Circulation: Cardiovascular Imaging最新文献

{"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}

{"title":"Mechanical Mitral Valve Avulsion and Mitral-Aortic Junction Pseudoaneurysm Following Surgical Treatment of Mitral Valve Aneurysm and Severe Aortic Insufficiency in a Patient With Spondyloarthropathy: A Rarity With a Possible Association.","authors":"Hongxia Ning, Jiajing Ouyang, Jun Yang, Zongyi Xiu, Tianxiang Gu, Yang Bai, Chunyan Ma","doi":"10.1161/CIRCIMAGING.124.017449","DOIUrl":"10.1161/CIRCIMAGING.124.017449","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017449"},"PeriodicalIF":6.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709598","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":"Determinants and Prognostic Value of Early Gadolinium Enhancement-Derived Myocardial Salvage Index in STEMI.","authors":"Jin-Yi Xiang, Jin-Yu Zheng, Yi-Si Dai, Ling-Yi Yu, Yu-Fan Qian, Wei-Hui Xie, Ruo-Yang Shi, Bing-Hua Chen, Jun Pu, Lian-Ming Wu","doi":"10.1161/CIRCIMAGING.124.017830","DOIUrl":"10.1161/CIRCIMAGING.124.017830","url":null,"abstract":"<p><strong>Background: </strong>T2-weighted imaging is commonly used to measure myocardial salvage in reperfused myocardial infarction but is hindered by poor reproducibility and indistinct boundaries. Early gadolinium enhancement (EGE) emerges as an alternative for measuring the area at risk. This study aims to evaluate the determinants of the myocardial salvage index (MSI) derived from EGE and its prognostic implications.</p><p><strong>Methods: </strong>We analyzed acute cardiac magnetic resonance scans of 453 reperfused patients with ST-segment-elevation myocardial infarction (mean age, 60±12 years; 389 men) from April 2017 to July 2023 at a single center retrospectively. EGE was collected at 3 minutes after contrast agent injection, where hyperintense areas (signal intensities > mean+2SD of remote myocardium) were considered as the area at risk, plus the hypointense core within. MSI was calculated as the ratio of salvageable myocardium to the area at risk. Major adverse cardiovascular events included cardiovascular death, hospitalization for heart failure, reinfarction, and unplanned revascularization for the target vessel.</p><p><strong>Results: </strong>During a median follow-up of 3.2 years (interquartile range, 1.6-4.7 years), at least one major adverse cardiac event occurred in 91 participants (20.1%). The median MSI was 35.0% (interquartile range, 22.9-59.5%), with smaller MSI observed in patients with larger infarcts (<i>P</i><0.001). Linear regression identified prepercutaneous coronary intervention Thrombolysis in Myocardial Infarction flow (β=3.35, <i>P</i><0.001) and microvascular obstruction (β=-11.92, <i>P</i><0.001) as independent determinants of MSI. Multivariable Cox regression showed that every 10% increase in MSI was associated with a 32% reduction in major adverse cardiac event risk (hazard ratio, 0.68 [95% CI, 0.53-0.86]; <i>P</i>=0.001). A graded response was observed between MSI and cardiovascular death and reinfarction. MSI greater than the median was associated with nontarget vessel-related reinfarctions but not target vessel-related ones (nontarget, <i>P</i>=0.027; target vessel, <i>P</i>=0.36). Good reproducibility was reported with EGE-measured area at risk (intraobserver, intraclass correlation coefficient [ICC]=0.95; interobserver, ICC=0.89).</p><p><strong>Conclusions: </strong>EGE-derived MSI was associated with prepercutaneous coronary intervention Thrombolysis in Myocardial Infarction flow and microvascular injuries. It was an independent predictor of major adverse cardiac events. Our results highlight the prognostic potential of EGE imaging in acute myocardial infarction.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017830"},"PeriodicalIF":6.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691337","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":"3D Echocardiographic and CMR Imaging for the Assessment of Right Ventricular Function and Tricuspid Regurgitation Severity.","authors":"Philipp M Doldi, Ludwig T Weckbach, Nicola Fink, Lukas Stolz, Cecilia Ennin, Julien Dinkel, Philipp Lurz, Holger Thiele, Rebecca T Hahn, João L Cavalcante, Christian Besler, Jörg Hausleiter","doi":"10.1161/CIRCIMAGING.124.017638","DOIUrl":"10.1161/CIRCIMAGING.124.017638","url":null,"abstract":"<p><strong>Background: </strong>Tricuspid regurgitation (TR) is associated with increased mortality and is often underdiagnosed due to limitations in imaging modalities. While routine 2-dimensional echocardiography (2DE) demonstrates frequent disagreement with cardiac magnetic resonance imaging (CMR) in classifying TR severity, the incremental value of 3-dimensional echocardiography (3DE) remains unknown also due to the lack of a generalizable grading scheme across imaging modalities. Therefore, this study provides an intermodality comparison of all 3 imaging modalities (2DE, 3DE, and CMR) in evaluating TR severity and proposes an adapted 5-class grading scheme for TR severity using CMR.</p><p><strong>Methods: </strong>A total of 144 patients with symptomatic TR were analyzed across 2 cohorts: a derivation cohort (n=91) from the University Hospital of Munich and a validation cohort (n=53) from the Heart Center Leipzig. All patients underwent multimodality imaging, including transthoracic 2DE, transesophageal 3DE, and CMR. The adapted 5-class CMR-based grading scheme was proposed and externally validated.</p><p><strong>Results: </strong>In the derivation cohort (median age 81 years, 66% female), TR severity grading by 3DE highly correlated with CMR (87% concordance within a 1-grade difference), significantly outperforming 2DE (68% concordance). While 3DE underestimated right ventricular dimensions compared with CMR (<i>P</i><0.001), it provided a comparable measure of TR severity and right ventricular function. 2DE achieved the lowest accuracy rates compared with CMR (34.5%; <i>P</i>=0.005) with frequent overestimation of TR severity. An overestimation of TR severity by 3DE compared with CMR was significantly less frequent than with 2DE (21% versus 56%; <i>P</i><0.001). Cohen κ analysis confirmed a substantial and superior agreement between 3DE and CMR compared with 2DE (κ=0.63 versus 0.41; <i>P</i>=0.01). The results were externally validated, showing comparable results within the derivation and validation cohorts.</p><p><strong>Conclusions: </strong>3DE provides an accurate assessment of TR severity comparable to CMR. The proposed 5-class grading scheme for TR severity using CMR demonstrates high accuracy and external validity.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017638"},"PeriodicalIF":6.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669347","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":"Abnormalities in Coronary Microvasculature in Pulmonary Atresia With Intact Ventricular Septum.","authors":"Annabelle Grace Binti Vincent, Kenzo Ichimura, Shoko Ichimura, Aubrey Olive Alden, Elizabeth Price, Darren Salmi, Ankit Kushwaha, Edda Spiekerkoetter, Sushma Reddy","doi":"10.1161/CIRCIMAGING.124.017415","DOIUrl":"10.1161/CIRCIMAGING.124.017415","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017415"},"PeriodicalIF":6.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715484","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}