Cardiovascular Computed Tomography and Magnetic Resonance: History and Growing Impact in Brazil and in the World

Tomography, X-Ray Computed/history; Tomography,X-Ray Computed/trends; Diagnostic Imaging/trends; Diagnostic Imaging/history; Magnetic Resonance Spectroscopy/history

Growth in Brazil and in the World

Cardiovascular computed tomography and magnetic resonance are an important topic within the area of cardiovascular imaging in Brazil and in the world. In the Arquivos Brasileiros de Cardiologia this is not different, and despite the increased focus in clinical study, these two topics have grown in impact and scientific publications in recent years.

It is notorious the expansion of the national technological park with entrance of countless devices capable of performing advanced studies using cardiovascular tomography and magnetic resonance with increasing impetus for opening more centers specialized in these methods.

When we perform a systematic review using EndNote as a search tool and select only PubMed as a database with the words "magnetic resonance" and "computed tomography", in the Arquivos Brasileiros de Cardiologia alone we observe a total of 182 studies (Figure 1).

Figure 1
Number of publications in the Arquivos Brasileiros de Cardiologia with exclusive focus on cardiovascular computed tomography and magnetic resonance.

In parallel, when we perform a search on PubMed using the word "cardiac" and the MeSH (Medical Subject Headings) terms "computed tomography" and "magnetic resonance imaging", we find a sum of publications close to 45 thousand articles (44,711 articles) (Figure 2).

Figure 2
Number of publications in PubMed with exclusive focus on cardiovascular computed tomography and magnetic resonance.

These graphics turn out to be merely illustrative, but are without doubt markers of the impact of these methods in Brazil (Figure 1) and in the world (Figure 2). It is easy to identify that after the year 2000 and in the last decade there has been a large insertion of these methods in the scientific scenario and we believe that this reflects also in the clinical scenario.

History in the Arquivos Brasileiros de Cardiologia

The first studies published in the Arquivos Brasileiros de Cardiologia were basically clinical studies and case reports in which the methods were able to contribute to a better diagnosis ^1-4. The first original articles emerged with the use of magnetic resonance imaging in the study by Kalil Filho et al ^5,6 in the year of 1995. At that same year, guided by Pinto et al ⁷, emerged the first Brazilian consensus for the use of cardiac magnetic resonance imaging in clinical cardiology. Computed tomography had its first original study published in 1997, by Kalil et al ⁸. One of the pioneering studies in the path of the evaluation of the current calcium score was performed by Feldman et al ⁹.

Relationship with International Societies

We currently have two international societies dedicated specifically to these methods. The SCMR (Society for Cardiovascular Magnetic Resonance) was the first society to be founded and by the year 2000, it was already organizing the process of credentialing for those dedicated to cardiovascular magnetic resonance ¹⁰. The SCCT (Society of Cardiovascular Computed Tomography) was founded shortly after, following the advances of the method, and in 2009, made available its guidelines for better practice of the method ^11,12. In Brazil, the Arquivos Brasileiros de Cardiologia had a fundamental role in the publication of our first guideline ¹³, which was updated this year (2014) and is currently undergoing editing for future publication.

Scientific and Educational Organization in Brazil

In the early days of the organization in Brazil, a study group of cardiovascular magnetic resonance and computed tomography called GERT was formed and played a key role in the diffusion of knowledge throughout Brazil. A group of physicians dedicated to cardiovascular computed tomography and magnetic resonance created in Brazil the National Meeting of Cardiac Radiology (Encontro Nacional de Radiologia Cardíaca, ENRC), which will be on its eighth consecutive year in 2015. This group is composed of radiologists and cardiologists supported by SCMR and SCCT, along with national societies, to enhance the methods in Brazil and discuss the experiences in national territory. Similarly, SBC's Department of Cardiovascular Imaging (DIC), bringing together specialists in nuclear medicine, echocardiography, vascular ultrasound, and cardiovascular magnetic resonance and computed tomography, gathers annually in a meeting with almost 2 thousand participants and maintains the role of diffusing knowledge in the areas of cardiovascular magnetic resonance and computed tomography started with GERT.

We still have only a few training centers of experts in the field, mostly in the Rio-São Paulo hub, but in the last 5 years an increasing number of private institutions and university hospitals are strengthening teaching and research in the area. Many who are currently in charge of the specialized centers in Brazil sought their expertises in international centers and we believe that in the near future this reality will no longer be true, since we will have large groups throughout the country.

Worldwide Impact of the Latest Publications by Brazilians

The increasing group of people involved in cardiovascular imaging in Brazil and in the world culminated in an explosion of publications dedicated to standardization and proper use of the method over the last years ^14-31.

Some pioneering work of great international impact has been elaborated by Brazilians and we managed, through this editorial, to draw attention to each one in their area.

- Computed Tomography

Assessment of the coronaries – The study conducted by Miller et al ³² had one of the highest scientific impact and collaboration of three Brazilians, one of which was the principal investigator, and also had the largest number of patients included in the study by a Brazilian center. Published in The New England Journal of Medicine , the authors concluded that computed tomography can identify the presence and severity of coronary artery disease with good accuracy, but when positive, could not replace conventional coronary angiography. Recently, tomography showed its value in patients with acute coronary syndrome ³³.

Assessment of myocardial perfusion – The studies by Cury et al³⁴, first published in Radiology, brought a new proposal for the use of computed tomography in the evaluation of myocardial ischemia. With simple protocols and easy clinical applicability, it managed to demonstrate that myocardial perfusion on computed tomography has good correlation with SPECT and with conventional coronary angiography in identifying stenosis of native vessels³⁵ or with stent³⁶. The first multicenter study validating this new technique to detect myocardial ischemia was recently published by Rochitte et al³⁷. This study reported high accuracy for detecting meaningful stenoses associated with perfusion defects in the same territory evaluated by tomography when compared with the combination of invasive catheterization with SPECT scintigraphy, and with a lower cost of radiation dose. Thus, this new method is able to diagnose hemodynamically meaningful stenoses or those associate with a reduction of myocardial blood flow.

Evaluation of volumes and function – The quantification of ventricular volumes and function has been validated against other methods of great clinical applicability^38,39, but recently the use of these measurements demonstrated a great potential for detection of cardiovascular risk and mortality⁴⁰.

Evaluation of focal fibrosis – In studies by Shiozaki et al^41,42 we can observe that, in addition to the ability to detect focal fibrosis, tomography can be used to predict ventricular arrhythmias. This field is of great importance because some patients are unable to undergo magnetic resonance and can benefit with this new technique.

Evaluation of interstitial fibrosis – In quantifying interstitial fibrosis by computed tomography, the studies by Nacif et al^43,44 were pioneers and open a potential for evaluating subclinical myocardial damage not previously possible in the context of cardiomyopathies.

Epidemiological impact – The studies by Bittencourt et al^45,46 demonstrated the prognostic potential of computed tomography in symptomatic patients with nonobstructive and obstructive coronary disease. However, Prazeres et al⁴⁷ were able to summarize in an unique way the potential of the technique for use in the emergency room, with potential of cost reduction for low-probability patients.

- Magnetic Resonance

Assessment of the coronaries – Evaluation of the coronary arteries by magnetic resonance is currently limited to the characterization of the origin or evaluation of the proximal thirds of the main vessels. Recently, new techniques and use of specific vascular contrast created a new horizon for implementation of this method which is free of ionizing radiation. Nacif et al ⁴⁸ demonstrated that the intravenous contrast medium Gadofosveset trisodium had a slightly better performance than the contrast media routinely used.

Assessment of myocardial perfusion – Since the initial studies on the characterization of microvascular obstruction by Rochitte et al⁴⁹ in 1998, until the clinical applicability of the evaluation of myocardial ischemia by Cury et al⁵⁰ in 2006, and the use of multimodal (combined) resonance techniques for characterization of coronary artery disease by de Mello et al⁵¹ in 2012, we are able to observe the current maturity of the method in the country.

Evaluation of volumes and function – After years using indexing and morphological, volumetric and functional values ​​of international studies, we can say that in a pioneer way, Macedo et al⁵² were able to demonstrate in a Brazilian population different morphological and volumetric standards for men and women. Nacif et al⁵³ demonstrated that there are several ways to quantify atrial volume and that all correlate with one another.

Evaluation of iron deposits – The studies by Fernandes et al^54-56 are of great importance for standardization and evaluation of patients with hepatic and myocardial iron storage.

Evaluation of focal fibrosis – In this topic of publications, there are countless contributions by Brazilians in the impact of the method worldwide, but without a doubt one of the most discussed was the study by Azevedo et al⁵⁷ who were able to demonstrate the importance of detection and quantification of delayed myocardial enhancement in patients who underwent aortic valve replacement with great implication in left ventricular functional improvement and evaluation of mortality.

Evaluation of interstitial fibrosis – The studies by Mongeon et al⁵⁸, Coelho-Filho et al⁵⁹, Nacif et al⁴⁴, Sibley et al⁶⁰ and Liu et al⁶¹ were pioneers in the evaluation of interstitial fibrosis by techniques of T1 map and quantification of extracellular volume.

Epidemiological impact – Without a doubt, magnetic resonance is one of the best methods for quantification of myocardial fibrosis. When present, myocardial fibrosis is associated with increased mortality and worse prognosis⁶². In Brazil, in addition to the diseases commonly evaluated in the world, we have Chagas disease that was very well studied by Rochitte et al^63,64. Now, one of the studies with a major impact on clinical decision using the method was in the risk reclassification using stressor agents⁶⁵.

Impact of the Latest Publications in the Arquivos Brasileiros de Cardiologia

The Arquivos Brasileiros de Cardiologia function as a national thermometer and a main scientific channel reflecting this explosion of publications. The article by Duarte⁶⁶, published in 2010, clearly demonstrates the growth of computed tomography and its impact on the detection of coronary artery disease. Over the past decade, we observed an increasing number of review articles^67-75 and original articles^47,52,76-90, which reinforces the impact of tomography and magnetic resonance in current cardiovascular imaging.

Finally, it is not possible to include all studies by Brazilian authors due to the increasing number of publications in the area, but we are sure that we are entering a new era of cardiovascular imaging. The great development of technology applied to medicine causes computed tomography and magnetic resonance to grow increasingly, changing day-to-day the impact on clinical practice.

References

• ¹
  Stolf NA, Moreira FA, Beyruti R. [Myxoma of the left atrium: the value of computerized tomography in its diagnosis]. Arq Bras Cardiol. 1982;38(2):125-9.
• ²
  de Medeiros Sobrinho JH, Luiz C, Santos DL, da Silva MV, Fontes VF. [Radiological archway sign in the scimitar syndrome and its importance in surgery. Report of 3 cases]. Arq Bras Cardiol. 1983;41(2):125-30.
• ³
  Brito JC, Ribeiro AC, Carvalho HG, Tadeu E, Nery AC, Eloy R, Ribeiro NA. [The scimitar syndrome. Report of 7 cases]. Arq Bras Cardiol. 1984;42(2):139-43.
• ⁴
  Araujo JA, Torres JM, de Souza Neto JD, Barros RB, da Rocha FA, de Almeida AP. [Difficulties of angiography in the diagnosis of acute aortic dissection. A case report]. Arq Bras Cardiol. 1987;49(1):51-5.
• ⁵
  Kalil Filho R, Chacra AP, de Albuquerque CP, Soares PR, Antelmi I, Rosemberg L, et al. [Significance of the nuclear magnetic resonance in the detection of coronary artery patency after thrombolysis]. Arq Bras Cardiol. 1995;64(3):221-4.
• ⁶
  Kalil R, Bocchi EA, Ferreira BM, de Lourdes Higuchi M, Lopes NH, Magalhaes AC, et al. [Magnetic resonance imaging in chronic Chagas cardiopathy. Correlation with endomyocardial biopsy findings]. Arq Bras Cardiol. 1995;65(5):413-6.
• ⁷
  Pinto IM, da Luz PL, Magalhaes HM, Pavanello R, Abizaid A, Kambara AM, et al. [Consensus SOCESP-SBC on magnetic resonance imaging in cardiology]. Arq Bras Cardiol. 1995;65(5):451-7.
• ⁸
  Kalil RA, Feldman CJ, Ludwig FW, da Silva AD, Prates PR, Sant'Anna JR, et al. [Late evaluation with spiral computed tomography of smooth bovine pericardium grafts]. Arq Bras Cardiol. 1997;69(2):111-5.
• ⁹
  Feldman C, Vitola D, Schiavo N. Detection of coronary artery disease based on the calcification index obtained by helical computed tomography. Arq Bras Cardiol. 2000;75(6):471-80.
• ¹⁰
  Guidelines for credentialing in cardiovascular magnetic resonance (CMR). Society for Cardiovascular Magnetic Resonance (SCMR) Clinical Practice Committee. J Cardiovasc Magn Reson. 2000;2(3):233-4.
• ¹¹
  Abbara S, Arbab-Zadeh A, Callister TQ, Desai MY, Mamuya W, Thomson L, et al. SCCT guidelines for performance of coronary computed tomographic angiography: a report of the Society of Cardiovascular Computed Tomography Guidelines Committee. J Cardiovasc Comput Tomogr. 2009;3(3):190-204.
• ¹²
  Raff GL, Abidov A, Achenbach S, Berman DS, Boxt LM, Budoff MJ, et al; Society of Cardiovascular Computed Tomography. SCCT guidelines for the interpretation and reporting of coronary computed tomographic angiography. J Cardiovasc Comput Tomogr. 2009;3(2):122-36.
• ¹³
  Sociedade Brasileira de Cardiologia. Departamento de Cardiologia Clínica. Grupo de Estudos de Ressonância e Tomografia Cardiovascular (GERT). [Guideline of Sociedade Brasileira de Cardiologia for Resonance and cardiovascular tomography. Executive Summary]. Arq Bras Cardiol. 2006;87 Suppl 3:e1-12.
• ¹⁴
  Hendel RC, Patel MR, Kramer CM, Poon M, Hendel RC, Carr JC, et al; American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group; American College of Radiology; Society of Cardiovascular Computed Tomography; Society for Cardiovascular Magnetic Resonance; American Society of Nuclear Cardiology; North American Society for Cardiac Imaging; Society for Cardiovascular Angiography and Interventions; Society of Interventional Radiology. ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging: a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group, American College of Radiology, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, American Society of Nuclear Cardiology, North American Society for Cardiac Imaging, Society for Cardiovascular Angiography and Interventions, and Society of Interventional Radiology. J Am Coll Cardiol. 2006;48(7):1475-97.
• ¹⁵
  Taylor AJ, Cerqueira M, Hodgson JM, Mark D, Min J, O'Gara P, et al; American College of Cardiology Foundation Appropriate Use Criteria Task Force; Society of Cardiovascular Computed Tomography; American College of Radiology; American Heart Association; American Society of Echocardiography; American Society of Nuclear Cardiology; North American Society for Cardiovascular Imaging; Society for Cardiovascular Angiography and Interventions; Society for Cardiovascular Magnetic Resonance. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 Appropriate Use Criteria for Cardiac Computed Tomography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance. Circulation. 2010;122(21):e525-55.
• ¹⁶
  Patel MR, White RD, Abbara S, Bluemke DA, Herfkens RJ, Picard M, et al; American College of Radiology Appropriateness Criteria Committee; American College of Cardiology Foundation Appropriate Use Criteria Task Force. 2013 ACCF/ACR/ASE/ASNC/SCCT/SCMR appropriate utilization of cardiovascular imaging in heart failure: a joint report of the American College of Radiology Appropriateness Criteria Committee and the American College of Cardiology Foundation Appropriate Use Criteria Task Force. J Am Coll Cardiol. 2013;61(21):2207-31.
• ¹⁷
  Russo AM, Stainback RF, Bailey SR, Epstein AE, Heidenreich PA, Jessup M, et al. ACCF/HRS/AHA/ASE/HFSA/SCAI/SCCT/SCMR 2013 appropriate use criteria for implantable cardioverter-defibrillators and cardiac resynchronization therapy: a report of the American College of Cardiology Foundation appropriate use criteria task force, Heart Rhythm Society, American Heart Association, American Society of Echocardiography, Heart Failure Society of America, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance. Heart Rhythm. 2013;10(4):e11-58.
• ¹⁸
  White RD, Patel MR, Abbara S, Bluemke DA, Herfkens RJ, Picard M, et al; American College of Radiology; American College of Cardiology Foundation. 2013 ACCF/ACR/ASE/ASNC/SCCT/SCMR appropriate utilization of cardiovascular imaging in heart failure: an executive summary: a joint report of the ACR Appropriateness Criteria (R) Committee and the ACCF Appropriate Use Criteria Task Force. J Am Coll Radiol. 2013;10(7):493-500.
• ¹⁹
  Mark DB, Anderson JL, Brinker JA, Brophy JA, Casey DE Jr, Cross RR, et al. ACC/AHA/ASE/ASNC/HRS/IAC/Mended Hearts/NASCI/RSNA/SAIP/SCAI/SCCT/SCMR/SNMMI 2014 health policy statement on use of noninvasive cardiovascular imaging: a report of the American College of Cardiology Clinical Quality Committee. J Am Coll Cardiol. 2014;63(7):698-721.
• ²⁰
  Wolk MJ, Bailey SR, Doherty JU, Douglas PS, Hendel RC, Kramer CM, et al; American College of Cardiology Foundation Appropriate Use Criteria Task Force. ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2014;63(4):380-406.
• ²¹
  Mark DB, Berman DS, Budoff MJ, Carr JJ, Gerber TC, Hecht HS, et al; American College of Cardiology Foundation Task Force on Expert Consensus Documents. ACCF/ACR/AHA/NASCI/SAIP/SCAI/SCCT 2010 expert consensus document on coronary computed tomographic angiography: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. Catheter Cardiovasc Interv. 2010;76(2):E1-42.
• ²²
  Halliburton SS, Abbara S, Chen MY, Gentry R, Mahesh M, Raff GL, et al; Society of Cardiovascular Computed Tomography. SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT. J Cardiovasc Comput Tomogr. 2011;5(4):198-224.
• ²³
  Achenbach S, Delgado V, Hausleiter J, Schoenhagen P, Min JK, Leipsic JA. SCCT expert consensus document on computed tomography imaging before transcatheter aortic valve implantation (TAVI)/transcatheter aortic valve replacement (TAVR). J Cardiovasc Comput Tomogr. 2012;6(6):366-80.
• ²⁴
  Patel MR, Dehmer GJ, Hirshfeld JW, Smith PK, Spertus JA. ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 Appropriate use criteria for coronary revascularization focused update: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, American Society of Nuclear Cardiology, and the Society of Cardiovascular Computed Tomography. J Am Coll Cardiol. 2012;59(9):857-81. Erratum in: J Am Coll Cardiol. 2012;59(14):1336.
• ²⁵
  Lesser JR. SCCT International Regional Committees: the best future option for appropriate CT utilization. J Cardiovasc Comput Tomogr. 2013;7(2):145-6.
• ²⁶
  Leipsic J, Abbara S, Achenbach S, Cury R, Earls JP, Mancini GJ, et al. SCCT guidelines for the interpretation and reporting of coronary CT angiography: a report of the Society of Cardiovascular Computed Tomography Guidelines Committee. J Cardiovasc Comput Tomogr. 2014;8(5):342-58.
• ²⁷
  Raff GL, Chinnaiyan KM, Cury RC, Garcia MT, Hecht HS, Hollander JE, et al. SCCT guidelines on the use of coronary computed tomographic angiography for patients presenting with acute chest pain to the emergency department: a report of the Society of Cardiovascular Computed Tomography Guidelines Committee. J Cardiovasc Comput Tomogr. 2014;8(4):254-71.
• ²⁸
  Hundley WG, Bluemke DA, Finn JP, Flamm SD, Fogel MA, Friedrich MG, et al; American College of Cardiology Foundation Task Force on Expert Consensus Documents. ACCF/ACR/AHA/NASCI/SCMR 2010 expert consensus document on cardiovascular magnetic resonance: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. J Am Coll Cardiol. 2010;55(23):2614-62.
• ²⁹
  Fratz S, Chung T, Greil GF, Samyn MM, Taylor AM, Valsangiacomo Buechel ER, et al. Guidelines and protocols for cardiovascular magnetic resonance in children and adults with congenital heart disease: SCMR expert consensus group on congenital heart disease. J Cardiovasc Magn Reson. 2013;15:51.
• ³⁰
  Moon JC, Messroghli DR, Kellman P, Piechnik SK, Robson MD, Ugander M, et al; Society for Cardiovascular Magnetic Resonance Imaging; Cardiovascular Magnetic Resonance Working Group of the European Society of Cardiology. Myocardial T1 mapping and extracellular volume quantification: a Society for Cardiovascular Magnetic Resonance (SCMR) and CMR Working Group of the European Society of Cardiology consensus statement. J Cardiovasc Magn Reson. 2013;15:92.
• ³¹
  Schulz-Menger J, Bluemke DA, Bremerich J, Flamm SD, Fogel MA, Friedrich MG, et al. Standardized image interpretation and post processing in cardiovascular magnetic resonance: Society for Cardiovascular Magnetic Resonance (SCMR) board of trustees task force on standardized post processing. J Cardiovasc Magn Reson. 2013;15:35.
• ³²
  Miller JM, Rochitte CE, Dewey M, Arbab-Zadeh A, Niinuma H, Gottlieb I, et al. Diagnostic performance of coronary angiography by 64-row CT. N Engl J Med. 2008;359(22):2324-36.
• ³³
  Sara L, Rochitte CE, Lemos PA, Niinuma H, Dewey M, Shapiro EP, et al. Accuracy of multidetector computed tomography for detection of coronary artery stenosis in acute coronary syndrome compared with stable coronary disease: a CORE64 multicenter trial substudy. Int J Cardiol. 2014 Aug 27. [Epub ahead of print].
• ³⁴
  Cury RC, Nieman K, Shapiro MD, Butler J, Nomura CH, Ferencik M, et al. Comprehensive assessment of myocardial perfusion defects, regional wall motion, and left ventricular function by using 64-section multidetector CT. Radiology. 2008;248(2):466-75.
• ³⁵
  Cury RC, Magalhaes TA, Paladino AT, Shiozaki AA, Perini M, Senra T, et al. Dipyridamole stress and rest transmural myocardial perfusion ratio evaluation by 64 detector-row computed tomography. J Cardiovasc Comput Tomogr. 2011;5(6):443-8.
• ³⁶
  Magalhaes TA, Cury RC, Pereira AC, Moreira Vde M, Lemos PA, Kalil-Filho R, et al. Additional value of dipyridamole stress myocardial perfusion by 64-row computed tomography in patients with coronary stents. J Cardiovasc Comput Tomogr. 2011;5(6):449-58.
• ³⁷
  Rochitte CE, George RT, Chen MY, Arbab-Zadeh A, Dewey M, Miller JM, et al. Computed tomography angiography and perfusion to assess coronary artery stenosis causing perfusion defects by single photon emission computed tomography: the CORE320 study. Eur Heart J. 2014;35(17):1120-30.
• ³⁸
  Vieira ML, Nomura CH, Tranchesi Junior B, Oliveira WA, Naccarato G, Serpa BS, et al. Left ventricular ejection fraction and volumes as measured by 3d echocardiography and ultrafast computed tomography. Arq Bras Cardiol. 2009;92(4):294-301.
• ³⁹
  Vieira ML, Nomura CH, Tranchesi B Jr, de Oliveira WA, Naccarato G, Serpa BS, et al. Real-time three-dimensional echocardiographic left ventricular systolic assessment: side-by-side comparison with 64-slice multi-detector cardiac computed tomography. Eur J Echocardiogr. 2010;11(3):257-63.
• ⁴⁰
  Arsanjani R, Berman DS, Gransar H, Cheng VY, Dunning A, Lin FY, et al; CONFIRM Investigators. Left ventricular function and volume with coronary CT angiography improves risk stratification and identification of patients at risk for incident mortality: results from 7758 patients in the prospective multinational CONFIRM observational cohort study. Radiology. 2014;273(1):70-7.
• ⁴¹
  Shiozaki AA, Senra T, Arteaga E, Martinelli Filho M, Pita CG, Avila LF, et al. Myocardial fibrosis detected by cardiac CT predicts ventricular fibrillation/ventricular tachycardia events in patients with hypertrophic cardiomyopathy. J Cardiovasc Comput Tomogr. 2013;7(3):173-81.
• ⁴²
  Shiozaki AA, Senra T, Arteaga E, Pita CG, Martinelli Filho M, Avila LF, et al. [Myocardial fibrosis in patients with hypertrophic cardiomyopathy and high risk for sudden death]. Arq Bras Cardiol. 2010;94(4):535-40.
• ⁴³
  Nacif MS, Liu Y, Yao J, Liu S, Sibley CT, Summers RM, et al. 3D left ventricular extracellular volume fraction by low-radiation dose cardiac CT: assessment of interstitial myocardial fibrosis. J Cardiovasc Comput Tomogr. 2013;7(1):51-7.
• ⁴⁴
  Nacif MS, Kawel N, Lee JJ, Chen X, Yao J, Zavodni A, et al. Interstitial myocardial fibrosis assessed as extracellular volume fraction with low-radiation-dose cardiac CT. Radiology. 2012;264(3):876-83.
• ⁴⁵
  Bittencourt MS, Hulten E, Ghoshhajra B, O'Leary D, Christman MP, Montana P, et al. Prognostic value of nonobstructive and obstructive coronary artery disease detected by coronary computed tomography angiography to identify cardiovascular events. Circ Cardiovasc Imaging. 2014;7(2):282-91.
• ⁴⁶
  Hulten E, Bittencourt MS, Ghoshhajra B, O'Leary D, Christman MP, Blaha MJ, et al. Incremental prognostic value of coronary artery calcium score versus CT angiography among symptomatic patients without known coronary artery disease. Atherosclerosis. 2014;233(1):190-5.
• ⁴⁷
  Prazeres CE, Cury RC, Carneiro AC, Rochitte CE. Coronary computed tomography angiography in the assessment of acute chest pain in the emergency room. Arq Bras Cardiol. 2013;101(6):562-9.
• ⁴⁸
  Raman FS, Nacif MS, Cater G, Gai N, Jones J, Li D, et al. 3.0-T whole-heart coronary magnetic resonance angiography: comparison of gadobenate dimeglumine and gadofosveset trisodium. Int J Cardiovasc Imaging. 2013;29(5):1085-94.
• ⁴⁹
  Rochitte CE, Lima JA, Bluemke DA, Reeder SB, McVeigh ER, Furuta T, et al. Magnitude and time course of microvascular obstruction and tissue injury after acute myocardial infarction. Circulation. 1998;98(10):1006-14.
• ⁵⁰
  Cury RC, Cattani CA, Gabure LA, Racy DJ, de Gois JM, Siebert U, et al. Diagnostic performance of stress perfusion and delayed-enhancement MR imaging in patients with coronary artery disease. Radiology. 2006;240(1):39-45.
• ⁵¹
  de Mello RA, Nacif MS, dos Santos AA, Cury RC, Rochitte CE, Marchiori E. Diagnostic performance of combined cardiac MRI for detection of coronary artery disease. Eur J Radiol. 2012;81(8):1782-9.
• ⁵²
  Macedo R, Fernandes JL, Andrade SS, Rochitte CE, Lima KC, Maciel AC, et al. Morphological and functional measurements of the heart obtained by magnetic resonance imaging in Brazilians. Arq Bras Cardiol. 2013;101(1):68-77.
• ⁵³
  Nacif MS, Barranhas AD, Turkbey E, Marchiori E, Kawel N, Mello RA, et al. Left atrial volume quantification using cardiac MRI in atrial fibrillation: comparison of the Simpson's method with biplane area-length, ellipse, and three-dimensional methods. Diagn Interv Radiol. 2013;19(3):213-20.
• ⁵⁴
  Fernandes JL, Fabron A Jr, Verissimo M. Early cardiac iron overload in children with transfusion-dependent anemias. Haematologica. 2009;94(12):1776-7.
• ⁵⁵
  Fernandes JL, Sampaio EF, Fertrin K, Coelho OR, Loggetto S, Piga A, et al. Amlodipine reduces cardiac iron overload in patients with thalassemia major: a pilot trial. Am J Med. 2013;126(9):834-7.
• ⁵⁶
  Fernandes JL, Sampaio EF, Verissimo M, Pereira FB, da Silva JA, de Figueiredo GS, et al. Heart and liver T2 assessment for iron overload using different software programs. Eur Radiol. 2011;21(12):2503-10.
• ⁵⁷
  Azevedo CF, Nigri M, Higuchi ML, Pomerantzeff PM, Spina GS, Sampaio RO, et al. Prognostic significance of myocardial fibrosis quantification by histopathology and magnetic resonance imaging in patients with severe aortic valve disease. J Am Coll Cardiol. 2010;56(4):278-87.
• ⁵⁸
  Mongeon FP, Jerosch-Herold M, Coelho-Filho OR, Blankstein R, Falk RH, Kwong RY. Quantification of extracellular matrix expansion by CMR in infiltrative heart disease. JACC Cardiovasc Imaging. 2012;5(9):897-907.
• ⁵⁹
  Coelho-Filho OR, Shah RV, Neilan TG, Mitchell R, Moreno H Jr, Kwong R, et al. Cardiac magnetic resonance assessment of interstitial myocardial fibrosis and cardiomyocyte hypertrophy in hypertensive mice treated with spironolactone. J Am Heart Assoc. 2014;3(3):e000790.
• ⁶⁰
  Sibley CT, Noureldin RA, Gai N, Nacif MS, Liu S, Turkbey EB, et al. T1 Mapping in cardiomyopathy at cardiac MR: comparison with endomyocardial biopsy. Radiology. 2012;265(3):724-32.
• ⁶¹
  Liu CY, Liu YC, Wu C, Armstrong A, Volpe GJ, van der Geest RJ, et al. Evaluation of age-related interstitial myocardial fibrosis with cardiac magnetic resonance contrast-enhanced T1 mapping: MESA (Multi-Ethnic Study of Atherosclerosis). J Am Coll Cardiol. 2013;62(14):1280-7.
• ⁶²
  Neilan TG, Shah RV, Abbasi SA, Farhad H, Groarke JD, Dodson JA, et al. The incidence, pattern, and prognostic value of left ventricular myocardial scar by late gadolinium enhancement in patients with atrial fibrillation. J Am Coll Cardiol. 2013;62(23):2205-14.
• ⁶³
  Rochitte CE, Oliveira PF, Andrade JM, Ianni BM, Parga JR, Avila LF, et al. Myocardial delayed enhancement by magnetic resonance imaging in patients with Chagas' disease: a marker of disease severity. J Am Coll Cardiol. 2005;46(8):1553-8.
• ⁶⁴
  Rochitte CE, Nacif MS, de Oliveira Junior AC, Siqueira-Batista R, Marchiori E, Uellendahl M, et al. Cardiac magnetic resonance in Chagas' disease. Artif Organs. 2007;31(4):259-67.
• ⁶⁵
  Shah R, Heydari B, Coelho-Filho O, Murthy VL, Abbasi S, Feng JH, et al. Stress cardiac magnetic resonance imaging provides effective cardiac risk reclassification in patients with known or suspected stable coronary artery disease. Circulation. 2013;128(6):605-14.
• ⁶⁶
  Duarte PS. Technologies for the investigation of CAD: association between scientific publications and clinical use. Arq Bras Cardiol. 2010;94(3):379-82, 401-5.
• ⁶⁷
  Bertaso AG, Bertol D, Duncan BB, Foppa M. Epicardial fat: definition, measurements and systematic review of main outcomes. Arq Bras Cardiol. 2013;101(1):e18-28.
• ⁶⁸
  Rodrigues AR, Barbosa MR, de Brito MS, Silva LC, Machado FS. [Minimally invasive coronary angiography using a multidetector CT]. Arq Bras Cardiol. 2006;86(5):323-30.
• ⁶⁹
  Piva e Mattos B, Torres MA, Rebelatto TF, Loreto MS, Scolari FL. The diagnosis of left ventricular outflow tract obstruction in hypertrophic cardiomyopathy. Arq Bras Cardiol. 2012;99(1):665-75.
• ⁷⁰
  Rosa LV, Salemi VM, Alexandre LM, Mady C. Noncompaction cardiomyopathy: a current view. Arq Bras Cardiol. 2011;97(1):e13-9.
• ⁷¹
  Nacif MS, Oliveira Junior AC, Carvalho AC, Rochitte CE. Cardiac magnetic resonance and its anatomical planes: how do I do it? Arq Bras Cardiol. 2010;95(6):756-63.
• ⁷²
  Mattos BP, Torres MA, Freitas VC. Diagnostic evaluation of hypertrophic cardiomyopathy in its clinical and preclinical phases. Arq Bras Cardiol. 2008;91(1):51-62.
• ⁷³
  Nigri M, Rochitte CE, Tarasoutchi F, Grinberg M. Magnetic resonance imaging is image diagnosis in heart valve disease. Arq Bras Cardiol. 2006;87(4):534-7.
• ⁷⁴
  Dias RR, Fernandes F, Ramires FJ, Mady C, Albuquerque CP, Jatene FB. Mortality and embolic potential of cardiac tumors. Arq Bras Cardiol. 2014;103(1):13-8.
• ⁷⁵
  Rajani R, Khattar R, Chiribiri A, Victor K, Chambers J. Multimodality imaging of heart valve disease. Arq Bras Cardiol. 2014;103(3):251-63.
• ⁷⁶
  Tassi EM, Continentino MA, Nascimento EM, Pereira Bde B, Pedrosa RC. Relationship between fibrosis and ventricular arrhythmias in Chagas heart disease without ventricular dysfunction. Arq Bras Cardiol. 2014;102(5):456-64.
• ⁷⁷
  Rochitte CE, Hoette S, Souza R. Myocardial delayed enhancement by cardiac magnetic resonance imaging in Pulmonary Arterial Hypertension: a marker of disease severity. Arq Bras Cardiol. 2013;101(5):377-8.
• ⁷⁸
  Bessa LG, Junqueira FP, Bandeira ML, Garcia MI, Xavier SS, Lavall G, et al. Pulmonary arterial hypertension: use of delayed contrast-enhanced cardiovascular magnetic resonance in risk assessment. Arq Bras Cardiol. 2013;101(4):336-43.
• ⁷⁹
  Fernandes AM, Rathi V, Biederman RW, Doyle M, Yamrozik JA, Willians RB, et al. Cardiovascular magnetic resonance imaging-derived mitral valve geometry in determining mitral regurgitation severity. Arq Bras Cardiol. 2013;100(6):571-8.
• ⁸⁰
  Villacorta Junior H, Villacorta AS, Amador F, Hadlich M, Albuquerque DC, Azevedo CF. Transthoracic impedance compared to magnetic resonance imaging in the assessment of cardiac output. Arq Bras Cardiol. 2012;99(6):1149-55.
• ⁸¹
  Mello RP, Szarf G, Schvartzman PR, Nakano EM, Espinosa MM, Szejnfeld D, et al. Delayed enhancement cardiac magnetic resonance imaging can identify the risk for ventricular tachycardia in chronic Chagas' heart disease. Arq Bras Cardiol. 2012;98(5):421-30.
• ⁸²
  Moreira Rde C, Haddad AF, Silva SA, Souza AL, Tuche FA, Oliveira MA, et al. Intracoronary stem-cell injection after myocardial infarction: microcirculation sub-study. Arq Bras Cardiol. 2011;97(5):420-6.
• ⁸³
  Efe D, Aygun F. Assessment of the relationship between non-alcoholic fatty liver disease and CAD using MSCT. Arq Bras Cardiol. 2014;102(1):10-8.
• ⁸⁴
  Staniak HL, Sharovsky R, Pereira AC, Castro CC, Bensenor IM, Lotufo PA, et al. Subcutaneous tissue thickness is an independent predictor of image noise in cardiac CT. Arq Bras Cardiol. 2014;102(1):86-92.
• ⁸⁵
  Azevedo JC, Ferreira Junior Dde S, Vieira FC, Prezotti LS, Simoes LS, Nacif MS, et al. Correlation between myocardial scintigraphy and CT angiography in the evaluation of coronary disease. Arq Bras Cardiol. 2013;100(3):238-45.
• ⁸⁶
  Staniak HL, Bittencourt MS, Sharovsky R, Bensenor I, Olmos RD, Lotufo PA. Calcium score to evaluate chest pain in the emergency room. Arq Bras Cardiol. 2013;100(1):90-3.
• ⁸⁷
  Barros MV, Rabelo DR, Nunes Mdo C, Siqueira MH. Coronary tomography for predicting adverse events in patients with suspected coronary disease. Arq Bras Cardiol. 2012;99(6):1142-8.
• ⁸⁸
  Hadlich MS, Oliveira GM, Feijoo RA, Azevedo CF, Tura BR, Ziemer PG, et al. Free and open-source software application for the evaluation of coronary computed tomography angiography images. Arq Bras Cardiol. 2012;99(4):944-51.
• ⁸⁹
  Rochitte CE, Azevedo GS, Shiozaki AA, Azevedo CF, Kalil Filho R. Diltiazem as an alternative to beta-blocker in coronary artery computed tomography angiography. Arq Bras Cardiol. 2012;99(2):706-13.
• ⁹⁰
  Rabelo DR, Barros MV, Nunes Mdo C, Oliveira CC, Siqueira MH. Multislice coronary angiotomography in the assessment of coronary artery anomalous origin. Arq Bras Cardiol. 2012;98(3):266-72.

Publication Dates

• Publication in this collection
  Nov 2014