Circulation: Cardiovascular Imaging最新文献

{"title":"Growth of Multimodality Cardiac Imagers in the United States, 2013-2022.","authors":"Ahmed Sayed, Mahmoud Al Rifai, Maria Alwan, Ahmad El Yaman, Asim Shaikh, William Zoghbi, Mouaz H Al-Mallah","doi":"10.1161/CIRCIMAGING.124.017953","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017953","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017953"},"PeriodicalIF":6.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741815","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":"Vasospastic Angina: How Much Can We Know Before Provocative Testing?","authors":"Khaled M Ziada","doi":"10.1161/CIRCIMAGING.125.018177","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.018177","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018177"},"PeriodicalIF":6.5,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718028","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":"Artificial Intelligence-Enhanced Analysis of Echocardiography-Based Radiomic Features for Myocardial Hypertrophy Detection and Etiology Differentiation.","authors":"Inki Moon, Jina Lee, Seung-Ah Lee, Dawun Jeong, Jaeik Jeon, Yeonggul Jang, Sihyeon Jeong, Jiyeon Kim, Hong-Mi Choi, In-Chang Hwang, Youngtaek Hong, Goo-Yeong Cho, Yeonyee E Yoon, Hyuk-Jae Chang","doi":"10.1161/CIRCIMAGING.124.017436","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017436","url":null,"abstract":"<p><strong>Background: </strong>While echocardiography is pivotal for detecting left ventricular hypertrophy (LVH), it struggles with etiology differentiation. To enhance LVH assessment, we aimed to develop an artificial intelligence algorithm using echocardiography-based radiomics. This algorithm is designed to detect LVH and differentiate its common etiologies, such as hypertrophic cardiomyopathy (HCM), cardiac amyloidosis (CA), and hypertensive heart disease (HHD), based on echocardiographic images.</p><p><strong>Methods: </strong>The developmental data sets from multiple medical centers included 867 subjects, with an independent external test set from a single tertiary medical center containing 619 subjects. Radiomic feature analysis was conducted on 4 echocardiographic views, extracting both conventional and harmonization-driven myocardial textures along with myocardial geographic features. Then, we developed classification models for each condition. Variable contributions were evaluated using Shapley Additive Explanations analysis.</p><p><strong>Results: </strong>The radiomics-based LightGBM model, selected from internal validation, maintained strong performance in the external test set (area under the curve of 0.96 for HCM, 0.89 for CA, and 0.86 for HHD). Compared with the logistic regression model using conventional echocardiographic parameters (left ventricular ejection fraction, left ventricular mass index, left atrial volume index, and E/e'), the final model demonstrated superior sensitivity (0.89 versus 0.80 for HCM, 0.80 versus 0.80 for CA, and 0.75 versus 0.33 for HHD) and F1-score (0.87 versus 0.57 for HCM, 0.84 versus 0.72 for CA, and 0.82 versus 0.50 for HHD). Feature analysis highlighted that harmonization-driven textures played a key role in differentiating HCM, while conventional textures and myocardial thickness were influential in differentiating CA and HHD.</p><p><strong>Conclusions: </strong>This study confirms that artificial intelligence-enhanced echocardiography-based radiomics effectively differentiate the etiology of LVH, highlighting the potential of artificial intelligence-driven texture and geographic analysis in LVH evaluation.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017436"},"PeriodicalIF":6.5,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718012","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":"Is 4D CMR Sufficient for Preoperative Planning?","authors":"Sara Santiaguel, Laura Schoeneberg, Jessie Hu, Charles Huddleston, Wilson King","doi":"10.1161/CIRCIMAGING.124.017802","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017802","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017802"},"PeriodicalIF":6.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728990","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":"Determinants and Prognostic Value of Early Gadolinium Enhancement-Derived Myocardial Salvage Index in STEMI.","authors":"Jin-Yi Xiang, Jin-Yu Zheng, Yi-Si Dai, Ling-Yi Yu, Yu-Fan Qian, Wei-Hui Xie, Ruo-Yang Shi, Bing-Hua Chen, Jun Pu, Lian-Ming Wu","doi":"10.1161/CIRCIMAGING.124.017830","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017830","url":null,"abstract":"<p><strong>Background: </strong>T2-weighted imaging is commonly used to measure myocardial salvage in reperfused myocardial infarction but is hindered by poor reproducibility and indistinct boundaries. Early gadolinium enhancement (EGE) emerges as an alternative for measuring the area at risk. This study aims to evaluate the determinants of the myocardial salvage index (MSI) derived from EGE and its prognostic implications.</p><p><strong>Methods: </strong>We analyzed acute cardiac magnetic resonance scans of 453 reperfused patients with ST-segment-elevation myocardial infarction (mean age, 60±12 years; 389 men) from April 2017 to July 2023 at a single center retrospectively. EGE was collected at 3 minutes after contrast agent injection, where hyperintense areas (signal intensities > mean+2SD of remote myocardium) were considered as the area at risk, plus the hypointense core within. MSI was calculated as the ratio of salvageable myocardium to the area at risk. Major adverse cardiovascular events included cardiovascular death, hospitalization for heart failure, reinfarction, and unplanned revascularization for the target vessel.</p><p><strong>Results: </strong>During a median follow-up of 3.2 years (interquartile range, 1.6-4.7 years), at least one major adverse cardiac event occurred in 91 participants (20.1%). The median MSI was 35.0% (interquartile range, 22.9-59.5%), with smaller MSI observed in patients with larger infarcts (<i>P</i><0.001). Linear regression identified prepercutaneous coronary intervention Thrombolysis in Myocardial Infarction flow (β=3.35, <i>P</i><0.001) and microvascular obstruction (β=-11.92, <i>P</i><0.001) as independent determinants of MSI. Multivariable Cox regression showed that every 10% increase in MSI was associated with a 32% reduction in major adverse cardiac event risk (hazard ratio, 0.68 [95% CI, 0.53-0.86]; <i>P</i>=0.001). A graded response was observed between MSI and cardiovascular death and reinfarction. MSI greater than the median was associated with nontarget vessel-related reinfarctions but not target vessel-related ones (nontarget, <i>P</i>=0.027; target vessel, <i>P</i>=0.36). Good reproducibility was reported with EGE-measured area at risk (intraobserver, intraclass correlation coefficient [ICC]=0.95; interobserver, ICC=0.89).</p><p><strong>Conclusions: </strong>EGE-derived MSI was associated with prepercutaneous coronary intervention Thrombolysis in Myocardial Infarction flow and microvascular injuries. It was an independent predictor of major adverse cardiac events. Our results highlight the prognostic potential of EGE imaging in acute myocardial infarction.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017830"},"PeriodicalIF":6.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691337","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":"Utility of 3D Intracardiac Echocardiography in TriClip: A Future Without Transesophageal Echocardiography?","authors":"Fei Yu, Scott Dougherty, Kent Chak-Yu So, Kevin Ka-Ho Kam, Chenxu Zhao, Xinghua Shan, Alex Pui-Wai Lee","doi":"10.1161/CIRCIMAGING.124.017738","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017738","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017738"},"PeriodicalIF":6.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691338","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":"Inflammatory Myofibroblastic Tumor Mimicking Pulmonary Artery Sarcoma and Causing Pulmonary Artery Obstruction: A Rare Case Report.","authors":"Pingping Han, Yanfen Shi, Huan Li, Liping Fu","doi":"10.1161/CIRCIMAGING.124.017658","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017658","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017658"},"PeriodicalIF":6.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669398","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":"3D Echocardiographic and CMR Imaging for the Assessment of Right Ventricular Function and Tricuspid Regurgitation Severity.","authors":"Philipp M Doldi, Ludwig T Weckbach, Nicola Fink, Lukas Stolz, Cecilia Ennin, Julien Dinkel, Philipp Lurz, Holger Thiele, Rebecca Hahn, João L Cavalcante, Christian Besler, Jörg Hausleiter","doi":"10.1161/CIRCIMAGING.124.017638","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017638","url":null,"abstract":"<p><strong>Background: </strong>Tricuspid regurgitation (TR) is associated with increased mortality and is often underdiagnosed due to limitations in imaging modalities. While routine 2-dimensional echocardiography (2DE) demonstrates frequent disagreement with cardiac magnetic resonance imaging (CMR) in classifying TR severity, the incremental value of 3-dimensional echocardiography (3DE) remains unknown also due to the lack of a generalizable grading scheme across imaging modalities. Therefore, this study provides an intermodality comparison of all 3 imaging modalities (2DE, 3DE, and CMR) in evaluating TR severity and proposes an adapted 5-class grading scheme for TR severity using CMR.</p><p><strong>Methods: </strong>A total of 144 patients with symptomatic TR were analyzed across 2 cohorts: a derivation cohort (n=91) from the University Hospital of Munich and a validation cohort (n=53) from the Heart Center Leipzig. All patients underwent multimodality imaging, including transthoracic 2DE, transesophageal 3DE, and CMR. The adapted 5-class CMR-based grading scheme was proposed and externally validated.</p><p><strong>Results: </strong>In the derivation cohort (median age 81 years, 66% female), TR severity grading by 3DE highly correlated with CMR (87% concordance within a 1-grade difference), significantly outperforming 2DE (68% concordance). While 3DE underestimated RV dimensions compared with CMR (<i>P</i><0.001), it provided a comparable measure of TR severity and RV function. 2DE achieved the lowest accuracy rates compared with CMR (34.5%; <i>P</i>=0.005) with frequent overestimation of TR severity. An overestimation of TR severity by 3DE compared with CMR was significantly less frequent than with 2DE (21% versus 56%; <i>P</i><0.001). Cohen κ analysis confirmed a substantial and superior agreement between 3DE and CMR compared with 2DE (κ=0.63 versus 0.41; <i>P</i>=0.01). The results were externally validated, showing comparable results within the derivation and validation cohorts.</p><p><strong>Conclusions: </strong>3DE provides an accurate assessment of TR severity comparable to CMR. The proposed 5-class grading scheme for TR severity using CMR demonstrates high accuracy and external validity.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017638"},"PeriodicalIF":6.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669347","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":"Severe Mitral Regurgitation in Paradoxical Low-Flow, Low-Gradient Severe Aortic Stenosis.","authors":"Shani Dahan, Jacob Dal-Bianco, Ygal Plakht, Mayooran Namasivayam, Romain Capoulade, Xin Zeng, Jonathan J Passeri, Evin Yucel, Michael H Picard, Robert A Levine, Judy Hung","doi":"10.1161/CIRCIMAGING.124.017598","DOIUrl":"10.1161/CIRCIMAGING.124.017598","url":null,"abstract":"<p><strong>Background: </strong>Patients with paradoxical low-flow, low-gradient severe aortic stenosis exhibit low transvalvular flow rate (Q), while maintaining preserved left ventricular ejection fraction. Severe mitral regurgitation (MR) also causes a low-flow state, adding complexity to diagnosis and management. This study aimed to examine the impact of severe MR on outcomes in paradoxical low-flow, low-gradient severe aortic stenosis.</p><p><strong>Methods: </strong>Data from an institutional echo database identified 1189 patients with adjudicated severe aortic stenosis (aortic valve area ≤1.0 cm²), low transaortic gradients (mean gradient <40 mm Hg), preserved left ventricular ejection fraction (≥50%), and low-flow rate (Q ≤210 mL/s) to confirm paradoxical low-flow, low-gradient severe aortic stenosis. Subgroups were based on MR severity (severe and nonsevere). Clinical outcomes included all-cause mortality, aortic valve replacement, heart failure hospitalizations, and a composite outcome.</p><p><strong>Results: </strong>In the severe MR group (n=80), patients had lower flow rates, increased left ventricular dimensions, and a more eccentric hypertrophy pattern compared with nonsevere MR (n=1109). Over a follow-up of up to 5 years, severe MR correlated with higher all-cause mortality (<i>P</i>=0.02) and aortic valve replacement rates (<i>P</i>=0.012). After adjustment, severe MR was independently associated with increased all-cause mortality risk (hazard ratio, 1.43; <i>P</i>=0.011) and composite outcome (hazard ratio, 1.64; <i>P</i><0.001). Aortic valve replacement significantly reduced mortality at every MR degree, with the most substantial impact in severe MR (hazard ratio, 0.18; <i>P</i><0.001). Propensity-adjusted models demonstrated a stronger aortic valve replacement impact with increasing MR degree (<i>P</i>_interaction=0.044).</p><p><strong>Conclusions: </strong>Severe MR in paradoxical low-flow, low-gradient severe aortic stenosis is associated with adverse outcomes and distinctive left ventricular remodeling. Aortic valve replacement improves survival across all MR grades, with greater impact in severe MR.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017598"},"PeriodicalIF":6.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669405","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":"MRI-Extracellular Volume Fraction Versus Histological Amyloid Load in Cardiac Amyloidosis: The Importance of T2 Mapping.","authors":"Masafumi Kidoh, Seitaro Oda, Seiji Takashio, Mami Morioka, Naoto Kuyama, Tetsuya Oguni, Takeshi Nakaura, Yasunori Nagayama, Yasuhiro Izumiya, Kenichi Tsujita, Toshinori Hirai","doi":"10.1161/CIRCIMAGING.124.017427","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017427","url":null,"abstract":"<p><strong>Background: </strong>MRI-derived myocardial extracellular volume fraction (ECV) is elevated in the presence of fibrosis, amyloid deposition, inflammation and edema. In patients with cardiac amyloidosis and prolonged T2 due to concomitant inflammation or edema, MRI-ECV may not correctly reflect histological amyloid load. The authors sought to determine whether MRI-ECV can accurately reflect histological amyloid load in 2 groups of patients with wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM), with and without T2 prolongation.</p><p><strong>Methods: </strong>This retrospective study included consecutive patients with ATTRwt-CM who underwent endomyocardial biopsy and cardiac MRI from March 2017 to October 2021 for initial evaluation of ATTRwt-CM. We measured MRI-ECV and T2, and evaluated correlation between MRI-ECV and amyloid load from endomyocardial biopsy by means of Pearson correlation analysis.</p><p><strong>Results: </strong>Of 44 patients (mean age, 75±6 years [SD]; 40 men), 24 showed T2 prolongation (T2≥50 milliseconds). All specimens obtained by endomyocardial biopsy were suitable for analysis. The interval between endomyocardial biopsy and cardiac MRI examination was a median of 3 days (interquartile range, 2-4). In the absence of T2 prolongation due to increased water content, MRI-ECV and amyloid load showed a moderately significant correlation (Spearman ρ=0.50, <i>P</i>=0.03). However, in the presence of T2 prolongation, there was no significant correlation between MRI-ECV and amyloid load (Spearman ρ=-0.05, <i>P</i>=0.83).</p><p><strong>Conclusions: </strong>In patients with ATTRwt-CM and prolonged T2, MRI-ECV did not accurately reflect histological amyloid load. Our findings underscore the need for a multiparametric imaging approach, combining both ECV and T2 mapping, to better characterize myocardial tissue in patients with ATTRwt-CM, and further prospective research in larger and more diverse cohorts is needed to validate our results.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017427"},"PeriodicalIF":6.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669402","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}