In this work, we present a technique to semi-automatically quantify the epicardial fat in non-contrasted computed tomography (CT) images. The epicardial fat is very close to the pericardial fat, being separated only by the pericardium that appears in the image as a very thin line, which is hard to detect. Therefore, an algorithm that uses the anatomy of the heart was developed to detect the pericardium line via control points of the line. From the points detected an interpolation was applied based on the cubic interpolation, which was also improved to avoid incorrect interpolation that occurs when the two variables are non-monotonic. The method is validated by using a set of 40 CT images of the heart of 40 human subjects. In 62.5% of the cases only minimal user intervention was required and the results compared favourably with the results obtained by the manual process.

AV calcium volume was an independent predictor of PVR and BPD in patients submitted to TAVI. Our results support a systematic assessment of AV calcium volume to identify patients at increased risk of post-procedural PVR.

BackgroundPrevious studies showed that metabolic syndrome is associated with aortic valve calcification (AVC) and poor outcomes in aortic stenosis (AS). However, if these associations change and how body fat impacts the prognosis of patients in late stage of the disease have been not yet explored.AimsTo determine the association of body mass index (BMI) and visceral fat with AVC and mortality after transcatheter aortic valve replacement (TAVR).MethodsThis was a prospective cohort of 170 severe AS patients referred to TAVR. We quantified AVC mass score and fat depots including epicardial adipose tissue, intrathoracic fat, and abdominal visceral (VAF) and subcutaneous fats by computed tomography. Fat depots were indexed to body surface area. All-cause and cardiovascular-related deaths after TAVR were recorded over a median follow-up of 1.2 years.ResultsHigher AVC mass was independently associated with low BMI and low VAF. All-cause mortality risk increased with the decrease of BMI and increment of VAF. A stratified analysis by obesity showed that in non-obese, VAF was inversely associated with mortality, whereas in obese, high VAF was associated with higher mortality (p value for interaction < 0.05). At long-term, hazard ratio [HR] with non-obese/low VAF was 2.3 (95% confidence interval [CI] 1.1–4.9; p = 0.021) and HR with obese/high VAF was 2.5 (95% CI 1.1–5.8; p = 0.031) compared with obese/low VAF patients.ConclusionsIn AS patients submitted to TAVR, BMI and VAF were inversely associated with AVC. Pre-intervention assessment of VAF by computed tomography may provide a better discrimination of mortality than BMI alone.Electronic supplementary materialThe online version of this article (doi:10.1186/s13098-017-0285-2) contains supplementary material, which is available to authorized users.

Tracking and reporting Adverse Drug Reactions (ADRs) is crucial for patient safety. This work aims to improve the data quality of the SIRAI application in Portugal by developing data validation rules and a scoring system for each record and the overall dataset. The goal is to enhance the effectiveness of the SIRAI application in monitoring adverse drug reactions.

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