Circulation: Cardiovascular Imaging最新文献

{"title":"Imaging of the Acute and Chronic Cardiovascular Complications of Radiation Therapy.","authors":"James Wilson, Chong Jun Hua, Nikoo Aziminia, Charlotte Manisty","doi":"10.1161/CIRCIMAGING.124.017454","DOIUrl":"10.1161/CIRCIMAGING.124.017454","url":null,"abstract":"<p><p>Chest radiotherapy (XRT) plays a crucial role in the treatment of a multitude of cancers including breast, lung, esophageal, and lymphoma. Although XRT enhances cancer survival rates, it may also expose healthy bystander tissues to radiation, potentially leading to severe complications. Initially considered relatively resistant to radiation damage, the heart has been shown over the past 4 decades to be susceptible to radiation-induced cardiovascular toxicity and despite advances in XRT which can minimize radiation exposure to heart tissue, no cardiac radiation dose is entirely safe. The clinical spectrum of radiation-induced cardiovascular toxicity is broad, encompassing coronary artery disease, myocardial dysfunction, valvular abnormalities, and pericardial disorders. Radiation-induced cardiovascular toxicity may manifest acutely or many years after XRT, with each condition more likely to present at certain time points post-XRT. Cardiac imaging is a crucial tool in both the screening and diagnosis of radiation-induced cardiovascular toxicity with an understanding of its pathophysiology, incidence, and progression required to implement a comprehensive, multimodality imaging approach to detect and manage these complications effectively.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017454"},"PeriodicalIF":6.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432713","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":"Prognosis and Risk Stratification in Dilated Cardiomyopathy With LVEF≤35%: Cardiac MRI Insights for Better Outcomes.","authors":"Di Zhou, Leyi Zhu, Shuang Li, Weichun Wu, Baiyan Zhuang, Jing Xu, Wenjing Yang, Jian He, Yining Wang, Yuhui Zhang, Guanshu Liu, Xiaoxin Sun, Qiang Zhang, Zhongzhao Teng, Arlene Sirajuddin, Andrew E Arai, Shihua Zhao, Minjie Lu","doi":"10.1161/CIRCIMAGING.124.017246","DOIUrl":"10.1161/CIRCIMAGING.124.017246","url":null,"abstract":"<p><strong>Background: </strong>Current guidelines recommend implantable cardioverter defibrillators for the primary prevention of sudden cardiac death (SCD) in patients with dilated cardiomyopathy with left ventricular ejection fraction (LVEF)≤35%. However, its effectiveness is hindered by the inability to reliably discriminate between the risk of SCD and competing death of heart failure deterioration, thereby limiting its clinical utility. We aimed to refine the SCD risk stratification model based on cardiac magnetic resonance imaging for patients with dilated cardiomyopathy with LVEF≤35%.</p><p><strong>Methods: </strong>A total of 1272 patients with dilated cardiomyopathy with LVEF≤35% who underwent cardiac magnetic resonance imaging were consecutively enrolled in this study. The primary end point is a composite of SCD or aborted SCD and the second end point is a composite of heart failure death and heart transplantation.</p><p><strong>Results: </strong>Over a median follow-up of 86.3 months, 101 patients reached the primary end point. In the adjusted analysis, age (hazard ratio [HR], 1.02 [95% CI, 1.01-1.04]; <i>P</i>=0.006) years, a family history of SCD (HR, 2.00 [95% CI, 1.01-3.98]; <i>P</i>=0.05), NT-proBNP (N-terminal pro-B-type natriuretic peptide) (HR, 2.02 [95% CI, 1.18-3.44]; <i>P</i>=0.01), LVEF (per 5% HR, 0.79 [95% CI, 0.66-0.95]; <i>P</i>=0.01), and late gadolinium enhancement≥7.5% (HR, 4.11[95% CI, 2.72-6.21]; <i>P</i><0.001) were associated with SCD or aborted SCD. Left atrial volume index≥68.3 mL/m² was an independent predictor of the secondary end point (adjusted HR, 1.65 [95% CI, 1.13-2.40]; <i>P</i>=0.009). Compared with late gadolinium enhancement<7.5%, patients with late gadolinium enhancement≥7.5% and LVEF≤20% had a 7.12-fold higher risk of experiencing SCD events in competing Cox analysis (annual event rate, 4.8%).</p><p><strong>Conclusions: </strong>Patients with dilated cardiomyopathy with late gadolinium enhancement≥7.5% were at heightened risk of SCD events, which can be used for risk assessment. Risk stratifications for SCD, combining clinical and cardiac magnetic resonance imaging may potentially guide decision-making for implantable cardioverter defibrillator therapy.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":"18 3","pages":"e017246"},"PeriodicalIF":6.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656371","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":"Interplay Between Social Vulnerability Index and Coronary Artery Calcium Scores With Major Adverse Cardiovascular Events.","authors":"Zainab Albar, Pedro R V O Salerno, Nour Tashtish, Santosh K Sirasapalli, Shuo Li, Khurram Nasir, Salil Deo, Sanjay Rajagopalan, Sadeer Al-Kindi","doi":"10.1161/CIRCIMAGING.124.016658","DOIUrl":"10.1161/CIRCIMAGING.124.016658","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery calcium (CAC) scoring predicts cardiovascular risk, but social determinants of health may play a role in its prognostic ability. We examined whether the Social Vulnerability Index (SVI) modifies the association between CAC and major adverse cardiovascular events (MACE) in a community-based screening cohort.</p><p><strong>Methods: </strong>We studied 49 224 participants without known cardiovascular disease referred for CAC scanning from 2014 to 2022 based on cardiovascular risk factors. SVI was determined for each participant based on the census tract. We examined 8-year incidence of MACE (myocardial infarction, stroke, heart failure, revascularization, death) by SVI quartile across CAC score strata (0, 1-99, 100-399, ≥400). Cox proportional hazard models estimated hazard ratios for MACE, associated with demographics, metabolic factors, and CAC.</p><p><strong>Results: </strong>Higher SVI was associated with female sex, non-White race, greater comorbidities, and higher CAC scores. The 8-year MACE rate increased monotonically by SVI quartile, with a hazard ratio of 1.54 (95% CI, 1.24-1.90, <i>P</i><0.001) for the highest versus lowest SVI quartile after adjustment. The association between CAC score and MACE was modified by SVI, with a stronger gradient in risk across CAC strata apparent among vulnerable subgroups.</p><p><strong>Conclusions: </strong>In this no-cost community-based CAC cohort, SVI independently predicted adverse cardiovascular outcomes across all CAC strata. Focused efforts to mitigate the incremental risk associated with social vulnerability are needed.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e016658"},"PeriodicalIF":6.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439998","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 Reconstruction of Pulmonary Vascular Lesions in Chronic Thromboembolic Pulmonary Hypertension.","authors":"Ryota Kakizaki, Lorenz Räber, Christian Gerges, Peter Dorfmüller, Irene M Lang","doi":"10.1161/CIRCIMAGING.124.017935","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017935","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017935"},"PeriodicalIF":6.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490990","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":"Longitudinal Changes in Myocardial Deformation in Hutchinson-Gilford Progeria Syndrome.","authors":"Flemming J Olsen, Tor Biering-Sørensen, Fatima I Lunze, Sheila M Hegde, Rachel Ehrbar, Joseph Massaro, Alessandra M Ferraro, David M Harrild, Monica E Kleinman, Leslie B Gordon, Ashwin Prakash","doi":"10.1161/CIRCIMAGING.124.017544","DOIUrl":"10.1161/CIRCIMAGING.124.017544","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017544"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000715","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":"Abnormal Exercise Electrocardiography With Normal Stress Echocardiography Is Associated With Subclinical Coronary Atherosclerosis.","authors":"Jessica M Duran, Peter Shrader, Chuan Hong, Francois Haddad, Everton J Santana, Nicholas Cauwenberghs, Tatiana Kouznetsova, Michael Salerno, Gerald Bloomfield, Lynne Koweek, Adrian Hernandez, Kenneth W Mahaffey, Svati H Shah, Pamela S Douglas, Melissa A Daubert","doi":"10.1161/CIRCIMAGING.124.017380","DOIUrl":"10.1161/CIRCIMAGING.124.017380","url":null,"abstract":"<p><strong>Background: </strong>Patients with abnormal (positive) exercise electrocardiography, but normal stress echocardiography (+ECG/-Echo), have an increased risk of adverse cardiovascular events compared with patients with a normal (negative) ECG and a normal stress Echo (-ECG/-Echo). However, it is unclear if +ECG/-Echo discordance is associated with a greater burden of subclinical coronary atherosclerosis.</p><p><strong>Methods: </strong>Project Baseline Health Study participants who underwent a stress Echo and coronary artery calcium (CAC) scan were stratified by stress Echo result: -ECG/-Echo or +ECG/-Echo. Multivariable regression investigated the association between stress Echo results and CAC burden. Event-free survival from a composite of adverse cardiovascular events was compared between groups.</p><p><strong>Results: </strong>Among 1630 asymptomatic participants in this observational cohort study, 1503 (92.2%) had a -ECG/-Echo, 105 (6.4%) had a +ECG/-Echo, and 22 (1.3%) had a +Echo. The +ECG/-Echo group had a significantly greater burden of coronary atherosclerosis than the -ECG/-Echo group (mean CAC score, 198±470 versus 53±186; <i>P</i><0.001; CAC_log, 2.2±2.7 versus 1.2±2.0; <i>P</i><0.001). The -ECG/-Echo group was more likely to have CAC=0 compared with the +ECG/-Echo group (65.9% versus 53.3%; <i>P</i>=0.01), whereas the +ECG/-Echo group more commonly had CAC ≥100 (28.6% versus 11.4%; <i>P</i><0.001). After adjustment, CAC_log scores were 52% higher in the +ECG/-Echo group than in the -ECG/-Echo group (<i>P</i>=0.002). Compared with the -ECG/-Echo group, the +ECG/-Echo group was 4.5× more likely to have a CAC score ≥400 (adjusted odds ratio, 4.54 [95% CI, 1.95-10.05]; <i>P</i><0.001). After a median follow-up of 4.3 years, a trend toward increased adverse cardiovascular events was observed among participants with +ECG/-Echo.</p><p><strong>Conclusions: </strong>Individuals with a +ECG/-Echo have a higher burden of subclinical coronary atherosclerosis than those with a -ECG/-Echo, which may explain, at least in part, the increased risk for adverse cardiac events in this population. Further study is needed to determine the optimal strategy for mitigating cardiovascular risk in these patients.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT03154346.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017380"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969621","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":"Platypnea-Orthodeoxia Syndrome After Esophageal Dilation in a Patient With a Dilated Ascending Aorta.","authors":"Matthew B Saunders, Matthew S Michaleski, Jeffrey Yim, Miles Marchand, John Jue, David A Wood, Christina L Luong, Michael Y C Tsang, Teresa S M Tsang, Darwin F Yeung","doi":"10.1161/CIRCIMAGING.124.016887","DOIUrl":"10.1161/CIRCIMAGING.124.016887","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e016887"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361217","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":"Predicting Outcomes in Uncomplicated Type B Aortic Dissection by Imaging: The Importance of External Validation.","authors":"Arturo Evangelista, Andrea Guala","doi":"10.1161/CIRCIMAGING.124.017874","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017874","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":"18 2","pages":"e017874"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448377","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":"Sudden Cardiac Arrest With Acute Myocardial Infarction Due to Myocardial Bridging and Hypertrophic Cardiomyopathy.","authors":"Yi-Ching Liu, Wei-Chung Tsai, Shu-Chien Huang, Min-Fang Chao, Shuenn-Nan Chiu, Yen-Hsien Wu, Shih-Hsing Lo, I-Chen Chen, Zen-Kong Dai, Jong-Hau Hsu","doi":"10.1161/CIRCIMAGING.124.016993","DOIUrl":"10.1161/CIRCIMAGING.124.016993","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e016993"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361218","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":"Multimodality Imaging Evaluation of Diseases of the Pulmonic Valve and Right Ventricular Outflow Tract for the Adult Cardiologist.","authors":"Seán P Murphy, Sadia Sultana, Emily K Zern, Albree Tower-Rader, Jessica L Churchill, Ada C Stefanescu Schmidt, Sihong Huang, Christopher P Learn, Timothy W Churchill, Doreen DeFaria Yeh, Evin Yucel","doi":"10.1161/CIRCIMAGING.124.017126","DOIUrl":"10.1161/CIRCIMAGING.124.017126","url":null,"abstract":"<p><p>Disorders of the pulmonic valve (PV) receive considerably less attention than other forms of valvular heart disease. Due to the dramatically improved survival of children with congenital heart disease over the last 5 decades, there has been a steady increase in the prevalence of adults with congenital heart disease, which necessitates that clinicians become familiar with the anatomy and the evaluation of right ventricular outflow tract and PV anomalies. A multimodality imaging approach using echocardiography, cardiac computed tomography, and magnetic resonance imaging is essential for a comprehensive evaluation of the anatomy and function of the right ventricular outflow tract, PV, and supravalvular region. As clinical presentation is often insidious with nonspecific symptoms, yet morbidity and mortality associated with severe untreated PV disease are significant, a high index of suspicion coupled with appropriate use of imaging techniques is critical in facilitating timely diagnosis and treatment. In this review, we aim to present a comprehensive approach to the diagnosis of PV disease and associated right ventricular outflow tract or supravalvular pulmonary stenosis, including optimal use of multimodality imaging to facilitate timely diagnosis, optimize therapeutic strategies, enhance postprocedural surveillance, and ultimately improve patient outcomes.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017126"},"PeriodicalIF":6.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969562","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}