JACC. Cardiovascular imaging最新文献

{"title":"Integrated Atrial and Ventricular Strain Assessment in Patients With Severe Degenerative Mitral Regurgitation Undergoing Surgery","authors":"Jin Kyung Oh MD, PhD ,&nbsp;Soongu Kwak MD ,&nbsp;Chan Soon Park MD, PhD ,&nbsp;Byung Joo Sun MD, PhD ,&nbsp;Sahmin Lee MD, PhD ,&nbsp;Jun-Bean Park MD, PhD ,&nbsp;Hyung-Kwan Kim MD, PhD ,&nbsp;Yong-Jin Kim MD, PhD ,&nbsp;Jong-Min Song MD, PhD ,&nbsp;Duk-Hyun Kang MD, PhD ,&nbsp;Jae-Kwan Song MD, PhD ,&nbsp;Jae-Hyeong Park MD, PhD ,&nbsp;Goo-Yeong Cho MD, PhD ,&nbsp;Seung-Pyo Lee MD, PhD ,&nbsp;Dae-Hee Kim MD, PhD","doi":"10.1016/j.jcmg.2025.12.011","DOIUrl":"10.1016/j.jcmg.2025.12.011","url":null,"abstract":"<div><h3>Background</h3><div>Current guidelines for degenerative mitral regurgitation (MR) emphasize left ventricular (LV) dysfunction. However, subclinical alterations in left atrial (LA) or LV strain may manifest earlier in severe MR.</div></div><div><h3>Objectives</h3><div>This study sought to determine whether combined LA and LV strain measurements improve long-term mortality prediction in severe degenerative MR, especially in asymptomatic individuals.</div></div><div><h3>Methods</h3><div>This retrospective derivation cohort included 1,314 patients (mean age: 55 ± 13 years; 35% women) who underwent valve repair or replacement for severe MR. Preoperative peak atrial longitudinal strain (PALS) and LV–global longitudinal strain (GLS) were measured. Patients were categorized into 4 groups by using spline-derived thresholds (PALS: &lt;21.4%; LV-GLS: &gt;−20.5%). The primary outcome was all-cause mortality (median follow-up, 8.4 years). External validation included 605 independent patients.</div></div><div><h3>Results</h3><div>Impaired PALS (adjusted HR [aHR]: 2.11; <em>P &lt;</em> 0.001) and impaired LV-GLS (aHR: 1.66; <em>P =</em> 0.008) were independently associated with high mortality. The group with both impaired PALS and LV-GLS demonstrated the worst outcome (aHR: 2.50; <em>P &lt;</em> 0.001). In asymptomatic patients (n = 900), the combined use of both strain parameters outperformed traditional LV dysfunction criteria (LV ejection fraction ≤60% or LV end-systolic dimension ≥40 mm), thereby significantly improving net reclassification (net reclassification index = 0.436; <em>P &lt;</em> 0.001) and discrimination (integrated discrimination improvement = 0.024; <em>P =</em> 0.003). Subgroup analyses demonstrated that the prognostic contribution of each strain parameter varied by the functional status of the other chamber. External validation confirmed these associations.</div></div><div><h3>Conclusions</h3><div>Concomitant impairment of both PALS and LV-GLS identified patients at the highest mortality risk. These findings support an integrated atrial-ventricular strain assessment to improve prognostic stratification, particularly in asymptomatic patients with severe degenerative MR who are undergoing MV surgery.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"19 5","pages":"Pages 588-599"},"PeriodicalIF":15.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146073078","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":"Lower Limit of the Reference Normal Range for Left Atrial Strain","authors":"Daniel A. Morris MD,&nbsp;Tor Biering‑Sørensen MD,&nbsp;Kristoffer Skaarup MD,&nbsp;Jo-Nan Liao MD, PhD,&nbsp;Philipp Stawowy MD,&nbsp;Tobias Trippel MD,&nbsp;Ingo Hilgendorf MD,&nbsp;Matthias Schneider-Reigbert MD,&nbsp;Chung-Lieh Hung MD,&nbsp;Athanasios Frydas MD","doi":"10.1016/j.jcmg.2025.12.009","DOIUrl":"10.1016/j.jcmg.2025.12.009","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"19 5","pages":"Pages 664-666"},"PeriodicalIF":15.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146072219","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":"Coronary Artery Calcium Score and Coronary Plaque","authors":"Keishi Ichikawa MD, PhD,&nbsp;April Kinninger MPH,&nbsp;Srikanth Krishnan MD, MS,&nbsp;Beshoy Iskander MD,&nbsp;Natdanai Punnanithinont MD, MPH,&nbsp;Suvasini Lakshmanan MD, MS,&nbsp;Muneeb Khan BS,&nbsp;Jonathan Fialkow MD,&nbsp;Matthew J. Budoff MD,&nbsp;Khurram Nasir MD, MPH, MS","doi":"10.1016/j.jcmg.2025.11.005","DOIUrl":"10.1016/j.jcmg.2025.11.005","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"19 5","pages":"Pages 662-663"},"PeriodicalIF":15.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145704309","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 Plaque Analysis in Clinical Practice: 2025 ACC Scientific Statement","authors":"Y. Chandrashekhar MD, FACC (Chair, Writing Committee),&nbsp;Ron Blankstein MD, FACC (Vice Chair) ,&nbsp;Leslee J. Shaw PhD, FACC (Vice Chair) ,&nbsp;Maros Ferencik MD, PhD, MCR,&nbsp;Jonathon Leipsic MD,&nbsp;Ludovic Trinquart PhD,&nbsp;Todd C. Villines MD, FACC,&nbsp;ACC Quantitative Coronary Plaque Analysis Symposium Collaborators","doi":"10.1016/j.jcmg.2025.11.008","DOIUrl":"10.1016/j.jcmg.2025.11.008","url":null,"abstract":"<div><div>Technological advances in coronary computed tomography angiography and artificial intelligence have resulted in an increasing capability to analyze and quantify information about atherosclerotic coronary plaque through noninvasive imaging. This has paved the way for a growing number of U.S. Food and Drug Administration–cleared products that can perform quantitative coronary plaque analysis (QCPA). To date, research has focused on the accuracy, prognostic value, and decision-making impact of QCPA, but there is no current consensus on its appropriate use in clinical practice. To address this gap, the American College of Cardiology convened a panel of experts for a 1-day symposium to discuss key questions related to the use of QCPA in clinical practice and develop consensus recommendations to guide cardiovascular clinicians and imagers on the use of QCPA. This scientific statement provides guidance on clinical indications (including possible uses of QCPA in serial imaging), methods for interpretation and reporting, and standardization. Future research directions are also addressed, including both the collection of ongoing registry data and potential for incorporation of QCPA into outcomes trials.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"19 5","pages":"Pages 637-652"},"PeriodicalIF":15.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145765487","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":"Adverse Cardiovascular Events Among Younger and Older Patients Referred for Coronary CTA","authors":"Daniel M. Huck MD, MPH ,&nbsp;Adam N. Berman MD, MPH ,&nbsp;Arthur Shiyovich MD ,&nbsp;Brittany N. Weber MD, PhD ,&nbsp;Rhanderson Cardoso MD ,&nbsp;Camila V. Blair MD ,&nbsp;David W. Biery BS ,&nbsp;Stephanie A. Besser MS ,&nbsp;Sumit Gupta MBBS, PhD ,&nbsp;Ayaz Aghayev MD ,&nbsp;Michael Steigner MD ,&nbsp;Joanne Miao BS ,&nbsp;Jon Hainer BS ,&nbsp;Cian McCarthy MB, BCH, BAO, SM ,&nbsp;Sandeep Hedgire MD ,&nbsp;Khurram Nasir MD, MPH ,&nbsp;Leslee J. Shaw PhD ,&nbsp;Marcelo F. Di Carli MD ,&nbsp;Brian Ghoshhajra MD, MBA ,&nbsp;Ron Blankstein MD","doi":"10.1016/j.jcmg.2025.12.012","DOIUrl":"10.1016/j.jcmg.2025.12.012","url":null,"abstract":"<div><h3>Background</h3><div>Recent guidelines suggest that coronary computed tomography angiography (CTA) may be the preferred testing modality in patients &lt;65 years of age who are suspected of having coronary artery disease (CAD). Because of a higher prevalence of CAD, the role of coronary CTA in older cohorts is less well established.</div></div><div><h3>Objectives</h3><div>The authors aimed to characterize the yield and prognostic utility of coronary CTA by age in a large registry with long-term follow-up.</div></div><div><h3>Methods</h3><div>Retrospective cohort of patients clinically referred to coronary CTA at 2 medical centers from 2006 to 2021, excluding patients with prior CAD, severe renal disease, and malignancy. Adjusted Cox regression was used to assess the association of CAD severity (absent, nonobstructive, obstructive) and extent (number of vessels with plaque) with adverse cardiovascular events (major adverse cardiovascular events [MACE]: cardiovascular death, nonfatal myocardial infarction, or ischemic stroke) across different age groups.</div></div><div><h3>Results</h3><div>Among 22,412 patients followed over a median of 6.2 years (Q1-Q3: 3.9-9.6 years), 16,726 were &lt;65 years of age and 5,686 were ≥65 years of age. Older patients had a higher prevalence of obstructive CAD (38% vs 15%) and extensive plaque (52% vs 20% with 3- to 4-vessel involvement) compared with their younger counterparts. Nonobstructive plaque was common in both groups (&lt;65 years of age: 37%; ≥65 years of age: 48%). Obstructive CAD was associated with MACE in both younger (HR: 2.45; <em>P &lt;</em> 0.001) and older individuals (HR: 1.97; <em>P &lt;</em> 0.001). Nonobstructive plaque was associated with MACE in younger individuals (HR: 1.39; <em>P =</em> 0.005), whereas only extensive nonobstructive CAD was associated with MACE in older individuals (HR: 1.56; <em>P =</em> 0.02). Among those with obstructive CAD on coronary CTA who underwent early invasive coronary angiography, revascularization was less common among older adults (48% vs 56%; <em>P =</em> 0.002).</div></div><div><h3>Conclusions</h3><div>In a large coronary CTA registry, patients ≥65 years of age were more likely to have extensive plaque and stenosis. Although the prognostic value of coronary CTA may be lower among older adults with nonobstructive plaque (a group that has a similar event rate as those with no CAD), the presence of extensive nonobstructive plaque or obstructive stenosis was independently associated with a significantly higher rate of MACE. Newer techniques to better risk stratify patients with nonobstructive plaque may improve the value of coronary CTA, especially in older adults.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"19 5","pages":"Pages 604-617"},"PeriodicalIF":15.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226875","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":"Where Is Echocardiography Going?","authors":"William A. Zoghbi MD (Deputy Editor, JACC: Cardiovascular Imaging),&nbsp;Y. Chandrashekhar MD, DM (Editor-in-Chief, JACC: Cardiovascular Imaging)","doi":"10.1016/j.jcmg.2026.04.001","DOIUrl":"10.1016/j.jcmg.2026.04.001","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"19 5","pages":"Pages 667-670"},"PeriodicalIF":15.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147808025","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":"Moving From Eyeball Assessment to Quantification of the Right Ventricular “Hot Spot” in Arrhythmogenic Cardiomyopathy","authors":"Andre La Gerche MBBS, PhD ,&nbsp;Stephanie J. Rowe BBiomed, MD","doi":"10.1016/j.jcmg.2025.12.005","DOIUrl":"10.1016/j.jcmg.2025.12.005","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"19 5","pages":"Pages 585-587"},"PeriodicalIF":15.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145902492","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 and Cardiac Structure From Routine CT Predict Cardiovascular Risk Beyond PREVENT and Coronary Calcium","authors":"Daniel W. Oo BA ,&nbsp;Matthias Jung MD ,&nbsp;Leonard Nürnberg MSc ,&nbsp;Jay Chandra BA ,&nbsp;Audra Sturniolo MS ,&nbsp;Nora Kerkovits MD ,&nbsp;Saman Doroodgar Jorshery MD, MPH ,&nbsp;Marcel Langenbach MD ,&nbsp;Borek Foldyna MD, PhD ,&nbsp;Douglas P. Kiel MD, MPH ,&nbsp;Hugo J.W.L. Aerts PhD ,&nbsp;Pradeep Natarajan MD, MMSc ,&nbsp;Michael T. Lu MD, MPH ,&nbsp;Vineet K. Raghu PhD","doi":"10.1016/j.jcmg.2026.01.006","DOIUrl":"10.1016/j.jcmg.2026.01.006","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular disease prevention relies on accurate risk assessment; however, existing scores are imprecise. Routine imaging may be opportunistically used to predict risk.</div></div><div><h3>Objectives</h3><div>The authors tested whether computed tomography (CT)–derived cardiac and aortic structure predicts major adverse cardiac events (MACE) beyond standard-of-care scores.</div></div><div><h3>Methods</h3><div>The authors developed a least absolute shrinkage and selection operator model to predict cardiovascular mortality using “radiomics” features describing cardiac and aortic structure from 13,437 lung cancer screening CTs from the NLST (National Lung Screening Trial). They compared this score to the PREVENT (Predicting Risk of Cardiovascular Disease Events) tool and the coronary artery calcium (CAC) score in patients with routine chest CT and no prior MACE from Mass General Brigham. They calculated discrimination using Harrel’s C-index and MACE rates in high-risk groups by the PREVENT score (≥7.5% risk) or the radiomics score (≥3.0% in men, ≥1.5% in women).</div></div><div><h3>Results</h3><div>In external testing (n = 14,577, mean age 61.1 ± 8.6 years, 47.5% male), 6.2% had incident MACE over a median of 5.7 years of follow-up. The radiomics score had higher discrimination for MACE than PREVENT (C-index 0.66 [95% CI: 0.64-0.68] vs 0.61 [95% CI: 0.59-0.63]) and was complementary to CAC (combined C-index 0.69 [95% CI: 0.67-0.71] vs CAC alone 0.66 [95% CI: 0.65-0.68]). High-risk patients by the radiomics score but not PREVENT had 3.6-fold higher MACE incidence than low-risk patients by both scores (23.1 [95% CI: 16.7-30.2] vs 6.5 [95% CI: 5.5-7.5] MACE per 1,000 person-years). Aortic surface-to-volume ratio, left ventricular volume, and left atrial short-axis length were among the most predictive features of MACE.</div></div><div><h3>Conclusions</h3><div>CT-derived structural cardiac and aortic radiomics identified high-risk patients missed by clinical scores and further stratified risk among CAC risk groups. High-risk patients may benefit from intensified primary prevention.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"19 5","pages":"Pages 621-633"},"PeriodicalIF":15.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146258264","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":"From Segmentation to MACE Prediction","authors":"Robert J.H. Miller MD,&nbsp;Michele Bertelli MD","doi":"10.1016/j.jcmg.2026.02.001","DOIUrl":"10.1016/j.jcmg.2026.02.001","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"19 5","pages":"Pages 634-636"},"PeriodicalIF":15.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365161","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":"Timing of Mitral Valve Intervention","authors":"Stephen H. Little MD","doi":"10.1016/j.jcmg.2026.02.010","DOIUrl":"10.1016/j.jcmg.2026.02.010","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"19 5","pages":"Pages 600-603"},"PeriodicalIF":15.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147447233","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}