Circulation: Cardiovascular Imaging最新文献

{"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":"https://doi.org/10.1161/CIRCIMAGING.125.018488","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018488"},"PeriodicalIF":6.5,"publicationDate":"2025-05-29","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":"Absolute Myocardial Blood Flow Quantification With PET: Should Diagnostic Cutoffs Be Tracer Specific?","authors":"Prem Soman, Robert J Gropler, Robert A deKemp","doi":"10.1161/CIRCIMAGING.125.018354","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.018354","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018354"},"PeriodicalIF":6.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172949","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":"Aortic Stenosis Grading With CT: Do We Still Need Noncontrast Scans?","authors":"Matthias Eberhard, Hatem Alkadhi","doi":"10.1161/CIRCIMAGING.125.018437","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.018437","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018437"},"PeriodicalIF":6.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101437","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":"How to Use Imaging: Cardiac Sarcoidosis.","authors":"Sanjay Divakaran","doi":"10.1161/CIRCIMAGING.125.017693","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.017693","url":null,"abstract":"<p><p>Sarcoidosis is characterized by noncaseating granulomatous inflammation that involves the lungs or lymph nodes in 90% of cases. The prevalence of cardiac involvement in patients with sarcoidosis is thought to be between 5% and 25%. However, cardiac sarcoidosis can also present without extracardiac disease (known as clinically isolated cardiac sarcoidosis) or with previously unrecognized extracardiac disease. The principal manifestations of cardiac sarcoidosis are heart failure or left ventricular systolic dysfunction, high-grade atrioventricular nodal disease, or ventricular arrhythmia. Cardiovascular imaging plays a crucial role in making the diagnosis, partly due to the low yield of endomyocardial biopsy in cardiac sarcoidosis. Cardiovascular imaging is also used for risk stratification for ventricular arrhythmia, to identify patients who may benefit from immunosuppressive therapy, and for longitudinal follow-up on and off therapy. It can also be used to identify alternative diagnoses to cardiac sarcoidosis. This review will discuss how to use imaging in the diagnosis and management of patients with suspected or known cardiac sarcoidosis.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017693"},"PeriodicalIF":6.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101439","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":"Aortic Valve Calcium Score Quantification by Contrast Cardiac CT: Correlations With Echocardiography and Optimal Thresholds.","authors":"Tiffany Dong, Elio Haroun, Aro Daniela Arockiam, Rishabh Khurana, Joseph El Dahdah, Ankit Agrawal, Yuichiro Okushi, David Moros, Kashyap Bodi, Ushasi Saraswati, Mohammad Alamer, Abdelrahman Abushouk, Agam Bansal, Serge Harb, Zoran Popovic, Leonardo Rodriguez, Rishi Puri, Grant Reed, Amar Krishnaswamy, Brian Griffin, Samir Kapadia, Tom Kai Ming Wang","doi":"10.1161/CIRCIMAGING.124.017373","DOIUrl":"10.1161/CIRCIMAGING.124.017373","url":null,"abstract":"<p><strong>Background: </strong>Aortic valve calcium score (AVCa) measured on noncontrast computed tomography (CT) is well-established for grading aortic stenosis (AS) severity. However, thresholds for AVCa measured on contrast CT remain uncertain. We evaluated correlations, associated factors, and severity thresholds of AVCa measured on contrast CT against transthoracic echocardiography (TTE) measures of AS.</p><p><strong>Methods: </strong>Patients with native AS undergoing transcatheter aortic valve replacement evaluation from 2019 to 2020 who underwent TTE and contrast-enhanced CT were retrospectively studied (n=1035, age 79±9 years, 429 (41.5%) women, 906 (87.5%) severe and 129 (12.5%) moderate AS by TTE). AVCa was measured using the modified Agatston method with the minimum threshold of 4 SD above the mean ascending aorta blood pool Hounsfield units. Receiver-operating characteristics analysis and Youden index were used to define sex-specific optimal AVCa thresholds for identifying severe AS defined by TTE (aortic valve area by continuity equation ≤1.0 cm²) in the derivation cohort and assessed when applied to the validation cohort.</p><p><strong>Results: </strong>Mean aortic valve area on TTE was 0.79±0.21 cm², while mean AVCa score, volume, and mass were 2152±1102 modified AU, 1853±1592 mm³, and 673±485 mg, respectively. Multivariable linear regression identified women to be associated with lower AVCa (β-coefficient, -358), while chronic kidney disease was associated with a higher AVCa (β-coefficient, 171). Optimal severe AS thresholds of ≥1840 modified AU for men and ≥1430 modified AU for women were determined, with area under curve (95% CIs) and sensitivities/specificities of 0.809 (0.749-0.869, 71.3%, 82.2%) for men and 0.822 (0.751-0.892), 73.4%/78.9% for women in the derivation cohort, and 0.830 (0.786-0.875), 75.9%/87.5% for men and 0.780 (0.670-0.890), 77.5%/71.4% for women in the validation cohort.</p><p><strong>Conclusions: </strong>AVCa by contrast CT is a useful tool for identifying severe AS by TTE, with sex-specific thresholds for severe AS identified. Further studies are necessary to externally validate our findings and evaluate their prognostic significance.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017373"},"PeriodicalIF":6.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076400","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":"Interesting Cause of Pseudopleural Effusion: Giant Left Atrium.","authors":"Shitong Su, Peng Yao, Yu Cao","doi":"10.1161/CIRCIMAGING.125.018165","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.018165","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018165"},"PeriodicalIF":6.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979090","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 Fat Attenuation on Nongated Noncontrast Chest CT Images to Assess Changes in Arterial Inflammation: Impact of Atorvastatin.","authors":"Guillaume Goudot, Shady Abohashem, Michael T Osborne, Wesam Aldosoky, Taha Z Ahmad, Michael T Lu, Borek Foldyna, Ahmed Tawakol","doi":"10.1161/CIRCIMAGING.124.017248","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017248","url":null,"abstract":"<p><strong>Background: </strong>Imaging markers of atherosclerotic inflammation are needed to enhance cardiovascular risk assessment and evaluate the impact of therapies. We sought to test the hypothesis that treatments impacting arterial inflammation can be evaluated using a simplified measure of periaortic fat attenuation (FA) assessed on noncontrast, nongated computed tomography (CT) of the descending thoracic aorta.</p><p><strong>Methods: </strong>Measurements were performed on ¹⁸F-fluorodeoxyglucose positron emission tomography/CT images from a double-blind, randomized trial conducted between 2008 and 2009 that assessed the impact of statin therapy on arterial inflammation. Periaortic adipose tissue quantification was performed on the chest CT images over a 10 cm portion of the descending aorta. FA was determined as the mean attenuation of the entire volume of delineated periaortic fat. Arterial inflammation (aorta) and leukopoietic activity (bone marrow and spleen) were assessed by measuring standardized uptake values on ¹⁸F-fluorodeoxyglucose positron emission tomography images. Baseline relationships and changes from baseline to 12 weeks were assessed. All models evaluating FA were adjusted for baseline kilovoltage peak.</p><p><strong>Results: </strong>Sixty subjects (79.9% male, mean age 60±8.9 years) with risk factors or established atherosclerosis (32 randomized to atorvastatin 10 mg, 28 randomized to atorvastatin 80 mg) were studied. On average, it took 88±17 seconds to assess FA per subject. At baseline, FA correlated with leukopoietic activity (<i>r</i>=0.412; <i>P</i>=0.021 and <i>r</i>=0.442; <i>P</i>=0.013, for bone marrow and spleen, respectively). Furthermore, FA correlated with aortic inflammation assessed on ¹⁸F-fluorodeoxyglucose positron emission tomography as quintiles (<i>r</i>=0.274; <i>P</i>=0.043). Moreover, high dose (versus low dose) atorvastatin was associated with a significant reduction in FA after 12 weeks (standardized β=-0.603; <i>P</i>=0.010) after adjustment for baseline FA, kilovoltage peak, and prior statin use.</p><p><strong>Conclusions: </strong>Periaortic FA is a marker of atherosclerotic inflammation that can be easily measured on nongated, nonenhanced chest CT images and be used to provide insights into the impact of therapies on atherosclerotic inflammation.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017248"},"PeriodicalIF":6.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062622","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 B Kavanagh, Aditya Killekar, Mark Lemley, Samuel Wopperer, Stacey Knight, Viet T Le, Steve Mason, Wanda Acampa, Tom Rosamond, Damini Dey, Daniel S Berman, Panithaya Chareonthaitawee, Marcelo F Di Carli, Piotr J Slomka","doi":"10.1161/CIRCIMAGING.124.018188","DOIUrl":"https://doi.org/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 consecutive cardiac PET/CT from 6 sites. A deep learning model estimated cardiac chamber volumes and left ventricular mass from computed tomography 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 computed tomography 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":"2025-05-13","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":"Clinical Impact of Persistent Microvascular Obstruction in CMR After Reperfused STEMI.","authors":"Felix Troger, Mathias Pamminger, Paulina Poskaite, Martin Reindl, Magdalena Holzknecht, Ivan Lechner, Christina Tiller, Sebastian von der Emde, Alex Kaser, Fritz Oberhollenzer, Matthias Schwab, Benjamin Henninger, Bernhard Metzler, Sebastian J Reinstadler, Agnes Mayr","doi":"10.1161/CIRCIMAGING.124.017645","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017645","url":null,"abstract":"<p><strong>Background: </strong>Microvascular injury in the course of acute ST-segment-elevation myocardial infarction (STEMI) has been identified a as determinant of adverse outcomes and manifests as microvascular obstruction (MVO). MVO has long been regarded as a transient finding, vanishing within a few weeks after infarction. However, recent studies have shown that it may persist beyond the early phase, resulting in adverse remodeling. However, its clinical implications remain unclear. This study aims to evaluate the association of MVO persistence and major adverse cardiac events after STEMI.</p><p><strong>Methods: </strong>In total, 609 patients with revascularized first-time STEMI underwent cardiac magnetic resonance imaging (CMR) at 4 days, 4 months, and 12 months after STEMI to assess MVO, infarct size, and left ventricular function. Major adverse cardiac events were defined as composite of death, reinfarction, and new congestive heart failure within a median interval of 3.2 years.</p><p><strong>Results: </strong>Baseline MVO was present in 365 (60%) patients and persisted in 35 (10%) patients at 4-month CMR and in 20 (5%) patients at 12-month CMR. Compared with transient MVO not present at follow-up, patients with MVO persistence ≥4 months were more likely to experience major adverse cardiac events during follow-up (29% versus 13%; <i>P</i>=0.016). Within patients with MVO, those with MVO persistence had lower left ventricular ejection fraction (<i>P</i>=0.002), larger infarcts (<i>P</i>=0.00001), and more frequent intramyocardial hemorrhage (<i>P</i>=0.001) at baseline CMR.</p><p><strong>Conclusions: </strong>Persistent MVO after STEMI occurs in up to 10% of patients with baseline MVO and is linked to major adverse cardiac events. Patients with MVO persistence had larger infarcts, lower left ventricular function, and more frequent intramyocardial hemorrhage at baseline CMR. All patients with MVO persisting ≥12 months initially showed intramyocardial hemorrhage.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017645"},"PeriodicalIF":6.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953589","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 Post-PCI Lipid Core Burden Index on Angiographic and Clinical Outcomes: Insights From NIRS-IVUS.","authors":"Woohyeun Kim, Hyungdon Kook, Soojung Park, Ran Heo, Jinkyu Park, Jinho Shin, Yonggu Lee, Young-Hyo Lim","doi":"10.1161/CIRCIMAGING.124.017740","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017740","url":null,"abstract":"<p><strong>Background: </strong>The impact of lipid core burden index (LCBI) after percutaneous coronary intervention (PCI) in the stented segment assessed by intracoronary near-infrared spectroscopy on the outcomes remains unclear.</p><p><strong>Methods: </strong>In this prospective observational study, we aimed to assess the impact of post-PCI LCBI on late luminal loss and clinical outcomes. Post-PCI intracoronary near-infrared spectroscopy imaging was performed in the stented segment after PCI. Patients were categorized into 2 groups based on the post-PCI _maxLCBI_4mm with a cut-off value of 200. Angiographic and clinical outcomes were compared at 12 months. The primary end point was angiographic late luminal loss. The secondary end point was target lesion failure (composite of cardiovascular death, target vessel myocardial infarction, and clinically driven target lesion revascularization) and major adverse cardiac and cerebrovascular events (composite of cardiac death, myocardial infarction, any repeat revascularization, and stroke).</p><p><strong>Results: </strong>A total of 228 patients with 278 target lesions were followed up for 1 year. One-year follow-up angiography was performed on 198 lesions in 163 patients. Follow-up quantitative coronary angiography revealed that stented segments with post-PCI _maxLCBI_4mm ≥200 had higher late luminal loss compared with those with a post-PCI _maxLCBI_4mm <200 (mean, 0.503±0.683 mm versus 0.115±0.326 mm; <i>P</i><0.001; median, 0.250 mm versus 0.050 mm; <i>P</i><0.001). Patients with post-PCI _maxLCBI_4mm ≥200 had a significantly higher 1-year cumulative incidence of both target lesion failure (6.9% versus 0.6%; <i>P</i>=0.002) and major adverse cardiac and cerebrovascular events (15.1% versus 2.2%; <i>P</i><0.001).</p><p><strong>Conclusions: </strong>Post-PCI LCBI assessed by intracoronary near-infrared spectroscopy-intravascular ultrasound was associated with late luminal loss as well as subsequent target lesion failure and major adverse cardiac and cerebrovascular events.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017740"},"PeriodicalIF":6.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977456","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}