Circulation: Cardiovascular Imaging最新文献

{"title":"Giant Hemorrhagic Pericardial Cyst Mimicking Primary Cardiac Lymphoma by Coronary Artery Encasement.","authors":"Kenta Uno, Suguru Araki, Shiro Nakamori, Satoshi Nakamura, Tetsuji Kitano, Taku Omori, Miyuko Fujita, Akihide Nakamura, Masaki Ishida, Kakuya Kitagawa, Yu Shomura, Kazuaki Maruyama, Naoto Kumagai, Hajime Sakuma, Kaoru Dohi","doi":"10.1161/CIRCIMAGING.126.019784","DOIUrl":"10.1161/CIRCIMAGING.126.019784","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019784"},"PeriodicalIF":9.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210469","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":"Past, Present, and Future of Evaluating Diastolic Function.","authors":"Sherif F Nagueh","doi":"10.1161/CIRCIMAGING.125.018986","DOIUrl":"10.1161/CIRCIMAGING.125.018986","url":null,"abstract":"<p><p>The assessment of left ventricular diastolic function started with invasive pressure measurements and is currently primarily based on echocardiographic imaging. The current approach to the diagnosis of diastolic function relies on mitral inflow velocities, tissue Doppler early diastolic velocity of the mitral annulus, peak velocity of tricuspid regurgitation, pulmonary vein flow, left atrial size and function, and the noninvasive estimation of right atrial pressure. The recommended algorithm in the 2025 American Society of Echocardiography guidelines for estimation of mean left atrial pressure has been validated in a large multicenter study that included 951 patients. Further, that algorithm has shown incremental value to triaging clinical scores in achieving accurate heart failure with preserved ejection fraction diagnosis, against the invasive gold standard. Newer promising approaches have been developed over the past few years to study left ventricular diastolic function, including shear wave propagation velocity, left atrial conduit volume, and timing of mitral and tricuspid valve opening in the apical 4-chamber view. Artificial intelligence has been applied to this field as a rule-based decision tree algorithm, and as deep-learning neural networks to train models for diagnosing and grading diastolic dysfunction, and for diagnosing heart failure with preserved ejection fraction.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018986"},"PeriodicalIF":9.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270464","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":"Unmuting the Silent Progression of Tricuspid Regurgitation: The Forward-Flow Perspective on RV-PA Coupling.","authors":"Thiago Quinaglia, Theo Pezel, Otávio Rizzi Coelho-Filho","doi":"10.1161/CIRCIMAGING.126.020120","DOIUrl":"10.1161/CIRCIMAGING.126.020120","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e020120"},"PeriodicalIF":9.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359620","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":"Primary Aldosteronism: CXCR4- and FAP-Targeted PET/MR for Adrenal-Cardiac Axis.","authors":"Jie Ding, Kun Wang, Jun Song, Jing Huang, Xinwei Cheng, Feng Yin, Xing Chen, Zengbei Yuan, Zirong Zhou, Na Qi, Haiyan Wang, Peicheng Li, Rongbing Li, Lin Ye, Bo Feng, Li Huo, Jun Zhao","doi":"10.1161/CIRCIMAGING.126.019657","DOIUrl":"10.1161/CIRCIMAGING.126.019657","url":null,"abstract":"<p><strong>Background: </strong>Primary aldosteronism (PA) carries excess cardiovascular risk not fully explained by hemodynamic load. While aldosterone promotes fibroblast activation experimentally, in vivo evidence linking adrenocortical activity with myocardial remodeling remains limited. This study integrated CXCR4 (C-X-C chemokine receptor type 4)-targeted ⁶⁸Ga-Pentixafor positron emission tomography (PET)/magnetic resonance and FAP (fibroblast activation protein)-targeted ⁶⁸Ga-FAPI (fibroblast activation protein inhibitor)-04 PET/cardiac magnetic resonance to evaluate the adrenal-cardiac axis in PA.</p><p><strong>Methods: </strong>Eighty-two participants (40 with PA [21 aldosterone-producing adenoma (APA), 19 idiopathic hyperaldosteronism], 21 with essential hypertension, and 21 normotensive controls) underwent ⁶⁸Ga-FAPI-04 PET/cardiac magnetic resonance; 48 concurrently underwent ⁶⁸Ga-Pentixafor PET/magnetic resonance. Adrenal CXCR4 and myocardial FAPI uptake, as well as integrated volumetric-uptake burdens, were quantified and correlated with clinical and cardiac magnetic resonance indices. Eight patients with APA underwent follow-up imaging postadrenalectomy.</p><p><strong>Results: </strong>Adrenal volume-adjusted CXCR4 signal served as a reliable marker of in vivo aldosterone burden and was significantly associated with adverse left ventricular remodeling, independent of blood pressure levels or hypertension duration. Myocardial ⁶⁸Ga-FAPI-04 uptake was detected in 55% of patients with PA (APA 71.4%, idiopathic hyperaldosteronism 36.8%), compared with 19% of patients with essential hypertension and 0% of controls (<i>P</i><0.001), localizing predominantly to the basal septum. Importantly, total adrenal volume-adjusted CXCR4 signal correlated with myocardial FAPI activity (<i>r</i>=0.38-0.64; all <i>P</i><0.05) and cardiac magnetic resonance markers of remodeling, both of which were positively associated with aldosterone levels. At 5.2±1.2 months post-adrenalectomy, myocardial FAPI uptake in 8 patients with APA declined significantly (<i>P</i><0.01), whereas late gadolinium enhancement and global cardiac function showed no significant change.</p><p><strong>Conclusions: </strong>Dual-tracer PET/magnetic resonance provided in vivo molecular evidence of a CXCR4-FAP-mediated adrenal-cardiac axis in PA, revealing cross-talk between adrenocortical function, aldosterone secretion, and myocardial fibroblast activation beyond blood pressure effects. FAPI PET demonstrated more severe myocardial activation in APA, with partial postadrenalectomy reversibility, underscoring the value of early diagnosis and timely surgical intervention.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT06756737.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019657"},"PeriodicalIF":9.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216831","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":"Automated AI-Based Aortic Measurements From Attenuation Correction CT as an Adjunctive Cardiovascular Risk Biomarker: An International Multicenter Study.","authors":"Anna M Marcinkiewicz, Aakash Shanbhag, Panithaya Chareonthaitawee, Wenhao Zhang, Hasanian Al-Jilaihawi, Ryan Zaid, Sebastien Cadet, Giselle Ramirez, Mark Lemley, Jirong Yi, Waseem Hijazi, Valerie Builoff, Joanna X Liang, Vinicius F Calsavara, Andrew J Einstein, Edward J Miller, Attila Feher, Terrence D Ruddy, Viet T Le, Steve Mason, Stacey Knight, Erick Alexanderson, Isabel Carvajal-Juarez, Leandro Slipczuk, Mark I Travin, Thomas L Rosamond, Samuel B Wopperer, Daniel S Berman, Damini Dey, Marcelo F Di Carli, Robert J H Miller, Piotr J Slomka","doi":"10.1161/CIRCIMAGING.125.019726","DOIUrl":"10.1161/CIRCIMAGING.125.019726","url":null,"abstract":"<p><strong>Background: </strong>Aortic enlargement is a powerful predictor of dissection and rupture, yet it is rarely evaluated during routine myocardial perfusion imaging, despite the widespread availability of computed tomography (CT) attenuation correction scans. The aim of this study was to determine whether fully automated, opportunistically derived, artificial intelligence-based aortic measurements from myocardial perfusion imaging CT attenuation correction scans are associated with adverse outcomes in a large multicenter cohort.</p><p><strong>Methods: </strong>CT attenuation correction scans from patients undergoing positron emission tomography/CT and single-photon emission CT/CT myocardial perfusion imaging across 10 centers were included. A deep learning model automatically segmented the thoracic aorta, and a postprocessing algorithm extracted maximum ascending and descending diameters. The aortic size index was calculated by indexing the diameter to body surface area.</p><p><strong>Results: </strong>A total of 29 339 patients (56% men; median age, 66 years [interquartile range, 58-75 years]) were included. Over a median follow-up of 3.5 years (interquartile range, 1.9-5.0 years), 5083 (17.3%) patients died. Median ascending and descending aortic size index values were 1.8 cm/m² (interquartile range, 1.6-2.0) and 1.5 cm/m² (interquartile range, 1.4-1.6), respectively, with an increase with age and higher values in females. Elevated aortic size index thresholds (ascending >2.2 cm/m²; descending >1.6 cm/m²) were significantly associated with increased all-cause mortality (ascending: adjusted hazard ratio, 1.16 [95% CI, 1.07-1.26], <i>P</i><0.001; descending: adjusted hazard ratio, 1.23 [95% CI, 1.14-1.31]; <i>P</i><0.001). Notably, the prognostic value of an abnormal aortic size index persisted independent of age, sex, and perfusion abnormalities.</p><p><strong>Conclusions: </strong>Artificial intelligence can unlock previously unused information within routine myocardial perfusion imaging CT attenuation correction scans by rapidly and automatically quantifying aortic size at scale. Opportunistic aortic measurements derived from CT attenuation correction may serve as an adjunctive risk biomarker and could add prognostic value to standard myocardial perfusion imaging without additional imaging or radiation.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019726"},"PeriodicalIF":9.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367537","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":"Correction to: \"Patient-Specific Myocardial Infarction Risk Thresholds From AI-Enabled Coronary Plaque Analysis\".","authors":"Robert J H Miller, Nipun Manral, Andrew Lin, Aakash Shanbhag, Caroline Park, Jacek Kwiecinski, Aditya Killekar, Priscilla McElhinney, Hidenari Matsumoto, Aryabod Razipour, Kajetan Grodecki, Alan C Kwan, Donghee Han, Keiichiro Kuronuma, Guadalupe Flores Tomasino, Jolien Geers, Markus Goeller, Mohamed Marwan, Heidi Gransar, Balaji K Tamarappoo, Sebastien Cadet, Victor Y Cheng, Stephan Achenbach, Stephen J Nicholls, Dennis T Wong, Lu Chen, J Jane Cao, Daniel S Berman, Marc R Dweck, David E Newby, Michelle C Williams, Piotr J Slomka, Damini Dey","doi":"10.1161/HCI.0000000000000092","DOIUrl":"https://doi.org/10.1161/HCI.0000000000000092","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":"19 7","pages":"e000092"},"PeriodicalIF":9.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548070","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":"CMR Reveals the Influence of Trigger and Classification on the Myocardial Tissue Response in Takotsubo Syndrome.","authors":"Alexander Gotschy, Victoria L Cammann, Victor Schweiger, Rabea Schlenker, Davide Di Vece, Mihaly Károlyi, Thanh H Nguyen, John D Horowitz, Yoshio Kobayashi, Ken Kato, Benjamin Meder, Annalisa Pasquini, Nicola Galea, Elisa Fedele, Leonardo Calò, Sebastian Kozerke, Frank Ruschitzka, Filippo Crea, Thomas F Lüscher, Robert Manka, Jelena R Ghadri, Christian Templin, Leonarda Galiuto","doi":"10.1161/CIRCIMAGING.125.019335","DOIUrl":"10.1161/CIRCIMAGING.125.019335","url":null,"abstract":"<p><strong>Background: </strong>The pathogenesis of Takotsubo syndrome (TTS) is poorly understood, but differences in outcome depending on the triggering factor imply differences in the pathophysiology. Beyond the established trigger-based InterTAK (International Takotsubo Registry) classification, the newly proposed distinction between primary and secondary TTS aims to differentiate emotionally primed heart dysfunction from TTS driven by direct myocardial injury. To explore these potential differences, we utilized cardiovascular magnetic resonance imaging to assess left ventricular function, myocardial edema, and myocardial injury across the InterTAK classification and between primary and secondary TTS.</p><p><strong>Methods: </strong>For this multicenter cohort study, 110 patients (95% women, age 66±12 years) from the InterTAK registry were included who received cardiovascular magnetic resonance 3 (interquartile range, 2-5) days after symptom onset. Cardiovascular magnetic resonance included assessment of myocardial function, edema (T2-weighted spin-echo and T2-mapping when available), and late gadolinium enhancement.</p><p><strong>Results: </strong>No significant differences were observed in left ventricular volumes, function, or mass across the 3 InterTAK groups or between primary and secondary TTS. Patients with emotional triggers exhibited significantly larger myocardial edema (72% versus 60% for physical triggers; <i>P</i><0.01), supported by higher T2-mapping values in a subset of 22 patients with T2-mapping. In multivariable regression, only emotional trigger (<i>P</i><0.01) and the absence of coronary artery disease (<i>P</i>=0.04) were independently associated with the extent of myocardial edema. Secondary TTS showed a higher prevalence of focal or patchy late gadolinium enhancement (primary 19%, secondary 54%; <i>P</i><0.01). In multivariable logistic regression, secondary TTS (<i>P</i><0.01) and early cardiovascular magnetic resonance (<i>P</i>=0.02) were associated with the presence of any late gadolinium enhancement.</p><p><strong>Conclusions: </strong>TTS due to emotional stress is associated with larger myocardial edema, and secondary TTS exhibited late gadolinium enhancement more frequently, indicative of direct myocardial damage. These findings suggest that emotionally primed heart dysfunction and direct myocardial injury contribute to TTS pathophysiology to varying extents, influenced by both the triggering factor and preexisting conditions.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019335"},"PeriodicalIF":9.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359528","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":"Prognostic Implications of RV-Arterial Coupling Estimated by CMR in a Large Cohort of Tricuspid Regurgitation Patients.","authors":"Davide Margonato, Miho Fukui, Takahiro Nishihara, Asa Phichaphop, Ellen Cravero, Paul Sorajja, Vinayak Bapat, Carlo Gaspardone, Cosmo Godino, Giovanni Benfari, Eustachio Agricola, Francesco Maisano, Jӧrg Hausleiter, Patrizio Lancellotti, Rebecca T Hahn, Luigi P Badano, Denisa Muraru, Marco Metra, Maurice Enriquez-Sarano, João L Cavalcante","doi":"10.1161/CIRCIMAGING.126.019717","DOIUrl":"10.1161/CIRCIMAGING.126.019717","url":null,"abstract":"<p><strong>Background: </strong>Right ventricular-pulmonary arterial coupling is a known prognostic marker in patients with tricuspid regurgitation (TR). However, its assessment by cardiac magnetic resonance and its clinical implications have not been evaluated. We aimed to assess the prognostic role of a cardiac magnetic resonance surrogate of right ventricular-pulmonary arterial coupling in a large cohort of patients with a spectrum of TR severity.</p><p><strong>Methods: </strong>Comprehensive data were collected from patients referred for cardiac magnetic resonance from 2019 to 2024 who had TR quantification. Right ventricular-pulmonary arterial coupling was calculated by dividing the forward right ventricular stroke volume (f-RVSV) by the right ventricular end-systolic volume (ESV). The outcome of interest was the composite of all-cause death and heart failure hospitalization, under medical management.</p><p><strong>Results: </strong>In the 631 patients included, median age was 66 (interquartile range [IQR], 54-75) years, median tricuspid regurgitant volume was 18 (IQR, 12-30 mL), median left ventricular ejection fraction was 53 (IQR, 41-61)%, median RV ejection fraction was 53 (IQR, 45-58)%, and median f-RVSV/ESV ratio was 0.82 (IQR, 0.58-1.11). In restricted spline curve analysis, the f-RVSV/ESV ratio cutoff associated with a hazard >1 for the composite outcome was ≤0.57. At baseline, a low f-RVSV/ESV ratio was strongly associated with subjective and objective signs of right heart failure, higher TRI-SCORE, and worse right-sided chamber remodeling (all <i>P</i><0.001). After a median follow-up of 1.8 years (IQR, 1.5-2.0), patients with a low f-RVSV/ESV ratio showed worse survival (<i>P</i><0.001). After comprehensive adjustment for clinical and imaging confounders, f-RVSV/ESV ≤0.57 remained a powerful predictor of outcome (adjusted hazard ratio, 2.36 [95% CI, 1.27-4.37]; <i>P</i>=0.004). Finally, patients with low f-RVSV/ESV displayed a worse long-term prognosis across mild, moderate, and severe TR groups (<i>P</i><0.001, <i>P</i><0.001, and <i>P</i>=0.018, respectively).</p><p><strong>Conclusions: </strong>In this large cohort of patients with a wide spectrum of TR severity, right ventricular-pulmonary arterial coupling assessed by cardiac magnetic resonance was strongly associated with right-sided heart failure and worse long-term prognosis, even after comprehensive adjustment.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019717"},"PeriodicalIF":9.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148316059","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":"Opening a New Path to Explore With Molecular Imaging: The Adrenal-Cardiac Axis!","authors":"Fabien Hyafil, James T Thackeray","doi":"10.1161/CIRCIMAGING.126.020109","DOIUrl":"10.1161/CIRCIMAGING.126.020109","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e020109"},"PeriodicalIF":9.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359535","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 Chen et al Regarding Article, \"Quantitative Coronary Atherosclerotic Plaque Burden From CCTA and the Benefit From Lipid-Lowering Medication\".","authors":"Lin Chen, Hua Yan, Jun Fu","doi":"10.1161/CIRCIMAGING.126.019975","DOIUrl":"10.1161/CIRCIMAGING.126.019975","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019975"},"PeriodicalIF":9.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148161796","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}