Cardiac exposure to ionizing radiation can damage both the microvasculature and coronary arteries, as well as increase the long-term risk of heart disease, myocardial fibrosis, and conduction abnormalities. Therapeutic agents capable of promoting recovery from radiation injury to the heart are limited. Growth hormone is linked to improved cardiac function following injury. Here, we leveraged a cynomolgus macaque model to determine the long-term outcomes of recombinant human growth hormone (rhGH) therapy on the heart following low-dose ionizing radiation. Macaques were exposed to 2 Gy radiation, treated with rhGH for one month, and assessed after 2 years. Overall, plasma lipid profile, cardiac function, and coronary artery disease were similar between rhGH and placebo treated animals. However, a subgroup of rhGH-treated animals exhibited more extensive atherosclerotic plaques in the coronary arteries. Together, these findings indicate that transient human growth hormone therapy subsequent to a single low dose of ionizing radiation involving the heart does not result in long-term changes to plasma cholesterol but may promote exacerbated coronary artery disease in a subset of individuals.

The advent of large language models (LLMs) marks a transformative leap in natural language processing, offering unprecedented potential in radiology, particularly in enhancing the accuracy and efficiency of coronary artery disease (CAD) diagnosis. While previous studies have explored the capabilities of specific LLMs like ChatGPT in cardiac imaging, a comprehensive evaluation comparing multiple LLMs in the context of CAD-RADS 2.0 has been lacking. This study addresses this gap by assessing the performance of various LLMs, including ChatGPT 4, ChatGPT 4o, Claude 3 Opus, Gemini 1.5 Pro, Mistral Large, Meta Llama 3 70B, and Perplexity Pro, in answering 30 multiple-choice questions derived from the CAD-RADS 2.0 guidelines. Our findings reveal that ChatGPT 4o achieved the highest accuracy at 100 %, with ChatGPT 4 and Claude 3 Opus closely following at 96.6 %. Other models, including Mistral Large, Perplexity Pro, Meta Llama 3 70B, and Gemini 1.5 Pro, also demonstrated commendable performance, though with slightly lower accuracy ranging from 90 % to 93.3 %. This study underscores the proficiency of current LLMs in understanding and applying CAD-RADS 2.0, suggesting their potential to significantly enhance radiological reporting and patient care in coronary artery disease. The variations in model performance highlight the need for further research, particularly in evaluating the visual diagnostic capabilities of LLMs-a critical component of radiology practice. This study provides a foundational comparison of LLMs in CAD-RADS 2.0 and sets the stage for future investigations into their broader applications in radiology, emphasizing the importance of integrating both text-based and visual knowledge for optimal clinical outcomes.

BACKGROUND: Spontaneous Coronary Artery Dissection (SCAD) is an acute coronary event of uncertain origin. SCAD occurs when the coronary artery wall dissects non-traumatically and non-atherosclerotically, leading to the formation of an intramural hematoma or intimal tear, ultimately compressing and restricting the true lumen, or even occluding it. The management of SCAD remains controversial despite modern imaging techniques. In addition to supportive drug therapy, percutaneous coronary intervention (PCI) is another option that can be used as an effective treatment modality.
METHODS: We describe A 50-year-old male with SCAD presented to the hospital emergency department complaining of chest pain. Coronary angiography incidentally showed spiral dissection from the proximal to distal right coronary artery (RCA). Three overlapping coroflex stents were deployed from the distal to the proximal RCA.
CONCLUSIONS: To stabilize the coronary artery in Acute Coronary Syndrome (ACS) patients due to SCAD, prompt interventions such as stenting and angioplasty are needed. However, it is necessary to pay attention to the clinical condition of patients and quick diagnosis for the recovery of patients and reduction of complications.

There is increasing evidence that coronary artery wall shear stress (WSS) measurement provides useful prognostic information that allows prediction of adverse cardiovascular events. Computational Fluid Dynamics (CFD) has been extensively used in research to measure vessel physiology and examine the role of the local haemodynamic forces on the evolution of atherosclerosis. Nonetheless, CFD modelling remains computationally expensive and time-consuming, making its direct use in clinical practice inconvenient. A number of studies have investigated the use of deep learning (DL) approaches for fast WSS prediction. However, in these reports, patient data were limited and most of them used synthetic data generation methods for developing the training set. In this paper, we implement 2 approaches for synthetic data generation and combine their output with real patient data in order to train a DL model with a U-net architecture for prediction of WSS in the coronary arteries. The model achieved 6.03% Normalised Mean Absolute Error (NMAE) with inference taking only 0.35 s; making this solution time-efficient and clinically relevant.

Kawasaki disease (KD) is the leading cause of acquired heart disease in children in developed countries. Delayed treatment can lead to coronary artery (CA) abnormalities, potentially causing myocardial ischemia, infarction, and death. Younger age is a risk factor for developing bilateral large CA aneurysms in KD patients. A one-and-a-half-month-old infant presented with fever and elevated inflammatory markers. Post-admission ceftriaxone injections were ineffective. Subsequently, the patient experienced recurrent high fevers, accompanied by rashes, erythema, and induration of the palms and soles, erythema, swelling at the Bacillus Calmette-Guerin (BCG) scar site, cracked lips, and conjunctival hyperemia, all of which were indicative of KD. Intravenous immunoglobulin (IVIG) and aspirin were administered on the third day of fever. Follow-ups at one, three, six, and 12 months post discharge revealed normal findings. This case demonstrates that even very young infants can develop complete KD, and early treatment can prevent CA complications.

BACKGROUND: Whether coronary computed-tomography angiography (CCTA) can detect cancer treatment-related impairments of coronary artery and predict major adverse cardiovascular events (MACEs) in lung cancer patients receiving chemotherapy (CHT) or chemoradiotherapy (CRT) is unclear.
OBJECTIVE: This study aimed to evaluate coronary arteries using CCTA parameters and explore the association of these parameters with MACEs in patients with lung cancer receiving CHT or CRT.
METHODS: This study retrospectively collected data from 697 lung cancer patients who received CHT or CRT and underwent CCTA examination within 2 weeks before or after treatment from June 2013 to May 2019. The patients were divided into CHT and CRT group, and for the control group, the propensity score matching (PSM) was used and 125 participants without carcinoma with a single CCTA examination were included. CCTA parameters, assessed using artificial intelligence software, were compared across different groups (control vs. CHT & CRT; CHT vs. CRT). We analyzed associations between CCTA parameters and MACEs using a Cox-regression model and Kaplan-Meier curves to compare MACE-free survival rates.
RESULTS: Before CHT or CRT, compared with the control group, in CHT&CRT group we observed higher fat attenuation index (FAI), coronary-artery calcium (CAC) score, CAD-RADS classification, stenosis severity and lower computed-tomography fractional flow reserve (CT-FFR; all P<0.05). After treatment, the CT-FFR decreased and the FAI increased; simultaneously, we observed a lower CT-FFR and higher FAI (all P<0.05) in the CRT than in the CHT group. Among the 146 cases developed MACEs, lower CT-FFR and higher FAI values were found compared with the non-MACE group (all P<0.05), and CT-FFR and FAI before treatment were associated with MACEs.
CONCLUSIONS: Cancer treatment-related impairments of coronary arteries could be identified using CT-FFR and FAI. Before treatment, these parameters were associated with MACEs in lung cancer patients receiving CHT or CRT.

OBJECTIVE: This study tested the hypothesis that administration of the KCa channel activator SKA-31 restores endothelium-dependent vasodilation in vivo in Type 2 Diabetic (T2D) rats.
BACKGROUND: Acute treatment of isolated resistance arteries from T2D rats and humans with SKA-31 significantly improved endothelium-dependent vasodilation. However, it is unknown whether these in situ actions translate to intact vascular beds in vivo.
METHODS: Male Sprague Dawley (SD) and T2D Goto-Kakizaki (GK) rats (26-32 weeks of age) were injected intraperitoneally with either drug vehicle or 10 mg/kg SKA-31. Doppler ultrasound imaging was used to record reactive hyperemia/flow-mediated dilation (FMD) in the femoral artery following release of an occlusion cuff on the distal hind limb, along with diameter changes in the left main coronary artery in response to inhaled isoflurane (2 % → 5 %).
RESULTS: Vehicle treated SD rats exhibited a robust and reversible FMD response, the magnitude and time course of which did not differ in SD rats treated with SKA-31. In contrast, only a weak FMD response was observed in vehicle-treated T2D GK rats, whereas prior SKA-31 administration restored FMD to the level observed in control SD rats. Exposure of SD rats to 5 % isoflurane caused robust coronary artery dilation, which was not altered by prior treatment with SKA-31. In T2D GK rats, 5 % isoflurane inhalation alone did not increase coronary artery diameter, however, a strong vasodilatory response was observed following SKA-31 treatment. SKA-31 administration did not modify intrinsic heart rate responses in either protocol.
CONCLUSIONS: Enhancement of KCa channel activity in vivo restores endothelium-dependent vasodilation in T2D rats that exhibit peripheral endothelial dysfunction.

Vascular diseases are greatly influenced by the hemodynamic parameters and the accuracy of determining these parameters depends on the use of correct boundary conditions. The present work carries out a two-way fluid-structure interaction (FSI) simulation to investigate the effects of outlet pressure boundary conditions on the hemodynamics through the left coronary artery bifurcation with moderate stenosis (50%) in the left anterior descending (LAD) branch. The Carreau viscosity model is employed to characterise the shear-thinning behaviour of blood. The results of the study reveal that the employment of zero pressure at the outlet boundaries significantly overestimates the values of hemodynamic variables like wall shear stress (WSS), and time-averaged wall shear stress (TAWSS) compared with human healthy and pulsatile pressure outlet conditions. However, the difference between these variables is marginally low for human healthy and pulsatile pressure outlets. The oscillatory shear index (OSI) remains the same across all scenarios, indicating independence from the outlet boundary condition. Furthermore, the magnitude of negative axial velocity and pressure drop across the plaque are found to be higher at the zero pressure outlet boundary condition.

We report the case of a 62-year-old woman who presented with an acute inferior wall myocardial infarction complicated by cardiogenic shock and refractory ventricular fibrillation. Following prolonged resuscitation in the emergency room, she was transferred to the cardiac catheterization laboratory where, as a first step, mechanical circulatory support with venoarterial extracorporeal membrane oxygenation (ECMO) was established. Next, a right heart catheterization study was performed, followed by coronary angiography and angioplasty of the infarct-related artery. Promptly on transfer to the intensive care unit, a hypothermia protocol was initiated. By postprocedure day 1, the patient\'s ventricular fibrillation had resolved, mean arterial pressure was >65 mm Hg, and pulmonary artery diastolic pressure was 10 mm Hg. Echocardiography demonstrated complete recovery of left ventricular systolic function. Lactate levels had fallen from 11.0 mmol/L (pre-ECMO) to 1.2 mmol/L. The patient was successfully weaned off pressor and ECMO support within 24 hours of the percutaneous coronary intervention procedure. She was extubated on postprocedure day 2 and discharged home on day 6. At 26-month follow-up, she remains well, angina free, neurologically intact, and without evidence of heart failure. The treatment algorithm used in this case should be considered favorably in the management of patients presenting with acute myocardial infarction complicated by cardiogenic shock and refractory ventricular fibrillation.

Background Congenital anomalies of the coronary artery anatomy (CAAs) encompass a spectrum of disorders, often asymptomatic but potentially carrying severe clinical implications such as arrhythmia, chest pain, myocardial infarction, or sudden death. The estimated prevalence of CAAs in the general population ranges from 0.3% to 1.3%, with underdiagnosis in asymptomatic individuals. Multidetector computed tomography angiography (CTA) has emerged as a vital non-invasive tool for diagnosing and characterising CAAs, offering improved visualisation and aiding in appropriate management decisions. This study aims to analyse the spectrum of CAAs in a tertiary care setting, focusing on imaging features, prevalence, and potential clinical significance, utilising data from patients who underwent multidetector CTA. Methodology A single-centre, retrospective analysis of consecutive coronary angiograms over a five-year period identified patients with CAAs, with imaging conducted using a 128-slice, single-source CT scanner. Detailed imaging evaluation was performed by experienced radiologists, with anomalies classified according to established criteria. Results Among 756 coronary CTA examinations analysed, 37 instances of anomalous coronary vessels were identified. The study revealed a diverse range of anomalies, including myocardial bridging, anomalous origin of coronary arteries, and extracardiac abnormalities. Conclusions This study contributes valuable insights into the prevalence and imaging features of CAAs, enhancing our understanding of these anomalies and guiding improved patient outcomes in cardiovascular care. Future research should focus on elucidating pathophysiological mechanisms and establishing multicenter registries to address the challenges associated with studying these infrequent but clinically significant anomalies.