JACC. Cardiovascular imaging最新文献

{"title":"General Purpose Deep Learning Attenuation Correction Improves Diagnostic Accuracy of SPECT MPI: A Multicenter Study.","authors":"Aakash D Shanbhag,Robert J H Miller,Mark Lemley,Paul Kavanagh,Joanna X Liang,Anna M Marcinkiewicz,Valerie Builoff,Serge Van Kriekinge,Terrence D Ruddy,Mathews B Fish,Andrew J Einstein,Monica Martins,Julian P Halcox,Philipp A Kaufmann,Christopher Buckley,Timothy M Bateman,Daniel S Berman,Damini Dey,Piotr J Slomka","doi":"10.1016/j.jcmg.2025.06.010","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.06.010","url":null,"abstract":"BACKGROUNDSingle-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) uses computed tomography (CT)-based attenuation correction (AC) to improve diagnostic accuracy. Deep learning (DL) has the potential to generate synthetic AC images, as an alternative to CT-based AC.OBJECTIVESThis study evaluated whether DL-generated synthetic SPECT images could enhance accuracy of conventional SPECT MPI.METHODSStudy investigators developed a DL model in a multicenter cohort of 4,894 patients from 4 sites to generate simulated SPECT AC images (DeepAC). The model was externally validated in 746 patients from 72 sites in a clinical trial (A Phase 3 Multicenter Study to Assess PET Imaging of Flurpiridaz F 18 Injection in Patients With CAD; NCT01347710) and in 320 patients from another external site. In the first external cohort, the study assessed the diagnostic accuracy for obstructive coronary artery disease (CAD)-defined as left main coronary artery stenosis ≥50% or ≥70% in other vessels-for total perfusion deficit (TPD). In the latter, the study completed change analysis and compared quantitative scores for AC, DeepAC, and nonattenuation correction (NC) with clinical scores.RESULTSIn the first external cohort (mean age, 63 ± 9.5 years; 69.0% male), 206 patients (27.6%) had obstructive CAD. The area under the receiver-operating characteristic curve (AUC) of DeepAC TPD (0.77; 95% CI: 0.73-0.81) was higher than the NC TPD (AUC: 0.73; 95% CI: 0.69-0.77; P < 0.001). In the second external cohort, DeepAC quantitative scores had closer agreement with actual AC scores compared with NC.CONCLUSIONSIn a multicenter external cohort, DeepAC improved prediction performance for obstructive CAD. This approach could enhance diagnostic accuracy in facilities using conventional SPECT systems without requiring additional equipment, imaging time, or radiation exposure.","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"15 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144797096","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":"Accelerating Drug Translation","authors":"Lohendran Baskaran MBBS ,&nbsp;Utkarsh Dutta MBBS, MSc ,&nbsp;Wang Xiaomeng PhD ,&nbsp;Michael Patrick Gray MPH ,&nbsp;Mark Chan MBBS, PhD ,&nbsp;Kelley Branch MD, MSc ,&nbsp;Matthew Budoff MD ,&nbsp;Ron Blankstein MD ,&nbsp;Pamela S. Douglas MD ,&nbsp;Gemma A. Figtree MBBS, DPhil","doi":"10.1016/j.jcmg.2025.03.017","DOIUrl":"10.1016/j.jcmg.2025.03.017","url":null,"abstract":"<div><div>There is an unmet need for new pathways to evaluate therapeutic targets and drugs for coronary artery disease (CAD). The use of major adverse cardiovascular events as a primary outcome is advantageous for rigor, but challenges related to large sample size requirements, long study durations, and associated costs and risks remain major disincentives for key stakeholders. Until now, a robust, well-validated surrogate biomarker for cardiovascular events that reflects atherosclerosis itself has been lacking. This is particularly important as new therapeutic candidates targeting inflammation and factors downstream of low-density lipoprotein and other well-recognized factors continue to emerge. Coronary computed tomography angiography (CTA) has emerged as an ideal modality to image, characterize, and quantify specific plaque components, with potential for a more formal role in the CAD drug development pipeline. This review examines both morphological (high-risk plaque) and quantitative (specific plaque components) measures, considering their pathophysiological correlation with other imaging measures of atherosclerosis, evidence for the association of each component with major adverse cardiovascular events, and their responsiveness to effective drug treatments. Given the rapid advancement in coronary CTA acquisition and analysis technology, there is an urgent need for coordination and collaboration among key stakeholders, including imaging hardware and software companies, pharmaceutical companies, as well as clinicians, patients, regulators, and payers. Progress in this area, and the opportunities that may follow for the broader cardiovascular community if standardized coronary CTA endpoints are validated as surrogates for clinical drug trials, could accelerate innovation and enhance efficiency in CAD drug development.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 8","pages":"Pages 912-927"},"PeriodicalIF":15.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144771023","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":"Echocardiographic Imaging Considerations for Post-Implant Evaluation of the Transcatheter EVOQUE Tricuspid Valve Replacement System.","authors":"Anna Sannino, Federica Ilardi, Rebecca T Hahn, Mehrnoush Toufan, Katie Nickolite, Vratika Agarwal, Benjamin Havens, Ivy Ku, Frank Silvestry, Ludwig Weckbach, Patrick Gleason, Mias Pretorius, Edwin Ho, John Tulloch, Tobias Ruf, Joshua Cohen, Neal Duggal, Partho P Sengupta, Noreen Kelly, Bassem M Chehab, Johanna Vogelhuber, Siddharth Vad, Florian Deuschl, Vinod H Thourani, Philipp Lurz, Susheel K Kodali, Paul A Grayburn","doi":"10.1016/j.jcmg.2025.06.011","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.06.011","url":null,"abstract":"<p><p>The transcatheter EVOQUE tricuspid valve replacement system is an approved device for the treatment of patients with symptomatic severe tricuspid regurgitation despite medical therapy both in the United States and in Europe. Specific imaging requirements are needed in the screening and in the intraprocedural phase as well as to assess this valve after implantation, in order to assess its positioning and performance. In this review, focus will be on the postoperative echocardiographic assessment of device positioning and stability; evaluation of residual central tricuspid regurgitation or paravalvular leak; valve thrombosis/degeneration; interaction of the device frame with the right ventricle and adjacent structures, including the aortic valve and interventricular septum; and placement of pacemaker leads. This review will therefore be centered on these essential imaging aspects in the echocardiographic postimplantation evaluation of the EVOQUE valve.</p>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":15.2,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799085","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 CT Angiography to Diagnose Healing of Spontaneous Coronary Artery Dissection: Comparison With Invasive Angiography.","authors":"Tristan T Demmert, Konstantin Klambauer, Lukas J Moser, Victor Schweiger, Victor Mergen, Michael Würdinger, Davide Di Vece, Andrea Biondo, Alexander Gotschy, Barbara Stähli, Julia Stehli, Martin F Reiner, Jelena-R Ghadri, Robert Manka, Matthias Eberhard, Christian Templin, Hatem Alkadhi","doi":"10.1016/j.jcmg.2025.06.013","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.06.013","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":15.2,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799084","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":"Comparative Analysis of Aortic Stiffness: Magnetic Resonance Validation Against Mechanical Testing in Ex Vivo Aortic Specimens.","authors":"Andrea Guala, Myriam Cilla, Gisela Teixido-Tura, Miguel Angel Martínez, Lydia Dux-Santoy Hurtado, Laura Galian-Gay, Juan Garrido-Oliver, Alvaro Latorre, Maria Luz Servato, Horacio Majul, Axel Hiram Hernandez-Pineda, Chiara Granato, Ignacio Ferreira-González, Arturo Evangelista, Estefania Peña, Jose Rodriguez-Palomares","doi":"10.1016/j.jcmg.2025.06.015","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.06.015","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":15.2,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835150","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":"Advanced Analyses of Coronary Computed Tomography Angiography to Predict Future Cardiac Events: A Meta-Analysis.","authors":"Emiliano Bianchini, Foziyah Alqahtani, Sara Alsubai, Paolo Alberto Del Sole, Hesham Elzomor, Ruth Sharif, John McCormick, Pruthvi Chenniganahosahalli Revaiah, Felicita Andreotti, Francesco Burzotta, Yoshinobu Onuma, Patrick Washington Serruys, Faisal Sharif","doi":"10.1016/j.jcmg.2025.05.017","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.05.017","url":null,"abstract":"<p><strong>Background: </strong>Although coronary computed tomographic angiography (CTA) is widely used for anatomical evaluation, its advanced analyses, including plaque characterization, computed tomography-derived fractional flow reserve (CT-FFR), and radiomics signature extraction, hold promise for improved prediction of major adverse cardiovascular events (MACE).</p><p><strong>Objectives: </strong>The aim of this meta-analysis was to assess the added prognostic value of advanced coronary CTA-based analyses in predicting MACE.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, and CENTRAL identified studies reporting coronary CTA-based advanced analyses predicting MACE. The pooled HR of advanced coronary CTA-based analyses for the prediction of MACE was the primary outcome measure. The secondary endpoint included the mean difference in C index (ΔC index) between advanced coronary CTA-based predictive models and conventional models. MACE were defined according to study-level definitions. The protocol was registered in the International Prospective Register of Systematic Reviews (CRD42024606545).</p><p><strong>Results: </strong>Of 75 studies, 52 were included in the primary analysis of HRs (n = 58,123) and 32 in the secondary analysis of ΔC index. The median follow-up time was 36 months (Q1-Q3: 24-57 months). Most advanced coronary CTA-based analyses, including CT-FFR, high-risk plaque, fat attenuation index, total plaque volume or low-attenuation plaque volume, and radiomics-derived scores, demonstrated a significant and consistent association with MACE, observed across both pooled unadjusted and adjusted HRs. In particular, CT-FFR (HR: 6.14 [95% CI: 3.75-10.05]; P < 0.01) and high-risk plaque (HR: 4.05 [95% CI: 3.16-5.18]; P < 0.01) showed the strongest associations with MACE despite a moderate to severe between-studies heterogeneity for most of the pooled analyses.</p><p><strong>Conclusions: </strong>Advanced coronary CTA-based analyses show consistent association to the occurrence of MACE, suggesting their potential for refining cardiovascular risk stratification on top of conventional clinical risk assessment. Given the heterogeneity of advanced imaging analyses by coronary CTA and their varying pathophysiological targets, future comparative studies are needed to evaluate their implementation in different clinical scenarios.</p>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":15.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775386","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":"Cardiac CT and PET for Surveillance of Heart Transplant Recipients: Systematic Review and Bayesian Meta-Analysis.","authors":"Ahmed Sayed,Malek Nayfeh,Fares Alahdab,Mahmoud Al Rifai,Dimitry Abramov,Marat Fudim,Yasbanoo Moayedi,Rayan Yousefzai,Mouaz H Al-Mallah","doi":"10.1016/j.jcmg.2025.05.019","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.05.019","url":null,"abstract":"BACKGROUNDFor noninvasive surveillance of cardiac allograft vasculopathy (CAV), cardiac computed tomography (cardiac computed tomography [CT]) and positron emission tomography (PET) received a Class IIa recommendation by the 2023 ISHLT (International Society for Heart and Lung Transplantation) guidelines. However, implementation has lagged behind because of concerns about their ability to rule out disease and stratify risk.OBJECTIVESThe purpose of this study was to define the diagnostic and prognostic ability of PET and cardiac CT in cardiac transplant recipients.METHODSElectronic databases were searched for studies evaluating CT or PET for their diagnostic (for detecting angiographic CAV) and prognostic (for predicting major adverse cardiovascular outcomes) value. Sensitivity and specificity were pooled using Bayesian bivariate binormal-normal models with random-effects. HRs were pooled using Bayesian normal random-effects models.RESULTSIn total, 44 studies (32 CT and 12 PET) enrolling 3,049 patients were included. Coronary computed tomography angiography (CTA) showed high sensitivity (97.6%; 95% credible interval [CrI]: 93.7%-99.1%) and specificity (82.3%; 95% CrI: 75.3%-88.3%) for detecting any CAV. Coronary CTA also showed high sensitivity (92.6%; 95% CrI: 86.2%-96.2%) and specificity (92.6%; 95% CrI: 89.8%-94.9%) for significant CAV. The PET CAV algorithm for detecting significant CAV showed good sensitivity (83.9%; 95% CrI: 69.1%-92.4%) and specificity (89.6%; 95% CrI: 82.2%-94.2%). PET-derived parameters including myocardial flow reserve, stress myocardial blood flow, PET CAV score, and summed stress score, predicted future major adverse cardiovascular outcomes.CONCLUSIONSBoth coronary CTA and PET can rule out significant CAV; however, at higher pretest probabilities, coronary CTA may be preferrable. Multiple PET-derived parameters may have prognostic value, whereas there is insufficient evidence for the long-term prognostic value of CT.","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"9 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747822","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":"Cardiac Magnetic Resonance-based Tissue Characterization for Detection of Transthyretin Cardiac Amyloidosis with Negative or Equivocal Technetium-Pyrophosphate Scan.","authors":"Varun Subashchandran, Vidya Nadig, Cristiane Singulane, Amit R Patel, Patricia R Lozano, Karolina M Zareba, Tommy Chiou, Justin Sipiora, Akash Goyal, Michael Elliot, Fabio Fernandes, Marcelo Campos Vieira, Shaimaa Fadi, Cory Trankle, Barbara Srichai, Dipan Shah, El-Moatasem Gabr, Nitasha Sarswat, Amit Pursnani, Roberto M Lang, Hena Patel, Jai Singh, Jeremy A Slivnick","doi":"10.1016/j.jcmg.2025.06.005","DOIUrl":"10.1016/j.jcmg.2025.06.005","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649488","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 Quantifying Coronary Plaque in Patients With Stable Chest Pain: Insights From the PROMISE Trial.","authors":"Jan M Brendel,Thomas Mayrhofer,Neha Pagidipati,Júlia Karády,Márton Kolossváry,Isabel L Langenbach,Marcel C Langenbach,Nóra M Kerkovits,Matthias Jung,Michelle D Kelsey,Maros Ferencik,Michael T Lu,Svati H Shah,Pamela S Douglas,Borek Foldyna","doi":"10.1016/j.jcmg.2025.06.007","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.06.007","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"37 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693417","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":"Multiphase Myocardial Microvascular Flow Dynamics Revealed by Transthoracic Ultrasound Localization Microscopy in HCM and Non-HCM Patients.","authors":"Biao Huang,Johanna Tonko,Jipeng Yan,Cameron A B Smith,Lasha Gvinianidze,Matthieu Toulemonde,Joseph Hansen-Shearer,Qingyuan Tan,Pier D Lambiase,Roxy Senior,Meng-Xing Tang","doi":"10.1016/j.jcmg.2025.06.004","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.06.004","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"65 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693418","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}