Circulation: Cardiovascular Imaging最新文献

{"title":"Prognostic Value of LV Global Longitudinal Strain by 2D and 3D Speckle-Tracking Echocardiography in Patients With HFpEF.","authors":"Yixia Lin, Mingxing Xie, Li Zhang, Yanting Zhang, Peige Zhang, Xin Chen, Mengmeng Ji, Lang Gao, Qing He, Zhenni Wu, Yali Yang, Yuman Li","doi":"10.1161/CIRCIMAGING.124.016975","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.016975","url":null,"abstract":"<p><strong>Background: </strong>In patients with heart failure with preserved ejection fraction (HFpEF), the impact of type 2 diabetes (T2D) on left ventricular global longitudinal strain (LV GLS) and its prognostic implications remains unclear. We aimed to evaluate LV function using two-dimensional (2D) and three-dimensional (3D) speckle-tracking echocardiography in patients with HFpEF with and without T2D, and to investigate its prognostic significance.</p><p><strong>Methods: </strong>A total of 335 patients with HFpEF were prospectively enrolled for echocardiographic evaluation. LV GLS was obtained using 2D- and 3D-speckle-tracking echocardiography. Cox proportional hazards regression was used to determine predictors of adverse outcomes. The C-index, Akaike information criterion, integrated discrimination improvement, and net reclassification improvement were used to assess model performance and discriminative ability.</p><p><strong>Results: </strong>LV 2D-GLS and 3D-GLS were impaired in patients with HFpEF and T2D compared with those without T2D. After a median follow-up of 17.6 months, 150 patients experienced adverse outcomes. Both 2D-GLS (hazard ratio, 1.323 [95% CI, 1.225-1.429]; <i>P</i><0.001) and 3D-GLS (hazard ratio, 1.412 [95% CI, 1.316-1.515]; <i>P</i><0.001) were independent predictors of adverse outcomes in patients with HFpEF after adjustment for confounders. The predictive accuracy of a model incorporating 3D-GLS (Akaike information criterion=-583.9, C-index=0.775 [95% CI, 0.742-0.808]) was superior to models using 2D-GLS (Akaike information criterion=-533.3, C-index=0.719 [95% CI, 0.678-0.760], ΔC-index=0.056; <i>P</i>=0.034) and LV ejection fraction (Akaike information criterion=-498.9, C-index=0.659 [95% CI, 0.610-0.708], ΔC-index=0.116; <i>P</i><0.001). The addition of 2D-GLS and 3D-GLS to the base model significantly enhanced its discriminatory and predictive abilities (integrated discrimination improvement=0.225 and 0.280; net reclassification improvement=0.612 and 0.734, respectively, <i>P</i><0.001 for all).</p><p><strong>Conclusions: </strong>LV 2D-GLS and 3D-GLS are impaired in patients with HFpEF and T2D, and are independent predictors of adverse outcomes. Moreover, 3D-GLS provides incremental prognostic value over 2D-GLS.</p><p><strong>Registration: </strong>URL: https://www.chictr.org.cn/; Unique identifier: ChiCTR2100047487.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e016975"},"PeriodicalIF":6.5,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969642","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":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inheritance of Imaging Parameters of Arrhythmic Risk in Mitral Valve Prolapse: A Pedigree Study.","authors":"Luca Cristin, Shalini Dixit, Dwight Bibby, Janet J Tang, Qizhi Fang, Lionel Tastet, Amy H Rich, Rohit Jhawar, Yasufumi Nagata, Satoshi Higuchi, Robert A Levine, Henry H Hsia, Zian H Tseng, Nelson B Schiller, Francesca N Delling","doi":"10.1161/CIRCIMAGING.124.017051","DOIUrl":"10.1161/CIRCIMAGING.124.017051","url":null,"abstract":"<p><strong>Background: </strong>A subset of patients with mitral valve prolapse (MVP), a highly heritable condition, experience sudden cardiac arrest (SCA) or sudden cardiac death (SCD). However, the inheritance of phenotypic imaging features of arrhythmic MVP remains unknown.</p><p><strong>Methods: </strong>We recruited 23 MVP probands, including 9 with SCA/SCD and 14 with frequent/complex ventricular ectopy. Participants underwent interviews, 2-dimensional and speckle-tracking echocardiography, and 48-hour Holter/event monitoring. Each individual was categorized as having a normal mitral valve, MVP, or borderline MVP. We assessed mitral annular disjunction, curling, global longitudinal strain, segmental peak longitudinal strain, electrical/mechanical dispersion, and the postsystolic shortening index in family members and unrelated healthy controls.</p><p><strong>Results: </strong>We enrolled 23 pedigrees (14 extended pedigrees, 4 trios, and 5 duos) with a total of 121 participants (mean age 45 years, 50% women). Multigenerational SCA/SCD occurred in 2 of 14 extended pedigrees (14%) with an SCA/SCD proband. Mitral annular disjunction was present in 2 generations among 3 families (13%) and absent in 3 of 9 (33%) SCA/SCD cases. Compared with nonarrhythmic cases, arrhythmic MVP cases had more bileaflet involvement, mitral annular disjunction, curling, and abnormal valvular-myocardial mechanics, as expressed by a higher mid-inferior/inferolateral postsystolic shortening index (<i>P</i><0.05). Among arrhythmic MVP cases, those with SCA had the highest mechanical dispersion (<i>P</i>=0.04). Family members with normal valves had lower global longitudinal strain and greater mechanical dispersion compared with nonpedigree controls (both <i>P</i><0.05).</p><p><strong>Conclusions: </strong>In the context of familial MVP, SCA/SCD is rarely observed in multiple generations and is not consistently linked to mitral annular disjunction. Instead, SCA may result from combination of abnormal valvular-myocardial mechanics and a substrate of increased mechanical/electrical dispersion. Family members with normal mitral valves also exhibit mildly abnormal global strain parameters, suggesting an underlying myopathy independent of MVP expression. Future studies are needed to determine whether SCA/SCD in MVP requires the concomitant presence of abnormal mechanics and a primary genetic myopathy.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":"18 1","pages":"e017051"},"PeriodicalIF":6.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000804","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":"Aortic Valve Calcification: Clarifying Severity and Prognosis in Low-Flow Aortic Stenosis.","authors":"Bassim El-Sabawi, Brian R Lindman","doi":"10.1161/CIRCIMAGING.124.017855","DOIUrl":"10.1161/CIRCIMAGING.124.017855","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017855"},"PeriodicalIF":6.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945692","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":"Association of T-Cell Phenotypes With Peri-Coronary Inflammation in People With and Without HIV and Without Cardiovascular Disease.","authors":"Michael L Freeman, Mian B Hossain, Shana A B Burrowes, Jean Jeudy, Felisa Diaz-Mendez, Sarah E Mitchell, Sumanth D Prabhu, Michael M Lederman, Shashwatee Bagchi","doi":"10.1161/CIRCIMAGING.124.017033","DOIUrl":"10.1161/CIRCIMAGING.124.017033","url":null,"abstract":"<p><strong>Background: </strong>Persistent immune activation is linked to elevated cardiovascular diseases in people with HIV on antiretroviral therapy. The fat attenuation index (FAI) is a measure of peri-coronary inflammation that independently predicts cardiovascular disease risk in people without HIV. Whether FAI is associated with immune activation is unknown.</p><p><strong>Methods: </strong>Peripheral blood T-cell activation and homing phenotypes were measured in people with HIV (n=58) and people without HIV (n=16) without known cardiovascular disease who underwent coronary computed tomography angiography and had FAI measurements. A cross-sectional analysis of an observational cohort was performed. The primary aim was to evaluate associations of T-cell activation and phenotypes with the outcome variables, FAI values of the right coronary artery and left anterior descending artery, which were assessed using multivariable regression models adjusted for age, natal sex, race, low-density lipoprotein cholesterol, body mass index, and use of lipid-lowering medication.</p><p><strong>Results: </strong>T cells from people with HIV showed greater activation, as measured by cluster of differentiation (CD) 38/human leukocyte antigen - DR isotype coexpression on CD4 central memory and terminally-differentiated effector memory subsets and on CD8 effector memory (TEM), than did cells from people without HIV. Expression of the chemokine receptor C-C Chemokine Receptor 2 was reduced on CD4 central memory and TEM and CD8 TEM and terminally-differentiated effector memory subsets in people with HIV. Among all participants, PD-1 (programmed cell death 1) in CD8 central memory was associated with worsened peri-coronary inflammation of the right coronary artery, whereas perforin/granzyme B on CD8 TEM was associated with improved peri-coronary inflammation of the right coronary artery and left anterior descending artery in adjusted analyses. When accounting for HIV serostatus, CD38/human leukocyte antigen - DR isotype coexpression on CD8 central memory, TEM, and terminally-differentiated effector memory cells was associated with more peri-coronary inflammation of the left anterior descending artery.</p><p><strong>Conclusions: </strong>The associations between T-cell activation with FAI are novel and suggest that T-cell activation may be an important driver of peri-coronary inflammation, occurring at an early stage of atherosclerosis, even before the development of clinical disease.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017033"},"PeriodicalIF":6.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784306","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":"Finding the Arrhythmic Needle in the Low-Risk Haystack: Heritability of Imaging Features of Arrhythmic Mitral Valve Prolapse.","authors":"Susan K Keen, Deborah H Kwon","doi":"10.1161/CIRCIMAGING.124.017854","DOIUrl":"10.1161/CIRCIMAGING.124.017854","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":"18 1","pages":"e017854"},"PeriodicalIF":6.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000747","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":"Comprehensive Non-invasive Versus Invasive Approach to Evaluate Cardiac Allograft Vasculopathy in Heart Transplantation: The CCTA-HTx Study.","authors":"Marta Belmonte, Pasquale Paolisso, Michele Mattia Viscusi, Monika Beles, Luca Bergamaschi, Angelo Sansonetti, Hirofumi Ohashi, Ruiko Seki, Emanuele Gallinoro, Giuseppe Esposito, Monika Shumkova, Attilio Leone, Marco Masetti, Emanuele Barbato, Sofie Verstreken, Riet Dierckx, Ward Heggermont, Jan Van Keer, Luciano Potena, Carmine Pizzi, Jozeph Bartunek, Marc Vanderheyden","doi":"10.1161/CIRCIMAGING.124.017197","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017197","url":null,"abstract":"<p><strong>Background: </strong>Coronary computed tomography angiography (CCTA) is emerging as a valuable tool for noninvasive surveillance of cardiac allograft vasculopathy (CAV) in patients with heart transplant (HTx). We assessed the diagnostic performance of a comprehensive CCTA-based approach compared with the invasive reference, which includes invasive coronary angiography, intravascular ultrasound, and fractional flow reserve, for detecting CAV.</p><p><strong>Methods: </strong>This was a multicenter prospective study including 37 patients with HTx who underwent CCTA, invasive coronary angiography, intravascular ultrasound, and fractional flow reserve. The comprehensive CCTA-based approach included quantitative and qualitative plaque analysis and functional assessment by fractional flow reserve derived from coronary computed tomography. CAV was diagnosed based on invasive coronary angiography (International Society for Heart and Lung Transplantation criteria) and intravascular ultrasound. Univariable logistic regression analysis was performed to test CCTA-derived predictors of CAV. The area under the curve and accuracy indicators were calculated to evaluate the performance and best cutoffs of CCTA predictors of CAV.</p><p><strong>Results: </strong>The median interval between CCTA and HTx was 5 years. Among the 37 recipients, 23 (62.2%) were diagnosed with CAV. The integration of diameter stenosis and plaque morphology (including plaque burden at minimum lumen area >42% and percent atheroma volume >23%) at CCTA yielded the highest diagnostic performance (accuracy, 84%; sensitivity, 83%; specificity, 86%). The integration of ∆fractional flow reserve derived from coronary computed tomography trans-vessel gradient led to increased sensitivity, albeit with decreased specificity and overall accuracy. The noninvasive approach was associated with a lower contrast and radiation dose, compared with the invasive approach.</p><p><strong>Conclusions: </strong>A noninvasive strategy based on CCTA is accurate for managing patients with HTx. CCTA might be considered the preferred imaging modality for annual CAV surveillance after the first year post-HTx.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":"18 1","pages":"e017197"},"PeriodicalIF":6.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000722","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":"Contemporary Approach to Cardiac Allograft Vasculopathy Surveillance: The Role of Coronary CT Angiography.","authors":"Haya Aziz, Adam D DeVore, Melissa A Daubert","doi":"10.1161/CIRCIMAGING.124.017787","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017787","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":"18 1","pages":"e017787"},"PeriodicalIF":6.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000728","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":"Right Ventricular Function: Deep Learning's Prognostic Edge in Mitral Regurgitation.","authors":"Vidhu Anand, Vuyisile T Nkomo","doi":"10.1161/CIRCIMAGING.124.017788","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017788","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":"18 1","pages":"e017788"},"PeriodicalIF":6.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000811","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":"Relationship Between Coronary Artery Calcium Score and Vulnerability of Culprit Plaque Assessed by OCT in Patients With Established Coronary Artery Disease.","authors":"Daichi Fujimoto, Eisuke Usui, Rocco Vergallo, Daisuke Kinoshita, Keishi Suzuki, Takayuki Niida, Marco Covani, Iris McNulty, Hang Lee, Hiromasa Otake, Junya Shite, Maros Ferencik, Damini Dey, Tsunekazu Kakuta, Ik-Kyung Jang","doi":"10.1161/CIRCIMAGING.124.017099","DOIUrl":"10.1161/CIRCIMAGING.124.017099","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery calcium score (CACS) is widely used for risk stratification. However, in patients with established coronary artery disease, its clinical implication and relationship with plaque vulnerability are unclear. We sought to correlate the CACS and plaque vulnerability assessed by optical coherence tomography.</p><p><strong>Methods: </strong>Patients with coronary artery disease who had CACS and optical coherence tomography before percutaneous coronary intervention were included. Patients were divided into 5 groups based on CACS: CACS of 0, 1 to 99, 100 to 399, 400 to 999, and ≥1000. Optical coherence tomography-derived vulnerable features in culprit plaque were compared between the groups.</p><p><strong>Results: </strong>In 460 patients, the prevalence of lipid-rich plaque, macrophage, and cholesterol crystal significantly differed among the 5 groups, being lowest in the patients with a CACS of 0. The prevalence of thin-cap fibroatheroma tended to be lower in those with a CACS of 0. No significant difference in vulnerable features was observed between the 4 groups with CACS >0. In the 2-group comparison between the group with a CACS of 0 and the other 4 groups combined, the prevalence of lipid-rich plaque (60.5% versus 85.9%; <i>P</i><0.001), macrophage (48.8% versus 74.1%; <i>P</i><0.001), thin-cap fibroatheroma (16.3% versus 35.0%; <i>P</i>=0.013), and cholesterol crystal (11.6% versus 32.9%; <i>P</i>=0.004) was significantly lower in the patients with CACS of 0. CACS of 0 was independently negatively associated with lipid-rich plaque, macrophage, thin-cap fibroatheroma, and cholesterol crystal after adjustment for patient characteristics.</p><p><strong>Conclusions: </strong>Patients with a CACS of 0 have a significantly lower prevalence of vulnerable plaque features compared with those with CACS >0 in patients with established coronary artery disease.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT04523194.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017099"},"PeriodicalIF":6.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863525","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}