Abstract
The complex and reciprocal relationship between the brain and the heart has gained increasing attention under the concept of neurocardiology. Myocardial injury is common in cerebrovascular disease, and cardiovascular complications are the second leading cause of death after stroke. Cardiac computed tomography (CT) is a fast and reliable non-invasive tool for the assessment of cardioembolic sources. Compared to single energy CT, spectral/dual energy cardiac CT improves tissue characterization and also leads to significant reductions in contrast volume. In this review article, we portray the potential clinical applications of spectral CT in neurocardiology, focusing in the enhanced diagnosis of cardioembolic sources and cardiovascular risk assessment of patients with stroke, including improved detection of thrombus, identification of subtle myocardial disease, and pulmonary complications within the same session.
Highlights
The heart and the brain are deeply interrelated both in health and disease, involving diverse physiological and pathophysiological aspects that can lead to brain injury causing myocardial damage and viceversa [1]
Relevant to the field of neurocardiology, cardiac computed tomography (CT) provides a reliable, fast, volumetric, non-invasive tool for the assessment of cardioembolic sources (Figs. 1-3). These aspects are critical since most patients with stroke have a number of characteristics including impaired sensory that can lead to gastrointestinal and pulmonary complications, which might potentially be worsened or promoted by transesophageal echocardiogram (TEE) [6, 7]
A number of cardioembolic sources less amenable for accurate assessment with TEE such as the left ventricular apex, the distal ascending aorta, and subtle myocardial disease can be evaluated with cardiac CT (Figs. 4, 5)
Summary
The heart and the brain are deeply interrelated both in health and disease, involving diverse physiological and pathophysiological aspects that can lead to brain injury causing myocardial damage and viceversa [1]. Such complex relationship has recently gained attention under the concept of neurocardiology. A number of cardioembolic sources less amenable for accurate assessment with TEE such as the left ventricular apex, the distal ascending aorta, and subtle myocardial disease can be evaluated with cardiac CT The aim of this review article was to portray the potential clinical applications of spectral CT in neurocardiology, focusing in the diagnosis of cardioembolic sources and cardiovascular risk assessment of patients with stroke
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