Circulation: Cardiovascular Imaging最新文献

{"title":"High-intensity Exercise, Fibrosis, and Ventricular Arrhythmias: How Much is Too Much?","authors":"Katie J McMenamin, Frederick L Ruberg","doi":"10.1161/CIRCIMAGING.125.018716","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.018716","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658587","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":"Ventricular Arrhythmia and Cardiac Fibrosis in Endurance Experienced Athletes (VENTOUX).","authors":"Wasim Javed, Ioannis Botis, Ze Min Goh, Mubien Shabi, Benjamin Brown, Raluca Tomoaia, Maryum Farooq, Eylem Levelt, Lee Graham, John Gierula, Peter Kellman, John P Greenwood, Sven Plein, Peter P Swoboda","doi":"10.1161/CIRCIMAGING.125.018470","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.018470","url":null,"abstract":"<p><strong>Background: </strong>Sudden cardiac death due to primary arrhythmia is a leading cause of mortality in athletes, predominantly affecting older males. Myocardial fibrosis is strongly associated with arrhythmogenesis in nonischemic cardiomyopathy, but its clinical significance in asymptomatic endurance athletes is unknown. We aimed to investigate whether myocardial fibrosis on cardiovascular magnetic resonance in asymptomatic veteran male athletes was associated with incident ventricular arrhythmia on long-term implantable loop recorder.</p><p><strong>Methods: </strong>Prospective observational cohort study involving 106 asymptomatic male competitive cyclists/triathletes (aged ≥50 years) who undertook ≥10 h/wk of exercise for ≥15 years. Exclusion criteria were any preexisting cardiovascular disease. Participants underwent clinical assessment, stress-perfusion late gadolinium enhancement-cardiovascular magnetic resonance, exercise testing, and implantable loop recorder implantation to detect ventricular arrhythmia. Athletes were followed up for the primary end point of incident ventricular arrhythmia.</p><p><strong>Results: </strong>A total of 50/106 (47.2%) athletes had focal myocardial fibrosis (all nonischemic distribution) on cardiovascular magnetic resonance predominantly affecting the basal inferolateral left ventricular segment. During follow-up (median 720 days), 23/106 (21.7%) athletes experienced ≥1 ventricular arrhythmic episode; 3/106 (2.8%) sustained ventricular tachycardia, and 20/106 (18.9%) nonsustained ventricular tachycardia. Myocardial fibrosis (hazard ratio, 4.7 [95% CI, 1.8-12.8]; <i>P</i>=0.002) and greater left ventricular end-diastolic volume indexed (hazard ratio, 1.4 [95% CI, 1.1-1.9]; <i>P</i>=0.02) were associated with an increased risk of incident ventricular arrhythmia, but right ventricular insertion point late gadolinium enhancement was not (hazard ratio, 1.7 [95% CI 0.6-5.1]; <i>P</i>=0.32). Myocardial fibrosis remained predictive after adjusting for left ventricular end-diastolic volume indexed (hazard ratio, 4.7 [95% CI, 1.7-12.7]; <i>P</i>=0.002).</p><p><strong>Conclusions: </strong>In male veteran endurance athletes, myocardial fibrosis was independently associated with the onset of ventricular arrhythmia, even after adjusting for left ventricular dilatation. Right ventricular insertion point late gadolinium enhancement was not associated with ventricular arrhythmia. Further studies are needed to establish whether myocardial fibrosis itself is arrhythmogenic or a marker of an underlying cardiomyopathic process.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018470"},"PeriodicalIF":6.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658588","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":"Assessing LV Contractility Identifies Populations With Preserved Ejection Fraction at Risk of Adverse Heart Failure Outcomes.","authors":"Sam Straw, Oliver I Brown, Charlotte A Cole, Judith E Lowry, Marcella Conning-Rowland, Stephe Kamalathasan, Sushma Datla, Maria F Paton, Ruth Burgess, Michael Drozd, Thomas A Slater, Samuel D Relton, Eylem Levelt, Klaus K Witte, Mark T Kearney, Richard M Cubbon, John Gierula","doi":"10.1161/CIRCIMAGING.125.018370","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.018370","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular ejection fraction (LVEF) is an essential tool for heart failure (HF) assessment but is limited by load dependence. Additional tools are needed to risk-stratify normal LVEF populations. We aimed to assess the prognostic value of systolic blood pressure-indexed left ventricular end-systolic volume ratio, or cardiac contractility index (CCI).</p><p><strong>Methods: </strong>In a prospective observational cohort study of people newly diagnosed with HF, we defined characteristics and outcomes associated with LVEF and CCI, including after stratification into HF with reduced ejection fraction or HF with preserved ejection fraction. We used UK Biobank to assess whether CCI is associated with subclinical myocardial dysfunction and incident HF.</p><p><strong>Results: </strong>In people with HF, mortality increased over tertiles of declining CCI (<i>P</i><0.001). Within the HF preserved ejection fraction group, below-median CCI was associated with distinct clinical characteristics and an all-cause mortality risk approximately twice that of those with above median CCI (observed event rate 17.3/100 patient-years versus 8.8/100 patient-years; <i>P</i><0.001), similar to those with HF with reduced ejection fraction. Modeled as continuous variables, there was a curvilinear relationship between mortality across the detected range of CCI, while there was no clear association with mortality risk across a wide range of LVEF (20%-55%). In UK Biobank for participants without HF and normal LVEF, below-median CCI was associated with ≈33% increased risk of incident heart failure (adjusted hazard ratio, 1.33 [1.01-1.75]; <i>P</i>=0.043). Decreasing CCI was also associated with lower myocardial contractility defined using global radial and circumferential strain.</p><p><strong>Conclusions: </strong>CCI is a simple, noninvasive, relatively afterload-independent method to stratify HF risk in populations with normal LVEF. Its simplicity means CCI could be applied to existing clinical trial data sets or used be as an inclusion criterion in future randomized controlled trials.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018370"},"PeriodicalIF":6.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641937","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":"Long-Term Follow-Up in Severe Mitral Stenosis With Low Transmitral Diastolic Pressure Gradient: From MASTER Registry.","authors":"Iksung Cho, Dae-Young Kim, Jinseob Kim, Ha Jeong Lim, Jiwon Seo, Kyu Kim, Seo-Yeon Gwak, Hyun-Jung Lee, Hee Jeong Lee, Kyu-Yong Ko, Chi Young Shim, Jong-Won Ha, Seonhwa Lee, In-Cheol Kim, Kang-Un Choi, Jang-Won Son, Joo Hee Park, Geu-Ru Hong, Jagat Narula","doi":"10.1161/CIRCIMAGING.125.018124","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.018124","url":null,"abstract":"<p><strong>Background: </strong>Long-term follow-up studies in severe mitral stenosis (MS) with low transmitral mean diastolic pressure gradient (MDPG) are not available. We evaluated the prognostic implications of severe MS with low MDPG in our MASTER (Multicenter Mitral Stenosis with Rheumatic Etiology) registry.</p><p><strong>Methods: </strong>We included patients with severe rheumatic MS (mitral valve area ≤1.5 cm²) from the long-term MASTER registry. Patients were categorized into high (≥5 mm Hg) or low (<5 mm Hg) MDPG groups. The primary outcome was a composite of all-cause mortality and stroke.</p><p><strong>Results: </strong>Among 1248 patients with severe MS, 322 (25.8%) had low MDPG and 926 (74.2%) had high MDPG. Their mean age was 59±13 years, 25% were men, and 74% had atrial fibrillation. Patients with low MDPG were older and had a higher prevalence of atrial fibrillation. During a mean follow-up of 6.8±5.9 years, 194 (15.5%) patients experienced major adverse events. Patients who had low MDPG sustained more events than those with high MDPG (hazard ratio, 1.56 [95% CI, 1.15-2.12]; <i>P</i>=0.004), and low MDPG was independently associated with poor outcome (hazard ratio, 1.42 [95% CI, 1.02-1.97]; <i>P</i>=0.038) in the multivariable model. In the subgroup analysis of patients with low MDPG, decreased LA reservoir strain was independently associated with poor outcome (hazard ratio, 3.22 [95% CI, 1.25-8.31]; <i>P</i>=0.016).</p><p><strong>Conclusions: </strong>Severe patients with MS and low MDPG carried a greater risk of adverse events than those with high MDPG and had less frequent and delayed mitral valve intervention. Also, it is not necessarily indicative of milder hemodynamic encumbrance. LA reservoir strain could help identify a subgroup associated with poor prognosis in patients with low MDPG.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018124"},"PeriodicalIF":6.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641938","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":"Pulmonary Vascular Oncology: A New Collaborative Field for Cancer-Related Pulmonary Hypertension.","authors":"Alexander J Gazda, John J Ryan","doi":"10.1161/CIRCIMAGING.125.018601","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.018601","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018601"},"PeriodicalIF":6.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590583","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":"<i>Z</i> Scores for Pediatric Echocardiography Dimensions Adjusted for Body Size, BMI, and Age.","authors":"Jonathan Lauzon-Schnittka, Virginie Plante, Nagib Dahdah, Steven C Greenway, Christian Drolet, Kenny Wong, Andrew S Mackie, Luc Mertens, Tiscar Cavallé-Garrido, Joshua Penslar, Derek Wong, Luis Martín Garrido-García, Frédéric Dallaire","doi":"10.1161/CIRCIMAGING.124.017944","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017944","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular dimensions measured during pediatric echocardiograms must be normalized for body size. However, other variables may confound their interpretation, such as age and abnormal body habitus. This retrospective cross-sectional study of the Canadian Congenital and Pediatric Cardiology Research Network aimed to create <i>Z</i> score equations for commonly measured dimensions in pediatric 2-dimensional echocardiography that were free of residual confounding effects of body size, body mass index, and age.</p><p><strong>Methods: </strong>The reference sample consisted of >20 000 children without heart disease from 9 institutions who underwent clinical echocardiography that was reported as normal. A generalized additive model for location, scale, and shape (GAMLSS) was used to model the expected distributions of measurements as a function of sex, height, weight, body mass index, and age.</p><p><strong>Results: </strong>Compared with a model that only considered body surface area, the proposed <i>Z</i> scores demonstrated less bias in subgroups of overweight, young, and early school-aged children.</p><p><strong>Conclusions: </strong>The proposed <i>Z</i> score equations may improve diagnostic and therapeutic accuracy by ensuring that body size, body mass index, and age do not confound the interpretation of measurements.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017944"},"PeriodicalIF":6.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590582","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":"Novel CAC Dispersion and Density Score to Predict Myocardial Infarction and Cardiovascular Mortality.","authors":"Gavin Huangfu, Abdul R Ihdayhid, Simon Kwok, John Konstantopoulos, Kai Niu, Juan Lu, Harry Smallbone, Gemma A Figtree, Clara K Chow, Lawrence Dembo, Brendan Adler, Christian Hamilton-Craig, Stuart M Grieve, Matthew T V Chan, Craig Butler, Vikas Tandon, Peter Nagele, Pamela K Woodard, Marko Mrkobrada, Wojciech Szczeklik, Yang Faridah Abdul Aziz, Bruce Biccard, Philip James Devereaux, Tej Sheth, Girish Dwivedi, Benjamin J W Chow","doi":"10.1161/CIRCIMAGING.125.018059","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.018059","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery calcification (CAC) provides robust prediction for major adverse cardiovascular events (MACE), but current techniques disregard plaque distribution and protective effects of high CAC density. We investigated whether a novel CAC-dispersion and density (CAC-DAD) score will exhibit superior prognostic value compared with the Agatston score (AS) for MACE prediction.</p><p><strong>Methods: </strong>We conducted a multicenter, retrospective, cross-sectional study of 961 patients (median age, 67 years; 61% male) who underwent cardiac computed tomography for cardiovascular or perioperative risk assessment. Blinded analyzers applied deep learning algorithms to noncontrast scans to calculate the CAC-DAD score, which adjusts for the spatial distribution of CAC and assigns a protective weight factor for lesions with ≥1000 Hounsfield units. Associations were assessed using frailty regression.</p><p><strong>Results: </strong>Over a median follow-up of 30 (30-460) days, 61 patients experienced MACE (nonfatal myocardial infarction or cardiovascular mortality). An elevated CAC-DAD score (≥2050 based on optimal cutoff) captured more MACE than AS ≥400 (74% versus 57%; <i>P</i>=0.002). Univariable analysis revealed that an elevated CAC-DAD score, AS ≥400 and AS ≥100, age, diabetes, hypertension, and statin use predicted MACE. On multivariable analysis, only the CAC-DAD score (hazard ratio, 2.57 [95% CI, 1.43-4.61]; <i>P</i>=0.002), age, statins, and diabetes remained significant. The inclusion of the CAC-DAD score in a predictive model containing demographic factors and AS improved the C statistic from 0.61 to 0.66 (<i>P</i>=0.008).</p><p><strong>Conclusions: </strong>The fully automated CAC-DAD score improves MACE prediction compared with the AS. Patients with a high CAC-DAD score, including those with a low AS, may be at higher risk and warrant intensification of their preventative therapies.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018059"},"PeriodicalIF":6.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559385","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":"Deep Learning-Derived Cardiac Chamber Volumes and Mass From PET/CT Attenuation Scans: Associations With Myocardial Flow Reserve and Heart Failure.","authors":"Waseem Hijazi, Aakash Shanbhag, Robert J H Miller, Paul Kavanagh, Aditya Killekar, Mark Lemley, Samuel Wopperer, Stacey Knight, Viet T Le, Steve Mason, Wanda Acampa, Thomas Rosamond, Damini Dey, Daniel S Berman, Panithaya Chareonthaitawee, Marcelo F Di Carli, Piotr J Slomka","doi":"10.1161/CIRCIMAGING.124.018188","DOIUrl":"10.1161/CIRCIMAGING.124.018188","url":null,"abstract":"<p><strong>Background: </strong>Computed tomography (CT) attenuation correction scans are an intrinsic part of positron emission tomography (PET) myocardial perfusion imaging using PET/CT, but anatomic information is rarely derived from these ultralow-dose CT scans. We aimed to assess the association between deep learning-derived cardiac chamber volumes (right atrial, right ventricular, left ventricular, and left atrial) and mass (left ventricular) from these scans with myocardial flow reserve and heart failure hospitalization.</p><p><strong>Methods: </strong>We included 18 079 patients with cardiac PET/CT from 6 sites. A deep learning model estimated cardiac chamber volumes and left ventricular mass from CT attenuation correction imaging. Associations between deep learning-derived CT mass and volumes with heart failure hospitalization and reduced myocardial flow reserve were assessed in a multivariable analysis.</p><p><strong>Results: </strong>During a median follow-up of 4.3 years, 1721 (9.5%) patients experienced heart failure hospitalization. Patients with 3 or 4 abnormal chamber volumes were 7× more likely to be hospitalized for heart failure compared with patients with normal volumes. In adjusted analyses, left atrial volume (hazard ratio [HR], 1.25 [95% CI, 1.19-1.30]), right atrial volume (HR, 1.29 [95% CI, 1.23-1.35]), right ventricular volume (HR, 1.25 [95% CI, 1.20-1.31]), left ventricular volume (HR, 1.27 [95% CI, 1.23-1.35]), and left ventricular mass (HR, 1.25 [95% CI, 1.18-1.32]) were independently associated with heart failure hospitalization. In multivariable analyses, left atrial volume (odds ratio, 1.14 [95% CI, 1.0-1.19]) and ventricular mass (odds ratio, 1.12 [95% CI, 1.6-1.17]) were independent predictors of reduced myocardial flow reserve.</p><p><strong>Conclusions: </strong>Deep learning-derived chamber volumes and left ventricular mass from CT attenuation correction were predictive of heart failure hospitalization and reduced myocardial flow reserve in patients undergoing cardiac PET perfusion imaging. This anatomic data can be routinely reported along with other PET/CT parameters to improve risk prediction.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018188"},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987455","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":"Myocardial Perfusion PET-CT: There's More Here Than Meets the (A)I.","authors":"Matthew James Memmott, Andrew Michael Crean, Parthiban Arumugam","doi":"10.1161/CIRCIMAGING.125.018488","DOIUrl":"10.1161/CIRCIMAGING.125.018488","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018488"},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172952","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":"Periaortic Adipose Tissue Density as a Marker of Vascular Inflammation From Ungated, Noncontrast CT.","authors":"Jacob Abdaem, Robert J H Miller","doi":"10.1161/CIRCIMAGING.125.018487","DOIUrl":"10.1161/CIRCIMAGING.125.018487","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018487"},"PeriodicalIF":6.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282712","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}