Circulation: Cardiovascular Imaging最新文献

{"title":"Deep Learning-Based 3D CT Body Composition Is Associated With Mortality in Patients Undergoing Transcatheter Aortic Valve Replacement.","authors":"Ibrahim Hadzic, Jan M Brendel, Thomas Mayrhofer, Matthias Jung, Lauren H Cooke, Marton Kolossvary, Evin Yucel, Sara Ersözlü, Vencel Juhasz, Isabel L Langenbach, Marcel C Langenbach, Nilay K Patel, Shady Abohashem, Vineet K Raghu, Brian Ghoshhajra, Sandeep Hedgire, Konstantin Nikolaou, Ahmed Tawakol, Michael T Lu, Pamela S Douglas, Hugo J W L Aerts, Borek Foldyna","doi":"10.1161/CIRCIMAGING.126.020106","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.126.020106","url":null,"abstract":"<p><strong>Background: </strong>Recent advances in artificial intelligence enable fully automated 3-dimensional computed tomography (CT)-based body composition quantification. We investigated whether automated CT-derived thoraco-abdominopelvic body composition measures are associated with mortality after transcatheter aortic valve replacement.</p><p><strong>Methods: </strong>In this retrospective multicenter study, consecutive patients undergoing transcatheter aortic valve replacement with preprocedural CT imaging were included between 2014 and 2023. A deep learning-based pipeline performed automated 3-dimensional segmentation of thoraco-abdominopelvic noncontrast CT scans to quantify volumes (L/m²) and attenuations (Hounsfield units) of subcutaneous adipose tissue, visceral adipose tissue, muscular adipose tissue, and lean skeletal muscle, indexed to body surface area. Associations with mortality were evaluated using Cox models and Harrell C statistics, adjusting for demographics (age, sex, body mass index) and cardiometabolic risk factors (hypertension, diabetes, chronic renal failure).</p><p><strong>Results: </strong>Among 915 patients (median age, 84 years [interquartile range, 77-90]; 58% men), 160 (17.5%) died over a median follow-up of 22 months (interquartile range, 14-36). Restricted cubic spline analyses demonstrated that lower subcutaneous adipose tissue volume and higher adipose tissue attenuation were associated with increased mortality, whereas higher skeletal muscle volume and attenuation were associated with improved survival. Addition of body composition measures provided incremental discriminatory value beyond demographics and cardiometabolic risk factors (Harrell C, 0.66 versus 0.71; <i>P</i><0.001).</p><p><strong>Conclusions: </strong>Automated 3-dimensional CT-derived body composition measures provide independent prognostic information and improve risk stratification for mortality after transcatheter aortic valve replacement. Low subcutaneous adipose tissue volume and higher adipose tissue attenuation identify patients at increased risk, whereas higher skeletal muscle volume and attenuation are associated with lower mortality.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e020106"},"PeriodicalIF":9.1,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Myocardial Perfusion Imaging to Guide Prognosis and Management in Older Adults: Is There an Age Limit?","authors":"Krishna K Patel, Robert J H Miller, Mark Lemley, Aakash Shanbhag, Giselle Ramirez, Joanna X Liang, Wanda Acampa, Timothy M Bateman, Sharmila Dorbala, Andrew J Einstein, M Timothy Hauser, Philipp A Kaufmann, Attila Feher, Edward J Miller, Terrence D Ruddy, Tali Sharir, Julian Halcox, Monica Martins, Panithaya Chareonthaitawee, Samuel Wopperer, Thomas L Rosamond, Rene R S Packard, Mouaz Al-Mallah, Isabel Carvajal-Juarez, Erick Alexanderson, Stacey Knight, Ronny R Buechel, Leandro Slipczuk, Damini Dey, Daniel S Berman, Marcelo Di Carli, Piotr J Slomka","doi":"10.1161/CIRCIMAGING.126.019932","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.126.019932","url":null,"abstract":"<p><strong>Background: </strong>Myocardial perfusion imaging is used to guide risk stratification and revascularization decisions. We aimed to determine whether the prognostic value of ischemia on myocardial perfusion imaging and the association with early revascularization (ER) and outcomes differ across age groups.</p><p><strong>Methods: </strong>We included 73 038 patients who underwent single photon emission computed tomography (n=45 252) or positron emission tomography (n=27 786) myocardial perfusion imaging across 20 sites from 2009 to 2024. ER was defined as revascularization within 90 days post-myocardial perfusion imaging. Propensity score-adjusted Cox models evaluated the interaction between age, ischemic burden (myocardial flow reserve for positron emission tomography), and ER for the primary outcome of all-cause death or nonfatal myocardial infarction.</p><p><strong>Results: </strong>Median age was 66 years; 45.3% were <65, 31.5% were 65 to 74, 19.1% were 75 to 84, and 4.2% were ≥85. ER was performed in 6.1%, rising to 7.0% in those aged 75 to 84 years and decreasing to 6.5% in those aged ≥85 years. During a median follow-up of 3.7 years, 10 757 deaths/myocardial infarctions occurred. Increasing ischemia was associated with lower event rates after ER versus medical therapy across most age groups, with no significant continuous age-ischemia-ER interaction (<i>P</i>=0.748). In an exploratory analysis of 3031 patients aged ≥85 years, this association appeared attenuated (hazard ratio for ischemia >10%: 0.90 [0.64-1.26]), although precision was limited, likely reflecting, in part, the small number of patients undergoing ER (n=198). Among positron emission tomography patients, the myocardial flow reserve×ER association did not vary with age (3-way interaction <i>P</i>=0.689). In analyses excluding patients with ER, ischemia remained prognostic in all age groups, though its associated risk declined with advancing age.</p><p><strong>Conclusions: </strong>Ischemia remains prognostic across all ages and may help identify candidates who have improved outcomes with ER. In an exploratory analysis, this association appeared attenuated in patients aged ≥85 years, a hypothesis-generating observation. Positron emission tomography-derived myocardial flow reserve may provide complementary physiological information for treatment selection in older adults.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019932"},"PeriodicalIF":9.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of ¹⁸FDG-Avidity and Immunosuppression on Idiopathic and Genetic Cardiomyopathies.","authors":"Shiva Tabaghi, Graham H Bevan, Stephen Hankinson, Esra D Gumuser, Mallika Lal, Madison Pico, Neal Chatterjee, Alexi Vasbinder, Richard K Cheng, April Stempien-Otero, Neal K Lakdawala, Ron Blankstein, Marcelo F Di Carli, Benjamin Levin, Sanjay Divakaran, Babak Nazer","doi":"10.1161/CIRCIMAGING.126.019970","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.126.019970","url":null,"abstract":"<p><strong>Background: </strong>Myocardial ¹⁸fluorodeoxyglucose (¹⁸FDG)-avidity is frequently seen in patients with genetic cardiomyopathy, as well as a growing \"idiopathic ¹⁸FDG-avidity\" group of genotype-negative patients who do not clearly have cardiac sarcoidosis. The prognostic implications of ¹⁸FDG-avidity in patients with and without genetic cardiomyopathy, and the effects of immunosuppression in the latter, remain uncertain.</p><p><strong>Methods: </strong>This multicenter, retrospective study included all patients who were referred for both ¹⁸FDG-PET and cardiomyopathy genetic testing. Patients with acute myocarditis, biopsy-proven sarcoidosis, or extracardiac ¹⁸FDG-avidity were excluded. We investigated heart failure (HF) composite (left ventricular assist device, heart transplant, HF hospitalization, or death) and arrhythmia composite (sustained ventricular arrhythmias [ventricular tachycardia/VF], atrioventricular block, or death) outcomes using survival analysis, including Cox proportional hazards modeling and inverse probability of treatment weighting.</p><p><strong>Results: </strong>Among 372 patients, 142 (38%) were ¹⁸FDG-avid. The prevalence of genetic cardiomyopathy among ¹⁸FDG-avid patients (12%) was similar to that of ¹⁸FDG-negative patients (18%; <i>P</i>=0.11). Unadjusted, ¹⁸FDG-avidity was associated with an increased risk of HF composite (hazard ratio, 1.69 [95% CI, 1.04-2.75]; <i>P</i>=0.034) and arrhythmia composite (hazard ratio, 1.63 [95% CI, 1.1-2.4]; <i>P</i>=0.014) outcomes compared with ¹⁸FDG-negative patients. However, these associations were not statistically significant after multivariable adjustment, nor were there significant differences in ¹⁸FDG-associated risks in patients with genetic cardiomyopathy versus genotype-negative patients. After inverse probability of treatment weighting, immunosuppression of ¹⁸FDG-avid patients (n=49) was not associated with a reduction in HF or arrhythmia composite outcomes compared with those who were not immunosuppressed (n=93).</p><p><strong>Conclusions: </strong>Myocardial-only ¹⁸FDG-avidity is not significantly associated with HF or arrhythmia risk in patients who do not clearly have cardiac sarcoidosis (including those with genetic cardiomyopathy). Immunosuppression therapy does not seem to modify the disease course, suggesting that not all myocardial ¹⁸FDG uptake reflects clinically significant inflammation.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019970"},"PeriodicalIF":9.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a Coronary Artery Calcium Volume and Density Score.","authors":"Harpreet S Bhatia, Alexander C Razavi, Zeina Dardari, Robyn L McClelland, David R Jacobs, James G Terry, J Jeffrey Carr, Daniel Duprez, Parag H Joshi, Anand Rohatgi, Amit Khera, Jamal S Rana, Ankeet Bhatt, Tara S Allen, Julie Denenberg, Matthew Budoff, Matthew Allison, Michael J Blaha, Michael Criqui","doi":"10.1161/CIRCIMAGING.126.020112","DOIUrl":"10.1161/CIRCIMAGING.126.020112","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery calcium (CAC) scoring is a useful tool for coronary heart disease (CHD) risk prediction. The current standard method, the Agatston score, weights plaque area upward by density. However, higher density is inversely associated with CHD. We aimed to develop and validate a CAC score accounting for the inverse association of density with CHD, and the nonlinear association between CAC volume and density in a prospective cohort study.</p><p><strong>Methods: </strong>A CAC volume and density score was developed, which adjusts CAC volume for density based on whether the volume level was <130 mm³. We used data from the MESA (Multi-Ethnic Study of Atherosclerosis) to develop and assess the score, including all participants with CAC>0 and follow-up for CHD events. Score performance for CHD risk prediction was compared with the pooled cohort equations and the Agatston score using Cox proportional hazards models and Harrell <i>C</i>-index and continuous and categorical net reclassification improvement. Analyses were also stratified by Agatston score, age, sex, race/ethnicity, and statin use. Finally, performance was evaluated in 4 longitudinal cohorts for external validation.</p><p><strong>Results: </strong>The MESA cohort included 3360 individuals. CAC volume and density score improved the <i>C</i>-index for CHD to a greater degree over the pooled cohort equation (0.699 [95% CI, 0.675-0.723]) compared with the Agatston score (0.687 [95% CI, 0.663-0.711]) and resulted in greater continuous net reclassification improvement (0.54 [95% CI, 0.43-0.64]) compared with the Agatston score (0.45 [95% CI, 0.34-0.56]) when added to the pooled cohort equation. The greatest improvement in risk prediction was in those with lower burden of CAC (Agatston <300). Consistent results were seen in stratified analyses and external validation cohorts.</p><p><strong>Conclusions: </strong>The CAC volume and density score, which adjusts CAC volume downward for higher density, and can be calculated from existing CAC reports, significantly improves risk discrimination and reclassification compared with the Agatston score.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e020112"},"PeriodicalIF":9.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13667856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter by Hayek et al Regarding Article, \"RACI: A Novel Prognostic Marker in Functional Tricuspid Regurgitation\".","authors":"Ahmad Hayek, Anissa Bouali, Brahim Harbaoui","doi":"10.1161/CIRCIMAGING.126.020410","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.126.020410","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e020410"},"PeriodicalIF":9.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opportunistic CT Fatty Muscle Fraction for Outcome Prediction in Patients Undergoing Transcatheter Mitral Valve Edge-to-Edge Repair.","authors":"Babak Salam, Marcel Weber, Alois M Sprinkart, Sebastian Nowak, Maike Theis, Muntadher Al-Zaidi, Atsushi Sugiura, Tetsu Tanaka, Tatjana Dell, Alexander Isaak, Daniel Kuetting, Sebastian Zimmer, Georg Nickenig, Julian A Luetkens, Johanna Vogelhuber","doi":"10.1161/CIRCIMAGING.125.018763","DOIUrl":"10.1161/CIRCIMAGING.125.018763","url":null,"abstract":"<p><strong>Background: </strong>Frailty is a risk factor for adverse outcomes in patients undergoing mitral valve transcatheter edge-to-edge repair (M-TEER) and is interrelated with sarcopenia. This study aimed to investigate the prognostic value of fatty muscle fraction (FMF), measured from routine preinterventional computed tomography, as an imaging biomarker for frailty in patients undergoing M-TEER.</p><p><strong>Methods: </strong>In patients undergoing M-TEER between 2010 and 2022 at the Heart Center Bonn who received preprocedural contrast-enhanced computed tomography, skeletal muscle quantity and quality at the L3 vertebral level were assessed on arterial-phase images using a deep learning-based segmentation algorithm. Fatty muscle fraction (FMF) was quantified and correlated with anthropometric, clinical, echocardiographic, and laboratory parameters. The primary end point was all-cause mortality at 1 year following the procedure, with additional follow-up at 30 days, 2 years, and 3 years.</p><p><strong>Results: </strong>A total of 197 patients (median age, 79.3 years [interquartile range, 75.0-84.0]; 54.3% men; median European System for Cardiac Operative Risk Evaluation II, 4.1 [2.6-5.8]) were investigated. One-year survivors had significantly lower FMF values than nonsurvivors (49.0% [39.0-58.7] versus 57.6% [49.6-69.2]; <i>P</i><0.001). Patients were divided into tertiles according to the extent of FMF: low FMF (<44.42%), medium FMF (44.42-56.69%), and high FMF (>56.69%). Following M-TEER, high FMF was associated with a higher all-cause mortality at 30 days (16.7% versus 6.1% versus 1.5%; <i>P</i>=0.005), 1 year (30.3% versus 19.7% versus 7.7%; <i>P</i>=0.004), 2 years (36.4% versus 22.7% versus 12.3%; <i>P</i>=0.005) and 3 years (37.9% versus 22.7% versus 13.8%; <i>P</i>=0.005) follow-up. Multivariable Cox regression analysis for 1-year mortality revealed age (hazard ratio, 0.96 [95% CI, 0.93-1.00]; <i>P</i>=0.023), male sex (hazard ratio, 3.65 [95% CI, 1.67-7.975]; <i>P</i><0.001), and FMF (hazard ratio, 1.05 [95% CI, 1.02-1.08]; <i>P</i><0.001) as independent predictors of 1-year all-cause mortality.</p><p><strong>Conclusions: </strong>Computed tomography-derived FMF, as a potentially new frailty marker, is independently associated with all-cause mortality in patients undergoing M-TEER and may serve as a promising parameter for risk stratification.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018763"},"PeriodicalIF":9.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Clinical Presentation and Outcome of Degenerative Mitral Regurgitation Quantified: The MIDA-Q Registry.","authors":"Benjamin Essayagh, Giovanni Benfari, Steele C Butcher, Gal Tsaban, Clemence Antoine, Francesco Grigioni, Thierry Le Tourneau, Jeroen J Bax, Nina Ajmone Marsan, Christophe Tribouilloy, Yan Topilsky, Prabin Thapa, Hector I Michelena, Maurice Enriquez-Sarano","doi":"10.1161/CIRCIMAGING.125.019952","DOIUrl":"10.1161/CIRCIMAGING.125.019952","url":null,"abstract":"<p><strong>Background: </strong>Degenerative mitral regurgitation (DMR) due to valve prolapse predominates in men, but sex-specific differences are poorly understood due to a lack of quantitative and sex-stratified studies.</p><p><strong>Methods: </strong>The international MIDA-Q (Mitral Regurgitation International Database-Quantitative) registry enrolled 3274 men and 2331 women with greater than or equal to mild DMR prospectively quantified, comprehensively characterized, and long-term follow-up.</p><p><strong>Results: </strong>Women were more symptomatic despite lower effective regurgitant orifice (ERO, 27±18 versus 38±22 mm², standardized mean difference 0.54; <i>P</i><0.0001) and regurgitant volume (46±26 versus 61±31 mL/beat, standardized mean difference 0.52; <i>P</i><0.0001), even for similar mitral lesions. With increasing ERO, women showed lower regurgitant volume, higher heart rate, lower blood pressure, but left ventricular size response in women was smaller in absolute measures while larger when body surface area normalized, with higher ejection fraction and cardiac index (all <i>P</i><0.0001). Incidence of mitral valve surgery was similar in symptomatic women and men, but lower in asymptomatic women versus men (adjusted hazard ratio, 0.80 [0.69-0.94]; <i>P</i>=0.008) for similar ERO, linked to smaller left ventricular diastolic absolute diameter (<i>P</i><0.0001). Excess mortality under medical management (of severe versus mild ERO) was similar in women (adjusted hazard ratio, 1.67 [1.24-2.24]; <i>P</i>=0.0007) and men (adjusted hazard ratio, 1.63 [1.27-2.09]; <i>P</i><0.0001) and versus expected survival (2.12 [1.51-2.98] in women and 2.27 [1.75-2.94] in men). However, moderate ERO (20-39 mm²) was associated with significant excess mortality in women (1.47 [1.19-1.77] versus mild). In men, the corresponding hazard ratio did not reach statistical significance. Postoperative survival was similar in men and women.</p><p><strong>Conclusions: </strong>Women with DMR present with lower ERO and regurgitant volume than men and with considerable adaptive differences to increasing DMR severity versus men. Asymptomatic women are less referred to surgery than men of similar DMR severity, linked to smaller absolute left ventricular size. Severe DMR by similar quantitative thresholds causes similar excess mortality in men and women; moderate quantitative DMR shows a trend for higher excess mortality versus expected in women than men, requiring further confirmation. These data emphasize the importance of quantitative DMR and left ventricular remodeling assessment in men and women for appropriate clinical management.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019952"},"PeriodicalIF":9.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Imaging in Clinical Trials of Intervention in Aortic Valve Stenosis.","authors":"Bethlehem Mengesha, Carlos Giuliani, Georgios Tzimas, Antonela Zanuttini, Jonathon Leipsic, Philippe Pibarot","doi":"10.1161/CIRCIMAGING.125.018670","DOIUrl":"10.1161/CIRCIMAGING.125.018670","url":null,"abstract":"<p><p>Cardiac imaging and in particular transthoracic echocardiography and computed tomography play a major role in the selection of the patients for surgical or transcatheter aortic valve replacement, for the assessment or procedural success and early prosthetic valve hemodynamics following aortic valve replacement, and for the evaluation and follow-up of the prosthetic valve structure and function in the longer-term, which is key to demonstrate the valve durability. The purpose of this review article is thus to present the role of cardiac imaging, and particularly transthoracic echocardiography and computed tomography, in: (1) patient selection for intervention; (2) assessment of procedural and device success, and of intended performance of the valve; and (3) assessment of the long-term success, valve durability, and prognosis, for clinical trials of intervention in patients with aortic stenosis. Transthoracic echocardiography is the primary imaging modality to detect and stage bioprosthetic valve dysfunction. However, multimodality imaging, including transesophageal echocardiography and computed tomography, is often necessary to determine the cause of bioprosthetic valve dysfunction and make the differential diagnosis between prosthesis-patient mismatch, structural valve deterioration, thrombosis, pannus, or endocarditis. The clinical trials in the field of structural heart disease, and particularly in the field of aortic valve intervention, include imaging end points as part of the primary or key secondary end points. Standardized methods and definitions should be applied to adjudicate these imaging end points, and ideally, these trial end points should be analyzed by independent imaging core labs.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018670"},"PeriodicalIF":9.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low Contrast Photon-Counting Detector CT Using Spectral Information to Enhance Structural Heart Intervention Planning.","authors":"Doosup Shin, Azka Naeem, Roosha Parikh, William B Chung, George A Petrossian, Ziad A Ali, Jaffar Khan, Omar K Khalique","doi":"10.1161/CIRCIMAGING.125.019341","DOIUrl":"10.1161/CIRCIMAGING.125.019341","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019341"},"PeriodicalIF":9.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147472225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Common Thresholds, Different Consequences in Degenerative Mitral Regurgitation.","authors":"Kenya Kusunose","doi":"10.1161/CIRCIMAGING.126.020484","DOIUrl":"10.1161/CIRCIMAGING.126.020484","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e020484"},"PeriodicalIF":9.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}