Circulation: Cardiovascular Imaging最新文献

{"title":"Increased Venous Volumes in Response to Catheter-Based Intervention for Acute PE: Lessons From the OPTALYSE PE Trial (OPTALYSE-3D).","authors":"Farbod N Rahaghi, Gregory Piazza, Behnood Bikdeli, Umberto Campia, Syed M Hassan, Ruben San Jose Estepar, Michael J Cuttica, Ruben Mylvaganam, George R Washko, Pietro Nardelli, Samuel Z Goldhaber, Raúl San José Estépar","doi":"10.1161/CIRCIMAGING.125.019239","DOIUrl":"10.1161/CIRCIMAGING.125.019239","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019239"},"PeriodicalIF":9.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13185720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764116","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":"Hemorrhagic Myocardial Infarction: Who Is at Risk?","authors":"Rohan Dharmakumar, Keyur P Vora","doi":"10.1161/CIRCIMAGING.126.019900","DOIUrl":"10.1161/CIRCIMAGING.126.019900","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019900"},"PeriodicalIF":7.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764097","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":"Diffuse Perfusion Impairment Versus Global Myocardial Flow Reserve and Focal Perfusion Impairments in Patients Undergoing ⁸²Rb-PET Imaging.","authors":"Ahmed Sayed, Jonathan B Moody, Alexis Poitrasson-Rivière, Jennifer M Renaud, Maria Alwan, Ahmad El Yaman, Mahmoud Al Rifai, Venkatesh L Murthy, Mouaz H Al-Mallah","doi":"10.1161/CIRCIMAGING.125.019246","DOIUrl":"10.1161/CIRCIMAGING.125.019246","url":null,"abstract":"<p><strong>Background: </strong>Although global myocardial flow reserve (MFR) is a powerful prognostic factor, it may overlook segmental abnormalities and does not differentiate focal from diffuse perfusion impairments. Therefore, we sought to assess whether integrated MFR provides incremental prognostic value beyond global MFR.</p><p><strong>Methods: </strong>Consecutive patients undergoing positron emission tomography myocardial perfusion imaging between 2019 and 2025 were included. For each patient, global MFR and the proportion of the myocardium with diffuse and focal integrated MFR impairment were quantified. The primary outcome was the total burden of death, myocardial infarction, and heart failure hospitalization. Multivariable Andersen-Gill Cox models with robust variance estimators were used to estimate hazard ratios (HRs). Restricted cubic splines were used to account for potential nonlinearity.</p><p><strong>Results: </strong>Over a median follow-up of 550 days (interquartile range, 203-1017 days), 1511 primary outcome events occurred in 8500 patients. In a multivariable model adjusted for both parameters, diffusely impaired integrated MFR (HR per interquartile range, 2.02 [95% CI, 1.33-3.05]), but not global MFR (HR per interquartile range, 1.10 [95% CI, 0.82-1.47]), was associated with poorer outcomes. Diffuse perfusion impairment was more strongly associated with the primary outcome (HR per interquartile range, 2.20 [95% CI, 1.72-2.82]) than focal impairment (HR, 1.25 [95% CI, 1.07-1.46]). Diffusely impaired integrated MFR was more prognostic in patients with a preserved left ventricular ejection fraction (<i>P</i> for interaction <0.001). At ejection fractions of 40%, 50%, 60%, and 70%, the HRs per interquartile range for greater diffuse impairment were 1.43, 1.97, 2.49, and 3.02, respectively.</p><p><strong>Conclusions: </strong>Diffuse impairments in myocardial perfusion are associated with poorer outcomes compared with focal impairments and are more informative than global MFR. Diffuse impairments may be more prognostic in patients with a preserved ejection fraction.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019246"},"PeriodicalIF":9.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811737","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":"Kinetics of Technetium-Labeled Cardiac Amyloid Radionuclide Imaging.","authors":"Brett W Sperry, Evan O'Keefe, Eric V Burgett, Erika Hutt, Philip G Jones, James A Case, Timothy M Bateman","doi":"10.1161/CIRCIMAGING.125.019371","DOIUrl":"10.1161/CIRCIMAGING.125.019371","url":null,"abstract":"<p><strong>Background: </strong>Technetium-labeled bone-avid tracers have been repurposed to diagnose transthyretin cardiac amyloidosis without rigorous kinetic studies. Supply shortages have necessitated the use of hydroxymethylene diphosphonate (HMDP) as an alternative to technetium-99m pyrophosphate, though comparative data remain limited. This study characterizes tracer kinetics using quantitative single-photon emission computed tomography with computed tomography.</p><p><strong>Methods: </strong>Twenty-four subjects undergoing evaluation for transthyretin cardiac amyloidosis underwent serial single-photon emission computed tomography with computed tomography imaging with pyrophosphate (n=11) or HMDP (n=13) on a cadmium zinc telluride system (SpectrumDynamics Veriton). Single-photon emission computed tomography acquisitions were obtained at intervals from 5 minutes to 3 hours post-injection. Quantitative parameters included standardized uptake values (SUVs), target-to-background ratios, and total cardiac activity derived from 3-dimensional volumes of interest for myocardium, blood pool, and bone. Mixed-effects models with splines compared time-activity trends between tracers.</p><p><strong>Results: </strong>All 16 subjects with positive imaging demonstrated visual myocardial uptake above the blood pool within 10 minutes post-injection. Myocardial SUVs were similar between tracers and decreased linearly over time, whereas blood pool SUVs declined biexponentially and bone SUVs increased exponentially. HMDP exhibited faster blood pool clearance and higher bone uptake than pyrophosphate, resulting in higher heart-to-blood pool target-to-background ratios across all time points. Bone activity exceeded myocardial activity earlier with HMDP (mean ≈90 versus 130 minutes; <i>P</i><0.001), resulting in a visual reduction of myocardial intensity with HMDP due to scaling. No association was observed between quantitative indices and clinical disease severity markers.</p><p><strong>Conclusions: </strong>Both pyrophosphate and HMDP provide diagnostic myocardial visualization within 10 minutes of injection, with similar myocardial SUVs that decline linearly over time. HMDP demonstrates more rapid blood pool clearance and greater bone uptake, resulting in earlier skeletal dominance and often requiring upward adjustment of image intensity to visualize myocardial uptake on delayed images. The results provide kinetic data that can inform future protocol optimization and quantitative standardization.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019371"},"PeriodicalIF":9.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147653898","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 Image Myocarditis.","authors":"Jan Gröschel, Bettina Heidecker, Yashraj Bhoyroo, Sebastian Spethmann, Jeanette Schulz-Menger","doi":"10.1161/CIRCIMAGING.125.018547","DOIUrl":"10.1161/CIRCIMAGING.125.018547","url":null,"abstract":"<p><p>Myocarditis is an inflammatory disease involving the heart muscle and potentially the pericardium. While there are many potential causative agents, commonly grouped into infectious (viral, bacterial, parasitic) or noninfectious (autoimmune, systemic disorders, drugs, cancer related), the main pathological pathways ultimately lead to an inflammatory process of the myocardium resulting in necrosis and edema. As there are specific therapies available for patients with myocarditis, reliable and early diagnosis is crucial. Multimodality imaging, especially cardiovascular magnetic resonance, has made a noninvasive diagnosis feasible. Cardiovascular magnetic resonance can not only provide a diagnosis based on the updated Lake Louise criteria, but it also functions as a diagnostic gateway, leading to other imaging modalities, for example, positron emission tomography or computed tomography. Finally, imaging results can help to initiate treatment options as well as determine when a patient can return to work or exercise. This review will cover multimodal imaging in patients with myocarditis with a focus on cardiovascular magnetic resonance, providing case examples of how imaging can guide care and treatment in these patients. In addition, the review focuses on the recent European Society for Cardiology guideline on the management of myocarditis and pericarditis comparing the recommendation to the American College of Cardiology expert consensus statements and the Japanese Circulation Society guidelines.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018547"},"PeriodicalIF":9.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764055","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":"Sex-Specific Prognostic Value of Aortic Valve Calcium and the Risk for Aortic Stenosis: Multi-Ethnic Study of Atherosclerosis (MESA).","authors":"Natalie Marrero, Kunal Jha, Jelani K Grant, Alexander C Razavi, Matthew J Budoff, Sanjiv J Shah, Jerome I Rotter, Roger S Blumenthal, Wendy S Post, Martha Gulati, Leslee J Shaw, George Thanassoulis, Michael J Blaha, Seamus P Whelton","doi":"10.1161/CIRCIMAGING.125.018849","DOIUrl":"10.1161/CIRCIMAGING.125.018849","url":null,"abstract":"<p><strong>Background: </strong>In general, women have lower aortic valve calcium (AVC) scores compared with men of similar age, and the AVC score threshold for diagnosing severe aortic stenosis (AS) is lower for women. We examined whether the association of AVC with the long-term risk of clinically significant AS differed for women compared with men.</p><p><strong>Methods: </strong>AVC was measured using cardiac computed tomography among 6810 MESA (Multi-Ethnic Study of Atherosclerosis) participants. We examined AVC as a continuous (ln [AVC+1]) and categorical variable (0, 1-99, 100-299, ≥300 AU). Incident moderate or severe AS was adjudicated using standard clinical criteria with a median follow-up of 16 years. The association between AVC and AS was examined using multivariable-adjusted Cox proportional hazards regression.</p><p><strong>Results: </strong>Women comprised 52.9% of participants, with AVC >0 present among 10.1% of women and 17.0% of men. There were 65 cases of incident AS in women and 75 in men. AVC as a continuous variable was associated with a higher risk of incident AS for women (hazard ratio, 1.91 [95% CI, 1.68-2.16]) and men (hazard ratio, 2.13 [95% CI, 1.88-2.41]). There was no interaction between AVC and sex (<i>P</i>=0.31) for their association with AS. Women and men had similar adjusted hazards for incident AS across AVC categories, and for those with AVC ≥300, the hazard ratio was 134.9 (95% CI, 45.1-403.9) for women and 132.8 (95% CI, 6.2-274.9) for men.</p><p><strong>Conclusions: </strong>The association of AVC with the long-term risk of incident AS was similar for women and men, further supporting the utility of AVC as a prognostic marker for incident AS.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018849"},"PeriodicalIF":9.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638140","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":"Ruptured Left Sinus of Valsalva Aneurysm With Concomitant Aortic Stenosis Treated by TAVR: CT and TEE Findings.","authors":"Yosuke Kirii, Masaki Ishiyama, Kosuke Kitada, Akihiro Takasaki, Taku Omori, Emiyo Sugiura, Tairo Kurita, Takeo Takahashi, Kaoru Dohi","doi":"10.1161/CIRCIMAGING.125.019498","DOIUrl":"10.1161/CIRCIMAGING.125.019498","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019498"},"PeriodicalIF":7.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442823","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":"Revascularization of Single-Vessel Coronary Artery Disease: Is it Still Worth Doing?","authors":"Riccardo Liga, Danilo Neglia","doi":"10.1161/CIRCIMAGING.126.019753","DOIUrl":"10.1161/CIRCIMAGING.126.019753","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019753"},"PeriodicalIF":7.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627322","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":"Myocardial Flow Reserve With ¹³N-Ammonia PET: From Quantification to Clinical Consequence.","authors":"Kevin E Boczar, Robert deKemp, Rob S Beanlands","doi":"10.1161/CIRCIMAGING.126.019571","DOIUrl":"10.1161/CIRCIMAGING.126.019571","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019571"},"PeriodicalIF":7.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147622040","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":"Multicenter Evaluation of Myocardial Flow Reserve as a Prognostic Marker for Mortality in ¹³N-Ammonia PET Myocardial Perfusion Imaging.","authors":"Giselle Ramirez, Valerie Builoff, Robert J H Miller, Mark Lemley, Isabel Carvajal-Juarez, Erick Alexanderson, Thomas L Rosamond, Na Song, Mark I Travin, Leandro Slipczuk, Andrew J Einstein, Samuel B Wopperer, Marcelo F Di Carli, Panithaya Chareonthaitawee, Piotr J Slomka","doi":"10.1161/CIRCIMAGING.125.018729","DOIUrl":"10.1161/CIRCIMAGING.125.018729","url":null,"abstract":"<p><strong>Background: </strong>Myocardial flow reserve (MFR), measured by positron emission tomography (PET) myocardial perfusion imaging, provides valuable information on epicardial coronary disease, diffuse atherosclerosis, and microvascular function. Despite its routine use, the prognostic efficacy of ¹³N-ammonia PET MFR remains unconfirmed in larger multicenter cohorts of patients with suspected or known coronary artery disease.</p><p><strong>Methods: </strong>We considered patients from 5 sites in the REFINE PET (Registry of Flow and Perfusion Imaging for Artificial Intelligence with PET) registry who underwent ¹³N-ammonia PET myocardial perfusion imaging for coronary artery disease. Clinical and imaging data were collected at the time of myocardial perfusion imaging. MFR was quantified as the ratio of stress to rest myocardial blood flow, using QPET software (Cedars-Sinai Medical Center, Los Angeles, CA). The primary outcome was all-cause mortality. Survival analyses were performed using Kaplan-Meier and Cox regression models adjusted for clinical and imaging covariates.</p><p><strong>Results: </strong>In total, 6277 patients were included (median age of 65 years, 56% male). Median follow-up time was 3.8 years. There were 1895 patients with MFR ≤2 and 4382 with MFR >2. Patients with MFR ≤2 had significantly higher mortality than those with MFR >2 (n=701 [37.0%] versus n=537 [12.3%], respectively; <i>P</i><0.001). Annualized all-cause mortality rates by MFR and summed stress score ranged from 1.7 to 15.8. In multivariable analysis, MFR ≤2 was independently associated with increased all-cause mortality in the overall population (hazard ratio, 2.70 [95% CI, 2.41-3.03]; <i>P</i><0.001), even among patients with no perfusion defects (hazard ratio, 2.36 [95% CI, 1.93-2.89]; <i>P</i><0.001). Mortality risk decreased across increasing MFR deciles, ranging from hazard ratio, 2.73 (95% CI, 2.39-3.11) to hazard ratio, 0.35 (95% CI, 0.25-0.49).</p><p><strong>Conclusions: </strong>In this large multicenter cohort, MFR derived from ¹³N-ammonia PET myocardial perfusion imaging is a strong, independent predictor of all-cause mortality, even in patients with normal perfusion. An MFR of ≤2 identifies elevated risk, while higher values are associated with improved survival. These findings support the routine integration of MFR to enhance risk stratification in patients with suspected or known coronary artery disease.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018729"},"PeriodicalIF":9.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146084310","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}