Circulation: Cardiovascular Imaging最新文献

{"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":"https://doi.org/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 EuroScore 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 gender (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":7.0,"publicationDate":"2026-05-07","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":"Advanced Imaging in Loeffler Endocarditis in the Setting of Dupilumab-Associated Hypereosinophilia: Diagnostic Utility of Cardiac MRI.","authors":"Felipe I Contreras-Yametti, Annalisa Filtz, Sanjana Nagraj, Daniel Lorenzatti, Kirtipal Bhatia, Franco Cossettini, Aldo Schenone, Leandro Slipczuk, Mario J Garcia","doi":"10.1161/CIRCIMAGING.126.019739","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.126.019739","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019739"},"PeriodicalIF":7.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834425","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":"Integrating PET-Determined Global and Focal Impairment of Myocardial Flow Reserve to Enhance Cardiovascular Prognostication?","authors":"Thomas Hellmut Schindler, Elgin Okzan","doi":"10.1161/CIRCIMAGING.126.019868","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.126.019868","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019868"},"PeriodicalIF":7.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811753","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":"Diffuse Perfusion Impairment Versus Global Myocardial Flow Reserve and Focal Perfusion Impairments in Patients Undergoing ⁸²Rb-PET Imaging.","authors":"Ahmed Sayed, Jonathan B Moody, Alexis Poitrasson-Rivière, Jennifer M Renaud, Maria Alwan, Ahmad El Yaman, Mahmoud Al Rifai, Venkatesh L Murthy, Mouaz Al-Mallah","doi":"10.1161/CIRCIMAGING.125.019246","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.019246","url":null,"abstract":"<p><strong>Background: </strong>Although global myocardial flow reserve (MFR) is a powerful prognostic factor, it may overlook segmental abnormalities and does not differentiate focal from diffuse perfusion impairments. Therefore, we sought to assess whether integrated MFR provides incremental prognostic value beyond global MFR.</p><p><strong>Methods: </strong>Consecutive patients undergoing positron emission tomography myocardial perfusion imaging between 2019 and 2025 were included. For each patient, global MFR and the proportion of the myocardium with diffuse and focal integrated MFR impairment were quantified. The primary outcome was the total burden of death, myocardial infarction, and heart failure hospitalization. Multivariable Andersen-Gill Cox models with robust variance estimators were used to estimate hazard ratios (HRs). Restricted cubic splines were used to account for potential nonlinearity.</p><p><strong>Results: </strong>Over a median follow-up of 550 days (interquartile range, 203-1017 days), 1511 primary outcome events occurred in 8500 patients. In a multivariable model adjusted for both parameters, diffusely impaired integrated MFR (HR per interquartile range, 2.02 [95% CI, 1.33-3.05]), but not global MFR (HR per interquartile range_, 1.10 [95% CI, 0.82-1.47]), was associated with poorer outcomes. Diffuse perfusion impairment was more strongly associated with the primary outcome (HR per interquartile range, 2.20 [95% CI, 1.72-2.82]) than focal impairment (HR, 1.25 [95% CI, 1.07-1.46]). Diffusely impaired integrated MFR was more prognostic in patients with a preserved left ventricular ejection fraction (<i>P</i> for interaction <0.001). At ejection fractions of 40%, 50%, 60%, and 70%, the HRs per interquartile range for greater diffuse impairment were 1.43, 1.97, 2.49, and 3.02, respectively.</p><p><strong>Conclusions: </strong>Diffuse impairments in myocardial perfusion are associated with poorer outcomes compared with focal impairments and are more informative than global MFR. Diffuse impairments may be more prognostic in patients with a preserved ejection fraction.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019246"},"PeriodicalIF":7.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811737","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":"Importance of Understanding the Kinetics of Cardiac Amyloid Radionuclide Imaging.","authors":"Edward J Miller, Cesia Gallegos, Albert J Sinusas","doi":"10.1161/CIRCIMAGING.126.019837","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.126.019837","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019837"},"PeriodicalIF":7.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764102","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":"Hemorrhagic Myocardial Infarction: Who Is at Risk?","authors":"Rohan Dharmakumar, Keyur Vora","doi":"10.1161/CIRCIMAGING.126.019900","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.126.019900","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019900"},"PeriodicalIF":7.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764097","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":"Coronary Culprit Lesion Location and Intramyocardial Hemorrhage in STEMI.","authors":"Fritz Oberhollenzer, Ivan Lechner, Christina Tiller, Magdalena Holzknecht, Alex Kaser, Philipp Fischer, Agnes Mayr, Felix Troger, Axel Bauer, Bernhard Metzler, Sebastian J Reinstadler, Martin Reindl","doi":"10.1161/CIRCIMAGING.125.019364","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.019364","url":null,"abstract":"<p><strong>Background: </strong>Intramyocardial hemorrhage (IMH) is a major determinant of adverse outcome in patients with ST-segment-elevation myocardial infarction, therefore making it a promising therapeutic target. This study aimed to investigate the association between coronary culprit lesion location and IMH in acute ST-segment-elevation myocardial infarction.</p><p><strong>Methods: </strong>We analyzed 767 patients with ST-segment-elevation myocardial infarction undergoing cardiac magnetic resonance imaging, including T2* mapping at 4 (interquartile range, 3-5) days after infarction. Coronary culprit vessel and lesion, Thrombolysis in Myocardial Infarction flow, and collateral circulation were assessed. The primary end point was the presence of IMH on cardiac magnetic resonance. An exploratory clinical end point at 12 months was defined as major adverse cardiac events, which comprised all-cause mortality, reinfarction and new congestive heart failure.</p><p><strong>Results: </strong>Median age was 59 (interquartile range, 53-67) years, and 19% (n=144) were female. IMH was detected in 265 (35%) patients. IMH was present in 27% (n=76/286) of patients with right coronary artery, in 39% (n=136/351) with left anterior descending artery, and 44% (n=48/109) with circumflex artery (CX) as the culprit lesion (<i>P</i><0.001). Segment 11 (CX proximal) showed the highest (n=23/41, 56%), segment 1 (right coronary artery proximal) the lowest risk for IMH (n=22/85, 26%). CX infarction remained independently associated with IMH (odds ratio, 1.27 [95% CI, 1.07-1.50]; <i>P</i>=0.005) after adjustment for angiographic and clinical IMH determinants, including Thrombolysis in Myocardial Infarction flow, ischemic time and troponin T concentration. Collateral flow was least frequent in CX infarctions (n=15/109, 14%) compared with right coronary artery (n=117/286, 41%) and left anterior descending infarctions (n=101/351, 29%; <i>P</i><0.001). Patients with CX infarction showed the highest rate of major adverse cardiac events (7%) compared with left anterior descending (6%) and right coronary artery (2%) infarctions (<i>P</i>=0.039).</p><p><strong>Conclusions: </strong>CX infarctions were independently associated with the highest risk of IMH. The low prevalence of collateral circulation may contribute to this susceptibility. These findings define CX infarctions as a high-risk phenotype that may benefit from targeted cardioprotective strategies.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019364"},"PeriodicalIF":7.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764033","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":"Prognostic Utility of Perivascular Adipose Tissue Attenuation in Patients Undergoing Endovascular Aneurysm Repair for Abdominal Aortic Aneurysms.","authors":"Koshi Matsuhama, Takayoshi Toba, Yoichiro Sugizaki, Tatsuya Kitagawa, Shotaro Yoshida, Mayuka Masuda, Keisuke Iida, Ken Takata, Nobuhiro Watanabe, Koutaro Higuchi, Hiroya Okamoto, Yuta Fukuishi, Yuki Sakamoto, Shota Naniwa, Hiroshi Tsunamoto, Tetsuya Yamamoto, Seigo Iwane, Yuto Osumi, Daichi Fujimoto, Takashi Hiromasa, Hiroyuki Kawamori, Hironaga Shiraki, Taishi Inoue, Katsuhiro Yamanaka, Hiroaki Takahashi, Tomoyuki Gentsu, Koji Sasaki, Masato Yamaguchi, Kenji Okada, Hiromasa Otake","doi":"10.1161/CIRCIMAGING.125.019185","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.019185","url":null,"abstract":"<p><strong>Background: </strong>Perivascular adipose tissue (PVAT) attenuation on computed tomography angiography reflects vascular inflammation. However, its prognostic value in patients undergoing endovascular aortic repair (EVAR) for abdominal aortic aneurysm (AAA) remains unclear.</p><p><strong>Methods: </strong>We retrospectively studied consecutive patients who underwent EVAR for unruptured infrarenal AAA with preprocedural computed tomography angiography. PVAT attenuation and aortic characteristics were assessed using computed tomography angiography. The primary outcome was major adverse cardiac or cerebrovascular events (MACCE), a composite of all-cause death, myocardial infarction, stroke, and any vessel treatment.</p><p><strong>Results: </strong>Among 275 patients treated with EVAR, 35.6% (98/275) experienced MACCE during a median follow-up of 3.5 years. Pre-EVAR PVAT attenuation was higher in patients who experienced MACCE than in those who did not (-69.8±10.3 HU versus -77.3±8.6 HU; <i>P</i><0.001). In the Cox proportional hazards model, higher PVAT attenuation (per 10 HU; unadjusted hazard ratio, 1.88 [95% CI, 1.56-2.28]; <i>P</i><0.001) was associated with MACCE after EVAR. Furthermore, higher PVAT attenuation was associated with AAA-related adverse events: a composite of AAA-related death, reintervention for AAA, embolization for endoleak, and AAA enlargement (per 10 HU; unadjusted hazard ratio, 2.16 [95% CI, 1.59-2.94]). Adding PVAT attenuation to post-EVAR prognostic factors and computed tomography angiography findings improved the predictive and reclassification abilities for MACCE after EVAR.</p><p><strong>Conclusions: </strong>In patients undergoing EVAR, higher PVAT attenuation was associated with both MACCE and AAA-related adverse events. PVAT attenuation may provide incremental prognostic value for identifying patients at higher risk of unfavorable outcomes following EVAR.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019185"},"PeriodicalIF":7.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764084","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":"Increased Venous Volumes in Response to Catheter-Based Intervention for Acute PE: Lessons From the OPTALYSE PE Trial (OPTALYSE-3D).","authors":"Farbod N Rahaghi, Gregory Piazza, Behnood Bikdeli, Umberto Campia, Syed M Hassan, Ruben San Jose Estepar, Michael J Cuttica, Ruben Mylvaganam, George R Washko, Pietro Nardelli, Samuel Z Goldhaber, Raúl San José Estépar","doi":"10.1161/CIRCIMAGING.125.019239","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.019239","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019239"},"PeriodicalIF":7.0,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764116","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 Image Myocarditis.","authors":"Jan Gröschel, Bettina Heidecker, Yashraj Bhoyroo, Sebastian Spethmann, Jeanette Schulz-Menger","doi":"10.1161/CIRCIMAGING.125.018547","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.018547","url":null,"abstract":"<p><p>Myocarditis is an inflammatory disease involving the heart muscle and potentially the pericardium. While there are many potential causative agents, commonly grouped into infectious (viral, bacterial, parasitic) or noninfectious (autoimmune, systemic disorders, drugs, cancer related), the main pathological pathways ultimately lead to an inflammatory process of the myocardium resulting in necrosis and edema. As there are specific therapies available for patients with myocarditis, reliable and early diagnosis is crucial. Multimodality imaging, especially cardiovascular magnetic resonance, has made a noninvasive diagnosis feasible. Cardiovascular magnetic resonance can not only provide a diagnosis based on the updated Lake Louise criteria, but it also functions as a diagnostic gateway, leading to other imaging modalities, for example, positron emission tomography or computed tomography. Finally, imaging results can help to initiate treatment options as well as determine when a patient can return to work or exercise. This review will cover multimodal imaging in patients with myocarditis with a focus on cardiovascular magnetic resonance, providing case examples of how imaging can guide care and treatment in these patients. In addition, the review focuses on the recent European Society for Cardiology guideline on the management of myocarditis and pericarditis comparing the recommendation to the American College of Cardiology expert consensus statements and the Japanese Circulation Society guidelines.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018547"},"PeriodicalIF":7.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764055","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}