Browsing by Author "Bettencourt, N"
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- Acute coronary syndrome and endocarditis 20 years before: how do they match?Publication . Ribeiro, S; Amorim, MJ; Torres, M; Almeida, J; Bettencourt, N
- An unusual trigger causing Takotsubo SyndromePublication . Abreu, G; Rocha, S; Bettencourt, N; Azevedo, P; Vieira, C; Rodrigues, C; Arantes, C; Braga, C; Martins, J; Marques, J
- Atypical presentation of an intracardiac massPublication . Abreu, G; Azevedo, P; Bettencourt, N; Vieira, C; Arantes, C; Quina, C; Vilaça, A; Marques, J
- Caseous calcification of the mitral annulus: A multi-modality imaging perspectivePublication . Ribeiro, S; Salgado, A; Salomé, N; Bettencourt, N; Azevedo, P; Costeira, A; Correia, AMitral annulus calcification is a common echocardiographic finding, particularly in the elderly and in end-stage renal disease patients under chronic dialysis. Caseous calcification or liquefaction necrosis of mitral annulus calcification is a rare evolution of mitral annular calcification. Early recognition of this entity avoids an invasive diagnostic approach, since it is benign and, unlike intracardiac tumors and abscesses, has a favorable prognosis. The authors present the case of an 84-year-old woman with a suspicious large, echodense mass at the level of the posterior mitral leaflet with associated severe mitral regurgitation. Cardiac magnetic resonance imaging demonstrated a hypoperfused mass with strong peripheral enhancement 10 minutes after gadolinium administration. Multislice computed tomography showed the calcified nature of the mass. A multi-modality imaging approach confirmed the diagnosis of caseous calcification of the posterior mitral annulus. The patient refused surgical treatment.
- Constrictive pericarditis: Insights from cardiac computed tomographyPublication . Ribeiro, S; Bettencourt, N; Van Zeller, P; Leite, D; Carvalho, M; Ribeiro, VG
- Degenerescência caseosa da calcificação do anel mitral: uma perspectiva multi-imagemPublication . Ribeiro, S; Salgado, A; Salomé, N; Bettencourt, N; Azevedo, P; Costeira, A; Correia, AMitral annulus calcification is a common echocardiographic finding, particularly in the elderly and in end-stage renal disease patients under chronic dialysis. Caseous calcification or liquefaction necrosis of mitral annulus calcification is a rare evolution of mitral annular calcification. Early recognition of this entity avoids an invasive diagnostic approach, since it is benign and, unlike intracardiac tumors and abscesses, has a favorable prognosis. The authors present the case of an 84-year-old woman with a suspicious large, echodense mass at the level of the posterior mitral leaflet with associated severe mitral regurgitation. Cardiac magnetic resonance imaging demonstrated a hypoperfused mass with strong peripheral enhancement 10 minutes after gadolinium administration. Multislice computed tomography showed the calcified nature of the mass. A multi-modality imaging approach confirmed the diagnosis of caseous calcification of the posterior mitral annulus. The patient refused surgical treatment.
- Isolated left ventricular apical hypoplasiaPublication . Galvão-Braga, C; Silva, P; Magalhães, S; Bettencourt, N; Themudo, R
- Noninvasive anatomical and functional assessment of coronary artery disease.Publication . Ramos, V; Bettencourt, N; Silva, J; Ferreira, N; Chiribiri, A; Schuster, A; Leite-Moreira, A; Silva-Cardoso, J; Nagel, E; Gama, VINTRODUCTION AND OBJECTIVE: In suspected coronary artery disease (CAD), invasive coronary angiography (ICA) is traditionally the diagnostic tool of choice. However, patients often have no significant disease. Moreover, assessment of fractional flow reserve (FFR) has been shown to have prognostic implications. Recently, coronary computed tomography angiography (CTA) and cardiac magnetic resonance (CMR) myocardial perfusion imaging (CMR-Perf) have gained increasing attention through their accurate anatomical and functional assessment, respectively. We studied the added value of integrating these tests (CT+CMRint) in the diagnosis of CAD, with FFR as the reference standard. METHODS: We included 101 patients consecutively referred for outpatient assessment of CAD who underwent CTA and CMR-Perf prior to ICA with FFR assessment. Lesions were considered positive by CT+CMRint only if positive in the two tests alone. The mean follow-up was 2.9±0.6 years. RESULTS: All patients completed the study protocol without adverse effects. Forty-four patients had CAD by FFR. CTA had excellent sensitivity and negative predictive value (100%) but, as expected, its specificity and positive predictive value were lower (61% and 67%, respectively). Diagnostic accuracy by FFR was 78% for CTA, 88% for CMR-Perf and 92% for CT+CMRint. Regarding diagnostic accuracy, CT+CMRint showed statistically significant superiority (AUC=0.917, 95% CI 0.845-0.963) compared with CTA (AUC=0.807, 95% CI 0.716-0.879, p=0.0057) or CMR-Perf (AUC=0.882, 95% CI 0.802-0.938, p=0.0398) alone. Regarding prediction of revascularization, the integrated protocol maintained its superior performance. CONCLUSIONS: CT+CMRint showed superior diagnostic accuracy and could thus lead to a considerable reduction in invasive procedures for CAD diagnosis, with less risk and greater patient comfort.
- Será o que parece?Publication . Abreu, G; Rocha, S; Bettencourt, N; Quina-Rodrigues, C; Arantes, C; Martins, J; Fonseca, S; Vieira, C; Barbosa, L; Azevedo, P; Marques, J
- Transcatheter mitral valve-in-valve implantation: Role of preprocedural multidetector computed tomographyPublication . Galvão-Braga, C; Carvalho, M; Ferreira, N; Bettencourt, N; Gama, V