JACC. Cardiovascular imaging最新文献

{"title":"Can We Detect a Vulnerable Plaque Phenotype and What Will We Do About It?","authors":"Stephen J. Nicholls MBBS, PhD (Associate Editor, JACC: Cardiovascular Imaging), Y. Chandrashekhar MD, DM (Editor-in-Chief, JACC: Cardiovascular Imaging)","doi":"10.1016/j.jcmg.2026.07.001","DOIUrl":"10.1016/j.jcmg.2026.07.001","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"19 8","pages":"Pages 1023-1025"},"PeriodicalIF":19.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660911","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":"Opportunistic CT-Derived Periaortic Fat Attenuation as a Novel Marker of Mortality in Patients Undergoing TAVR","authors":"Jan M. Brendel MD, Ibrahim Hadzic MSc, Thomas Mayrhofer PhD, Lauren H. Cooke MS, Evin Yucel MD, Nilay Patel MD, Marcel C. Langenbach MD, Nóra M. Kerkovits MD, Vencel Juhasz MD, Márton Kolossváry MD, PhD, Sara Ersözlü MD, Matthias Jung MD, Isabel L. Langenbach MD, Shady Abohashem MD, MPH, Vineet K. Raghu PhD, Brian Ghoshhajra MD, MBA, Sandeep Hedgire MD, Konstantin Nikolaou MD, Ahmed Tawakol MD, Michael T. Lu MD, MPH, Borek Foldyna MD, PhD","doi":"10.1016/j.jcmg.2026.03.004","DOIUrl":"10.1016/j.jcmg.2026.03.004","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"19 8","pages":"Pages 1010-1012"},"PeriodicalIF":19.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147636153","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":"Integrated Coronary CT Angiography Assessment of Plaque Vulnerability and Clinical Outcomes","authors":"Stefano Andreaggi MD,&nbsp;Riccardo Scalamera MD,&nbsp;Sekeun Kim PhD,&nbsp;Kyungsang Kim PhD,&nbsp;Iris McNulty RN,&nbsp;Hang Lee PhD,&nbsp;Damini Dey PhD,&nbsp;Jouke Dijkstra PhD,&nbsp;Adrian P. Banning MBChB, MD,&nbsp;Tsunekazu Kakuta MD, PhD,&nbsp;Ik-Kyung Jang MD, PhD","doi":"10.1016/j.jcmg.2026.04.017","DOIUrl":"10.1016/j.jcmg.2026.04.017","url":null,"abstract":"<div><h3>Background</h3><div>Invasive intracoronary imaging represents the gold standard for identifying vulnerable coronary plaques, but it is not suitable for widespread clinical use. Coronary computed tomography angiography (CTA) may offer a noninvasive alternative.</div></div><div><h3>Objectives</h3><div>This study aims to integrate coronary CTA–derived plaque morphology, pericoronary inflammation, and plaque burden into a unified morphology-inflammation-burden (MIB) score and to evaluate its association with plaque vulnerability and clinical outcomes.</div></div><div><h3>Methods</h3><div>Patients undergoing coronary CTA followed by optical coherence tomography (OCT) and intravascular ultrasound (IVUS) were followed for a median of 31 months. High-risk plaque, pericoronary adipose tissue attenuation, and total plaque burden (TPB) were quantified and compared with invasive imaging. A vulnerable lesion was defined as ≥2 vulnerability features on OCT.</div></div><div><h3>Results</h3><div>A total of 438 patients (median age 67 years) and 1,038 plaques were included; 45.4% presented with non–ST-segment elevation acute coronary syndrome. High-risk plaque, elevated pericoronary adipose tissue attenuation, and high TPB were independently associated with OCT-defined vulnerability (<em>P</em> &lt; 0.05 for all). TPB correlated with IVUS percent atheroma volume (Pearson’s <em>r</em> = 0.69; <em>P</em> &lt; 0.001). The MIB score demonstrated a stepwise increase in vulnerability, exceeding a predicted risk of 90% in the highest category. Vulnerable patients, defined by the presence of ≥1 untreated lesion with a high MIB score, had a significantly higher rate of cardiac death, acute coronary syndrome, or revascularization (15.3% vs 4.4%; <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>A coronary CTA–derived MIB score correlates with plaque vulnerability by intracoronary imaging and identifies patients at increased risk for adverse events. These findings support the value of coronary CTA for noninvasive risk stratification in clinical practice. (Massachusetts General Hospital and Tsuchiura Kyodo General Hospital Coronary Imaging Collaboration; <span><span>NCT04523194</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"19 8","pages":"Pages 955-966"},"PeriodicalIF":19.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264542","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":"Comparison of Photon-Counting and Energy-Integrating Computed Coronary Tomography Angiography for Coronary Artery Disease: A Systematic Review and Meta-Analysis.","authors":"Rakila Kurugalage,Arian Bhatia,Aditya Mukherjee,Gunaseelan K,Gemma A Figtree,Christina A Bursill,Damini Dey,Dennis T L Wong,Jessica A Marathe,Peter J Psaltis","doi":"10.1016/j.jcmg.2026.05.021","DOIUrl":"https://doi.org/10.1016/j.jcmg.2026.05.021","url":null,"abstract":"BACKGROUNDPhoton-counting detector (PCD)-computed tomography (CT) offers higher spatial resolution and spectral capability compared with energy-integrating (EID)-CT. In coronary computed tomography angiography (CTA), these features may mitigate calcium blooming, enhance stenosis quantification, limit stenosis overestimation, and reduce low-yield referrals to invasive coronary angiography (ICA).OBJECTIVESThis meta-analysis compared diagnostic outcomes between PCD-CT and EID-CT in adults with stable coronary artery disease undergoing coronary CTA.METHODSThe authors' protocol was preregistered and followed the PRISMA 2020 guidelines. Primary outcomes were vessel-level stenosis reclassification, downstream ICA referral, and revascularization rates among those referred. Where multiple studies with compatible definitions were available, random-effects meta-analysis was performed; otherwise, results were described narratively.RESULTSFifteen studies (N = 11,350) met inclusion criteria. At the vessel level, PCD-CT down-classified stenosis severity in a pooled absolute proportion of 34.2% of vessels compared with EID-CT (95% CI: 27.3-41.9; P < 0.0001). This was associated with fewer downstream ICA referrals (pooled OR: 0.71; 95% CI; 0.63-0.79; P < 0.0001) and higher rates of revascularization among those undergoing ICA (OR: 1.43; 95% CI: 1.14-1.79; P = 0.0017). Stratified by coronary artery calcium score (CACS), ICA referrals were lower with PCD-CT when CACS was <400 (OR: 0.62; 95% CI: 0.52-0.75; P < 0.0001) and trended lower when CACS ≥400 (OR: 0.42; 95% CI: 0.16-1.11; P = 0.08).CONCLUSIONSCompared against conventional EID-CT, PCD-CT was associated with down-classification of stenosis severity, translating to fewer referrals for ICA and a greater rate of revascularization when angiography is undertaken.","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"51 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148522177","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":"Understanding HFpEF Through Imaging: Strengths, Limitations, and Current State of the Art.","authors":"Tomonari Harada,Jwan A Naser,Fahime Ghanbari,Barry A Borlaug","doi":"10.1016/j.jcmg.2026.05.017","DOIUrl":"https://doi.org/10.1016/j.jcmg.2026.05.017","url":null,"abstract":"Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome characterized by dyspnea caused by hemodynamic congestion, which develops at rest or with exercise. Noninvasive diagnosis remains challenging, because resting diastolic pressures may be normal, and even when abnormal, currently applied noninvasive indices lack sensitivity. The pathophysiology of HFpEF extends far beyond diastolic dysfunction, and such complexity can be better understood through imaging. This State-of-the-Art Review emphasizes echocardiography and other noninvasive imaging approaches as the first-line tools for HFpEF evaluation, while linking multimodality imaging to invasive hemodynamics as a physiologic reference standard. The authors emphasize evidence-based, multiparametric assessment, where combined cardiopulmonary exercise testing with exercise stress echocardiography can quantify the diverse reserve limitations that characterize HFpEF, including cardiac and extracardiac contributors, atrial and right heart dysfunction, pulmonary vascular and ventilatory limitation, dynamic atrioventricular regurgitation, extrinsic restraint, pulmonary congestion, and peripheral impairments, acknowledging that such phenotyping must be anchored to actionable findings and evidence-based interventions. The authors describe the potential role of exercise cardiac magnetic resonance and artificial intelligence-enabled imaging analysis for phenotyping and risk stratification. Finally, the authors propose an echo-first Bayesian pathway that updates pretest to posttest probability and supports identification of patients in whom invasive hemodynamic exercise testing may be required to confirm the diagnosis and validate imaging markers against invasively measured congestion.","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"15 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148476178","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":"PET-Based Coronary Microvascular Dysfunction Phenotypes and Outcomes in Patients With Normal Myocardial Perfusion.","authors":"Yoshito Kadoya,Sayed Abdulmotaleb Almoosawy,Yousef Abumustafa,Ramtin Hakimjavadi,Shahin Sean Abtahi,Shihab Sarwar,Anahita Tavoosi,Gary R Small,Benjamin J W Chow,Terrence D Ruddy,Robert A deKemp,Rob Beanlands,Kevin Emery Boczar","doi":"10.1016/j.jcmg.2026.06.005","DOIUrl":"https://doi.org/10.1016/j.jcmg.2026.06.005","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"27 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148476177","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":"Biological, Radiological, and Clinical Significance of Spotty Calcification in Coronary Artery Disease","authors":"Sina Fathieh BMed, PhD,&nbsp;Michael P. Gray MPhil,&nbsp;Max Kirkby BPhil,&nbsp;Elijah Genetzakis PhD,&nbsp;Alireza Gholipour PhD,&nbsp;Christopher Poole PhD,&nbsp;Peter J. Psaltis MD, PhD,&nbsp;David E. Newby MD, PhD,&nbsp;Pamela S. Douglas MD,&nbsp;Ron Blankstein MD,&nbsp;Matthew J. Budoff MD,&nbsp;Kelley Branch MD, MS,&nbsp;Andrew J. Buckler PhD,&nbsp;Gemma A. Figtree MD, Oxon,&nbsp;Stuart M. Grieve MD, Oxon","doi":"10.1016/j.jcmg.2026.02.004","DOIUrl":"10.1016/j.jcmg.2026.02.004","url":null,"abstract":"<div><div>Spotty calcification is a marker of microcalcification in coronary artery plaques, where it becomes large enough to be visible on imaging modalities such as computed tomography. Two prevailing hypotheses posit spotty calcification as either a passive indicator of unstable plaque or an active catalyst of plaque vulnerability. Alongside this conceptual development, there has been paired evolution in radiologic characterization, with various imaging modalities demonstrating commendable accuracy in identifying spotty calcification. Many studies have linked the presence of spotty calcification to plaque instability and have reported a higher frequency in culprit lesions leading to acute coronary syndrome. Researchers have thus explored medications such as statins, metformin, and omega-3 fatty acids for their impact on the development and progression of spotty calcification. However, the field lacks standardized definitions that will enhance the clinical utility of this finding. This paper summarizes the evidence that describes spotty calcification as a unique plaque phenotype, its radiologic characteristics on routine cardiac imaging modalities, and its clinical relevance as a novel radiomarker of vulnerable coronary artery disease. This paper benefits from a systematic review of the evidence and, where possible, meta-analysis of the available data to address key questions conclusively in each of 3 areas of interest.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"19 7","pages":"Pages 857-880"},"PeriodicalIF":19.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483781","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":"Multimodal Imaging Improves Detection of Symptomatic Carotid Plaques With 3-Dimensional Ultrasound and Volumetric Computed Tomography","authors":"Simon Stemmler MD,&nbsp;Martin Soschynski MD,&nbsp;Martin Czerny MD,&nbsp;Matthias Siepe MD,&nbsp;Till Keller MD,&nbsp;Thomas Zeller MD,&nbsp;Christopher L. Schlett MD, MPH,&nbsp;Fabian Bamberg MD, MPH,&nbsp;Dirk Westermann MD, PhD,&nbsp;Roland-Richard Macharzina MD","doi":"10.1016/j.jcmg.2026.02.013","DOIUrl":"10.1016/j.jcmg.2026.02.013","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"19 7","pages":"Pages 894-896"},"PeriodicalIF":19.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147471355","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":"Epicardial Adipose Tissue Volume and Coronary Plaque Progression","authors":"Xinyu Nie MD,&nbsp;Zhihao Yang MD,&nbsp;Jason Zhensheng Qu MD,&nbsp;Zhifen Chen MD, PhD,&nbsp;Can Xu MD, PhD","doi":"10.1016/j.jcmg.2026.04.010","DOIUrl":"10.1016/j.jcmg.2026.04.010","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"19 7","pages":"Page 897"},"PeriodicalIF":19.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148393639","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":"Multimodality Image Integration of FDG-PET and CMR Into Electroanatomic Mapping Identifies Electrophysiologic Signatures of Myocardial Inflammation in Cardiac Sarcoidosis","authors":"Boldizsar Kovacs MD, MSc,&nbsp;Chaitanya Madamanchi MD,&nbsp;Venkatesh L. Murthy MD, PhD,&nbsp;Anil Attili MD,&nbsp;Michael Ghannam MD,&nbsp;Jackson Liang DO,&nbsp;Kelly Arps MD,&nbsp;Amrish Deshmukh MD,&nbsp;Hubert Cochet MD,&nbsp;Frederic Sacher MD,&nbsp;Mélèze Hocini MD,&nbsp;Pierre Jais MD,&nbsp;Rakesh Latchamsetty MD,&nbsp;Krit Jongnarangsin MD,&nbsp;Fred Morady MD,&nbsp;Frank Bogun MD","doi":"10.1016/j.jcmg.2026.01.010","DOIUrl":"10.1016/j.jcmg.2026.01.010","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"19 7","pages":"Pages 881-883"},"PeriodicalIF":19.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146219725","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}