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Aims: Cardiovascular disease, primarily coronary artery disease (CAD), is the leading cause of mortality worldwide. Accurate diagnosis of CAD often requires pre-test probability (PTP) estimation, traditionally performed using scoring systems like the Diamond-Forrester (DF) and European Society of Cardiology (ESC) models. However, the applicability of such models in specific populations may vary. This study compares the performance of DF and PTP scores in the Brazilian context, using coronary computed tomography angiography (CCTA) as a reference standard. Methods and results: PTP for obstructive CAD was calculated using DF and ESC scores in 409 symptomatic patients without known CAD who underwent CCTA between 2019 and 2022. Predicted PTP was compared with actual CAD prevalence. DF overestimated CAD prevalence across age and symptom categories, while ESC showed better alignment with actual prevalence. Conclusion: Our study confirms that the ESC PTP model is more appropriate than the DF model for determining PTP in the Brazilian population.
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Despite recent advancements in newer biomarkers development and improved imaging techniques, the diagnosis of cardiac amyloidosis (CA) remains a frequent clinical challenge. In this setting, cardiac MR (CMR) imaging has emerged as a powerful tool to assess heart morphology and function, with the unique advantage of noninvasive tissue characterization. This article summarizes the CMR imaging common findings in CA and the latest research in this field, including delayed enhancement, native T1 mapping, and extracellular volume quantification.
Assuntos
Amiloidose/diagnóstico por imagem , Cardiopatias/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Coração/diagnóstico por imagem , HumanosRESUMO
Ischemic heart failure is a growing disease with high morbidity and mortality. Several studies suggest the benefit of viability imaging to assist revascularization decision, but there is controversy. Multiple imaging modalities can be used to accurately define hibernating myocardium; however, the best approach remains uncertain. This review will highlight current evidence and future directions of viability imaging assessment