Circulation: Cardiovascular Imaging最新文献

{"title":"Finding the Arrhythmic Needle in the Low-Risk Haystack: Heritability of Imaging Features of Arrhythmic Mitral Valve Prolapse.","authors":"Susan K Keen, Deborah H Kwon","doi":"10.1161/CIRCIMAGING.124.017854","DOIUrl":"10.1161/CIRCIMAGING.124.017854","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":"18 1","pages":"e017854"},"PeriodicalIF":6.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000747","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":"Comprehensive Non-invasive Versus Invasive Approach to Evaluate Cardiac Allograft Vasculopathy in Heart Transplantation: The CCTA-HTx Study.","authors":"Marta Belmonte, Pasquale Paolisso, Michele Mattia Viscusi, Monika Beles, Luca Bergamaschi, Angelo Sansonetti, Hirofumi Ohashi, Ruiko Seki, Emanuele Gallinoro, Giuseppe Esposito, Monika Shumkova, Attilio Leone, Marco Masetti, Emanuele Barbato, Sofie Verstreken, Riet Dierckx, Ward Heggermont, Jan Van Keer, Luciano Potena, Carmine Pizzi, Jozeph Bartunek, Marc Vanderheyden","doi":"10.1161/CIRCIMAGING.124.017197","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017197","url":null,"abstract":"<p><strong>Background: </strong>Coronary computed tomography angiography (CCTA) is emerging as a valuable tool for noninvasive surveillance of cardiac allograft vasculopathy (CAV) in patients with heart transplant (HTx). We assessed the diagnostic performance of a comprehensive CCTA-based approach compared with the invasive reference, which includes invasive coronary angiography, intravascular ultrasound, and fractional flow reserve, for detecting CAV.</p><p><strong>Methods: </strong>This was a multicenter prospective study including 37 patients with HTx who underwent CCTA, invasive coronary angiography, intravascular ultrasound, and fractional flow reserve. The comprehensive CCTA-based approach included quantitative and qualitative plaque analysis and functional assessment by fractional flow reserve derived from coronary computed tomography. CAV was diagnosed based on invasive coronary angiography (International Society for Heart and Lung Transplantation criteria) and intravascular ultrasound. Univariable logistic regression analysis was performed to test CCTA-derived predictors of CAV. The area under the curve and accuracy indicators were calculated to evaluate the performance and best cutoffs of CCTA predictors of CAV.</p><p><strong>Results: </strong>The median interval between CCTA and HTx was 5 years. Among the 37 recipients, 23 (62.2%) were diagnosed with CAV. The integration of diameter stenosis and plaque morphology (including plaque burden at minimum lumen area >42% and percent atheroma volume >23%) at CCTA yielded the highest diagnostic performance (accuracy, 84%; sensitivity, 83%; specificity, 86%). The integration of ∆fractional flow reserve derived from coronary computed tomography trans-vessel gradient led to increased sensitivity, albeit with decreased specificity and overall accuracy. The noninvasive approach was associated with a lower contrast and radiation dose, compared with the invasive approach.</p><p><strong>Conclusions: </strong>A noninvasive strategy based on CCTA is accurate for managing patients with HTx. CCTA might be considered the preferred imaging modality for annual CAV surveillance after the first year post-HTx.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":"18 1","pages":"e017197"},"PeriodicalIF":6.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000722","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":"Contemporary Approach to Cardiac Allograft Vasculopathy Surveillance: The Role of Coronary CT Angiography.","authors":"Haya Aziz, Adam D DeVore, Melissa A Daubert","doi":"10.1161/CIRCIMAGING.124.017787","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017787","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":"18 1","pages":"e017787"},"PeriodicalIF":6.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000728","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":"Right Ventricular Function: Deep Learning's Prognostic Edge in Mitral Regurgitation.","authors":"Vidhu Anand, Vuyisile T Nkomo","doi":"10.1161/CIRCIMAGING.124.017788","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017788","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":"18 1","pages":"e017788"},"PeriodicalIF":6.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000811","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":"Relationship Between Coronary Artery Calcium Score and Vulnerability of Culprit Plaque Assessed by OCT in Patients With Established Coronary Artery Disease.","authors":"Daichi Fujimoto, Eisuke Usui, Rocco Vergallo, Daisuke Kinoshita, Keishi Suzuki, Takayuki Niida, Marco Covani, Iris McNulty, Hang Lee, Hiromasa Otake, Junya Shite, Maros Ferencik, Damini Dey, Tsunekazu Kakuta, Ik-Kyung Jang","doi":"10.1161/CIRCIMAGING.124.017099","DOIUrl":"10.1161/CIRCIMAGING.124.017099","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery calcium score (CACS) is widely used for risk stratification. However, in patients with established coronary artery disease, its clinical implication and relationship with plaque vulnerability are unclear. We sought to correlate the CACS and plaque vulnerability assessed by optical coherence tomography.</p><p><strong>Methods: </strong>Patients with coronary artery disease who had CACS and optical coherence tomography before percutaneous coronary intervention were included. Patients were divided into 5 groups based on CACS: CACS of 0, 1 to 99, 100 to 399, 400 to 999, and ≥1000. Optical coherence tomography-derived vulnerable features in culprit plaque were compared between the groups.</p><p><strong>Results: </strong>In 460 patients, the prevalence of lipid-rich plaque, macrophage, and cholesterol crystal significantly differed among the 5 groups, being lowest in the patients with a CACS of 0. The prevalence of thin-cap fibroatheroma tended to be lower in those with a CACS of 0. No significant difference in vulnerable features was observed between the 4 groups with CACS >0. In the 2-group comparison between the group with a CACS of 0 and the other 4 groups combined, the prevalence of lipid-rich plaque (60.5% versus 85.9%; <i>P</i><0.001), macrophage (48.8% versus 74.1%; <i>P</i><0.001), thin-cap fibroatheroma (16.3% versus 35.0%; <i>P</i>=0.013), and cholesterol crystal (11.6% versus 32.9%; <i>P</i>=0.004) was significantly lower in the patients with CACS of 0. CACS of 0 was independently negatively associated with lipid-rich plaque, macrophage, thin-cap fibroatheroma, and cholesterol crystal after adjustment for patient characteristics.</p><p><strong>Conclusions: </strong>Patients with a CACS of 0 have a significantly lower prevalence of vulnerable plaque features compared with those with CACS >0 in patients with established coronary artery disease.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT04523194.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017099"},"PeriodicalIF":6.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863525","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":"How to Use Imaging: Complex Cases of Atherosclerosis, Myocardial Inflammation, and Cardiomyopathy in Cardio-Oncology.","authors":"Mohamad Khattab, Mariam Baig, Talal El Zarif, Ana Barac, Maros Ferencik, Mariana L Henry, Juan Lopez-Mattei, Alban Redheuil, Joe-Elie Salem, Marielle Scherrer-Crosbie, Eric H Yang, Lauren A Baldassarre","doi":"10.1161/CIRCIMAGING.124.015981","DOIUrl":"10.1161/CIRCIMAGING.124.015981","url":null,"abstract":"<p><p>It is well understood that cancer therapies including chemotherapy, tyrosine kinase inhibitors, immune checkpoint inhibitors, and radiation can increase the risk of cardiovascular disease in patients with cancer. This can manifest as a multitude of pathologies including left ventricular dysfunction, myocarditis, cardiomyopathy, accelerated atherosclerosis, and coronary vasospasm. Multimodal cardiac imaging plays a critical role in diagnosing such pathologies by relying on noninvasive tools including echocardiograms, cardiac magnetic resonance imaging, positron emission tomography, single-photon emission computed tomography, and coronary computed tomography angiography. These methods have unique considerations and in recent years have made significant progress in their diagnostic capabilities in this patient population. As the field of cardio-oncology continues to expand rapidly, guidance on the management of such toxicities and the development of imaging technologies is crucial. In this review, we present 2 complex cases of atherosclerosis and myocarditis in patients with cancer, highlighting our rationale for management and discussing the nuances of various cardiac imaging modalities.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e015981"},"PeriodicalIF":6.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945694","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":"Usefulness of Aortic Valve Calcification in Patients With Low-Flow Aortic Stenosis.","authors":"Nils Sofus Borg Mogensen, Jordi Sanchez Dahl, Mulham Ali, Mohamed-Salah Annabi, Amal Haujir, Andréanne Powers, Rasmus Carter-Storch, Jasmine Grenier-Delaney, Jacob Eifer Møller, Kristian Altern Øvrehus, Philippe Pibarot, Marie-Annick Clavel","doi":"10.1161/CIRCIMAGING.124.017122","DOIUrl":"10.1161/CIRCIMAGING.124.017122","url":null,"abstract":"<p><strong>Background: </strong>Aortic valve calcification (AVC) has been shown to be a powerful assessment of aortic stenosis (AS) severity and a predictor of adverse outcomes. However, its accuracy in patients with low-flow AS has not yet been proven. The objective of the study was to assess the predictive value of AVC in patients with classical low-flow (CLF, that is, low-flow reduced left ventricular ejection fraction) or paradoxical low-flow (PLF, that is, low-flow preserved left ventricular ejection fraction) AS.</p><p><strong>Methods: </strong>We prospectively included 641 patients, 319 (49.8%) with CLF-AS and 322 (50.2%) with PLF-AS, who underwent Doppler echocardiography and multidetector computed tomography. AVC ratio (AVCratio) was calculated as AVC divided by the sex-specific AVC threshold for AS severity; AVC score ≥2000 Agatston units in male patients and ≥1200 Agatston units in female patients. The primary end point of the study was all-cause mortality regardless of treatment.</p><p><strong>Results: </strong>Sex-specific AVC thresholds identified AS severity correctly in 137 (87%) of the patients. During a median follow-up of 4.9 (4.3-5.9) years, there were 265 deaths. After comprehensive adjustment, AVCratio was associated with all-cause mortality in patients with CLF-AS (adjusted hazard ratio, 1.25 [95% CI, 1.01-1.56]; <i>P</i>=0.046) and PLF-AS (adjusted hazard ratio, 1.51 [95% CI, 1.14-2.00]; <i>P</i>=0.004). There was an interaction (<i>P</i>=0.001) between AVC and AS flow patterns (ie, CLF versus PLF) with regard to the prediction of mortality. The best AVCratio threshold to predict mortality was different in patients with CLF-AS (AVCratio ≥0.7) and PLF-AS (AVCratio ≥1). After a comprehensive analysis, AVCratio as a dichotomic variable was associated with all-cause mortality in all groups (<i>P</i>≤0.001). The addition of AVCratio to the models improved all models' predictive value (all net reclassification index >18%; all <i>P</i>≤0.05).</p><p><strong>Conclusions: </strong>In patients with CLF-AS or PLF-AS, AVC is a major predictor of mortality. Thus, AVC should be used in low-flow patients to assess AS severity and stratify risk. Importantly, in patients with reduced left ventricular ejection fraction, a nonsevere AS (ie, AVC 70% of severe) could be associated with reduced survival.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017122"},"PeriodicalIF":6.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945696","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":"Deep Learning-Enabled Assessment of Right Ventricular Function Improves Prognostication After Transcatheter Edge-to-Edge Repair for Mitral Regurgitation.","authors":"Mark Lachmann, Vera Fortmeier, Lukas Stolz, Márton Tokodi, Attila Kovács, Amelie Hesse, Antonia Leipert, Elena Rippen, Héctor Alfonso Alvarez Covarrubias, Moritz von Scheidt, Jule Tervooren, Ferdinand Roski, Michelle Fett, Muhammed Gerçek, Tibor Schuster, Gerhard Harmsen, Shinsuke Yuasa, N Patrick Mayr, Adnan Kastrati, Heribert Schunkert, Michael Joner, Erion Xhepa, Karl-Ludwig Laugwitz, Jörg Hausleiter, Volker Rudolph, Teresa Trenkwalder","doi":"10.1161/CIRCIMAGING.124.017005","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.124.017005","url":null,"abstract":"<p><strong>Background: </strong>Right ventricular (RV) function has a well-established prognostic role in patients with severe mitral regurgitation (MR) undergoing transcatheter edge-to-edge repair (TEER) and is typically assessed using echocardiography-measured tricuspid annular plane systolic excursion. Recently, a deep learning model has been proposed that accurately predicts RV ejection fraction (RVEF) from 2-dimensional echocardiographic videos, with similar diagnostic accuracy as 3-dimensional imaging. This study aimed to evaluate the prognostic value of the deep learning-predicted RVEF values in patients with severe MR undergoing TEER.</p><p><strong>Methods: </strong>This multicenter registry study analyzed the associations between the predicted RVEF values and 1-year mortality in patients with severe MR undergoing TEER. To predict RVEF, 2-dimensional apical 4-chamber view videos from preprocedural transthoracic echocardiographic studies were exported and processed by a rigorously validated deep learning model.</p><p><strong>Results: </strong>Good-quality 2-dimensional apical 4-chamber view videos could be retrieved for 1154 patients undergoing TEER between 2017 and 2023. Survival at 1 year after TEER was 84.7%. The predicted RVEF values ranged from 26.6% to 64.0% and correlated only modestly with tricuspid annular plane systolic excursion (Pearson <i>R</i>=0.33; <i>P</i><0.001). Importantly, predicted RVEF was superior to tricuspid annular plane systolic excursion levels in predicting 1-year mortality after TEER (area under the curve, 0.687 versus 0.625; <i>P</i>=0.029). Furthermore, Kaplan-Meier survival analysis revealed that patients with reduced RV function (n=723; defined as a predicted RVEF of <45%) had significantly worse 1-year survival rates than patients with preserved RV function (n=431; defined as a predicted RVEF of ≥45%; 80.3% [95% CI, 77.4%-83.3%] versus 92.1% [95% CI, 89.5%-94.7%]; hazard ratio for 1-year mortality, 2.67 [95% CI, 1.82-3.90]; <i>P</i><0.001).</p><p><strong>Conclusions: </strong>Deep learning-enabled assessment of RV function using standard 2-dimensional echocardiographic videos can refine the prognostication of patients with severe MR undergoing TEER. Thus, it can be used to screen for patients with RV dysfunction who might benefit from intensified follow-up care.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":"18 1","pages":"e017005"},"PeriodicalIF":6.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000733","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":"Editors and Editorial Board.","authors":"","doi":"10.1161/HCI.0000000000000086","DOIUrl":"https://doi.org/10.1161/HCI.0000000000000086","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":"18 1","pages":"e000086"},"PeriodicalIF":6.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000737","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":"Chronic Subepicardial Hematoma: A Multimodality Imaging Diagnostic Approach After Elective Percutaneous Transluminal Coronary Angioplasty.","authors":"Maria Riasat, Sakul Sakul, Vikram Agarwal","doi":"10.1161/CIRCIMAGING.124.016667","DOIUrl":"10.1161/CIRCIMAGING.124.016667","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e016667"},"PeriodicalIF":6.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035428","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}