Circulation: Cardiovascular Imaging最新文献

{"title":"Prognostic Value of PET-Derived Myocardial Flow Reserve in Patients With Very High Coronary Artery Calcium Score.","authors":"Mahmoud Al Rifai, Maria Alwan, Ahmed Ibrahim Ahmed, Talal Alnabelsi, Ahmed Aljizeeri, Mouaz H Al-Mallah","doi":"10.1161/CIRCIMAGING.125.018361","DOIUrl":"10.1161/CIRCIMAGING.125.018361","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery calcium (CAC) is a strong predictor of cardiovascular outcomes, with patients having high CAC experiencing event rates similar to those in secondary prevention populations. Emerging evidence suggests that patients with extremely high CAC (≥1000) represent a distinct high-risk group. Therefore, this study aims to evaluate the prognostic value of myocardial flow reserve (MFR) in patients with very high CAC.</p><p><strong>Methods: </strong>Consecutive patients who had a clinically indicated positron emission tomography were enrolled and followed prospectively for incident outcomes (all-cause death and myocardial infarction). Multivariable-adjusted Cox proportional hazards models were used to study the association between MFR and incident events (composite of all-cause death and myocardial infarction) among those with CAC ≥400.</p><p><strong>Results: </strong>The study population consisted of 3091 patients; mean (SD) age 69.6 (10.1) years, 36.8% female, 64.5% White, 46.0% with a CAC score of 400 to 999, and 54.0% with a CAC score of ≥1000. The median (interquartile range) MFR was 1.9 (1.45-2.35). Over a median (interquartile range) follow-up time of 1.36 (0.45-2.50) years, there were 278 incident events (81 myocardial infarctions and 217 deaths). In adjusted analyses, an MFR ≥2 was inversely associated with a lower risk of incident events; hazard ratio, 0.65 (95% CI, 0.38-1.12) for a CAC score of 400 to 999 and hazard ratio, 0.44 (95% CI, 0.28-0.69) for a CAC score of ≥ 1000. There was no significant interaction between MFR and CAC score; <i>P</i>=0.53.</p><p><strong>Conclusions: </strong>Among patients with CAC ≥400, positron emission tomography-derived MFR ≥2 is inversely associated with a lower risk of all-cause death and myocardial infarction.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018361"},"PeriodicalIF":7.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793607","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":"Long-Term Follow-Up in Severe Mitral Stenosis With Low Transmitral Diastolic Pressure Gradient: From MASTER Registry.","authors":"Iksung Cho, Dae-Young Kim, Jinseob Kim, Ha Jeong Lim, Jiwon Seo, Kyu Kim, Seo-Yeon Gwak, Hyun-Jung Lee, Hee Jeong Lee, Kyu-Yong Ko, Chi Young Shim, Jong-Won Ha, Seonhwa Lee, In-Cheol Kim, Kang-Un Choi, Jang-Won Son, Joo Hee Park, Geu-Ru Hong, Jagat Narula","doi":"10.1161/CIRCIMAGING.125.018124","DOIUrl":"10.1161/CIRCIMAGING.125.018124","url":null,"abstract":"<p><strong>Background: </strong>Long-term follow-up studies in severe mitral stenosis (MS) with low transmitral mean diastolic pressure gradient (MDPG) are not available. We evaluated the prognostic implications of severe MS with low MDPG in our MASTER (Multicenter Mitral Stenosis with Rheumatic Etiology) registry.</p><p><strong>Methods: </strong>We included patients with severe rheumatic MS (mitral valve area ≤1.5 cm²) from the long-term MASTER registry. Patients were categorized into high (≥5 mm Hg) or low (<5 mm Hg) MDPG groups. The primary outcome was a composite of all-cause mortality and stroke.</p><p><strong>Results: </strong>Among 1248 patients with severe MS, 322 (25.8%) had low MDPG and 926 (74.2%) had high MDPG. Their mean age was 59±13 years, 25% were men, and 74% had atrial fibrillation. Patients with low MDPG were older and had a higher prevalence of atrial fibrillation. During a mean follow-up of 6.8±5.9 years, 194 (15.5%) patients experienced major adverse events. Patients who had low MDPG sustained more events than those with high MDPG (hazard ratio, 1.56 [95% CI, 1.15-2.12]; <i>P</i>=0.004), and low MDPG was independently associated with poor outcome (hazard ratio, 1.42 [95% CI, 1.02-1.97]; <i>P</i>=0.038) in the multivariable model. In the subgroup analysis of patients with low MDPG, decreased left atrial reservoir strain was independently associated with poor outcome (hazard ratio, 3.22 [95% CI, 1.25-8.31]; <i>P</i>=0.016).</p><p><strong>Conclusions: </strong>Patients with severe MS and low MDPG carried a greater risk of adverse events than those with high MDPG and had less frequent and delayed mitral valve intervention. Also, it is not necessarily indicative of milder hemodynamic encumbrance. Left atrial reservoir strain could help identify a subgroup associated with poor prognosis in patients with low MDPG.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018124"},"PeriodicalIF":7.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641938","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":"Continuing the Quest to Refine Coronary Risk Stratification.","authors":"Leandro Slipczuk, Mario J Garcia","doi":"10.1161/CIRCIMAGING.125.018896","DOIUrl":"10.1161/CIRCIMAGING.125.018896","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018896"},"PeriodicalIF":7.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944966","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":"Low-Gradient Severe Mitral Stenosis: Pressure Gradients Do Not Tell the Whole Story.","authors":"Kenya Kusunose","doi":"10.1161/CIRCIMAGING.125.018786","DOIUrl":"10.1161/CIRCIMAGING.125.018786","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018786"},"PeriodicalIF":7.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752466","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":"Diagnostic Value of Relative Flow Reserve in Patients With Prior Coronary Artery Disease: A Post Hoc Analysis of the PACIFIC-2 Trial.","authors":"Roel Hoek, Yvemarie B O Somsen, Ruben W de Winter, Ruurt A Jukema, Jos W Twisk, Pieter G Raijmakers, Ibrahim Danad, Juhani Knuuti, Paul Knaapen, Pepijn A van Diemen, Roel S Driessen","doi":"10.1161/CIRCIMAGING.125.018574","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.018574","url":null,"abstract":"<p><strong>Background: </strong>The relative flow reserve (RFR) derived from quantitative myocardial perfusion imaging is the ratio of absolute myocardial perfusion in a stenotic to normally perfused area and is considered the noninvasive equivalent of fractional flow reserve (FFR). In patients with prior coronary artery disease (CAD), detecting hemodynamically significant CAD using hyperemic myocardial blood flow (hMBF) is complicated by diffuse CAD and microvascular disease. In these patients, RFR may improve the diagnostic performance of myocardial perfusion imaging. Therefore, we studied the diagnostic value of RFR over hMBF in patients with prior CAD.</p><p><strong>Methods: </strong>The PACIFIC-2 trial included symptomatic patients with prior myocardial infarction and percutaneous coronary intervention who prospectively underwent [¹⁵O]H₂O positron emission tomography perfusion imaging and invasive coronary angiography with 3-vessel FFR. RFR was assessed using positron emission tomography in an overall cohort incorporating all trial patients, and an optimal cohort of patients with angiographic 1- or 2-vessel disease (diameter stenosis ≥50%) and a nonstenotic reference vessel (diameter stenosis <30%). RFR was calculated as the ratio between the lowest to highest regional hMBF (overall cohort), or the lowest hMBF of a stenotic to the reference area (optimal cohort). Position emission tomography-derived flow indices were referenced by invasive FFR (≤0.80 deemed hemodynamically significant).</p><p><strong>Results: </strong>The overall cohort included 187 patients (63±9.3 years, 36 [19%] female), and the optimal cohort 80 patients (62±9.6 years, 19 [24%] female). Significant CAD was present in 87 (47%) and 43 (54%) patients, respectively. Correlations between RFR and FFR were 0.42 and 0.52 (<i>P</i><0.001 for both). C statistics for hMBF and RFR were comparable in the overall (0.81 versus 0.78; <i>P</i>=0.288) and the optimal cohort (0.79 versus 0.82; <i>P</i>=0.512).</p><p><strong>Conclusions: </strong>RFR proves clinically applicable, even without specific patient selection and knowledge of the coronary anatomy. However, RFR does not outperform absolute hyperemic myocardial perfusion for detecting FFR-defined significant CAD in patients with prior CAD and recurrence of symptoms.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018574"},"PeriodicalIF":7.0,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944974","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":"Dynamic Changes of Distinct Compartmental LV Remodeling Following Septal Myectomy in Hypertrophic Obstructive Cardiomyopathy.","authors":"Xinyi Luo, Guanyu Lu, Ziyu Liu, Yinzhu Chen, Jiehao Ou, Hongxiang Wu, Wei Zhu, Rui Chen, Huiming Guo, Hui Liu, Yuelong Yang","doi":"10.1161/CIRCIMAGING.125.018131","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.018131","url":null,"abstract":"<p><strong>Background: </strong>In hypertrophic obstructive cardiomyopathy, left ventricular mass index (LVMi) regresses following septal myectomy, but the specific dynamics, mechanisms (involving cellular and extracellular compartments), and related factors remain unclear.</p><p><strong>Methods: </strong>This prospective study included hypertrophic obstructive cardiomyopathy patients who underwent septal myectomy. Cardiac magnetic resonance imaging was performed preoperatively and at 6, 12, and 24 months postoperatively. LVMi, indexed cellular volume, and indexed extracellular volume were analyzed using repeated measures ANOVA. Factors associated with LVMi regression, postoperatively, were identified using linear regression.</p><p><strong>Results: </strong>The study included 27 patients (53.70±13.85 years; 17 female). LVMi significantly decreased from 105.76±25.22 g/m², preoperatively, to 82.52±25.90 g/m² at 6 months, postoperatively, further declining to 78.86±24.73 g/m² at 12 months and 76.22±23.93 g/m² at 24 months (<i>P</i><0.05). The average percent decrease in LVMi from baseline was 22.97% at 6 months, 26.26% at 12 months, and 28.58% at 24 months postoperatively. This regression is primarily driven by indexed cellular volume regression (23.70%), with a smaller reduction in the indexed extracellular volume (18.40%) in the first 6 months. Both compartments exhibited sustained reductions through 12 months. But from 12 to 24 months, only indexed extracellular volume continued to decline (from 22.13±6.76 to 20.89±6.25 mL/m²; <i>P</i><0.001). Greater left ventricular outflow tract pressure gradient reduction (β=0.157; <i>P</i>=0.001) was associated with LVMi regression after septal myectomy.</p><p><strong>Conclusions: </strong>In patients with hypertrophic obstructive cardiomyopathy postseptal myectomy, early LVMi reduction involves both cellular and extracellular compartments, with slower reduction from 12 to 24 months, mainly driven by the extracellular component. This demonstrates rapid myocardial adaptability to afterload relief, with slower extracellular matrix remodeling. Greater left ventricular outflow tract pressure gradient reduction was associated with greater LVMi regression after surgery.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: CTR2100043699.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018131"},"PeriodicalIF":7.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944932","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":"Three-Dimensional Printing of the Human Pericardium to Facilitate Understanding of the Pericardial Reflections, Recesses, and Sinuses.","authors":"Yuichiro Miyazaki, Mark Rimmer, Warwick J Peacock, Shili Xu, Kalyanam Shivkumar, Shumpei Mori","doi":"10.1161/CIRCIMAGING.125.018410","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.018410","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018410"},"PeriodicalIF":7.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944970","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":"Role of Passive Leg Raise Stress Echocardiography in Latent Stiff Left Atrial Syndrome.","authors":"Michito Murayama, Hiroyuki Iwano, Satonori Tsuneta, Noriyuki Otsuka, Makoto Kambayashi, Yui Shimono, Yoji Tamaki, Suguru Ishizaka, Shinobu Yokoyama, Hisao Nishino, Sanae Kaga, Toshiyuki Nagai, Toshihisa Anzai","doi":"10.1161/CIRCIMAGING.125.018662","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.018662","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018662"},"PeriodicalIF":7.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788396","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 Sacoransky Regarding Article, \"Deep Learning-Derived Cardiac Chamber Volumes and Mass From PET/CT Attenuation Scans: Associations With Myocardial Flow Reserve and Heart Failure\".","authors":"Ethan Sacoransky","doi":"10.1161/CIRCIMAGING.125.018652","DOIUrl":"10.1161/CIRCIMAGING.125.018652","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018652"},"PeriodicalIF":7.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483345","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":"High-Intensity Exercise, Fibrosis, and Ventricular Arrhythmias: How Much Is Too Much?","authors":"Katie J McMenamin, Frederick L Ruberg","doi":"10.1161/CIRCIMAGING.125.018716","DOIUrl":"10.1161/CIRCIMAGING.125.018716","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018716"},"PeriodicalIF":7.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658587","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}