The thesis aims to describe novel insights into cardiac imaging in patients with cardiovascular disease. Quantitative computed tomography (CT) allows detailed assessment of coronary artery disease ... Show moreThe thesis aims to describe novel insights into cardiac imaging in patients with cardiovascular disease. Quantitative computed tomography (CT) allows detailed assessment of coronary artery disease (CAD), improving diagnosis of CAD. Furthermore, phase analysis on gated myocardial perfusion SPECT enables to improve patient selection for cardiac resynchronization therapy (CRTT). Finally, cardiac 123-I MIBG scintigraphy allows improved risk stratification of patients for cardiac arrhythmias. Show less
Laan, A.M. van der; Schirmer, S.H.; Vries, M.R. de; Koning, J.J.; Volger, O.L.; Fledderus, J.O.; ... ; Royen, N. van 2012
This thesis proposes several new algorithms including X-ray angiographic image enhancement, three-dimensional (3D) angiographic reconstruction, angiographic overlap prediction, and the co... Show moreThis thesis proposes several new algorithms including X-ray angiographic image enhancement, three-dimensional (3D) angiographic reconstruction, angiographic overlap prediction, and the co-registration of X-ray angiography with intracoronary imaging devices, such as intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The algorithms were integrated into prototype software packages that were validated at a number of clinical centers. The feasibility of using such software packages in typical clinical population was verified, while the advantages and accuracy of the proposed algorithms were demonstrated by phantoms and in-vivo clinical studies. In addition, based on the proposed approaches and the conducted studies, this thesis reports a number of findings including the impact of acquisition angle difference on 3D quantitative coronary angiography (QCA), the clinical characteristics of bifurcation optimal viewing angles and bifurcation angles, and the discrepancy of lumen dimensions as assessed by 3D QCA and by IVUS or OCT. Show less
Although the beneficial effect of ICD treatment has been proven in selected patients, the population assessed in large clinical trials does not reflect the population with ICDs in the real world.... Show moreAlthough the beneficial effect of ICD treatment has been proven in selected patients, the population assessed in large clinical trials does not reflect the population with ICDs in the real world. The aim of the current thesis is to give better insight in these patients at risk for lifethreatening arrhythmias by studying a large population of patients treated with an ICD, outside the setting of a clinical trial. In part I, the actual need for defibrillator backup during long-term follow-up is evaluated. Chapter 2 describes differences in mortality and the occurrence of ventricular arrhythmia between patients receiving an ICD as primary vs. secondary prevention of SCD. The actual need for device replacement after an event-free first battery service-life is studied in Chapter 3. In part II, an attempt is made to improve risk stratification by evaluating currently available parameters and the additive value of novel parameters. In Chapter 4 all classic baseline variables are combined to construct a clinically applicable mortality risk score in primary prevention ICD recipients with ischemic heart disease. Chapter 5 demonstrates the importance of atrial fibrillation in patients with ICD or CRT-D. Chapter 6 shows that usage of a risk model can predict the risk of non-benefit (death, prior to first ventricular arrhythmia) which might have important clinical consequences. In Chapter 7 the spatial QRS-T angle is evaluated in the prediction of ventricular arrhythmia. Chapter 8 demonstrates the risk of lead failure in smalldiameter defibrillation leads compared with a benchmark cohort. Show less
