Circulation: Cardiovascular Imaging最新文献

{"title":"Myocardial Perfusion Imaging With PET: A Head-to-Head Comparison of ⁸²Rubidium Versus ¹⁵O-water Tracers Using Invasive Coronary Measurements as Reference.","authors":"Simon Winther, Laust Dupont Rasmussen, Salma Raghad Karim, Jelmer Westra, Jonathan Nørtoft Dahl, Jacob Hartmann Søby, Louise Nissen, Fabian Bøgild Lomstein, Morten Würtz, Jens Munch Sundbøll, June Anita Ejlersen, Jesper Mortensen, Lars Poulsen Tolbod, Hanne Maare Søndergaard, Nicolaj Christopher Lyng Hansson, Mette Nyegaard, Rebekka Vibjerg Jensen, Michael Alle Madsen, Evald Høj Christiansen, Lars Christian Gormsen, Morten Böttcher","doi":"10.1161/CIRCIMAGING.124.017479","DOIUrl":"10.1161/CIRCIMAGING.124.017479","url":null,"abstract":"<p><strong>Background: </strong>Myocardial perfusion imaging by positron emission tomography (PET) is recommended as a first-line test in stable patients with chest pain symptoms and as a selective second-line test after an abnormal coronary computed tomography angiography (CTA). It is, however, unknown whether the use of Rubidium-82 (⁸²Rb) versus [¹⁵O]H₂O (¹⁵O-water) affects the diagnostic performance in coronary artery disease (CAD). The aim of this study was to compare ⁸²Rb-PET versus ¹⁵O-water-PET head-to-head for diagnosing obstructive CAD.</p><p><strong>Methods: </strong>The study included consecutive patients (n=1000) referred for CTA with symptoms suggestive of obstructive CAD. Patients with suspected stenosis based on CTA were referred for both ⁸²Rb-PET, ¹⁵O-water-PET, and subsequently invasive coronary angiography (ICA), including 3-vessel fractional flow reserve and coronary flow reserve measurements.</p><p><strong>Results: </strong>In total, 196/270 (73%) patients with suspected stenosis on CTA completed ⁸²Rb-PET, ¹⁵O-water-PET, and ICA. Myocardial blood flow measurements from ⁸²Rb-PET and ¹⁵O-water-PET correlated strongly at rest (ρ, 0.62-0.69) but only moderately during hyperemia (ρ, 0.41-0.59). Only weak correlations were demonstrated between myocardial blood flow reserve by both PET tracers compared with ICA coronary flow reserve (ρ, 0.11-0.38). Hemodynamically obstructive CAD defined as ICA fractional flow reserve ≤0.80, was identified in 86/196 (44%) patients. Using predefined cutoffs, the diagnostic accuracies of ⁸²Rb-PET versus ¹⁵O-water-PET were similar (sensitivity 69% [58-78%] versus 71% [60-80%], <i>P</i>=0.59; specificity 85% [76-91%] versus 77% [68-85%], <i>P</i>=0.12). Using ICA diameter stenoses >70% as a reference, only 48/196 (24%) patients had anatomically severe CAD, and ⁸²Rb-PET and ¹⁵O-water-PET sensitivities increased to >85%.</p><p><strong>Conclusions: </strong>For detection of obstructive CAD by PET myocardial perfusion imaging, ⁸²Rb versus ¹⁵O-water have similar diagnostic performance.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT04707859.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017479"},"PeriodicalIF":6.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771618","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":"Cave Under the Aortic Valve: The Rare Left Ventricular Outflow Tract Pseudoaneurysm With Thrombosis.","authors":"Shuang Wang, Wanwan Song, Wenjun Yu, Jinping Liu, Bin Wang","doi":"10.1161/CIRCIMAGING.124.017574","DOIUrl":"10.1161/CIRCIMAGING.124.017574","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017574"},"PeriodicalIF":6.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000655","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":"Impact of Post-PCI Lipid Core Burden Index on Angiographic and Clinical Outcomes: Insights From NIRS-IVUS.","authors":"Woohyeun Kim, Hyungdon Kook, Soojung Park, Ran Heo, Jin-Kyu Park, Jinho Shin, Yonggu Lee, Young-Hyo Lim","doi":"10.1161/CIRCIMAGING.124.017740","DOIUrl":"10.1161/CIRCIMAGING.124.017740","url":null,"abstract":"<p><strong>Background: </strong>The impact of lipid core burden index (LCBI) after percutaneous coronary intervention (PCI) in the stented segment assessed by intracoronary near-infrared spectroscopy on the outcomes remains unclear.</p><p><strong>Methods: </strong>In this prospective observational study, we aimed to assess the impact of post-PCI LCBI on late lumen loss and clinical outcomes. Post-PCI intracoronary near-infrared spectroscopy imaging was performed in the stented segment after PCI. Patients were categorized into 2 groups based on the post-PCI _maxLCBI_4mm with a cut-off value of 200. Angiographic and clinical outcomes were compared at 12 months. The primary end point was angiographic late lumen loss. The secondary end point was target lesion failure (composite of cardiovascular death, target vessel myocardial infarction, and clinically driven target lesion revascularization) and major adverse cardiac and cerebrovascular events (composite of cardiac death, myocardial infarction, any repeat revascularization, and stroke).</p><p><strong>Results: </strong>A total of 228 patients with 278 target lesions were followed up for 1 year. One-year follow-up angiography was performed on 198 lesions in 163 patients. Follow-up quantitative coronary angiography revealed that stented segments with post-PCI _maxLCBI_4mm ≥200 had higher late lumen loss compared with those with a post-PCI _maxLCBI_4mm <200 (mean, 0.503±0.683 mm versus 0.115±0.326 mm; <i>P</i><0.001; median, 0.250 mm versus 0.050 mm; <i>P</i><0.001). Patients with post-PCI _maxLCBI_4mm ≥200 had a significantly higher 1-year cumulative incidence of both target lesion failure (6.9% versus 0.6%; <i>P</i>=0.002) and major adverse cardiac and cerebrovascular events (15.1% versus 2.2%; <i>P</i><0.001).</p><p><strong>Conclusions: </strong>Post-PCI LCBI assessed by intracoronary near-infrared spectroscopy-intravascular ultrasound was associated with late lumen loss as well as subsequent target lesion failure and major adverse cardiac and cerebrovascular events.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017740"},"PeriodicalIF":6.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977456","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":"Response to Letter Regarding Article, \"Abnormal Exercise Electrocardiography With Normal Stress Echocardiography Is Associated With Subclinical Coronary Atherosclerosis\".","authors":"Jessica M Duran, Melissa A Daubert","doi":"10.1161/CIRCIMAGING.125.018367","DOIUrl":"10.1161/CIRCIMAGING.125.018367","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018367"},"PeriodicalIF":6.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955274","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":"Response to Mavacamten in Patients With High Baseline Left Ventricular Filling Pressures in the EXPLORER-HCM Trial.","authors":"Sharon Cresci, Richard G Bach, Anjali T Owens, Neal K Lakdawala, Sara Saberi, Sheila M Hegde, Ester Kim Nilles, Daniel M Wojdyla, Amy J Sehnert, Andrew Wang","doi":"10.1161/CIRCIMAGING.124.017824","DOIUrl":"10.1161/CIRCIMAGING.124.017824","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017824"},"PeriodicalIF":6.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802715","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: Cardiac Sarcoidosis.","authors":"Sanjay Divakaran","doi":"10.1161/CIRCIMAGING.125.017693","DOIUrl":"10.1161/CIRCIMAGING.125.017693","url":null,"abstract":"<p><p>Sarcoidosis is characterized by noncaseating granulomatous inflammation that involves the lungs or lymph nodes in 90% of cases. The prevalence of cardiac involvement in patients with sarcoidosis is thought to be between 5% and 25%. However, cardiac sarcoidosis can also present without extracardiac disease (known as clinically isolated cardiac sarcoidosis) or with previously unrecognized extracardiac disease. The principal manifestations of cardiac sarcoidosis are heart failure or left ventricular systolic dysfunction, high-grade atrioventricular nodal disease, or ventricular arrhythmia. Cardiovascular imaging plays a crucial role in making the diagnosis, partly due to the low yield of endomyocardial biopsy in cardiac sarcoidosis. Cardiovascular imaging is also used for risk stratification for ventricular arrhythmia, to identify patients who may benefit from immunosuppressive therapy, and for longitudinal follow-up on and off therapy. It can also be used to identify alternative diagnoses to cardiac sarcoidosis. This review will discuss how to use imaging in the diagnosis and management of patients with suspected or known cardiac sarcoidosis.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017693"},"PeriodicalIF":6.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101439","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 Valve Calcium Score Quantification by Contrast Cardiac CT: Correlations With Echocardiography and Optimal Thresholds.","authors":"Tiffany Dong, Elio Haroun, Aro Daniela Arockiam, Rishabh Khurana, Joseph El Dahdah, Ankit Agrawal, Yuichiro Okushi, David Moros, Kashyap Bodi, Ushasi Saraswati, Mohammad Alamer, Abdelrahman Abushouk, Agam Bansal, Serge Harb, Zoran Popovic, L Leonardo Rodriguez, Rishi Puri, Grant Reed, Amar Krishnaswamy, Brian Griffin, Samir Kapadia, Tom Kai Ming Wang","doi":"10.1161/CIRCIMAGING.124.017373","DOIUrl":"10.1161/CIRCIMAGING.124.017373","url":null,"abstract":"<p><strong>Background: </strong>Aortic valve calcium score (AVCa) measured on noncontrast computed tomography (CT) is well-established for grading aortic stenosis (AS) severity. However, thresholds for AVCa measured on contrast CT remain uncertain. We evaluated correlations, associated factors, and severity thresholds of AVCa measured on contrast CT against transthoracic echocardiography (TTE) measures of AS.</p><p><strong>Methods: </strong>Patients with native AS undergoing transcatheter aortic valve replacement evaluation from 2019 to 2020 who underwent TTE and contrast-enhanced CT were retrospectively studied (n=1035, age 79±9 years, 429 (41.5%) women, 906 (87.5%) severe and 129 (12.5%) moderate AS by TTE). AVCa was measured using the modified Agatston method with the minimum threshold of 4 SD above the mean ascending aorta blood pool Hounsfield units. Receiver-operating characteristics analysis and Youden index were used to define sex-specific optimal AVCa thresholds for identifying severe AS defined by TTE (aortic valve area by continuity equation ≤1.0 cm²) in the derivation cohort and assessed when applied to the validation cohort.</p><p><strong>Results: </strong>Mean aortic valve area on TTE was 0.79±0.21 cm², while mean AVCa score, volume, and mass were 2152±1102 modified AU, 1853±1592 mm³, and 673±485 mg, respectively. Multivariable linear regression identified women to be associated with lower AVCa (β-coefficient, -358), while chronic kidney disease was associated with a higher AVCa (β-coefficient, 171). Optimal severe AS thresholds of ≥1840 modified AU for men and ≥1430 modified AU for women were determined, with area under curve (95% CIs) and sensitivities/specificities of 0.809 (0.749-0.869, 71.3%, 82.2%) for men and 0.822 (0.751-0.892), 73.4%/78.9% for women in the derivation cohort, and 0.830 (0.786-0.875), 75.9%/87.5% for men and 0.780 (0.670-0.890), 77.5%/71.4% for women in the validation cohort.</p><p><strong>Conclusions: </strong>AVCa by contrast CT is a useful tool for identifying severe AS by TTE, with sex-specific thresholds for severe AS identified. Further studies are necessary to externally validate our findings and evaluate their prognostic significance.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017373"},"PeriodicalIF":6.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076400","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":"Characterization of Aortic Valve Stenosis by CT Angiography in a Diverse US Cohort.","authors":"Daniel Lorenzatti, Annalisa Filtz, Pamela Pina, Jolien Geers, Jake Gilman, Jonathan Daich, Paul Ippolito, Abdullah Aftab, Aldo L Schenone, Carlos A Gongora, Justin Johannesen, Andrea Scotti, Edwin C Ho, Mario J Garcia, Azeem Latib, Carlos J Rodriguez, Daniel S Berman, Marie-Annick Clavel, Philippe Pibarot, Robert O Bonow, Piotr J Slomka, Marc R Dweck, Damini Dey, Leandro Slipczuk","doi":"10.1161/CIRCIMAGING.124.017858","DOIUrl":"10.1161/CIRCIMAGING.124.017858","url":null,"abstract":"<p><strong>Background: </strong>Aortic stenosis (AS) involves calcific and fibrotic degeneration of the valve tissue. The only noninvasive method for evaluating both processes is contrast-enhanced computed tomography angiography. We aimed to explore the differences in aortic valve (AV) tissue composition across sex, race/ethnicity, and AS hemodynamic phenotype in US patients referred for transcatheter AV replacement planning.</p><p><strong>Methods: </strong>We retrospectively analyzed symptomatic patients with AS who underwent computed tomography angiography for transcatheter AV replacement planning between 2015 and 2022. Using semi-automated software, we quantified the AV tissue composition by fibrotic, calcific, and fibro-calcific volumes, and the fibro-calcific ratio (fibrotic/calcific volume) as a measure of valve phenotype.</p><p><strong>Results: </strong>The study included 651 patients (mean age 84 years; 55% women) with 38% non-Hispanic (NH)-White, 27% Hispanic, and 13% NH-Black. Women had lower fibro-calcific (230 versus 293 mm³/cm²; <i>P</i><0.001) and calcific volumes (85 versus 149 mm³/cm²; <i>P</i><0.001), and higher fibro-calcific ratio (1.47 versus 0.83; <i>P</i><0.001). No differences were observed in the fibrotic volumes (<i>P</i>=0.805). NH-White women had higher fibro-calcific (256 mm³/cm², <i>P</i>=0.002) and fibrotic volumes (145 mm³/cm²; <i>P</i><0.001), and fibro-calcific ratio (1.57; <i>P</i>=0.01) compared with Hispanic and NH-Black women. No differences were found among men. High-gradient AS had higher fibro-calcific (295 versus 219 mm³/cm²; <i>P</i><0.001) and calcific volumes (148 versus 88 mm³/cm²; <i>P</i><0.001), and a lower fibro-calcific ratio (0.90 versus 1.45; <i>P</i><0.001), although no difference in fibrotic volume (<i>P</i>=0.099) compared with low-gradient AS.</p><p><strong>Conclusions: </strong>Phenotypic differences in computed tomography angiography valve tissue composition exist in patients with AS referred for transcatheter AV replacement, with women and low-gradient AS showing a proportionally more fibrotic phenotype. NH-White women have the highest fibrotic tissue composition, and no differences are evident among men.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017858"},"PeriodicalIF":6.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966593","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":"Clinical Impact of Persistent Microvascular Obstruction in CMR After Reperfused STEMI.","authors":"Felix Troger, Mathias Pamminger, Paulina Poskaite, Martin Reindl, Magdalena Holzknecht, Ivan Lechner, Christina Tiller, Sebastian von der Emde, Alex Kaser, Fritz Oberhollenzer, Matthias Schwab, Benjamin Henninger, Bernhard Metzler, Sebastian J Reinstadler, Agnes Mayr","doi":"10.1161/CIRCIMAGING.124.017645","DOIUrl":"10.1161/CIRCIMAGING.124.017645","url":null,"abstract":"<p><strong>Background: </strong>Microvascular injury in the course of acute ST-segment-elevation myocardial infarction (STEMI) has been identified as determinant of adverse outcomes and manifests as microvascular obstruction (MVO). MVO has long been regarded as a transient finding, vanishing within a few weeks after infarction. However, recent studies have shown that it may persist beyond the early phase, resulting in adverse remodeling. However, its clinical implications remain unclear. This study aims to evaluate the association of MVO persistence and major adverse cardiac events after STEMI.</p><p><strong>Methods: </strong>In total, 609 patients with revascularized first-time STEMI underwent cardiac magnetic resonance imaging (CMR) at 4 days, 4 months, and 12 months after STEMI to assess MVO, infarct size, and left ventricular function. Major adverse cardiac events were defined as composite of death, reinfarction, and new congestive heart failure within a median interval of 3.2 years.</p><p><strong>Results: </strong>Baseline MVO was present in 365 (60%) patients and persisted in 35 (10%) patients at 4-month CMR and in 20 (5%) patients at 12-month CMR. Compared with transient MVO not present at follow-up, patients with MVO persistence ≥4 months were more likely to experience major adverse cardiac events during follow-up (29% versus 13%; <i>P</i>=0.016). Within patients with MVO, those with MVO persistence had lower left ventricular ejection fraction (<i>P</i>=0.002), larger infarcts (<i>P</i>=0.00001), and more frequent intramyocardial hemorrhage (<i>P</i>=0.001) at baseline CMR.</p><p><strong>Conclusions: </strong>Persistent MVO after STEMI occurs in up to 10% of patients with baseline MVO and is linked to major adverse cardiac events. Patients with MVO persistence had larger infarcts, lower left ventricular function, and more frequent intramyocardial hemorrhage at baseline CMR. All patients with MVO persisting ≥12 months initially showed intramyocardial hemorrhage.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e017645"},"PeriodicalIF":6.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953589","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":"Interesting Cause of Pseudopleural Effusion: Giant Left Atrium.","authors":"Shitong Su, Peng Yao, Yu Cao","doi":"10.1161/CIRCIMAGING.125.018165","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.125.018165","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e018165"},"PeriodicalIF":6.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979090","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}