Circulation: Cardiovascular Imaging最新文献

{"title":"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.125.019491","DOIUrl":"10.1161/CIRCIMAGING.125.019491","url":null,"abstract":"<p><strong>Background: </strong>Alternative indexation methods for left atrial volume (LAV) have been proposed to achieve better proportional scaling than the current standard body surface area indexation. However, there are limited data showing that these alternative indices provide long-term prognostic value in individuals with overweight or obesity. The aim of this study was to determine and compare the performance of various LAV indexation methods in predicting all-cause mortality in individuals with overweight or obesity.</p><p><strong>Methods: </strong>We obtained data from the National Echocardiography Database Australia with linkage to mortality outcomes, selecting individuals with body mass index ≥25 kg/m² and valid LAV, height, weight, and left ventricular ejection fraction. We conducted receiver operating characteristic analyses, including area under the curve calculations, to compare the performance of 9 LAV indices in predicting all-cause mortality. In addition, we performed a survival analysis between LAV and all-cause mortality.</p><p><strong>Results: </strong>A total of 109 543 individuals (age 60±16 years, 47% women) were included. Indexing LAV by most methods performed similarly in predicting all-cause mortality, with areas under the curve between 0.60 and 0.62 (<i>P</i><0.05), except that LAV and LAV/body mass index had the lowest area under the curve with 0.600 (0.595-0.604) and 0.602 (0.597-0.606). Indexation methods also performed similarly when separated by age, sex, or follow-up duration. A mortality threshold for LAV/body surface area was observed at 34 mL/m², with no difference by sex.</p><p><strong>Conclusions: </strong>Among patients with overweight or obesity, the majority of LAV indices performed similarly in predicting all-cause mortality. Our findings support the continued use of LA volume indexed to body surface area for prognosis in this population, and the current normal range of <34 mL/m².</p><p><strong>Registration: </strong>URL: https://anzctr.org.au/Default.aspx; Unique identifier: ACTRN12617001387314.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019491"},"PeriodicalIF":9.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927076","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":"Multimodal Artificial Intelligence for Cardiac Amyloidosis Diagnosis: Integrating Echocardiography With Clinical and Laboratory Data for Improved Detection.","authors":"Jeremy A Slivnick, Sze Chi Lim, Michael Randazzo, Mathew S Maurer, Stephen Helmke, Marielle Scherrer-Crosbie, Azin Vakilpour, Karolina M Zareba, Akash Goyal, Richard Cheng, Nicole Nakamatsu, Tetsuji Kitano, Masaaki Takeuchi, Viviane Tiemi Hotta, Marcelo Luiz Campos Vieira, Pablo Elissamburu, Ricardo E Ronderos, Aldo Prado, Efstratios Koutroumpakis, Anita Deswal, Amit Pursnani, Nitasha Sarswat, Karima Addetia, Juan Cotella, Frederick L Ruberg, Matthew Frost, Marianna Fontana, Carolyn Lam Su Ping, Roberto M Lang, Federico M Asch","doi":"10.1161/CIRCIMAGING.126.019610","DOIUrl":"10.1161/CIRCIMAGING.126.019610","url":null,"abstract":"<p><strong>Background: </strong>Cardiac amyloidosis (CA) is an underdiagnosed yet treatable cause of heart failure in which timely diagnosis is essential to initiate life-prolonging therapies. While artificial intelligence (AI)-based tools using transthoracic echocardiography (TTE), electrocardiography, or electronic health records have demonstrated promise for CA detection, most rely on single data sources. We aimed to evaluate whether integrating clinical, laboratory, and TTE biomarkers improves the performance of an existing TTE-based AI model for CA detection.</p><p><strong>Methods: </strong>We developed and tested a combined AI echo-clinical model (AI-ECM) incorporating demographics, laboratory biomarkers, and TTE parameters into a previously validated TTE-only AI model (Us2.Ca). Model training and internal validation were performed using the Amyloidosis Imaging International Consortium, a global multiethnic registry comprised of 727 patients with CA and 316 controls, including 202 with suspected transthyretin-CA with negative diagnostic evaluation and 114 patients with biopsy-proven extracardiac light chain amyloidosis without cardiac involvement. Ground truth CA diagnosis was adjudicated per consensus criteria. AI-ECM and Us2.Ca performance was assessed using area under the curve, accuracy, sensitivity, and specificity.</p><p><strong>Results: </strong>In building the AI-ECM, feature importance analysis showed that having the Us2.Ca prediction scores, relative wall thickness, sex, and estimated glomerular filtration rate contributed most to performance. The AI-ECM demonstrated superior performance (area under the curve, 0.94; accuracy, 90%; sensitivity, 93%; specificity, 85%) compared with the Us2.Ca (area under the curve, 0.89; accuracy, 80%; sensitivity, 76%; specificity, 91%; <i>P</i>=0.006). While the Us2.Ca model classification was indeterminate in 9% of the cases, the AI-ECM allowed classification of all cases. The AI-ECM improved sensitivity for light chain-CA detection and maintained high accuracy across subtypes and control groups.</p><p><strong>Conclusions: </strong>A multiparametric AI model integrating basic clinical, laboratory, and TTE data with the deep learning Us2.Ca improved performance for CA detection over Us2.Ca alone. This approach represents a step toward scalable, AI-guided precision diagnostics for CA in diverse populations.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019610"},"PeriodicalIF":9.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148027776","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 Performance of Two CCTA Derived Noninvasive FFR Techniques: The TripleFFR Study.","authors":"Akruti P Prabhakar, Usman Sagheer, Sarah Malik, Dong Bo Yu, Omar Khalique, Dinesh K Kalra","doi":"10.1161/CIRCIMAGING.125.019530","DOIUrl":"10.1161/CIRCIMAGING.125.019530","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019530"},"PeriodicalIF":9.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147873672","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 Atrial Enlargement in Obesity: Does How We Index Matter?","authors":"Kyla M Lara-Breitinger, Jae K Oh","doi":"10.1161/CIRCIMAGING.126.020033","DOIUrl":"10.1161/CIRCIMAGING.126.020033","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e020033"},"PeriodicalIF":9.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148027751","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":"Importance of Understanding the Kinetics of Cardiac Amyloid Radionuclide Imaging.","authors":"Edward J Miller, Cesia Gallegos, Albert J Sinusas","doi":"10.1161/CIRCIMAGING.126.019837","DOIUrl":"10.1161/CIRCIMAGING.126.019837","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019837"},"PeriodicalIF":7.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764102","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":"Correction to: 2025 ACC/AHA/ASE/ASNC/SCCT/SCMR Advanced Training Statement on Advanced Cardiovascular Imaging: A Report of the ACC Competency Management Committee.","authors":"Lauren A Baldassarre, Lisa A Mendes, Ron Blankstein, Rebecca T Hahn, Amit R Patel, Raymond Russell, Suhny Abbara, Shawn M Ahmad, Mary Beth Brady, Renee P Bullock-Palmer, João L Cavalcante, Panithaya Chareonthaitawee, Tiffany Chen, Daniel E Clark, Darcy Green Conaway, Melissa A Daubert, Jennifer Day, Marcelo F Di Carli, Patrycja Galazka, Cesia Gallegos-Kattán, Howard Herrmann, Edwin C Ho, Christine L Jellis, Viet T Le, Penelope C Lema, Diana E Litmanovich, Stephen H Little, Jennifer E Liu, Juan C Lopez-Mattei, Alan B Lumsden, S Chris Malaisrie, Rowlens M Melduni, Koen Nieman, Sara Nikravan, Karen G Ordovas, Purvi Parwani, Krishna K Patel, Dawn R Phoubandith, Lynn R Punnoose, Frank J Rybicki, William F Sensakovic, Michael D Shapiro, Brett W Sperry, David Spragg, Matthew S Tong, Esther Vogel-Bass, Annabelle Santos Volgman, Anam Waheed, Gaby Weissman, Bryan J Wells","doi":"10.1161/HCI.0000000000000091","DOIUrl":"https://doi.org/10.1161/HCI.0000000000000091","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":"19 5","pages":"e000091"},"PeriodicalIF":7.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147970983","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 Culprit Lesion Location and Intramyocardial Hemorrhage in STEMI.","authors":"Fritz Oberhollenzer, Ivan Lechner, Christina Tiller, Magdalena Holzknecht, Alex Kaser, Philipp Fischer, Agnes Mayr, Felix Troger, Axel Bauer, Bernhard Metzler, Sebastian J Reinstadler, Martin Reindl","doi":"10.1161/CIRCIMAGING.125.019364","DOIUrl":"10.1161/CIRCIMAGING.125.019364","url":null,"abstract":"<p><strong>Background: </strong>Intramyocardial hemorrhage (IMH) is a major determinant of adverse outcome in patients with ST-segment-elevation myocardial infarction, therefore making it a promising therapeutic target. This study aimed to investigate the association between coronary culprit lesion location and IMH in acute ST-segment-elevation myocardial infarction.</p><p><strong>Methods: </strong>We analyzed 767 patients with ST-segment-elevation myocardial infarction undergoing cardiac magnetic resonance imaging, including T2* mapping at 4 (interquartile range, 3-5) days after infarction. Coronary culprit vessel and lesion, Thrombolysis in Myocardial Infarction flow, and collateral circulation were assessed. The primary end point was the presence of IMH on cardiac magnetic resonance. An exploratory clinical end point at 12 months was defined as major adverse cardiac events, which comprised all-cause mortality, reinfarction, and new congestive heart failure.</p><p><strong>Results: </strong>Median age was 59 (interquartile range, 53-67) years, and 19% (n=144) were female. IMH was detected in 265 (35%) patients. IMH was present in 27% (n=76/286) of patients with right coronary artery, in 39% (n=136/351) with left anterior descending artery, and 44% (n=48/109) with circumflex artery (CX) as the culprit lesion (<i>P</i><0.001). Segment 11 (CX proximal) showed the highest (n=23/41, 56%), segment 1 (right coronary artery proximal) the lowest risk for IMH (n=22/85, 26%). CX infarction remained independently associated with IMH (odds ratio, 1.27 [95% CI, 1.07-1.50]; <i>P</i>=0.005) after adjustment for angiographic and clinical IMH determinants, including Thrombolysis in Myocardial Infarction flow, ischemic time, and troponin T concentration. Collateral flow was least frequent in CX infarctions (n=15/109, 14%) compared with right coronary artery (n=117/286, 41%) and left anterior descending infarctions (n=101/351, 29%; <i>P</i><0.001). Patients with CX infarction showed the highest rate of major adverse cardiac events (7%) compared with left anterior descending (6%) and right coronary artery (2%) infarctions (<i>P</i>=0.039).</p><p><strong>Conclusions: </strong>CX infarctions were independently associated with the highest risk of IMH. The low prevalence of collateral circulation may contribute to this susceptibility. These findings define CX infarctions as a high-risk phenotype that may benefit from targeted cardioprotective strategies.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019364"},"PeriodicalIF":9.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764033","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 Utility of Perivascular Adipose Tissue Attenuation in Patients Undergoing Endovascular Aneurysm Repair for Abdominal Aortic Aneurysms.","authors":"Koshi Matsuhama, Takayoshi Toba, Yoichiro Sugizaki, Tatsuya Kitagawa, Shotaro Yoshida, Mayuka Masuda, Keisuke Iida, Ken Takata, Nobuhiro Watanabe, Kotaro Higuchi, Hiroya Okamoto, Yuta Fukuishi, Yuki Sakamoto, Shota Naniwa, Hiroshi Tsunamoto, Tetsuya Yamamoto, Seigo Iwane, Yuto Osumi, Daichi Fujimoto, Takashi Hiromasa, Hiroyuki Kawamori, Hironaga Shiraki, Taishi Inoue, Katsuhiro Yamanaka, Hiroaki Takahashi, Tomoyuki Gentsu, Koji Sasaki, Masato Yamaguchi, Kenji Okada, Hiromasa Otake","doi":"10.1161/CIRCIMAGING.125.019185","DOIUrl":"10.1161/CIRCIMAGING.125.019185","url":null,"abstract":"<p><strong>Background: </strong>Perivascular adipose tissue (PVAT) attenuation on computed tomography angiography reflects vascular inflammation. However, its prognostic value in patients undergoing endovascular aortic repair (EVAR) for abdominal aortic aneurysm (AAA) remains unclear.</p><p><strong>Methods: </strong>We retrospectively studied consecutive patients who underwent EVAR for unruptured infrarenal AAA with preprocedural computed tomography angiography. PVAT attenuation and aortic characteristics were assessed using computed tomography angiography. The primary outcome was major adverse cardiac or cerebrovascular events (MACCE), a composite of all-cause death, myocardial infarction, stroke, and any vessel treatment.</p><p><strong>Results: </strong>Among 275 patients treated with EVAR, 35.6% (98/275) experienced MACCE during a median follow-up of 3.5 years. Pre-EVAR PVAT attenuation was higher in patients who experienced MACCE than in those who did not (-69.8±10.3 HU versus -77.3±8.6 HU; <i>P</i><0.001). In the Cox proportional hazards model, higher PVAT attenuation (per 10 HU; unadjusted hazard ratio, 1.88 [95% CI, 1.56-2.28]; <i>P</i><0.001) was associated with MACCE after EVAR. Furthermore, higher PVAT attenuation was associated with AAA-related adverse events: a composite of AAA-related death, reintervention for AAA, embolization for endoleak, and AAA enlargement (per 10 HU; unadjusted hazard ratio, 2.16 [95% CI, 1.59-2.94]). Adding PVAT attenuation to post-EVAR prognostic factors and computed tomography angiography findings improved the predictive and reclassification abilities for MACCE after EVAR.</p><p><strong>Conclusions: </strong>In patients undergoing EVAR, higher PVAT attenuation was associated with both MACCE and AAA-related adverse events. PVAT attenuation may provide incremental prognostic value for identifying patients at higher risk of unfavorable outcomes following EVAR.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019185"},"PeriodicalIF":9.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764084","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":"Aortic-Left Ventricular Tunnel Secondary to LVOT Diverticulum in an Adult.","authors":"Lan Lan, Zhiling Liu, Mei Zhu, Hao Liang, Jie Zhang, Qiao Li","doi":"10.1161/CIRCIMAGING.126.019659","DOIUrl":"10.1161/CIRCIMAGING.126.019659","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019659"},"PeriodicalIF":7.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638148","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":"Integrating PET-Determined Global and Focal Impairment of Myocardial Flow Reserve to Enhance Cardiovascular Prognostication?","authors":"Thomas Hellmut Schindler, Elgin Ozkan","doi":"10.1161/CIRCIMAGING.126.019868","DOIUrl":"10.1161/CIRCIMAGING.126.019868","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019868"},"PeriodicalIF":7.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811753","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}