{"title":"Higher Precision With CCTA Compared With TEE for Detection of Residual LAA Patency After Closure.","authors":"Jacqueline Saw, Jaya Chandrasekhar","doi":"10.1161/CIRCIMAGING.125.018714","DOIUrl":"10.1161/CIRCIMAGING.125.018714","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018714"},"PeriodicalIF":7.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752465","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}
Wasim Javed, Ioannis Botis, Ze Min Goh, Mubien Shabi, Benjamin Brown, Raluca Tomoaia, Maryum Farooq, Eylem Levelt, Lee Graham, John Gierula, Peter Kellman, John P Greenwood, Sven Plein, Peter P Swoboda
{"title":"Ventricular Arrhythmia and Cardiac Fibrosis in Endurance Experienced Athletes (VENTOUX).","authors":"Wasim Javed, Ioannis Botis, Ze Min Goh, Mubien Shabi, Benjamin Brown, Raluca Tomoaia, Maryum Farooq, Eylem Levelt, Lee Graham, John Gierula, Peter Kellman, John P Greenwood, Sven Plein, Peter P Swoboda","doi":"10.1161/CIRCIMAGING.125.018470","DOIUrl":"10.1161/CIRCIMAGING.125.018470","url":null,"abstract":"<p><strong>Background: </strong>Sudden cardiac death due to primary arrhythmia is a leading cause of mortality in athletes, predominantly affecting older male athletes. Myocardial fibrosis is strongly associated with arrhythmogenesis in nonischemic cardiomyopathy, but its clinical significance in asymptomatic endurance athletes is unknown. We aimed to investigate whether myocardial fibrosis on cardiovascular magnetic resonance in asymptomatic veteran male athletes was associated with incident ventricular arrhythmia on long-term implantable loop recorder.</p><p><strong>Methods: </strong>Prospective observational cohort study involving 106 asymptomatic male competitive cyclists/triathletes (aged ≥50 years) who undertook ≥10 h/wk of exercise for ≥15 years. Exclusion criteria were any preexisting cardiovascular disease. Participants underwent clinical assessment, stress-perfusion late gadolinium enhancement-cardiovascular magnetic resonance, exercise testing, and implantable loop recorder implantation to detect ventricular arrhythmia. Athletes were followed up for the primary end point of incident ventricular arrhythmia.</p><p><strong>Results: </strong>A total of 50/106 (47.2%) athletes had focal myocardial fibrosis (all nonischemic distribution) on cardiovascular magnetic resonance predominantly affecting the basal inferolateral left ventricular segment. During follow-up (median 720 days), 23/106 (21.7%) athletes experienced ≥1 ventricular arrhythmic episode; 3/106 (2.8%) sustained ventricular tachycardia, and 20/106 (18.9%) nonsustained ventricular tachycardia. Myocardial fibrosis (hazard ratio, 4.7 [95% CI, 1.8-12.8]; <i>P</i>=0.002) and greater left ventricular end-diastolic volume indexed (hazard ratio, 1.4 [95% CI, 1.1-1.9]; <i>P</i>=0.02) were associated with an increased risk of incident ventricular arrhythmia, but right ventricular insertion point late gadolinium enhancement was not (hazard ratio, 1.7 [95% CI 0.6-5.1]; <i>P</i>=0.32). Myocardial fibrosis remained predictive after adjusting for left ventricular end-diastolic volume indexed (hazard ratio, 4.7 [95% CI, 1.7-12.7]; <i>P</i>=0.002).</p><p><strong>Conclusions: </strong>In male veteran endurance athletes, myocardial fibrosis was independently associated with the onset of ventricular arrhythmia, even after adjusting for left ventricular dilatation. Right ventricular insertion point late gadolinium enhancement was not associated with ventricular arrhythmia. Further studies are needed to establish whether myocardial fibrosis itself is arrhythmogenic or a marker of an underlying cardiomyopathic process.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018470"},"PeriodicalIF":7.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658588","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}
Woohyeun Kim, Hyungdon Kook, Yonggu Lee, Young-Hyo Lim
{"title":"Response by Kim et al to Letter Regarding Article, \"Impact of Post-PCI Lipid Core Burden Index on Angiographic and Clinical Outcomes: Insights From NIRS-IVUS\".","authors":"Woohyeun Kim, Hyungdon Kook, Yonggu Lee, Young-Hyo Lim","doi":"10.1161/CIRCIMAGING.125.018586","DOIUrl":"10.1161/CIRCIMAGING.125.018586","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018586"},"PeriodicalIF":7.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368003","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}
Ryota Kakizaki, Lorenz Räber, Christian Gerges, Peter Dorfmüller, Irene M Lang
{"title":"3D Reconstruction of Pulmonary Vascular Lesions in Chronic Thromboembolic Pulmonary Hypertension.","authors":"Ryota Kakizaki, Lorenz Räber, Christian Gerges, Peter Dorfmüller, Irene M Lang","doi":"10.1161/CIRCIMAGING.124.017935","DOIUrl":"10.1161/CIRCIMAGING.124.017935","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017935"},"PeriodicalIF":7.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490990","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":"Pulmonary Vascular Oncology: A New Collaborative Field for Cancer-Related Pulmonary Hypertension.","authors":"Alexander J Gazda, John J Ryan","doi":"10.1161/CIRCIMAGING.125.018601","DOIUrl":"10.1161/CIRCIMAGING.125.018601","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018601"},"PeriodicalIF":7.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590583","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}
Waseem Hijazi, Aakash Shanbhag, Robert J H Miller, Piotr J Slomka
{"title":"Response by Hijazi et al to Letter Regarding Article, \"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, Piotr J Slomka","doi":"10.1161/CIRCIMAGING.125.018683","DOIUrl":"10.1161/CIRCIMAGING.125.018683","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018683"},"PeriodicalIF":7.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728328","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}
Fei Yu, Scott Dougherty, Kent Chak-Yu So, Kevin Ka-Ho Kam, Chenxu Zhao, Xinghua Shan, Alex Pui-Wai Lee
{"title":"Utility of 3D Intracardiac Echocardiography in TriClip: A Future Without Transesophageal Echocardiography?","authors":"Fei Yu, Scott Dougherty, Kent Chak-Yu So, Kevin Ka-Ho Kam, Chenxu Zhao, Xinghua Shan, Alex Pui-Wai Lee","doi":"10.1161/CIRCIMAGING.124.017738","DOIUrl":"10.1161/CIRCIMAGING.124.017738","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017738"},"PeriodicalIF":7.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691338","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}
Thomas M Vollbrecht, Christopher Hart, Christoph Katemann, Alexander Isaak, Marilia B Voigt, Claus C Pieper, Daniel Kuetting, Annegret Geipel, Brigitte Strizek, Julian A Luetkens
{"title":"Improving Clinical Utility of Fetal Cine CMR Using Deep Learning Super-Resolution.","authors":"Thomas M Vollbrecht, Christopher Hart, Christoph Katemann, Alexander Isaak, Marilia B Voigt, Claus C Pieper, Daniel Kuetting, Annegret Geipel, Brigitte Strizek, Julian A Luetkens","doi":"10.1161/CIRCIMAGING.125.018090","DOIUrl":"10.1161/CIRCIMAGING.125.018090","url":null,"abstract":"<p><strong>Background: </strong>Fetal cardiovascular magnetic resonance is an emerging tool for prenatal congenital heart disease assessment, but long acquisition times and fetal movements limit its clinical use. This study evaluates the clinical utility of deep learning super-resolution reconstructions for rapidly acquired, low-resolution fetal cardiovascular magnetic resonance.</p><p><strong>Methods: </strong>This prospective study included participants with fetal congenital heart disease undergoing fetal cardiovascular magnetic resonance in the third trimester of pregnancy, with axial cine images acquired at normal resolution and low resolution. Low-resolution cine data was subsequently reconstructed using a deep learning super-resolution framework (cine<sub>DL</sub>). Acquisition times, apparent signal-to-noise ratio, contrast-to-noise ratio, and edge rise distance were assessed. Volumetry and functional analysis were performed. Qualitative image scores were rated on a 5-point Likert scale. Cardiovascular structures and pathological findings visible in cine<sub>DL</sub> images only were assessed. Statistical analysis included the Student paired <i>t</i> test and the Wilcoxon test.</p><p><strong>Results: </strong>A total of 42 participants were included (median gestational age, 35.9 weeks [interquartile range (IQR), 35.1-36.4]). Cine<sub>DL</sub> acquisition was faster than cine images acquired at normal resolution (134±9.6 s versus 252±8.8 s; <i>P</i><0.001). Quantitative image quality metrics and image quality scores for cine<sub>DL</sub> were higher or comparable with those of cine images acquired at normal-resolution (eg, fetal motion, 4.0 [IQR, 4.0-5.0] versus 4.0 [IQR, 3.0-4.0]; <i>P</i><0.001). Nonpatient-related artifacts (eg, backfolding) were more pronounced in cine<sub>DL</sub> compared with cine images acquired at normal-resolution images (4.0 [IQR, 4.0-5.0] versus 5.0 [IQR, 3.0-4.0]; <i>P</i><0.001). Volumetry and functional results were comparable. Cine<sub>DL</sub> revealed additional structures in 10 of 42 fetuses (24%) and additional pathologies in 5 of 42 fetuses (12%), including partial anomalous pulmonary venous connection.</p><p><strong>Conclusions: </strong>Deep learning super-resolution reconstructions of low-resolution acquisitions shorten acquisition times and achieve diagnostic quality comparable with standard images, while being less sensitive to fetal bulk movements, leading to additional diagnostic findings. Therefore, deep learning super-resolution may improve the clinical utility of fetal cardiovascular magnetic resonance for accurate prenatal assessment of congenital heart disease.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018090"},"PeriodicalIF":7.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494978","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}
Bryan E-Xin Tan, Faiz Baqai, Fernando Padilla, Nadeem Nimri, Jim W Cheung, Anupama Kottam, Hector M Medina
{"title":"Cardiac CT Versus Transesophageal Echocardiography Following Left Atrial Appendage Closure: A Systematic Review and Meta-Analysis.","authors":"Bryan E-Xin Tan, Faiz Baqai, Fernando Padilla, Nadeem Nimri, Jim W Cheung, Anupama Kottam, Hector M Medina","doi":"10.1161/CIRCIMAGING.125.018151","DOIUrl":"10.1161/CIRCIMAGING.125.018151","url":null,"abstract":"<p><strong>Background: </strong>In the landmark WATCHMAN trials, transesophageal echocardiography (TEE) was used to evaluate peri-device leak (PDL) and device-related thrombus (DRT) after percutaneous left atrial appendage closure (LAAC). We aimed to investigate the diagnostic utility of cardiac computed tomography angiography (CCTA) compared with TEE for post-LAAC device surveillance.</p><p><strong>Methods: </strong>We conducted a literature search of 5 electronic databases to identify studies that included patients who underwent both CCTA and TEE after LAAC. We performed a meta-analysis by pooling outcomes for residual leak (left atrial appendage patency), any PDL, large PDL (>5 mm), and DRT.</p><p><strong>Results: </strong>We included 17 cohort studies with 1313 patients who underwent both CCTA and TEE after LAAC. CCTA was associated with higher odds of detecting residual leak (58.8% versus 34.6%, odds ratio, 2.26 [95% CI, 1.48-3.44], <i>P</i>=0.0002; <i>I</i><sup>2</sup>=73%; 15 studies, 975 patients; moderate certainty) and any PDL (51.6% versus 35.5%, odds ratio, 1.59 [95% CI, 1.01-2.51], <i>P</i>=0.04; <i>I</i><sup>2</sup>=73%; 12 studies, 870 patients; moderate certainty) when compared with TEE. There were no significant differences in the detection rates of large PDL (>5 mm) between CCTA and TEE (2.8% versus 0.8%, odds ratio, 3.12 [95% CI, 0.73-13.36], <i>P</i>=0.13; <i>I</i><sup>2</sup>=0%; 5 studies, 338 patients; moderate certainty). The incidence of DRT was low (1.7%), and the detection rate did not differ between the 2 modalities (1.7% versus 1.7%, odds ratio, 1.0 [95% CI, 0.41-2.42], <i>P</i>=1.0; <i>I</i><sup>2</sup>=0%; 6 studies, 584 patients; high-certainty).</p><p><strong>Conclusions: </strong>Following LAAC, CCTA had higher odds of detecting residual leak and any PDL compared with TEE, whereas there were no significant differences in the detection of large PDL (> 5mm) and DRT between the 2 modalities. The findings of this meta-analysis should provide reassurance to patients and clinicians who prefer CCTA over TEE after LAAC. While DRT and left atrial appendage patency with visible PDL are known to be associated with thromboembolism, the clinical significance of left atrial appendage patency without visible PDL is uncertain and warrants further investigation.</p><p><strong>Registration: </strong>URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD42024578802.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018151"},"PeriodicalIF":7.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504991","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}