Circulation: Cardiovascular Imaging最新文献

{"title":"Preload Stress With Leg Positive Pressure During TEE Unmasks Latent Severe Secondary Mitral Regurgitation.","authors":"Ryota Kosaki, Yasuhide Mochizuki, Sakiko Gohbara, Yumi Yamamoto, Saaya Ichikawa-Ogura, Hiroto Fukuoka, Toshiro Shinke","doi":"10.1161/CIRCIMAGING.126.020150","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.126.020150","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e020150"},"PeriodicalIF":9.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910909","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 to Letter Regarding Article, \"Assessing Left Atrial Volume Indexation to Predict Mortality in Individuals With Overweight and Obesity\".","authors":"Christine M Madronio, Gary K K Low, Nishant Nundlall, David Playford, Geoffrey Strange, Faraz Pathan, Kazuaki Negishi","doi":"10.1161/CIRCIMAGING.126.020155","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.126.020155","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e020155"},"PeriodicalIF":9.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910951","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":"In Utero Metabolic Maturation: Longitudinal 18F-FDG PET/CT Visualization of the Human Fetal Heart.","authors":"Karine Madsen, Elisabet Lundholm, Marie Manon Krarup Stolberg, Flemming Littrup Andersen, Kirsten Korsholm, Philip Hasbak","doi":"10.1161/CIRCIMAGING.126.020050","DOIUrl":"10.1161/CIRCIMAGING.126.020050","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e020050"},"PeriodicalIF":9.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764177","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":"Artificial Intelligence to Unmask LVOT Obstruction in Hypertrophic Cardiomyopathy.","authors":"Daniele Massera, Mark V Sherrid","doi":"10.1161/CIRCIMAGING.126.020318","DOIUrl":"10.1161/CIRCIMAGING.126.020318","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e020318"},"PeriodicalIF":9.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817393","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 Ventricular Remodelling in Mitral Valve Prolapse: More Than Volume Overload.","authors":"Lobke L Pype, Oksana Marchenko, Sven L Van Laer, Bernard P Paelinck, Hanne M Boen, Nicole Sturkenboom, Pier Giorgio Masci, Rachel M A Ter Bekke, Julia Grapsa, Paul G A Volders, Emeline M Van Craenenbroeck, Caroline M Van De Heyning","doi":"10.1161/CIRCIMAGING.126.019974","DOIUrl":"10.1161/CIRCIMAGING.126.019974","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular (LV) remodeling in mitral valve prolapse (MVP) may occur disproportionally to mitral regurgitation (MR) severity, especially in patients with Barlow disease. This study hypothesized an underlying MVP cardiomyopathy, potentially driven by ventricular arrhythmias or a genetic substrate. We investigated the determinants of LV remodeling in patients with MVP beyond MR volume load.</p><p><strong>Methods: </strong>Prospective inclusion of patients with nonsyndromic MVP at 3 centers. Patients were scheduled for cardiac magnetic resonance scans, 24-hour Holter monitoring and the presence of an underlying cardiomyopathy-associated genetic variant was assessed. Disproportionate LV remodeling was defined as LV end-diastolic volume above the age- and sex-specific upper limit of normal (LVEDVi_ULN) after correction for the total MR volume load, using the following formula: (LV end-diastolic volume-MR volume)/body surface area-LVEDVi_ULN >0.</p><p><strong>Results: </strong>A total of 103 patients with MVP were included (58% males, age 52±17 years). Disproportionate LV remodeling was present in 37% and was more frequent in Barlow disease compared with nonclassic MVP (<i>P</i>=0.067). After correction for age, sex, and MR volume load, Barlow disease phenotypic features like mitral annular dilatation are independently associated with LV dilatation (<i>P</i><0.001 at multivariable regression analysis for LV end-systolic volume index, <i>R</i>²=0.518). The total volume load (MR volume+prolapse volume) had a stronger correlation with LV remodeling than MR volume alone. In addition, ventricular arrhythmia-particularly ≥3% premature ventricular contractions-was independently associated with increased LV end-systolic volume index even after correction for other classical risk factors (<i>P</i>=0.024, <i>R</i>²=0.518). None of the patients carried a likely pathogenic or pathogenic variant in cardiomyopathy-associated genes.</p><p><strong>Conclusions: </strong>LV remodeling in MVP is a multifactorial process, where, especially in patients with Barlow disease, the associated mitral annular dilatation and larger prolapse volume drive LV dilatation beyond MR severity. In addition, a burden of ≥3% ventricular ectopy is strongly correlated with LV dilatation and dysfunction. Finally, a monogenic cardiomyopathy substrate appears unlikely.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019974"},"PeriodicalIF":9.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812278","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 Myocardial Fibrosis and Female Sex on Life-Threatening Arrhythmias and Sudden Cardiac Death in Mitral Valve Prolapse.","authors":"Amr Darwish, Duc T Nguyen, Thammarak Songsangjinda, Danai Kitkungvan, Mujtaba Saeed, Akila Bersali, Fatima Qamar, Mariya Potapenko, Fareeha Dadabhoy, Lionel Tastet, K Carlos El-Tallawi, Gerald Lawrie, Miguel Valderrábano, Francesca N Delling, Edward A Graviss, Raymond J Kim, Dipan J Shah","doi":"10.1161/CIRCIMAGING.126.020017","DOIUrl":"10.1161/CIRCIMAGING.126.020017","url":null,"abstract":"<p><strong>Background: </strong>Mitral valve prolapse (MVP) is a common cardiac condition that is generally benign, yet a subset of affected patients develop malignant ventricular arrhythmias and sudden cardiac death. Female sex and myocardial fibrosis detected by late gadolinium enhancement on cardiovascular magnetic resonance imaging have been proposed as risk factors though their independent contributions to arrhythmic risk remain uncertain.</p><p><strong>Methods: </strong>We conducted a prospective cohort study of 550 consecutive patients with MVP referred for cardiovascular magnetic resonance at a tertiary academic center between May 2008 and December 2021. Patients with potential confounders, including coronary artery disease, cardiomyopathy, infiltrative disease, or prior cardiac surgery, were excluded. The primary end point was a composite arrhythmic outcome comprising sudden cardiac death, aborted sudden cardiac arrest, and symptomatic sustained or inducible ventricular tachycardia or ventricular fibrillation leading to implantable cardioverter defibrillator placement or ventricular ablation at an MVP-related scar site.</p><p><strong>Results: </strong>Among the 550 patients (median age, 62 [interquartile range, 52-71] years; 50% women), late gadolinium enhancement (LGE) was present in 210 (38%). Over a median follow-up of 4.4 years (interquartile range, 2.8-7.1; 2700 patient-years), 48 patients (8.7%) reached the primary end point. On univariable analysis, both female sex (hazard ratio, 3.33 [95% CI, 1.72-6.44]; <i>P</i><0.001) and LGE presence (hazard ratio, 3.17 [95% CI, 1.74-5.77]; <i>P</i><0.001) were significantly associated with arrhythmic events, and both remained independently associated on multivariable analysis. Women with LGE represented the highest-risk subgroup, with a 5-year event-free survival of 76.5%, compared with 98.5% in men without LGE (<i>P</i><0.001).</p><p><strong>Conclusions: </strong>In a large prospective cardiovascular magnetic resonance cohort of patients with MVP, female sex and myocardial fibrosis were each independently associated with life-threatening arrhythmic events. Their combination identified a subgroup at particularly elevated risk, highlighting the importance of integrating sex-specific factors and myocardial tissue characterization into MVP risk stratification strategies.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e020017"},"PeriodicalIF":9.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668682","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":"How to Use Cardiovascular Imaging in Pregnancy.","authors":"An Van Berendoncks, José Rodríguez-Palomares, Julie De Backer","doi":"10.1161/CIRCIMAGING.125.018658","DOIUrl":"10.1161/CIRCIMAGING.125.018658","url":null,"abstract":"<p><p>Cardiovascular imaging plays a central role in the diagnosis, risk stratification, and longitudinal management of cardiovascular disease during pregnancy. Physiological adaptations-including increased blood volume, cardiac output, and chamber remodeling-pose important challenges for image acquisition and interpretation, necessitating a nuanced understanding of normal versus pathological findings. This review provides a practical, cardiology-focused framework for the use of imaging in pregnant patients with suspected or established cardiovascular disease. We emphasize key aspects relevant to cardiac imagers, including appropriate modality selection, pregnancy-adapted imaging protocols, and interpretation of findings in the context of dynamic physiological changes. Transthoracic echocardiography remains the first-line modality, while cardiovascular magnetic resonance offers complementary, radiation-free evaluation in selected cases. Imaging techniques involving ionizing radiation, such as computed tomography and invasive angiography, should be reserved for acute or high-risk scenarios and carefully optimized to minimize fetal exposure. We further discuss common diagnostic pitfalls, limitations of each modality, and areas of uncertainty, including the use of contrast agents and thresholds for advanced imaging. The importance of integrating imaging findings into multidisciplinary decision-making within Pregnancy Heart Teams is highlighted. By providing a structured, clinically oriented approach, this review aims to support cardiac imagers in delivering safe, accurate, and evidence-informed care to this complex patient population.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018658"},"PeriodicalIF":9.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577421","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":"Beyond Doppler: Scalable AI Detection of LVOT Obstruction in HCM.","authors":"Owen R Crystal, Juan M Farina, Isabel G Scalia, Chadi Ayoub, Cecilia C Villa Etchegoyen, Laurève Chollet, Hyung Bok Park, Kyung An Kim, Reza Arsanjani, Steven J Lester, Imon Banerjee","doi":"10.1161/CIRCIMAGING.126.019956","DOIUrl":"10.1161/CIRCIMAGING.126.019956","url":null,"abstract":"<p><strong>Background: </strong>Accurate assessment of left ventricular outflow tract (LVOT) gradients is critical for hypertrophic cardiomyopathy management, yet Doppler-based measurements are technically demanding and require expertise. The objective of this work was to develop a multi-view deep learning model capable of classifying LVOT obstruction (>20 mm Hg) using routine 2-dimensional echocardiographic windows without reliance on Doppler imaging.</p><p><strong>Methods: </strong>We trained and externally validated a cross-attention-based video-to-video fusion framework that integrated EchoPrime-derived video representations from 3 standard transthoracic echocardiographic views to classify LVOT gradients.</p><p><strong>Results: </strong>Training was performed on a derivation cohort (N=1833) from a tertiary care system in the United States, with model performance evaluated on an internally held-out test set (N=275) and a Korean external validation cohort (N=46). Single-view baselines showed limited discrimination (external area under the receiver operating curves, 0.47-0.70). Conversely, the domain-specific foundational model (EchoPrime) achieved superior single-view performance (area under the receiver operating curves, 0.75-0.80 internal; 0.79-0.83 external), highlighting the importance of echo-specific pretraining and temporal modeling. The proposed multi-view fusion further enhanced predictive performance, with the late fusion model reaching an area under the receiver operating curve of 0.84 on the external cohort with significant population-shift.</p><p><strong>Conclusions: </strong>These results suggest LVOT physiology is encoded in routine 2-dimensional imaging and can be leveraged for clinically relevant gradient classification without Doppler input. The proposed artificial intelligence-guided strategy demonstrates substantial cost savings compared with the screen-all approach. By integrating complementary spatial-temporal information across multiple views, our approach generalizes robustly across populations and may enable real-time decision support, extend LVOT assessment to portable or resource-limited settings, and complement Doppler-based evaluation for longitudinal hypertrophic cardiomyopathy management.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019956"},"PeriodicalIF":9.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148676942","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":"Unique Constellation of Venous Anomalies Associated With Tetralogy of Fallot: First Magnetic Resonance Angiography Documentation of Dual Inferior Vena Cava Anatomy.","authors":"Marwen Eid, Giulia Passaniti, Amanda Leung, Michaela Schmidt, Karl Kunze, Rene Botnar, Claudia Prieto, Omar K Khalique, Jason Craft","doi":"10.1161/CIRCIMAGING.126.019963","DOIUrl":"10.1161/CIRCIMAGING.126.019963","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019963"},"PeriodicalIF":9.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788528","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 Inflammation Is Associated With Plaque Progression in Men With HIV.","authors":"Nadim Nasrallah, Mark Atallah, Christelle Lattouf, Tarek Harb, Gary Gerstenblith, Sabina Haberlen, Theodoros Kelesidis, Jared W Magnani, Valentina Stosor, Kenneth Chan, Cheerag Shirodaria, Todd T Brown, Allison G Hays, Matthew Budoff, Wendy S Post, Charalambos Antoniades, Thorsten M Leucker","doi":"10.1161/CIRCIMAGING.126.020165","DOIUrl":"10.1161/CIRCIMAGING.126.020165","url":null,"abstract":"<p><strong>Background: </strong>People with HIV are at elevated risk for atherosclerotic cardiovascular disease despite viral suppression, suggesting contributions from nontraditional mechanisms. Coronary vascular inflammation may play a role, but its relationship to plaque progression remains incompletely defined. The perivascular fat attenuation index (FAI) score, derived from coronary computed tomography angiography, is associated with vascular inflammation. We evaluated whether coronary inflammation is associated with the incidence and progression of coronary plaque and whether these relationships differ by HIV status.</p><p><strong>Methods: </strong>A total of 504 men (n=292 with HIV; n=212 without HIV) from the Multicenter AIDS Cohort Study underwent coronary computed tomography angiography over a median of 4.5 years (3.8-4.9). FAI measurements were performed on baseline scans. Changes in noncalcified, calcified, and total plaque volumes were categorized into tertiles of progression. Associations were estimated using multinomial logistic regression adjusted for interscan time and cardiovascular risk factors. Modified Poisson regression estimated incident plaque.</p><p><strong>Results: </strong>Higher FAI scores in the left anterior descending (LAD) and left circumflex were associated with greater odds of belonging to the highest tertile of noncalcified (LAD odds ratio [OR], 1.83 [1.27-2.64]; left circumflex OR, 2.55 [1.66-3.91]); calcified (LAD OR, 2.62 [1.64-4.18]; left circumflex OR, 3.92 [2.36-6.51]); and total plaque progression (LAD OR, 1.81 [1.25-2.62]; left circumflex OR, 2.65 [1.71-4.10]) among men with HIV, per SD increase in FAI score after adjusting for cardiovascular risk factors, and remained significant after adjustment for baseline plaque. Higher LAD FAI score was associated with incident calcified plaque in men with HIV (RR, 1.21 [1.01-1.46]). Associations for noncalcified and calcified plaque progression were stronger in men with HIV than in men without HIV.</p><p><strong>Conclusions: </strong>Coronary inflammation, assessed by FAI, is independently associated with incident and progressive coronary plaque in men with HIV. These findings support a role for vascular inflammation in accelerated atherosclerosis in people with HIV and highlight FAI as a potential biomarker for risk stratification.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e020165"},"PeriodicalIF":9.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817358","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}