JACC. Cardiovascular imaging最新文献

{"title":"Mechanism and Impact of Left Atrial Dyssynchrony on Long-Term Clinical Outcome During Cardiac Resynchronization Therapy.","authors":"Lars-Egil R Hammersboen, Marie Stugaard, Alexis Puvrez, Camilla K Larsen, Espen W Remme, Erik Kongsgård, Jürgen Duchenne, Elena Galli, Faraz H Khan, Ole Jakob Sletten, Martin Penicka, Erwan Donal, Jens-Uwe Voigt, Otto A Smiseth, John M Aalen","doi":"10.1016/j.jcmg.2024.09.008","DOIUrl":"https://doi.org/10.1016/j.jcmg.2024.09.008","url":null,"abstract":"<p><strong>Background: </strong>Left bundle branch block (LBBB) causes left atrial (LA) dyssynchrony. It is unknown if LA dyssynchrony impacts long-term prognosis.</p><p><strong>Objectives: </strong>The purpose of this study was to determine mechanisms of LA dyssynchrony in LBBB and if LA dyssynchrony impacts long-term prognosis.</p><p><strong>Methods: </strong>In a prospective multicenter study of 168 heart failure patients with LBBB, echocardiographic strain imaging was done before and after 6 months with cardiac resynchronization therapy (CRT). Outcome was assessed after 6 years. Dyssynchrony was measured relative to septum as delay in left ventricular (LV) lateral wall shortening and LA lateral wall stretch. Response to CRT was defined as at least 15% reduction in LV end-systolic volume.</p><p><strong>Results: </strong>Before CRT, there was marked LA dyssynchrony of 105 ± 76 ms, which decreased to 37 ± 68 ms in CRT-responders (P < 0.001), whereas nonresponders showed only a modest reduction in LA dyssynchrony (P < 0.05). There was strong association between LA and LV dyssynchrony (r = 0.70), consistent with direct LV-LA mechanical interaction. CRT caused modest increase in LA reservoir strain (P < 0.01) and marked increase of LV filling time (P < 0.001) in responders. Mortality after 6 years was 21% (35 deaths). LA dyssynchrony did not independently predict mortality. However, the combination of preserved LA reservoir strain (≥18%) and resolved LA dyssynchrony (≤53 ms) after 6 months with CRT was associated with excellent long term-prognosis: HR: 0.11 (95% CI: 0.03-0.42) vs preserved reservoir strain and persistent LA dyssynchrony.</p><p><strong>Conclusions: </strong>LA dyssynchrony in LBBB was attributed to direct LV-LA mechanical interactions. CRT improved diastolic function by increasing LV filling time. Patients with preserved LA reservoir strain and resolution of LA dyssynchrony by CRT had excellent long-term prognosis. (Contractile Reserve in Dyssynchrony: A Novel Principle to Identify Candidates for Cardiac Resynchronization Therapy [CRID-CRT]; NCT02525185).</p>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681816","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":"Improving Precision and Refining Risk Prediction of CTRCD With Cardiovascular CT","authors":"Purvi J. Parwani MBBS, MPH ,&nbsp;Juan Lopez-Mattei MD","doi":"10.1016/j.jcmg.2024.09.002","DOIUrl":"10.1016/j.jcmg.2024.09.002","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 11","pages":"Pages 1348-1350"},"PeriodicalIF":12.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578846","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":"Longitudinal Evaluation of Coronary Arteries and Myocardium in Breast Cancer Using Coronary Computed Tomographic Angiography","authors":"Chunrong Tu MD ,&nbsp;Hesong Shen MD ,&nbsp;Xiaoqin Li BS,&nbsp;Xing Wang BS,&nbsp;Zhiming Miao BS,&nbsp;Wei Deng BS,&nbsp;Renwei Liu BS,&nbsp;Xiaosong Lan MD,&nbsp;Huifang Chen BS,&nbsp;Jiuquan Zhang PhD","doi":"10.1016/j.jcmg.2024.05.017","DOIUrl":"10.1016/j.jcmg.2024.05.017","url":null,"abstract":"<div><h3>Background</h3><div>The association of coronary computed tomography angiography<span> (CTA) and left ventricular (LV) myocardium measurements with cancer therapy–related cardiac dysfunction (CTRCD) is limited.</span></div></div><div><h3>Objectives</h3><div>In this study, the authors sought to evaluate the changes in coronary arteries<span> and LV myocardium in patients with left breast cancer (BC) receiving anthracycline with or without radiotherapy, with the use of coronary CTA.</span></div></div><div><h3>Methods</h3><div><span><span>Participants with left BC receiving anthracycline with or without radiotherapy were prospectively included. All participants underwent coronary CTA before and after treatment, including nonenhanced calcium-scoring scan, </span>computed tomography angiography, and dual-energy late enhancement scan. Computed tomographic </span>fractional flow reserve<span><span> (CT-FFR), pericoronary adipose tissue (PCAT) CT attenuation, and LV segments’ extracellular volume (ECV) before and after treatment were compared. </span>Logistic regression analysis was used to assess the association between baseline coronary CTA parameters and CTRCD.</span></div></div><div><h3>Results</h3><div>Eighty participants receiving anthracycline and 59 participants receiving anthracycline with radiotherapy were included. CT-FFR decreased and PCAT CT attenuation and LV global and segments’ ECV increased after treatment (all <em>P &lt;</em><span> 0.05). After chemoradiotherapy<span>, CT-FFR was lower and PCAT CT attenuation and LV myocardial ECV were higher than after chemotherapy. Twenty-four participants developed CTRCD. After adjustment by Heart Failure Association–International Cardio-Oncology Society risk in multivariable logistic regression analysis, baseline stenosis of the left anterior descending artery (LAD) (OR: 1.987 [95% CI: 1.322-2.768]; </span></span><em>P =</em> 0.021), left circumflex artery (LCX) (OR: 1.895 [95% CI: 1.281-2.802]; <em>P =</em><span> 0.031), and right coronary artery (RCA) (OR: 1.920 [95% CI: 1.405-2.811]; </span><em>P =</em> 0.028), and baseline CT-FFR of the LAD (OR: 3.425 [95% CI: 1.621-9.434]; <em>P &lt;</em> 0.001), LCX (OR: 2.058 [95% CI: 1.030-5.076]; <em>P =</em> 0.006), and RCA (OR: 2.469 [95% CI: 1.232-6.944]; <em>P =</em> 0.004) were associated with CTRCD.</div></div><div><h3>Conclusions</h3><div>Multiparameter coronary CTA contributes to comprehensive assessment of the coronary arteries and myocardium in patients with left BC receiving anthracycline with or without radiotherapy. Baseline coronary artery stenosis and CT-FFR might be imaging markers for predicting CTRCD in these patients.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 11","pages":"Pages 1335-1347"},"PeriodicalIF":12.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603658","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 Bariatric Surgery on Coronary Microvascular Function","authors":"Paul Poirier MD, PhD","doi":"10.1016/j.jcmg.2024.08.007","DOIUrl":"10.1016/j.jcmg.2024.08.007","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 11","pages":"Pages 1317-1319"},"PeriodicalIF":12.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371923","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":"Clinical Outcomes in Hypertrophic Cardiomyopathy and No Late Gadolinium Enhancement","authors":"Omar M. Abdelfattah MD,&nbsp;Xander Jacquemyn BSc,&nbsp;Amro Aglan MD,&nbsp;Ethan Rowin MD,&nbsp;Martin Maron MD,&nbsp;Matthew W. Martinez MD","doi":"10.1016/j.jcmg.2024.06.004","DOIUrl":"10.1016/j.jcmg.2024.06.004","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 11","pages":"Pages 1387-1388"},"PeriodicalIF":12.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788114","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":"Prognostication and Interventional Guidance Using Acceleration-Ejection Time Ratio in Undifferentiated Paradoxical Low-Flow Low-Gradient Aortic Stenosis","authors":"Adrian Chong MBBS, BPharm ,&nbsp;Jonathan Sen MBBS, BHSc ,&nbsp;Reza Reyaldeen MBBS, BSc ,&nbsp;Sudhir Wahi MBBS, MD ,&nbsp;Quan Huynh BMed, PhD ,&nbsp;William Y.S. Wang MBBS, PhD ,&nbsp;Thomas H. Marwick MBBS, PhD, MPH","doi":"10.1016/j.jcmg.2024.05.015","DOIUrl":"10.1016/j.jcmg.2024.05.015","url":null,"abstract":"<div><h3>Background</h3><div>Studies in paradoxical low-flow low-gradient aortic stenosis (PLFAS) have demonstrated conflicting outcomes with variable survival advantage from aortic valve replacement (AVR). PLFAS is a heterogeneous composition of patients with uncertainty regarding true stenosis severity that continues to confound decision-making for AVR.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to investigate the utility of the Doppler acceleration (AT) to ejection (ET) time ratio (AT:ET) for prediction of prognosis and benefit from AVR in undifferentiated PLFAS.</div></div><div><h3>Methods</h3><div>Patients with echocardiographic findings of PLFAS (aortic valve area &lt;1.0 cm² or indexed aortic valve area &lt;0.6 cm²/m², mean gradient &lt;40 mm Hg, indexed stroke volume &lt;35 mL/m², and left ventricular ejection fraction ≥50%) were identified and grouped according to an AT:ET cutoff of 0.35. The primary outcome was a 5-year composite of cardiac mortality or AVR. Secondary outcomes included the individual components of the primary endpoint and all-cause mortality at 5 years. Effect of AVR was analyzed in the AT:ET &lt;0.35 and ≥0.35 groups.</div></div><div><h3>Results</h3><div>A total of 171 PLFAS patients (median age 77.0 years, 57% women) were followed for a median of 8.9 years. AT:ET ≥0.35 was an independent predictor of the primary outcome (HR: 4.77 [95% CI: 2.94-7.75]; <em>P &lt;</em> 0.001) with incremental value over standard indices of stenosis severity (net reclassification improvement: 0.57 [95% CI: 0.14-0.84]). AT:ET ≥0.35 also remained predictive of increased cardiac death (HR: 2.91 [95% CI: 1.47-5.76]; <em>P =</em> 0.002) and AVR (HR: 8.45 [95% CI: 4.16-17.1]; <em>P &lt;</em> 0.001), respectively, following competing risk analysis. No difference in all-cause mortality was observed. AVR in the AT:ET ≥0.35 group was associated with significant reductions in 5-year cardiac (HR: 0.09 [95% CI: 0.02-0.36]; <em>P &lt;</em> 0.001) and all-cause mortality (HR: 0.16 [95% CI: 0.07-0.38]; <em>P &lt;</em> 0.001). No improvement in survival from AVR was demonstrated in AT:ET &lt;0.35 patients.</div></div><div><h3>Conclusions</h3><div>AT:ET ≥0.35 in PLFAS predicts poorer outcomes and/or need for AVR. In undifferentiated PLFAS patients, AT:ET may have a potential role in improving patient selection for prognostic AVR.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 11","pages":"Pages 1290-1301"},"PeriodicalIF":12.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995761","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":"Evaluating Patient-Oriented Echocardiogram Reports Augmented by Artificial Intelligence","authors":"Jacob A. Martin MD, MSCR,&nbsp;Theodore Hill BA,&nbsp;Muhamed Saric MD, PhD,&nbsp;Alan F. Vainrib MD,&nbsp;Daniel Bamira MD,&nbsp;Samuel Bernard MD,&nbsp;Richard Ro MD,&nbsp;Hao Zhang MS,&nbsp;Jonathan S. Austrian MD,&nbsp;Yindalon Aphinyanaphongs MD, PhD,&nbsp;Vidya Koesmahargyo MS,&nbsp;Mathew R. Williams MD,&nbsp;Larry A. Chinitz MD,&nbsp;Lior Jankelson MD, PhD","doi":"10.1016/j.jcmg.2024.05.021","DOIUrl":"10.1016/j.jcmg.2024.05.021","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 11","pages":"Pages 1381-1383"},"PeriodicalIF":12.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874846","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":"Imaging in Amyloidosis","authors":"Marianna Fontana MD, PhD ,&nbsp;Aldostefano Porcari MD","doi":"10.1016/j.jcmg.2024.06.005","DOIUrl":"10.1016/j.jcmg.2024.06.005","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 11","pages":"Pages 1287-1289"},"PeriodicalIF":12.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874848","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":"Fibro-Calcific Imaging","authors":"Stephanie L. Sellers MSc, PhD ,&nbsp;David Meier MD","doi":"10.1016/j.jcmg.2024.07.020","DOIUrl":"10.1016/j.jcmg.2024.07.020","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 11","pages":"Pages 1363-1365"},"PeriodicalIF":12.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251229","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":"Clinical Significance of Myocardial Injury in Patients Hospitalized for COVID-19","authors":"Hunain Shiwani BMBS ,&nbsp;Jessica Artico MD ,&nbsp;James C. Moon MD ,&nbsp;Miroslawa Gorecka MB ,&nbsp;Gerry P. McCann MD ,&nbsp;Giles Roditi MD ,&nbsp;Andrew Morrow MBChB ,&nbsp;Kenneth Mangion PhD ,&nbsp;Elena Lukaschuk MSc ,&nbsp;Mayooran Shanmuganathan MBBS ,&nbsp;Christopher A. Miller PhD ,&nbsp;Amedeo Chiribiri PhD ,&nbsp;Mohammed Alzahir MBBS ,&nbsp;Sara Ramirez MD ,&nbsp;Andrew Lin MBBS ,&nbsp;Peter P. Swoboda PhD ,&nbsp;Adam K. McDiarmid PhD ,&nbsp;Robert Sykes MBChB ,&nbsp;Trisha Singh MBBS ,&nbsp;Chiara Bucciarelli-Ducci PhD ,&nbsp;Ifza Hussain","doi":"10.1016/j.jcmg.2024.06.008","DOIUrl":"10.1016/j.jcmg.2024.06.008","url":null,"abstract":"<div><h3>Background</h3><div>Hospitalized COVID-19 patients with troponin elevation have a higher prevalence of cardiac abnormalities than control individuals. However, the progression and impact of myocardial injury on COVID-19 survivors remain unclear.</div></div><div><h3>Objectives</h3><div>This study sought to evaluate myocardial injury in COVID-19 survivors with troponin elevation with baseline and follow-up imaging and to assess medium-term outcomes.</div></div><div><h3>Methods</h3><div>This was a prospective, longitudinal cohort study in 25 United Kingdom centers (June 2020 to March 2021). Hospitalized COVID-19 patients with myocardial injury underwent cardiac magnetic resonance (CMR) scans within 28 days and 6 months postdischarge. Outcomes were tracked for 12 months, with quality of life surveys (EuroQol-5 Dimension and 36-Item Short Form surveys) taken at discharge and 6 months.</div></div><div><h3>Results</h3><div>Of 342 participants (median age: 61.3 years; 71.1% male) with baseline CMR, 338 had a 12-month follow-up, 235 had a 6-month CMR, and 215 has baseline and follow-up quality of life surveys. Of 338 participants, within 12 months, 1.2% died; 1.8% had new myocardial infarction, acute coronary syndrome, or coronary revascularization; 0.8% had new myopericarditis; and 3.3% had other cardiovascular events requiring hospitalization. At 6 months, there was a minor improvement in left ventricular ejection fraction (1.8% ± 1.0%; <em>P &lt;</em> 0.001), stable right ventricular ejection fraction (0.4% ± 0.8%; <em>P =</em> 0.50), no change in myocardial scar pattern or volume (<em>P =</em> 0.26), and no imaging evidence of continued myocardial inflammation. All pericardial effusions (26 of 26) resolved, and most pneumonitis resolved (95 of 101). EuroQol-5 Dimension scores indicated an overall improvement in quality of life (<em>P &lt;</em> 0.001).</div></div><div><h3>Conclusions</h3><div>Myocardial injury in severe hospitalized COVID-19 survivors is nonprogressive. Medium-term outcomes show a low incidence of major adverse cardiovascular events and improved quality of life. (COVID-19 Effects on the Heart; <span><span>ISRCTN58667920</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 11","pages":"Pages 1320-1331"},"PeriodicalIF":12.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107563","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}