Circulation: Cardiovascular Imaging最新文献

{"title":"Diagnosis of Cardiac Amyloidosis on Echocardiography Using Artificial Intelligence.","authors":"Adam Ioannou, Michel G Khouri, Takeshi Kitai, Sreekanth Vemulapalli, Chung-Lieh Hung, Sze Chi Lim, Matthew Frost, Weile Wayne Tee, Josephine Mansell, Awais Sheikh, Lucia Venneri, Yousuf Razvi, Aldostefano Porcari, Ana Martinez-Naharro, Muhammad U Rauf, Helen Lachmann, Philip N Hawkins, Ashutosh Wechelakar, William Moody, Francesco Bandera, Justin A Ezekowitz, Carolyn S P Lam, Scott D Solomon, Julian D Gillmore, Marianna Fontana","doi":"10.1161/CIRCIMAGING.125.018991","DOIUrl":"10.1161/CIRCIMAGING.125.018991","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing cardiac amyloidosis (CA) on echocardiography can be challenging due to the imaging overlap between CA and more prevalent causes of a hypertrophic phenotype. This study sought to (1) evaluate the performance of artificial-intelligence (AI) derived measurements incorporated into the established multiparametric echocardiographic scoring system to detect CA; (2) develop and validate an AI-based deep-learning model for video-based detection of CA on echocardiography.</p><p><strong>Methods: </strong>The study population comprised 5776 patients (CA, 2756; controls, 3020). The training data set included patients from the UK National Amyloidosis Center and Taiwan MacKay Memorial Hospital (CA, 2241; controls, 2130). External test data sets were obtained from the US Duke University Health System (CA, 334; left ventricular hypertrophy controls, 668) and Japan National Cerebral and Cardiovascular Center (CA, 181; left ventricular hypertrophy controls, 222).</p><p><strong>Results: </strong>The multiparametric echocardiographic score computed using AI-derived measurements achieved an accuracy of 79.5% (sensitivity, 75.4%; specificity, 81.5%) in the United States cohort and 79.7% (sensitivity, 81.6%; specificity, 78.1%) in the Japan cohort. The deep-learning model demonstrated accuracies of 96.2% (sensitivity, 96.8%; specificity, 95.7%) and 95.8% (sensitivity, 97.3%; specificity, 94.3%) in the internal validation and internal test sets, respectively. External validation of the deep-learning model showed accuracies of 87.5% (sensitivity, 86.6%; specificity, 87.9%) in the United States and 88.4% (sensitivity, 92.3%; specificity, 85.3%) in the Japanese cohort. Subgroup analysis demonstrated that the deep-learning model showed robust discrimination of CA from other hypertrophic phenocopies: CA versus hypertension (area under the curve [AUC], 0.92 [95% CI, 0.91-0.94]), CA versus hypertrophic cardiomyopathy (AUC, 0.91 [95% CI, 0.87-0.94]), CA versus aortic stenosis (AUC, 0.93 [95% CI, 0.90-0.95]), CA versus chronic kidney disease (AUC, 0.93 [95% CI, 0.91-0.95]). The deep-learning model was able to classify a greater proportion of patients compared with the AI-derived multiparametric echocardiographic score and achieved superior diagnostic accuracy (AUC, 0.93 [95% CI, 0.91-0.95] versus AUC, 0.88 [95% CI, 0.85-0.90]; <i>P</i><0.001).</p><p><strong>Conclusions: </strong>Both the multiparametric echocardiographic score computed from AI-derived measurements and the fully automated deep-learning model can accurately identify patients with CA in globally diverse cohorts, with the deep-learning model providing superior performance.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018991"},"PeriodicalIF":9.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13095060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164492","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":"Response by Oikonomou et al to Letter Regarding Article, \"Artificial Intelligence-Enabled Echocardiography as a Surrogate for Multimodality Aortic Stenosis Imaging: Post Hoc Analysis of a Clinical Trial\".","authors":"Evangelos K Oikonomou, Marc R Dweck, Rohan Khera","doi":"10.1161/CIRCIMAGING.126.019756","DOIUrl":"10.1161/CIRCIMAGING.126.019756","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019756"},"PeriodicalIF":9.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13088801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572175","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":"PET-Derived Renal Perfusion Provides a Window Into Cardiorenal Risk Beyond Filtration.","authors":"Krishna K Patel, Vasken Dilsizian","doi":"10.1161/CIRCIMAGING.126.019570","DOIUrl":"10.1161/CIRCIMAGING.126.019570","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019570"},"PeriodicalIF":9.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12912788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149289","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":"Risk in Women Emerges at Lower Coronary Plaque Burden Than in Men: PROMISE Trial.","authors":"Jan M Brendel, Thomas Mayrhofer, Júlia Karády, Márton Kolossváry, Nóra M Kerkovits, Isabel L Langenbach, Matthias Jung, Michelle D Kelsey, Marcel C Langenbach, Neha Pagidipati, Svati H Shah, Michael T Lu, Maros Ferencik, Pamela S Douglas, Borek Foldyna","doi":"10.1161/CIRCIMAGING.125.019011","DOIUrl":"10.1161/CIRCIMAGING.125.019011","url":null,"abstract":"<p><strong>Background: </strong>Quantitative coronary plaque measures differ in prognostic value between women and men. It remains unclear whether cardiovascular risk increases proportionally with plaque extent in both sexes. We aimed to compare cardiovascular risk trajectories across quantitative coronary plaque measures in women and men with stable chest pain.</p><p><strong>Methods: </strong>We analyzed data from the PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) coronary computed tomography angiography arm, quantifying total coronary plaque volume and burden (plaque burden [PB]; % vessel volume), including calcified, noncalcified, and low-attenuation components. Associations with major adverse cardiovascular events (death, myocardial infarction, or unstable angina hospitalization) were assessed using sex-stratified spline Cox models over a median 26 months (interquartile range, 18-34).</p><p><strong>Results: </strong>Among 4267 patients (mean age, 60.4±8.2; 2199 women), plaque was less frequent in women (55% versus 75%; <i>P</i><0.001), with lower total plaque volume but similar total PB and incident major adverse cardiovascular events (2.3% versus 3.4%). Major adverse cardiovascular event risk became elevated at lower PB in women than in men: for total PB, hazard ratio crossed 1.0 at 20% in women versus 28% in men, reaching hazard ratio 1.5 at 32% in women versus 42% in men, respectively. Noncalcified PB showed a similar pattern, crossing hazard ratio 1.0 at 7% in women versus 9% in men; hazard ratio 1.5 at 13% in women versus 20% in men. Findings were similar after adjustment for atherosclerotic cardiovascular disease risk score.</p><p><strong>Conclusions: </strong>In women, major adverse cardiovascular events appeared to emerge at a lower PB, and to rise more sharply. Findings support sex-specific interpretation of coronary computed tomography angiography-derived plaque metrics for timely intervention in women.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT01174550.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019011"},"PeriodicalIF":9.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269731","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":"Early RV Reverse Remodeling Following Transcatheter Tricuspid Valve Replacement.","authors":"Lea Rogosik, Jakob Christoph Voran, Marie Noormalal, Likoh Timothy Nicholson, Katharina Epe, Hatim Seoudy, Georg Lutter, Johanne Frank, Derk Frank, Felix Kreidel, Inga Voges","doi":"10.1161/CIRCIMAGING.125.019089","DOIUrl":"10.1161/CIRCIMAGING.125.019089","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019089"},"PeriodicalIF":7.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282634","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":"Left Atrial Strain Predicts Cardiac Outcomes in Moderate Aortic Stenosis.","authors":"Minjung Bak, Sang Yoon Lee, Sung-Ji Park, Heayoung Shin, Jihoon Kim, Eun Kyoung Kim, Sung-A Chang, Sang-Chol Lee, Seung Woo Park","doi":"10.1161/CIRCIMAGING.125.018451","DOIUrl":"10.1161/CIRCIMAGING.125.018451","url":null,"abstract":"<p><strong>Background: </strong>Moderate aortic stenosis (AS) poses a substantial risk for adverse outcomes, yet its prognostic determinants and cardiac remodeling markers remain underexplored. This study aimed to evaluate prognostic factors, including left atrial strain, and their predictive value for adverse cardiac events in patients with moderate AS.</p><p><strong>Methods: </strong>A retrospective cohort study included 1125 patients diagnosed with moderate AS between 2008 and 2019. Cardiac remodeling indices, including left atrial reservoir strain (LARS) and left ventricular global longitudinal strain, were assessed using speckle-tracking echocardiography. The primary outcome was cardiac death, while the secondary outcome was a composite of cardiac death or heart failure hospitalization.</p><p><strong>Results: </strong>Among the study population (median age, 74 years; 47.2% women), the Kaplan-Meier-estimated 5-year rates of cardiac mortality and the composite outcome were 16.7% and 33.9%, respectively, during a median follow-up of 42.8 months. Of the cardiac remodeling indices evaluated, LARS emerged as the most sensitive and independent predictor of cardiac death (adjusted hazard ratio, 0.948 per 1% increase; <i>P</i>=0.003) and the composite outcome (adjusted hazard ratio, 0.940 per 1% increase; <i>P</i><0.001). Notably, the prognostic significance of reduced LARS persisted even after aortic valve replacement (hazard ratio, 2.177 for LARS <20.6% versus ≥20.6%; <i>P</i>=0.024). Furthermore, among all cardiac remodeling parameters analyzed, LARS showed the highest predictive performance for the composite outcome (C-index, 0.586 [95% CI, 0.541-0.632]) compared with other parameters.</p><p><strong>Conclusions: </strong>LARS is a sensitive and independent prognostic marker in moderate AS, reflecting cardiac remodeling. Regular assessment of left atrial strain could enhance risk stratification and guide clinical management strategies in patients with moderate AS.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018451"},"PeriodicalIF":9.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225704","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":"Disentangling Fact From Fiction: Sex-Specific Characteristics of Coronary Artery Disease.","authors":"Armin Arbab-Zadeh","doi":"10.1161/CIRCIMAGING.126.019556","DOIUrl":"10.1161/CIRCIMAGING.126.019556","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019556"},"PeriodicalIF":7.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269715","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":"Current State of RV Multimodality Imaging in Pediatric Pulmonary Hypertension: Current Evidence, Knowledge Gaps, and Future Research Directions.","authors":"Kimberley G Miles, Dan M Dorobantu, Johannes Menno Douwes, Benjamin S Frank, Pei-Ni Jone, Vivek Muthurangu, D Dunbar Ivy, Hythem Nawaytou, Mark K Friedberg","doi":"10.1161/CIRCIMAGING.125.019264","DOIUrl":"10.1161/CIRCIMAGING.125.019264","url":null,"abstract":"<p><p>Right ventricular (RV) failure is a principal determinant of morbidity and mortality in children with pulmonary hypertension, making accurate RV assessment a cornerstone of risk stratification and long-term management. Noninvasive imaging plays a central role in this evaluation; however, commonly used modalities, including 2- and 3-dimensional echocardiography and cardiac magnetic resonance imaging, each have distinct advantages and limitations in the pediatric population. Consequently, an integrated, multimodal imaging strategy is required. This review provides a contemporary, critical appraisal of the existing evidence and key knowledge gaps related to noninvasive multimodality imaging of the RV in pediatric pulmonary hypertension. The discussion is structured around fundamental aspects of RV physiology, including chamber size and mass, systolic function, diastolic function and stiffness, RV-left ventricle interactions, ventriculoarterial coupling, and exercise assessment. Echocardiography and cardiac magnetic resonance imaging are presented in parallel to highlight their complementary roles within a multimodality framework. Current prognostic thresholds in pediatric pulmonary hypertension imaging are largely supported by level of evidence C, underscoring persistent gaps that limit the development of definitive clinical recommendations and a unified approach. We propose a roadmap to guide future research efforts and collaborative initiatives among pediatric pulmonary hypertension and imaging specialists, emphasizing the role of professional networks in advancing the field.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019264"},"PeriodicalIF":9.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12991334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218962","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":"Rare Cause of Mitral Prolapse: Myocardial Infarction With Nonobstructive Coronary Arteries.","authors":"Julin Zhang, Wei Meng, Chaoyi Qin","doi":"10.1161/CIRCIMAGING.125.019488","DOIUrl":"10.1161/CIRCIMAGING.125.019488","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019488"},"PeriodicalIF":7.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164483","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":"Stress-Induced Reversible Left Atrial and Mitral Annular Dilation Causing Severe Transient Central Mitral Regurgitation: First Reported Case.","authors":"Jing Ping Sun, Yuanzheng Wang, Jun Zhang, Jingjin Wang, Zhiling Luo","doi":"10.1161/CIRCIMAGING.125.019304","DOIUrl":"10.1161/CIRCIMAGING.125.019304","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019304"},"PeriodicalIF":9.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12991323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009173","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}