Imaging and outcomes in cardiac, valvular, and peripheral arterial disease

Download the Issue @ a Glance podcast Subscribe to the EHJ Podcast ![Graphic][1] After clinical history and examination, imaging is often the next and essential step in the diagnosis and management of cardiac disease. Indeed, the heart is an invisible organ, only accessible to clinicians since the discovery of radiation, ultrasound, and magnetic resonance. Today, a number of imaging modalities are available to us such as echocardiography, coronary computed tomography (CT),1 nuclear perfusion imaging, and cardiac magnetic resonance imaging (MRI). The major issue that remains is comprehensive imaging, i.e. the use of the right modality for the right patient. Thus, ‘ The year in cardiology 2015: imaging ’, by Jeroen J. Bax from Leiden University Medical Center in The Netherlands,2 is a timely summary of the current progress and appropriate use of different imaging modalities. Recently, prognostic implications of several non-invasive imaging techniques have been the focus of some landmark studies. Non-invasive characterization of atherosclerosis processes and vulnerable plaques has been possible with advances in cardiac MRI and nuclear imaging techniques. In addition, 3-D echocardiography and multidetector-row CT (MDCT) have improved our understanding of valvular heart disease. Finally, data on the clinical role of integration of non-invasive imaging techniques3 are accumulating, and its use is expected to increase in the coming years. Imaging is important not only for cardiac conditions, but also for peripheral arterial disease.4 In ‘ The year in cardiology 2015: peripheral circulation ’,5 Victor Aboyans and colleagues from the Hopital Dupuytren in Limoges, France note that last year the use of carotid intima-media thickness to reclassify individual risk in such patients has been challenged, but may remain of interest for use in younger individuals. In a middle-aged Spanish cohort, the co-existence of several peripheral plaques was common, with ilio-femoral plaques having the best … [1]: /embed/inline-graphic-1.gif