Abstract
Imaging of the coronary circulation is a critical clinical topic, as only the best knowledge of coronary anatomy allows efficacious and safe coronary interventions [1]. However this is a fast moving field, with new techniques continuously added to the inventory of the cardiologists and with new evidence supporting such techniques continuously accumulating in literature [2]. Such needs largely justify the present monothematic issue which collects up to date information regarding coronary multimodality imaging. The backbone of coronary imaging, coronary angiography, is turning to the trans-radial approach, which offers important advantages both in terms of patient satisfaction and prognosis. This topic is tackled by the review by Rognoni et al. [3], describing the principles of quantitative coronary angiography, a robust method that nowadays allows researchers to assess the impact of the process of atherosclerosis on the lumen of the coronary artery and to establish over time whether an intervention attenuates progression or regression of atherosclerotic disease. In this paper the latest developments of computer assisted assessment of coronary artery luminograms are described and the limitations and difficulties related to interpretation of the angiographic information are discussed. The probably most dynamic field of cardiac and coronary imaging is constituted by the tomographic imaging techniques, among which cardiac and coronary CT-scan and cardiac magnetic resonance are gaining more and more favor to assess cardiac and coronary anatomy as well as the consequences of coronary artery disease, myocardial ischemia and necrosis. CT-scan of coronary arteries are becoming better and better in selecting patients for subsequent coronary interventions with magnificent 3- D reconstructions of the whole coronary tree. These topics are widely discussed by the reviews of Schaffer et al. [4]. Finally, the most exciting evolution has involved the invasive coronary imaging: IVUS, with particular attention to newer development of the technique, that is to say radiofrequency IVUS (virtual histology) for vulnerable coronary plaques detection; fractional flow reserve, which adds to coronary angiography fundamental functional information to guide coronary interventions; and finally optical coherence tomography which with its amazing resolution power can detect stent endothelization with details comparable to an histological examination. These fields are exhaustively covered in the reviews of Barbieri et al. [5] and the paper from the group of Imperial College of London lead by Prof Di Mario [6]. To finally turn the readers’ attention to the clinical point of view, the reviews of Lupi et al. [7] and Nardi et al. [8] address two of the most exciting imaging problems in the clinical cardiology, the search for vulnerable coronary plaques and the detection of cardioembolic sources.
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