Circulation: Cardiovascular Imaging最新文献

{"title":"Two Hearts Beating in One Chest.","authors":"Isabella Leo, Giandomenico Bisaccia, Joyce Wong, Fernando Riesgo-Gil, Peter Kellman, Chiara Bucciarelli-Ducci","doi":"10.1161/CIRCIMAGING.124.017666","DOIUrl":"10.1161/CIRCIMAGING.124.017666","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017666"},"PeriodicalIF":6.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846020","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":"Toward Multiparametric MRI to Unravel Myocardial Pathology in Cardiac Amyloidosis.","authors":"Olivier F Clerc, Michael Jerosch-Herold, Sharmila Dorbala","doi":"10.1161/CIRCIMAGING.125.018178","DOIUrl":"10.1161/CIRCIMAGING.125.018178","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018178"},"PeriodicalIF":6.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961342","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":"Severe Mitral Regurgitation in Paradoxical Low-Flow, Low-Gradient Severe Aortic Stenosis.","authors":"Shani Dahan, Jacob P Dal-Bianco, Ygal Plakht, Mayooran Namasivayam, Romain Capoulade, Xin Zeng, Jonathan Passeri, Evin Yucel, Michael H Picard, Robert A Levine, Judy Hung","doi":"10.1161/CIRCIMAGING.124.017598","DOIUrl":"10.1161/CIRCIMAGING.124.017598","url":null,"abstract":"<p><strong>Background: </strong>Patients with paradoxical low-flow, low-gradient severe aortic stenosis exhibit low transvalvular flow rate (Q), while maintaining preserved left ventricular ejection fraction. Severe mitral regurgitation (MR) also causes a low-flow state, adding complexity to diagnosis and management. This study aimed to examine the impact of severe MR on outcomes in paradoxical low-flow, low-gradient severe aortic stenosis.</p><p><strong>Methods: </strong>Data from an institutional echo database identified 1189 patients with adjudicated severe aortic stenosis (aortic valve area ≤1.0 cm²), low transaortic gradients (mean gradient <40 mm Hg), preserved left ventricular ejection fraction (≥50%), and low-flow rate (Q ≤210 mL/s) to confirm paradoxical low-flow, low-gradient severe aortic stenosis. Subgroups were based on MR severity (severe and non-severe). Clinical outcomes included all-cause mortality, aortic valve replacement, heart failure hospitalizations, and a composite outcome.</p><p><strong>Results: </strong>In the severe MR group (n=80), patients had lower flow rates, increased left ventricular dimensions, and a more eccentric hypertrophy pattern compared with non-severe MR (n=1109). Over a follow-up of up to 5 years, severe MR correlated with higher all-cause mortality (<i>P</i>=0.02) and aortic valve replacement rates (<i>P</i>=0.012). After multivariable adjustment, severe MR was independently associated with increased all-cause mortality risk (hazard ratio=1.43; <i>P</i>=0.011) and composite outcome (hazard ratio=1.64; <i>P</i><0.001). Aortic valve replacement significantly reduced mortality at every MR degree, with the most substantial impact in severe MR (hazard ratio=0.18; <i>P</i><0.001). Propensity-adjusted models demonstrated a stronger aortic valve replacement impact with increasing MR degree (<i>P</i>_interaction=0.044).</p><p><strong>Conclusions: </strong>Severe MR in paradoxical low-flow, low-gradient severe aortic stenosis is associated with adverse outcomes and distinctive left ventricular remodeling. Aortic valve replacement improves survival across all MR grades, with greater impact in severe MR.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017598"},"PeriodicalIF":6.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669405","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":"Artificial Intelligence-Enhanced Analysis of Echocardiography-Based Radiomic Features for Myocardial Hypertrophy Detection and Etiology Differentiation.","authors":"Inki Moon, Jina Lee, Seung-Ah Lee, Dawun Jeong, Jaeik Jeon, Yeonggul Jang, Sihyeon Jeong, Jiyeon Kim, Hong-Mi Choi, In-Chang Hwang, Youngtaek Hong, Goo-Yeong Cho, Yeonyee E Yoon, Hyuk-Jae Chang","doi":"10.1161/CIRCIMAGING.124.017436","DOIUrl":"10.1161/CIRCIMAGING.124.017436","url":null,"abstract":"<p><strong>Background: </strong>While echocardiography is pivotal for detecting left ventricular hypertrophy (LVH), it struggles with etiology differentiation. To enhance LVH assessment, we aimed to develop an artificial intelligence algorithm using echocardiography-based radiomics. This algorithm is designed to detect LVH and differentiate its common etiologies, such as hypertrophic cardiomyopathy (HCM), cardiac amyloidosis (CA), and hypertensive heart disease (HHD), based on echocardiographic images.</p><p><strong>Methods: </strong>The developmental data sets from multiple medical centers included 867 subjects, with an independent external test set from a single tertiary medical center containing 619 subjects. Radiomic feature analysis was conducted on 4 echocardiographic views, extracting both conventional and harmonization-driven myocardial textures along with myocardial geographic features. Then, we developed classification models for each condition. Variable contributions were evaluated using Shapley Additive Explanations analysis.</p><p><strong>Results: </strong>The radiomics-based LightGBM model, selected from internal validation, maintained strong performance in the external test set (area under the curve of 0.96 for HCM, 0.89 for CA, and 0.86 for HHD). Compared with the logistic regression model using conventional echocardiographic parameters (left ventricular ejection fraction, left ventricular mass index, left atrial volume index, and E/e'), the final model demonstrated superior sensitivity (0.89 versus 0.80 for HCM, 0.80 versus 0.80 for CA, and 0.75 versus 0.33 for HHD) and F1-score (0.87 versus 0.57 for HCM, 0.84 versus 0.72 for CA, and 0.82 versus 0.50 for HHD). Feature analysis highlighted that harmonization-driven textures played a key role in differentiating HCM, while conventional textures and myocardial thickness were influential in differentiating CA and HHD.</p><p><strong>Conclusions: </strong>This study confirms that artificial intelligence-enhanced echocardiography-based radiomics effectively differentiate the etiology of LVH, highlighting the potential of artificial intelligence-driven texture and geographic analysis in LVH evaluation.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017436"},"PeriodicalIF":6.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718012","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":"MRI-Extracellular Volume Fraction Versus Histological Amyloid Load in Cardiac Amyloidosis: The Importance of T2 Mapping.","authors":"Masafumi Kidoh, Seitaro Oda, Seiji Takashio, Mami Morioka, Naoto Kuyama, Tetsuya Oguni, Takeshi Nakaura, Yasunori Nagayama, Yasuhiro Izumiya, Kenichi Tsujita, Toshinori Hirai","doi":"10.1161/CIRCIMAGING.124.017427","DOIUrl":"10.1161/CIRCIMAGING.124.017427","url":null,"abstract":"<p><strong>Background: </strong>Magnetic resonance imaging (MRI)-derived myocardial extracellular volume fraction (ECV) is elevated in the presence of fibrosis, amyloid deposition, inflammation, and edema. In patients with cardiac amyloidosis and prolonged T2 due to concomitant inflammation or edema, MRI-ECV may not correctly reflect histological amyloid load. The authors sought to determine whether MRI-ECV can accurately reflect histological amyloid load in 2 groups of patients with wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM), with and without T2 prolongation.</p><p><strong>Methods: </strong>This retrospective study included consecutive patients with ATTRwt-CM who underwent endomyocardial biopsy and cardiac MRI from March 2017 to October 2021 for initial evaluation of ATTRwt-CM. We measured MRI-ECV and T2, and evaluated correlation between MRI-ECV and amyloid load from endomyocardial biopsy by means of Pearson correlation analysis.</p><p><strong>Results: </strong>Of 44 patients (mean age, 75±6 years [SD]; 40 men), 24 showed T2 prolongation (T2≥50 milliseconds). All specimens obtained by endomyocardial biopsy were suitable for analysis. The interval between endomyocardial biopsy and cardiac MRI examination was a median of 3 days (interquartile range, 2-4). In the absence of T2 prolongation due to increased water content, MRI-ECV and amyloid load showed a moderately significant correlation (Spearman ρ=0.50, <i>P</i>=0.03). However, in the presence of T2 prolongation, there was no significant correlation between MRI-ECV and amyloid load (Spearman ρ=-0.05, <i>P</i>=0.83).</p><p><strong>Conclusions: </strong>In patients with ATTRwt-CM and prolonged T2, MRI-ECV did not accurately reflect histological amyloid load. Our findings underscore the need for a multiparametric imaging approach, combining both ECV and T2 mapping, to better characterize myocardial tissue in patients with ATTRwt-CM, and further prospective research in larger and more diverse cohorts is needed to validate our results.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017427"},"PeriodicalIF":6.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669402","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 Stenosis and Mitral Regurgitation: Partners in Crime.","authors":"Marie-Annick Clavel, Philippe Pibarot","doi":"10.1161/CIRCIMAGING.125.018290","DOIUrl":"10.1161/CIRCIMAGING.125.018290","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018290"},"PeriodicalIF":6.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968745","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 Findings in the Long-Term Outcomes After Multisystem Inflammatory Syndrome in Children (MUSIC) Study.","authors":"Sean M Lang, Dongngan T Truong, Andrew J Powell, Valiantsina Kazlova, Jane W Newburger, Jordan D Awerbach, Edem Binka, Tamara T Bradford, Mark Cartoski, Andrew Cheng, Michael P DiLorenzo, Audrey Dionne, Adam L Dorfman, Matthew D Elias, Olukayode Garuba, Jennifer F Gerardin, Keren Hasbani, Pei-Ni Jone, Christopher Z Lam, Nilanjana Misra, Lerraughn M Morgan, Arni Nutting, Jyoti K Patel, Joshua D Robinson, Eleanor L Schuchardt, Kristen Sexson Tejtel, Gautam K Singh, Timothy C Slesnick, Felicia Trachtenberg, Michael D Taylor","doi":"10.1161/CIRCIMAGING.124.017420","DOIUrl":"10.1161/CIRCIMAGING.124.017420","url":null,"abstract":"<p><strong>Background: </strong>Multisystem Inflammatory Syndrome in Children is characterized by high rates of acute cardiovascular involvement with rapid recovery of organ dysfunction. However, information regarding long-term sequelae is lacking. We sought to characterize the systolic function and myocardial tissue properties using cardiac magnetic resonance (CMR) imaging in a multicenter observational cohort of Multisystem Inflammatory Syndrome in Children patients.</p><p><strong>Methods: </strong>In this observational cohort study, comprising 32 centers in North America, CMR studies were analyzed by a core laboratory to assess ventricular volumetric data, tissue characterization, and coronary involvement.</p><p><strong>Results: </strong>A total of 263 CMRs from 255 Multisystem Inflammatory Syndrome in Children patients were analyzed. The mean patient age was 11.4±4.4 years. Most studies were performed at 3 months (33%) or 6 months (45%) after hospitalization. Left ventricular dysfunction was present in 17 (6.7%) of the first CMRs and was never worse than mild. Dysfunction was observed in 4/7 (57%) patients at admission, 5/87 (6.9%) patients at 3 months, and 6/129 (4.6%) patients imaged either at 6 months or 1 year post-hospitalization. Late gadolinium enhancement was present in 2 (0.8%) patients, 1 at 3 months and another at 6 months following hospitalization. Coronary artery dilation was present in 13 of the 174 (7.5%) patients. Nine patients met the Lake Louise criteria for myocarditis (3.5%) at the time of CMR.</p><p><strong>Conclusions: </strong>In this largest published multiinstitutional longitudinal CMR evaluation of confirmed Multisystem Inflammatory Syndrome in Children patients, the prevalence of ventricular dysfunction and myocardial tissue characterization abnormalities on medium-term follow-up was low. However, a small number of patients had mild residual abnormalities at 6 months and 1 year following hospitalization.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT05287412.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017420"},"PeriodicalIF":6.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779328","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":"Cervical Circumflex Aortic Arch: A Rare Vascular Anomaly and Its Surgical Correction.","authors":"Hüseyin Sicim, Daniel A Velez, Mohamad Alaeddine","doi":"10.1161/CIRCIMAGING.125.018062","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.018062","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018062"},"PeriodicalIF":6.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763066","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":"Temporal Trends in Noninvasive and Invasive Cardiac Testing From 2010 to 2022 in the US Medicare Population.","authors":"Yosef A Cohen, Luca Bremner, Mrinali Shetty, Michelle Castillo, Julia Susan Cappell, Jay S Leb, Lynne L Johnson, Andrew J Einstein","doi":"10.1161/CIRCIMAGING.124.017567","DOIUrl":"10.1161/CIRCIMAGING.124.017567","url":null,"abstract":"<p><strong>Background: </strong>Cardiac diagnostic testing continues to evolve, and controversies remain regarding the optimal utilization of different procedures. We sought to evaluate changes in long-term utilization trends for a wide range of cardiac diagnostic tests in the context of advancing technologies and updated guidelines.</p><p><strong>Methods: </strong>Annual cardiac testing volumes from 2010 to 2022 in the Medicare Part B population were compared across tests and by provider specialty and analyzed using Joinpoint regression.</p><p><strong>Results: </strong>The most-utilized test in the Medicare population remained transthoracic echocardiography, accounting for 61.5% of cardiac testing use in 2011 and 67.7% in 2022, followed by single-photon emission computed tomography (CT) myocardial perfusion imaging, which decreased from 20.8% to 12.9%. Single-photon emission CT myocardial perfusion imaging use decreased relative to positron emission tomography myocardial perfusion imaging (ratio of 39:1 in 2011 to 7:1 in 2022), stress cardiac magnetic resonance (1179:1 in 2011, 268:1 in 2022), and coronary CT angiography (61:1 in 2011, 10:1 in 2022). Decreased use was also observed for exercise treadmill testing (2.3% to 1.7%), stress echocardiography (3.6% to 2.6%), multigated acquisition (0.4% to 0.1%), and invasive coronary angiography (8.0% to 7.0%). The use of fractional flow reserve by CT per 100 000 Medicare enrollees increased by >16-fold from 2018 (the first year covered) to 2022, and cardiac amyloidosis pyrophosphate scintigraphy studies increased 4-fold from 2011 to 2022 (0.17% to 0.68%). Positron emission tomography myocardial perfusion imaging volumes have surpassed exercise treadmill test volumes and, assuming the current rate of change continues, are projected to surpass stress echocardiography volumes in 2024. Coronary CT angiography is projected to overtake exercise treadmill testing in 2024 and stress echocardiography in 2025.</p><p><strong>Conclusions: </strong>Between 2010 and 2022, cardiac diagnostic testing in the US Medicare population shifted from invasive angiography and traditional stress testing toward an increase in cardiac CT, cardiac magnetic resonance, and positron emission tomography. Pyrophosphate scintigraphy studies also increased, as did fractional flow reserve by CT since its introduction. Changes in preferred diagnostic modalities suggest a need to reevaluate current recommendations for training in cardiovascular medicine.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017567"},"PeriodicalIF":6.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613753","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":"Quantitative Coronary Artery Plaque Parameters and Severity of Ischemia in Patients With INOCA.","authors":"Johanna Ben-Ami Lerner, Mitchell Pleasure, James K Min, Michael H Picard, Jesus Peteiro, Roxy Senior, Jelena Celutkiene, Michael D Shapiro, Patricia A Pellikka, Alexandre Schaan de Quadros, Benjamin J W Chow, Jacqueline E Tamis-Holland, Fatima Rodriguez, Jerome L Fleg, David J Maron, Judith S Hochman, Harmony R Reynolds","doi":"10.1161/CIRCIMAGING.124.017367","DOIUrl":"10.1161/CIRCIMAGING.124.017367","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017367"},"PeriodicalIF":6.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751270","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}