Eur J Echocardiogr 8(3):213–221. doi:10.1016/j.euje.2006.03.014 PubMedCrossRef

34.

Falk RH (2005) Diagnosis and management of the cardiac amyloidoses. Circulation 112(13):2047–2060. doi:10.1161/CIRCULATIONAHA.104.489187 PubMedCrossRef

35.

Koyama J, Ray-Sequin PA, Falk RH (2003) Longitudinal myocardial function assessed by tissue velocity, strain, and strain rate tissue Doppler echocardiography in patients with AL (primary) cardiac amyloidosis. Circulation 107(19):2446–2452. doi:10.1161/01.CIR.0000068313.67758.4F PubMedCrossRef

36.

Bellavia D, Pellikka PA, Abraham TP et al (2008) Evidence of impaired left ventricular systolic function by Doppler myocardial imaging in patients with systemic amyloidosis and no evidence of cardiac involvement by standard two-dimensional and Doppler echocardiography. Am J Cardiol 101(7):1039–1045. doi:10.1016/j.amjcard.2007.11.047 PubMedCrossRef

37.

Bellavia D, Abraham TP, Pellikka PA et al (2007) Detection of left ventricular systolic dysfunction in cardiac amyloidosis with strain rate echocardiography. J Am Soc Echocardiogr 20(10):1194–1202. doi:10.1016/j.echo.2007.02.025 PubMedCrossRef

38.

Dubrey SW, Cha K, Skinner M et al (1997) Familial and primary (AL) cardiac amyloidosis: echocardiography similar diseases with distinctly different clinical outcomes. Heart 78(1):74–82PubMed

39.

Ogiwara F, Koyama J, Ikeda S et al (2005) Comparison of the strain Doppler echocardiographic features of familial amyloid polyneuropathy (FAP) and light-chain amyloidosis. Am J Cardiol 95(4):538–540. doi:10.1016/j.amjcard.2004.10.029 PubMedCrossRef

40.

Wigle ED, Rakowski H, Kimball BP et al (1995) Hypertrophic cardiomyopathy clinical spectrum and treatment. Circulation 92(7):1680–1692PubMed

41.

Seidman C (2002) Genetic causes of inherited cardiac hypertrophy: Robert L. Fyre lecture. Mayo Clin Proc 77(12):1315–1319PubMedCrossRef

42.

Maron BJ, Towbin JA, Thiene G et al (2006) Contemporary definitions and classification of the cardiomyopathies:an American Heart association scientific statement from the council on clinical cardiology, heart failure and transplantation committee; quality of care and outcomes research and functional genomics and translational biology interdisciplinary working groups;and council on epidemiology and prevention. Circulation 113(14):1807–1816. doi:10.1161/CIRCULATIONAHA.106.174287 PubMedCrossRef

43.

Palka P, Lange A, Fleming AD et al (1997) Differences in myocardial velocity gradient measured throughout the cardiac cycle in patients with hypertrophic cardiomyopathy, athletes, and patients with left ventricular hypertrophy due to hypertension. J Am Coll Cardiol 30(3):760–768. doi:10.1016/S0735-1097(97)00231-3 PubMedCrossRef

44.

Kato TS, Noda A, Izawa H et al (2004) Discrimination of nonobstructive hypertrophic cardiomyopathy from hypertensive left ventricular hypertrophy on the basis of strain rate imaging by tissue Doppler ultrasonography. Circulation 110(25):3808–3814. doi:10.1161/01.CIR.0000150334.69355.00 PubMedCrossRef

45.

Nagueh SF, Bachinski LL, Meyer D et al (2001) Tissue Doppler imaging consistently detects myocardial abnormalities in patients with hypertrophic cardiomyopathy and provides a novel means for an early diagnosis before and independently of hypertrophy. Circulation 104(2):128–130PubMed

46.

Maier SE, Fischer SE, McKinnon GC et al (1992) Evaluation of left ventricular segmental wall motion in hypertrophic cardiomyopathy with myocardial tagging. Circulation 86(6):1919–1928PubMed

47.

Yang H, Sun JP, Lever HM et al (2003) Use of strain imaging in detecting segmental dysfunction in patients with hypertrophic cardiomyopathy. J Am Soc Echocardiogr 16(3):233–239. doi:10.1067/mje.2003.60 PubMedCrossRef

48.

Kato TS, Izawa H, Komamura K et al (2008) Heterogeneity of regional systolic function detected by tissue Doppler imaging is linked to impaired global left ventricular relaxation in hypertrophic cardiomyopathy. Heart 94(10):1302–1306. doi:10.1136/hrt.2007.124453 PubMedCrossRef

49.

Carasso S, Yang H, Woo A et al (2008) Systolic myocardial mechanics in hypertrophic cardiomyopathy: novel concepts and implications for clinical status. J Am Soc Echocardiogr 21(6):675–683. doi:10.1016/j.echo.2007.10.021 PubMedCrossRef

50.

Carasso S, Woo A, Yang H et al (2008) Myocardial mechanics explains the time course of benefit for septal ethanol ablation for hypertrophic cardiomyopathy. J Am Soc Echocardiogr 21(5):494–499. doi:10.1016/j.echo.2007.08.020

51.

Rakowski H, Carasso S (2007) Quantifying diastolic function in hypertrophic cardiomyopathy: the ongoing search for the holy grail. Circulation 116(23):2662–2665. doi:10.1161/CIRCULATIONAHA.107.742395 PubMedCrossRef

52.

Corrado D, Fontaine G, Marcus FI et al (2000) Arrhythmogenic right ventricular dysplasia/cardiomyopathy: need for an international registry. Study Group on arrhythmogenic right ventricular dysplasia/cardiomyopathy of the working groups on myocardial and pericardial disease and arrhythmias of the European society of cardiology and of the scientific council on cardiomyopathies of the World heart federation. Circulation 101(11):E101–E106PubMed

53.

Prakasa KR, Wang J, Tandri H et al (2007) Utility of tissue Doppler and strain echocardiography in arrhythmogenic right ventricular dysplasia/cardiomyopathy. Am J Cardiol 100(3):507–512. doi:10.1016/j.amjcard.2007.03.053 PubMedCrossRef

54.

Pirat B, McCulloch ML, Zoghbi WA (2006) Evaluation of global and regional right ventricular systolic function in patients with pulmonary hypertension using a novel speckle tracking method. Am J Cardiol 98(5):699–704. doi:10.1016/j.amjcard.2006.03.056 PubMedCrossRef

55.

Agmon Y, Connolly HM, Olson LJ et al (1999) Noncompaction of the ventricular myocardium. J Am Soc Echocardiogr 12(10):859–863. doi:10.1016/S0894-7317(99)70192-6 PubMedCrossRef

56.

Alizad A, Seward JB (2000) Echocardiographic features of genetic diseases: part 1. Cardiomyopathy. J Am Soc Echocardiogr 13((1):73–86PubMed

57.

Williams RI, Masani ND, Buchalter MB et al (2003) Abnormal myocardial strain rate in noncompaction of the left ventricle. J Am Soc Echocardiogr 16(3):293–296. doi:10.1067/mje.2003.47 PubMedCrossRef

58.

Child JS, Perloff JK, Bach PM et al (1986) Cardiac Involvement in Friedreich’s ataxia: a clinical study of 75 patients. J Am Coll Cardiol 7(6):1370–1378PubMedCrossRef

59.

Weidemann F, Eyskens B, Mertens L et al (2003) Quantification of regional right and left ventricular function by ultrasonic strain rate and strain indexes in Friedreich’s ataxia. Am J Cardiol 91(5):622–626. doi:10.1016/S0002-9149(02)03325-8 PubMedCrossRef

60.

Dutka DP, Donnelly JE, Palka P et al (2000) Echocardiographic characterization of cardiomyopathy in Friedreich’s ataxia with tissue Doppler echocardiographically derived myocardial velocity gradients. Circulation 102(11):1276–1282PubMed

61.

Schiffmann R, Kopp JB, Austin HA 3rd et al (2001) Enzyme replacement therapy in Fabry disease: a randomized controlled trial. JAMA 285(21):2743–2749. doi:10.1001/jama.285.21.2743 PubMedCrossRef

62.

Pieroni M, Chimenti C, Ricci R et al (2003) Early detection of Fabry cardiomyopathy by tissue Doppler imaging. Circulation 107(15):1978–1984. doi:10.1161/01.CIR.0000061952.27445.A0 PubMedCrossRef

63.

Weidemann F, Breunig F, Beer M et al (2003) Improvement of cardiac function during enzyme replacement therapy in patients with Fabry disease: a prospective strain rate imaging study. Circulation 108(11):1299–1301. doi:10.1161/01.CIR.0000091253.71282.04 PubMedCrossRef

64.

Epstein AE, DiMarco JP, Ellenbogen KA et al (2008) ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities. Heart Rhythm 5(6):e1–e62. doi:10.1016/j.hrthm.2008.04.014 PubMedCrossRef

65.

Abraham WT, Fisher WG, Smith AL et al (2002) Cardiac resynchronization in chronic heart failure. N Engl J Med 346(24):1845–1853. doi:10.1056/NEJMoa013168 PubMedCrossRef

66.

Cleland JG, Daubart JC, Erdmann E et al (2005) The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med 352(15):1539–1549. doi:10.1056/NEJMoa050496 PubMedCrossRef

67.

Chung ES, Leon AR, Tavazzi L et al (2008) Results of the predictors of response to CRT (prospect) trial. Circulation 117(20):2608–2616. doi:10.1161/CIRCULATIONAHA.107.743120 PubMedCrossRef

68.

Yu CM, Zhang Q, Chan YS et al (2006) Tissue Doppler velocity is superior to displacement and strain mapping in predicting left ventricular reverse remodeling response after cardiac resynchronisation therapy. Heart 92(10):1452–1456. doi:10.1136/hrt.2005.083592 PubMedCrossRef

69.

Yu CM, Gorcsan J 3rd, Bleeker GB et al (2007) Usefulness of tissue Doppler velocity and strain dyssynchrony for predicting left ventricular reverse remodeling response after cardiac resynchronization therapy. Am J Cardiol 100(8):1263–1270. doi:10.1016/j.amjcard.2007.05.060 PubMedCrossRef

70.

Knebel F, Schattke S, Bondke H et al (2007) Evaluation of longitudinal and radial two-dimensional strain imaging versus Doppler tissue echocardiography in predicting long-term response to cardiac resynchronization therapy. J Am Soc Echocardiogr 20(4):335–341. doi:10.1016/j.echo.2006.09.007 PubMedCrossRef

71.

Miyazaki C, Lin G, Powell BD et al (2008) Strain dyssynchrony index correlates with improvement in left ventricular volume after cardiac resynchronization therapy better than tissue velocity dyssynchrony indexes. Circ Cardiovasc Imaging 1:14–22. doi:10.1161/CIRCIMAGING.108.774513 CrossRefPubMed

72.

Miyazaki C, Powell BD, Bruce CJ et al (2008) Comparison of echocardiographic dyssynchrony assessment by tissue velocity and strain imaging in subjects with or without systolic dysfunction and with or without left bundle-branch block. Circulation 117(20):2617–2625. doi:10.1161/CIRCULATIONAHA.107.733675 PubMedCrossRef

73.

Mele D, Pasanisi G, Capasso F et al (2006) Left intraventricular myocardial deformation dyssynchrony identifies responders to cardiac resynchronization therapy in patients with heart failure. Eur Heart J 27(9):1070–1078. doi:10.1093/eurheartj/ehi814 PubMedCrossRef

74.

Dohi K, Suffoletto MS, Schwartzman D et al (2005) Utility of echocardiographic radial strain imaging to quantify left ventricular dyssynchrony and predict acute response to cardiac resynchronization therapy. Am J Cardiol 96(1):112–116. doi:10.1016/j.amjcard.2005.03.032 PubMedCrossRef

75.

Suffoletto MS, Dohi K, Cannesson M et al (2006) Novel speckle-tracking radial strain from routine black-and-white echocardiographic images to quantify dyssynchrony and predict response to cardiac resynchronization therapy. Circulation 113(7):960–968. doi:10.1161/CIRCULATIONAHA.105.571455 PubMedCrossRef

76.

Delgado V, Ypenburg C, van Bommel RJ et al (2008) Assessment of left ventricular dyssynchrony by speckle tracking strain imaging comparison between longitudinal, circumferential, and radial strain in cardiac resynchronization therapy. J Am Coll Cardiol 51(2):1944–1952. doi:10.1016/j.jacc.2008.02.040 PubMedCrossRef

77.

Lim P, Buakhamsri A, Popovic ZB et al (2008) Longitudinal strain delay index by speckle tracking imaging: a new marker of response to cardiac resynchronization therapy. Circulation 118(11):1130–1137. doi:10.1161/CIRCULATIONAHA.107.750190 PubMedCrossRef

78.

Park SJ, Miyazaki C, Bruce CJ et al (2008) Left ventricular torsion by two-dimensional speckle tracking echocardiography in patients with diastolic dysfunction and normal ejection fraction. J Am Soc Echocardiogr 21(10):1129–1137. doi:10.1016/j.echo.2008.04.002 PubMedCrossRef

Title: Strain imaging in echocardiography: methods and clinical applications
Authors: Gillian C. Nesbitt
Sunil Mankad
Jae K. Oh
Publication date: 01-04-2009
Publisher: Springer Netherlands
Published in: The International Journal of Cardiovascular Imaging / Issue Special Issue 1/2009
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-008-9414-1

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Strain imaging in echocardiography: methods and clinical applications

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Special Issue 1/2009

Launching of a new cardiovascular imaging society: the Asian Society of Cardiovascular Imaging

Suggestion for a new image-based aortic wall stiffness evaluation technique: arterial wall stiffness index

CT coronary angiography of chronic total occlusions of the coronary arteries: how to recognize and evaluate and usefulness for planning percutaneous coronary interventions

History of cardiac computed tomography: single to 320-detector row multislice computed tomography

A study of in vitro and in vivo MR of free-breathing whole-heart 3D coronary angiography using parallel imaging

Incidental extracardiac findings at cardiac CT angiography: comparison of prevalence and clinical significance between precontrast low-dose whole thoracic scan and postcontrast retrospective ECG-gated cardiac scan

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page