Applications of artificial intelligence-based models in vulnerable carotid plaque

Carotid atherosclerotic disease is a widely acknowledged risk factor for ischemic stroke, making it a major concern on a global scale. To alleviate the socio-economic impact of carotid atherosclerotic disease, crucial objectives include prioritizing prevention efforts and early detection. So far, the degree of carotid stenosis has been regarded as the primary parameter for risk assessment and determining appropriate therapeutic interventions. Histopathological and imaging-based studies demonstrated important differences in the risk of cardiovascular events given a similar degree of luminal stenosis, identifying plaque structure and composition as key determinants of either plaque vulnerability or stability. The application of Artificial Intelligence (AI)-based techniques to carotid imaging can offer several solutions for tissue characterization and classification. This review aims to present a comprehensive overview of the main concepts related to AI. Additionally, we review the existing literature on AI-based models in ultrasound (US), computed tomography (CT), and Magnetic Resonance Imaging (MRI) for vulnerable plaque detection, and we finally examine the advantages and limitations of these AI approaches

Atrial and Ventricular Involvement in Acute Myocarditis Patients with Preserved Ejection Fraction: A Single-Center Cardiovascular Magnetic Resonance Study

Cardiac magnetic resonance (CMR) is commonly employed to confirm the diagnosis of acute myocarditis (AM). However, the impact of atrial and ventricular function in AM patients with preserved ejection fraction (EF) deserves further investigation. Therefore, the aim of this study was to explore the incremental diagnostic value of combining atrial and strain functions using CMR in patients with AM and preserved EF. This retrospective study collected CMR scans of 126 consecutive patients with AM (meeting the Lake Louise criteria) and with preserved EF, as well as 52 age- and sex-matched control subjects. Left atrial (LA) and left ventricular (LV) strain functions were assessed using conventional cine-SSFP sequences. In patients with AM and preserved EF, impaired ventricular and atrial strain functions were observed compared to control subjects. These impairments remained significant even in multivariable analysis. The combined model of atrial and ventricular functions proved to be the most effective in distinguishing AM patients with preserved ejection fraction from control subjects, achieving an area under the curve of 0.77 and showing a significant improvement in the likelihood ratio. These findings suggest that a combined analysis of both atrial and ventricular functions may improve the diagnostic accuracy for patients with AM and preserved EF

Could Hop-derived Bitter Compounds Improve Glucose Homeostasis by Stimulating the Secretion of GLP-1?

Hops (Humulus lupulus L.) is by far the greatest contributors to the bitter property of beer. Over the past years, a large body of evidence demonstrated the presence of taste receptors in different locations of the oral cavity. In addition to the taste buds of the tongue, cells expressing these receptors have been identified in olfactory bulbs, respiratory and gastrointestinal tract. In the gut, the attention was mainly directed to sweet Taste Receptor (T1R) and bitter Taste Receptor (T2R) receptors. In particular, T2R has shown to modulate secretion of different gut hormones, mainly Glucagon-like Peptide 1 (GLP-1), which are involved in the regulation of glucose homeostasis and the control of gut motility, thereby increasing the sense of satiety. Scientific interest in the activity of bitter taste receptors emerges because of their wide distribution in the human species and the large range of natural substances that interact with them. Beer, whose alcohol content is lower than in other common alcoholic beverages, contains a considerable amount of bitter compounds and current scientific evidence shows a direct effect of beer compounds on glucose homeostasis. The purpose of this paper is to review the available literature data in order to substantiate the novel hypothesis of a possible direct effect of hop-derived bitter compounds on secretion of GLP-1, through the activation of T2R, with consequent improvement of glucose homeostasis

Role of nutrition and adherence to the mediterranean diet in the multidisciplinary approach of hidradenitis suppurativa: Evaluation of nutritional status and its association with severity of disease

Hidradenitis suppurativa (HS) is a chronic, inflammatory and debilitating skin disorder. The exacerbating factors of HS include nutrition and adiposity. We aimed to investigate the relationships between body composition and the adherence to the Mediterranean diet (MD) with the severity of HS in a sample of naive-treatment patients with HS. In this case⁻controlled, cross-sectional study, we enrolled 41 HS patients and 41 control subjects. Body composition was evaluated by a bioelectrical impedance analysis (BIA) phase-sensitive system. PREvención con DIeta MEDiterránea (PREDIMED) and the 7-day food records were used to evaluate the degree of adherence to the MD and dietary pattern, respectively. The clinical severity was assessed by using the Sartorius HS score. HS patients had a worse body composition, in particular lower phase angle (PhA) (p < 0.001), and a lower adherence to the MD than controls, in spite of no differences in energy intake between the two groups. The receiver operator characteristic (ROC) analysis showing a value of PhA of ≤ 5.7 and a PREDIMED score of ≤ 5.0 identified HS patients with the highest clinical severity of the disease. After adjusting for sex, age, body mass index (BMI), and total energy intake, the HS Sartorius score maintained negative correlations with PhA (p < 0.001), PREDIMED score, and n-3 polyunsaturated fatty acids (p = 0.005). The results of the multivariate analysis showed PhA and PREDIMED score were the major determinants of HS Sartorius score, explaining 82.0% and 30.4% of its variability, respectively (p < 0.001). Novel associations were demonstrated between PhA and the degree of adherence to the MD with the HS severity. PhA and PREDIMED score might represent possible markers of severity of HS in a clinical setting

Cardiovascular magnetic resonance (CMR) and positron emission tomography (PET) imaging in the diagnosis and follow-up of patients with acute myocarditis and chronic inflammatory cardiomyopathy : A review paper with practical recommendations on behalf of the European Society of Cardiovascular Radiology (ESCR).

Advanced cardiac imaging techniques such as cardiovascular magnetic resonance (CMR) and positron emission tomography (PET) are widely used in clinical practice in patients with acute myocarditis and chronic inflammatory cardiomyopathies (I-CMP). We aimed to provide a review article with practical recommendations from the European Society of Cardiovascular Radiology (ESCR), in order to guide physicians in the use and interpretation of CMR and PET in clinical practice both for acute myocarditis and follow-up in chronic forms of I-CMP

Effect of late gadolinium enhancement on left atrial impairment in myocarditis patients

ObjectiveThe aims of our study were to investigate the effect of the extent and location of late gadolinium enhancement (LGE) on the left atrium (LA) function in patients with acute myocarditis (AM) using cardiovascular magnetic resonance (CMR).MethodThis retrospective study performed CMR scans in 113 consecutive patients (89 males, 24 females; mean age 45.8 &amp; PLUSMN; 17.3 years) with AM that met the updated Lake Louise criteria. Reservoir, conduit, and booster LA functions were analyzed by CMR feature tracking using dedicated software. Besides LA strain measurements, myocardial scar location and extent were assigned and quantified by LGE imaging.ResultsAM patients with septal LGE had impaired reservoir, conduit, and conduit strain rate function in comparison with AM patients with non-septal LGE (p = 0.001, for all). In fully adjusted multivariable linear regression, reservoir and conduit were significantly associated with left ventricle (LV) LGE location (&amp; beta; coefficient = 8.205, p = 0.007; &amp; beta; coefficient = 5.185, p = 0.026; respectively). In addition, LA parameters decreased according to the increase in the extent of LV fibrosis (LGE &amp; LE; 10%; LGE 11-19%; LGE &amp; GE; 20%). After adjustment in multivariable linear regression, the association with LV LGE extent was no longer statistically significant.ConclusionIn patients with acute myocarditis, LA function abnormalities are significantly associated with LV LGE location, but not with LGE extent. Septal LGE is paralleled by a deterioration of LA reservoir and conduit function.Clinical relevance statementLeft atrium dysfunction is associated with the presence of late gadolinium enhancement in the left ventricle septum and can be useful in the clinical prognostication of patients with acute myocarditis, allowing individually tailored treatment.Key Points &amp; BULL; Myocardial fibrosis is related to atrial impairment.&amp; BULL; The location of myocardial fibrosis is the main determinant of atrial dysfunction in myocarditis patients.&amp; BULL; The quantification of atrial mechanisms may provide more in-depth insight into myocarditis pathophysiology.Key Points &amp; BULL; Myocardial fibrosis is related to atrial impairment.&amp; BULL; The location of myocardial fibrosis is the main determinant of atrial dysfunction in myocarditis patients.&amp; BULL; The quantification of atrial mechanisms may provide more in-depth insight into myocarditis pathophysiology.Key Points &amp; BULL; Myocardial fibrosis is related to atrial impairment.&amp; BULL; The location of myocardial fibrosis is the main determinant of atrial dysfunction in myocarditis patients.&amp; BULL; The quantification of atrial mechanisms may provide more in-depth insight into myocarditis pathophysiology

Atrial and ventricular strain using cardiovascular magnetic resonance in the prediction of outcomes of pericarditis patients: a pilot study

Objective Our study aimed to explore with cardiovascular magnetic resonance (CMR) the impact of left atrial (LA) and left ventricular (LV) myocardial strain in patients with acute pericarditis and to investigate their possible prognostic signifcance in adverse outcomes. Method This retrospective study performed CMR scans in 36 consecutive patients with acute pericarditis (24 males, age 52 [23–52]). The primary endpoint was the combination of recurrent pericarditis, constrictive pericarditis, and surgery for pericardial diseases defned as pericardial events. Atrial and ventricular strain function were performed on conventional cine SSFP sequences. Results After a median follow-up time of 16 months (interquartile range [13–24]), 12 patients with acute pericarditis reached the primary endpoint. In multivariable Cox regression analysis, LA reservoir and LA conduit strain parameters were all independent determinants of adverse pericardial diseases. Conversely, LV myocardial strain parameters did not remain an independent predictor of outcome. With receiving operating characteristics curve analysis, LA conduit and reservoir strain showed excellent predictive performance (area under the curve of 0.914 and 0.895, respectively) for outcome prediction at 12 months. Conclusion LA reservoir and conduit mechanisms on CMR are independently associated with a higher risk of adverse pericardial events. Including atrial strain parameters in the management of acute pericarditis may improve risk stratifcation. Clinical relevance statement Atrial strain could be a suitable non-invasive and non-contrast cardiovascular magnetic resonance parameter for predicting adverse pericardial complications in patients with acute pericarditis

Coffee consumption, metabolic syndrome and clinical severity of psoriasis: Good or bad stuff?

Despite the wide consumption of coffee, its anti-inflammatory effect on clinical severity of psoriasis is still debatable. The aim of this study was to evaluate the association between the coffee consumption and clinical severity of psoriasis in a sample of patients stratified according to the presence of the metabolic syndrome (MetS) and smoking. This cross-sectional case-control observational study was conducted on 221 treatment-naïve psoriatic patients. Lifestyle habits, anthropometric measures, clinical and biochemical evaluations were obtained. Clinical severity of psoriasis was assessed by Psoriasis Area and Severity Index (PASI) score. Data on energy caloric intake and coffee consumption were collected using a 7-day food diary record. The coffee consumption was analyzed as coffee intake (consumers and non-consumers) and daily servings (range 0-4 servings/day). Coffee consumers have a lower PASI score vs non-consumers (p < 0.001). The lowest PASI score and MetS prevalence were found in patients consuming 3 cups of coffee/day (p < 0.001), which was also the most common daily serving (34.8%), whereas the highest PASI score was found among those drinking ≥ 4 cups/day. Grouping the case patients according to smoking and MetS, the best odds of PASI score was observed in those drinking 3 cups of coffee per day and no smokers, after adjusting for total energy intake (OR 74.8; p < 0.001). As a novel finding, we reported a negative association between coffee intake, MetS prevalence and clinical severity of psoriasis. The evaluation of the anti-inflammatory effect of coffee on clinical severity of psoriasis, whose metabolic risk increases along with its clinical severity, could be of great importance from a public health perspective