Faculty Bibliography

Whether congenital or acquired, timely recognition and management of disease is imperative, as hemodynamic alterations in blood flow, tissue perfusion, and cellular oxygenation can have profound effects on organ function, growth and development, and quality of life for the pediatric patient. Ensuring safe computed tomographic angiography (CTA) practice and "gentle" pediatric imaging requires the cardiovascular imager to have sound understanding of CTA advantages, limitations, and appropriate indications as well as strong working knowledge of acquisition principles and image post processing. From this vantage point, CTA can be used as a useful adjunct along with the other modalities. This article presents a summary of dose reduction CTA methodologies along with techniques the authors have employed in clinical practice to achieve low-dose and ultralow-dose exposure in pediatric CTA. CTA technical principles are discussed with an emphasis on the low-dose methodologies and safe contrast medium delivery strategies. Recommended parameters for currently available multidetector-row computed tomography scanners are summarized alongside recommended radiation and contrast medium parameters. In the second part of the article an overview of pediatric CTA clinical applications is presented, illustrating low-dose and ultra-low dose techniques, with an emphasis on the specific protocols.

The following training statement, "Task Force 13: Training in Advanced Cardiovascular Imaging (Computed Tomography)," is the result of a close collaboration between the American College of Cardiology (Adult Cardiovascular Medicine Core Cardiology Training [COCATS] Task Force 13) and the Society of Cardiovascular Computed Tomography. This Task Force 13 Report is 1 of 13 COCATS 3 Task Force Reports, which encompass training recommendations for fellowship programs in adult cardiovascular medicine and are published in their entirely in the January 22, 2008, issue of the Journal of the American College of Cardiology (J Am Coll 2008;51:409-14). This document has been endorsed by the Board of Trustees of the American College of Cardiology and the Society of Cardiovascular Computed Tomography.

Angiotensin II is a biologically active component of the renin-angiotensin system. High levels of angiotensin II may be responsible for hypertension and heart failure because they increase systemic vascular resistance, arterial pressure, and sodium and fluid retention. Therefore, it is important to monitor angiotensin II levels for the treatment of hypertension and heart diseases. The goal of this work was to develop a bioluminescence immunoassay using aequorin as a label to measure angiotensin II levels in human plasma. This method utilizes a genetically engineered fusion protein between angiotensin II and aequorin. For that, the C terminus of angiotensin II was fused to the N terminus of apoaequorin using molecular biology techniques. A heterogeneous immunoassay was then developed for the determination of angiotensin II. A detection limit of 1 pg/mL was obtained with the optimized assay, allowing for the determination of angiotensin II at physiological levels in human plasma.