Circulation: Cardiovascular Imaging最新文献

{"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}

{"title":"Characterization of Aortic Valve Stenosis by CT Angiography in a Diverse US Cohort.","authors":"Daniel Lorenzatti, Annalisa Filtz, Pamela Pina, Jolien Geers, Jake Gilman, Jonathan Daich, Paul Ippolito, Aftab Abdullah, Aldo L Schenone, Carlos A Gongora, Justin Johannesen, Andrea Scotti, Edwin C Ho, Mario J Garcia, Azeem Latib, Carlos J Rodriguez, Daniel S Berman, Marie-Annick Clavel, Philippe Pibarot, Robert O Bonow, Piotr J Slomka, Marc R Dweck, Damini Dey, Leandro Slipczuk","doi":"10.1161/CIRCIMAGING.124.017858","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017858","url":null,"abstract":"<p><strong>Background: </strong>Aortic stenosis (AS) involves calcific and fibrotic degeneration of the valve tissue. The only noninvasive method for evaluating both processes is contrast-enhanced computed tomography angiography. We aimed to explore the differences in aortic valve (AV) tissue composition across sex, race/ethnicity, and AS hemodynamic phenotype in US patients referred for transcatheter AV replacement planning.</p><p><strong>Methods: </strong>We retrospectively analyzed symptomatic patients with AS who underwent computed tomography angiography for transcatheter AV replacement planning between 2015 and 2022. Using semi-automated software, we quantified the AV tissue composition by fibrotic, calcific, and fibro-calcific volumes, and the fibro-calcific ratio (fibrotic/calcific volume) as a measure of valve phenotype.</p><p><strong>Results: </strong>The study included 651 patients (mean age 84 years; 55% women) with 38% non-Hispanic (NH)-White, 27% Hispanic, and 13% NH-Black. Women had lower fibro-calcific (230 versus 293 mm³/cm²; <i>P</i><0.001) and calcific volumes (85 versus 149 mm³/cm²; <i>P</i><0.001), and higher fibro-calcific ratio (1.47 versus 0.83; <i>P</i><0.001). No differences were observed in the fibrotic volumes (<i>P</i>=0.805). NH-White women had higher fibro-calcific (256 mm³/cm², <i>P</i>=0.002) and fibrotic volumes (145 mm³/cm²; <i>P</i><0.001), and fibro-calcific ratio (1.57; <i>P</i>=0.01) compared with Hispanic and NH-Black women. No differences were found among men. High-gradient AS had higher fibro-calcific (295 versus 219 mm³/cm²; <i>P</i><0.001) and calcific volumes (148 versus 88 mm³/cm²; <i>P</i><0.001), and a lower fibro-calcific ratio (0.90 versus 1.45; <i>P</i><0.001), although no difference in fibrotic volume (<i>P</i>=0.099) compared with low-gradient AS.</p><p><strong>Conclusions: </strong>Phenotypic differences in computed tomography angiography valve tissue composition exist in AS patients referred for transcatheter AV replacement, with females and low-gradient AS showing a proportionally more fibrotic phenotype. NH-White women have the highest fibrotic tissue composition, and no differences are evident among men.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017858"},"PeriodicalIF":6.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966593","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":"Letter by Barbieri et al Regarding Article, \"Abnormal Exercise Electrocardiography With Normal Stress Echocardiography Is Associated With Subclinical Coronary Atherosclerosis\".","authors":"Andrea Barbieri, Fracesca Bursi, Francesca Mantovani","doi":"10.1161/CIRCIMAGING.125.018294","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.018294","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018294"},"PeriodicalIF":6.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983764","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":"Doughnut Sign: A Mixed Plaque Phenotype Unraveled Only by the Photon Counting CCTA.","authors":"Pruthvi C Revaiah, Patrick W Serruys, Sean O Hynes, Christos V Bourantas, Helle Precht, Yoshinobu Onuma, Erica Maffei, Filippo Cademartiri","doi":"10.1161/CIRCIMAGING.124.017925","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017925","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017925"},"PeriodicalIF":6.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955070","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":"Interrupted Inferior Vena Cava, Partial Anomalous Pulmonary Venous Return and Extra-Mediastinal Superior Vena Cava: A Rare Case of Multilevel Congenital Anomalous Venous Return.","authors":"Francisco Javier Ruperti-Repilado, Gorka Gómez Ciriz, Begoña Manso-García","doi":"10.1161/CIRCIMAGING.124.017917","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017917","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017917"},"PeriodicalIF":6.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966776","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 Fibrosis Pattern in an Arrhythmogenic Cardiomyopathy Caused by a Titin-Truncating Variant.","authors":"Melissa A Austin, Tarryn Tertulien, Bruk Mekonen, Mahesh K Vidula, Nosheen Reza","doi":"10.1161/CIRCIMAGING.125.018149","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.018149","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018149"},"PeriodicalIF":6.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062621","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":"Response by Barbieri et al to Letter Regarding Article, \"Abnormal Exercise Electrocardiography With Normal Stress Echocardiography Is Associated With Subclinical Coronary Atherosclerosis\".","authors":"Jessica M Duran, Melissa A Daubert","doi":"10.1161/CIRCIMAGING.125.018367","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.018367","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018367"},"PeriodicalIF":6.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955274","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":"Sex-Specific Impact of Angiotensin Receptor Blockers on the Progression of Aortic Stenosis in Patients With Hypertension: Results From the HYTAS Study.","authors":"Karolanne Demers, Kathia Abdoun, Philippe Pibarot, Lionel Tastet, Mulham Ali, Erwan Salaun, Paul Poirier, Andréanne Powers, Jordi Sanchez Dahl, Jonathan Beaudoin, Marie-Annick Clavel","doi":"10.1161/CIRCIMAGING.124.017913","DOIUrl":"10.1161/CIRCIMAGING.124.017913","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017913"},"PeriodicalIF":6.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763067","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}