JACC. Cardiovascular imaging最新文献

{"title":"The Key Role of Diagnostic Imaging in Early HFpEF","authors":"Hidenori Yaku MD, PhD,&nbsp;Sanjiv J. Shah MD","doi":"10.1016/j.jcmg.2025.05.016","DOIUrl":"10.1016/j.jcmg.2025.05.016","url":null,"abstract":"<div><div>Heart failure with preserved ejection fraction (HFpEF) is a prevalent, costly, and highly morbid syndrome that affects more than one-half of all patients with heart failure. For patients with HFpEF, it is crucial to identify patients as early as possible in stage C for prompt diagnosis and intervention. However, detecting HFpEF in its early stage can be challenging without suspecting its potential, particularly in cases without overt volume overload or those with elevated left atrial pressure only during exercise (ie, early stage C HFpEF). Consequently, it has become increasingly important to investigate and understand early HFpEF in greater detail, with the overall goal of reducing the burden of overt and advanced stage C HFpEF in the population. The authors provide a comprehensive update on the epidemiology, pathogenesis, diagnostic testing, and management of the early stage of HFpEF, with a particular focus on diagnostic imaging.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 10","pages":"Pages 1145-1160"},"PeriodicalIF":15.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747823","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":"Concomitant Takotsubo Cardiomyopathy and Spontaneous Coronary Artery Dissection","authors":"Ghasaq Saleh MD ,&nbsp;Abdullah Al-Abcha MD ,&nbsp;Karam Chaaban MD ,&nbsp;Mahmoud Zhour Adi MD ,&nbsp;Marysia Tweet MD ,&nbsp;Jeremy D. Collins MD ,&nbsp;Mohamad Alkhouli MD, MBA ,&nbsp;Rajiv Gulati MD, PhD","doi":"10.1016/j.jcmg.2025.05.020","DOIUrl":"10.1016/j.jcmg.2025.05.020","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 10","pages":"Pages 1161-1166"},"PeriodicalIF":15.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775387","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":"Unmasking the High-Risk Heart in Aortic Regurgitation","authors":"Lei Xu PhD,&nbsp;Wenzhe Zhao PhD","doi":"10.1016/j.jcmg.2025.06.021","DOIUrl":"10.1016/j.jcmg.2025.06.021","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 10","pages":"Page 1179"},"PeriodicalIF":15.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145229831","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":"Guiding Automated Implementation Strategies for Patients With Atherosclerotic Plaque on Coronary Computed Tomographic Angiography","authors":"Sarah Rinehart MD ,&nbsp;Ron Blankstein MD ,&nbsp;James L. Januzzi MD ,&nbsp;Cian McCarthy MD ,&nbsp;Markus Scherer MD ,&nbsp;Wesley T. O’Neal MD, MPH ,&nbsp;Sarah Mullen MBT ,&nbsp;Campbell Rogers MD ,&nbsp;Leslee J. Shaw PhD ,&nbsp;DECIDE Investigators","doi":"10.1016/j.jcmg.2025.03.019","DOIUrl":"10.1016/j.jcmg.2025.03.019","url":null,"abstract":"<div><h3>Background</h3><div>Approximately half of the patients with abnormal findings have no minimal changes in clinical management after stress testing.</div></div><div><h3>Objectives</h3><div>The primary aim of this study is to assess changes in preventive and anti-ischemic care for stable patients with atherosclerotic plaque on coronary computed tomographic angiography (CTA).</div></div><div><h3>Methods</h3><div>Projected enrollment is 20,000 patients (∼40 sites) who underwent diagnostic testing for suspected or known coronary artery disease. Changes in medical therapy (dosing and type) and coronary revascularization will be collected through an automated electronic health record data extraction through 1 year of follow-up. In select subgroups, artificial intelligence–enabled quantitative measures of coronary atherosclerotic plaque (QCPA) will be provided promptly or delayed by 90 days, such that prompt decisions guided by coronary artery disease stenosis alone can be compared with QCPA-guided treatment.</div></div><div><h3>Results</h3><div>A total of 6 care pathways will be evaluated: 1) <em>no</em> QCPA is provided (usual testing); 2) QCPA is provided but <em>delayed</em> and subsequently incorporated into a revised final report to guide patient management; 3) <em>immediate</em> QCPA is provided in nonrevascularized patients; 4) immediate QCPA is provided to patients with prior stenting in 1 vessel; 5) <em>immediate</em> QCPA is provided to asymptomatic patients referred for coronary CTA; and 6) patients referred to <em>stress testing</em> with no coronary CTA (ie, the comparator).</div></div><div><h3>Conclusions</h3><div>The DECIDE (DErived Plaque Quantification: CCTA and AI-QCPA for Determining Effective CAD management) study will enroll and characterize a broad spectrum of patients who require initiation and intensification of preventive care. The authors will use efficient and automated systems to evaluate the impact of quantitative atherosclerotic plaque measurement on preventive care that will help guide implementation strategies to improve outcomes for patients undergoing coronary CTA.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 10","pages":"Pages 1107-1115"},"PeriodicalIF":15.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645811","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":"Staging of Cardiac Adverse Remodeling in Moderate or Severe Aortic Regurgitation","authors":"Maan Malahfji MD ,&nbsp;Duc T. Nguyen MD, PhD ,&nbsp;Priyanka Bhugra MD ,&nbsp;Valentina Crudo MD ,&nbsp;Mujtaba Saeed MD ,&nbsp;Sachin S. Goel MD ,&nbsp;Michael J. Reardon MD ,&nbsp;Neal S. Kleiman MD ,&nbsp;William A. Zoghbi MD ,&nbsp;Edward A. Graviss PhD ,&nbsp;Dipan J. Shah MD","doi":"10.1016/j.jcmg.2025.04.010","DOIUrl":"10.1016/j.jcmg.2025.04.010","url":null,"abstract":"<div><h3>Background</h3><div>A recently proposed staging system for cardiac structural and functional abnormalities demonstrated incremental prognostic value in aortic stenosis.</div></div><div><h3>Objectives</h3><div>The authors investigate a staging system incorporating cardiac magnetic resonance (CMR) in moderate or severe aortic regurgitation (AR).</div></div><div><h3>Methods</h3><div>Patients prospectively enrolled in DEBAKEY-CMR (DeBakey Cardiovascular Magnetic Resonance Study; <span><span>NCT04281823</span><svg><path></path></svg></span>) between 2009 and 2020 who had moderate or severe AR by CMR were studied. We excluded patients with a primary cardiomyopathy (eg, hypertrophic cardiomyopathy, amyloidosis, sarcoidosis) or prior valve intervention. The stages were defined as stage 0: no cardiac remodeling; stage 1: left ventricular (LV) remodeling; stage 2: mitral valve or left atrial abnormalities; and stage 3: right heart remodeling. The outcome was all-cause mortality.</div></div><div><h3>Results</h3><div>The authors studied 395 patients, median age 62 years (Q1-Q3: 51-72 years); 79.2% were male, and 25.8% had bicuspid aortic valve. Thirty-two patients (8.10%) were classified as stage 0, 146 (37.0%) as stage 1, 77 (19.5%) as stage 2, and 140 (35.4%) as stage 3. Over a mean follow-up period of 3.9 ± 2.9 years, the annualized mortality rate was 0.68% per year in stage 0, 2.25% per year in stage 1, 3.76% per year in stage 2, and 7.25% per year in stage 3 (<em>P</em> for trend of mortality &lt;0.001). The extent of cardiac remodeling was independently associated with increased hazard for mortality (adjusted HR: 1.69 per increment of stage [95% CI: 1.28-2.23]; <em>P &lt;</em> 0.001) after adjusting for regurgitation severity, aortic valve replacement (AVR), and EuroSCORE II (European System for Cardiac Operative Risk Evaluation). Patients with right heart remodeling had the highest hazard for events.</div></div><div><h3>Conclusions</h3><div>A cardiac remodeling staging system incorporating CMR findings provides incremental prognostication in AR after adjusting for surgical risk, AVR, and regurgitation severity. Right heart remodeling in AR was associated with the highest mortality. Further research can determine whether the staging system could aid in guiding patient management and the timing of intervention.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 10","pages":"Pages 1093-1103"},"PeriodicalIF":15.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775389","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":"Observe, Treat, Adhere","authors":"Kelley R.H. Branch MD, MSc,&nbsp;Sumeet Brar MD, MPH","doi":"10.1016/j.jcmg.2025.08.003","DOIUrl":"10.1016/j.jcmg.2025.08.003","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 10","pages":"Pages 1128-1130"},"PeriodicalIF":15.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145229827","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":"Of Invasive Hemodynamics, Shear Waves, and Echocardiography","authors":"Sorin V. Pislaru MD, PhD,&nbsp;Cristina Pislaru MD","doi":"10.1016/j.jcmg.2025.06.014","DOIUrl":"10.1016/j.jcmg.2025.06.014","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 10","pages":"Pages 1090-1092"},"PeriodicalIF":15.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144824936","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":"Full issue PDF","authors":"","doi":"10.1016/S1936-878X(25)00507-8","DOIUrl":"10.1016/S1936-878X(25)00507-8","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 10","pages":"Pages I-CXVII"},"PeriodicalIF":15.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145229830","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 Paroxysmal to Persistent Atrial Fibrillation","authors":"Yuji Zhang MD ,&nbsp;Yufeng Chen MD ,&nbsp;Jia Guo MD ,&nbsp;Fangran Xin MD ,&nbsp;Ming Liang MD ,&nbsp;Zongtao Yin MD ,&nbsp;Jinsong Han MD ,&nbsp;Keyan Zhao MD ,&nbsp;Jian Zhang MD ,&nbsp;Guannan Liu MD ,&nbsp;Guoxu Zhang MD ,&nbsp;Zulu Wang MD ,&nbsp;David G. Benditt MD ,&nbsp;Sunny S. Po MD, PhD ,&nbsp;Huishan Wang MD","doi":"10.1016/j.jcmg.2025.03.013","DOIUrl":"10.1016/j.jcmg.2025.03.013","url":null,"abstract":"<div><h3>Background</h3><div>The path from paroxysmal to persistent atrial fibrillation (AF) is still poorly understood, leading to suboptimal treatment outcomes.</div></div><div><h3>Objectives</h3><div><span>In this study, the authors sought to investigate the level of fibrosis<span> in different stages of AF with the use of </span></span>¹⁸<span>F-labeled aluminum fluoride<span> (AlF) targeting fibroblast activation protein inhibitor (FAPI) positron emission tomography (PET)–magnetic resonance imaging (MRI).</span></span></div></div><div><h3>Methods</h3><div>A total of 78 patients with AF and 49 health volunteers were enrolled in this study. All participants received FAPI-PET-MRI. Measurement of positive ratios and the proportion was performed in various regions of the left atrium<span> posterior wall (LAPW), the atrial septum<span>, anterior wall, appendage, and roof. Patients were categorized into paroxysmal (PAF), persistent (PsAF), and permanent (PmAF) AF groups based on 7-day ambulatory monitoring and history. Another cohort of 36 patients undergoing cardiac surgery, with 124 fragments of image-guided tissue, consented to biopsy during cardiac surgery for histology examinations.</span></span></div></div><div><h3>Results</h3><div><span><span>The positive ratio for fibrosis was significantly higher in the PsAF and PmAF groups compared with the </span>PAF and healthy volunteer groups across all atrial regions (</span><em>P &lt;</em><span><span> 0.05). The LAPW showed the highest level of fibrosis. The AUC for the positive ratio was 0.991 to differentiate PAF from PsAF in the LA (cutoff: 0.072), and 0.983 in the LAPW (cutoff: 0.025). Between PsAF and </span>PmAF, the AUC was 0.756 in the LA (cutoff: 0.382). Histologic analysis demonstrated an increased area of fibrotic deposition in regions with increased </span>¹⁸F-FAPI uptake.</div></div><div><h3>Conclusions</h3><div>LAPW fibrosis may be an important factor in the progression from PAF to PsAF. (A Single-Center, Prospective, Cohort Study on the Clinical Application of ¹⁸<span>F-FAPI PET Imaging in Atrial Fibrillation; </span><span><span>ChiCTR2300075806</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 10","pages":"Pages 1131-1144"},"PeriodicalIF":15.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496724","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":"Prediction of Left Ventricular Filling Pressures Using Natural Shear Waves","authors":"Annegret Elisabeth Werner MD ,&nbsp;Stéphanie Bézy MSc, PhD ,&nbsp;Laurine Wouters MSc ,&nbsp;Marta Orlowska MSc, PhD ,&nbsp;Jürgen Duchenne MSc, PhD ,&nbsp;Marcus Ingram MSc, PhD ,&nbsp;Keir McCutcheon MD, PhD ,&nbsp;Maarten Vanhaverbeke MD, PhD ,&nbsp;Youri Bekhuis MD ,&nbsp;Lennert Minten MD, PhD ,&nbsp;Walter Desmet MD, PhD ,&nbsp;Marion Delcroix MD, PhD ,&nbsp;Johan Van Cleemput MD, PhD ,&nbsp;Hüseyin Ince MD, PhD ,&nbsp;Jan D’hooge MSc, PhD ,&nbsp;Jens-Uwe Voigt MD, PhD","doi":"10.1016/j.jcmg.2025.04.009","DOIUrl":"10.1016/j.jcmg.2025.04.009","url":null,"abstract":"<div><h3>Background</h3><div>Increased myocardial stiffness can lead to diastolic dysfunction, resulting eventually in increased left ventricular filling pressures (LVFPs). The clinical assessment of left ventricular (LV) diastolic function is challenging. Shear wave elastography is a novel method based on tracking shear waves, such as those induced by mitral valve closure (MVC), using high frame rate (HFR) echocardiography. The propagation velocity of shear waves is directly related to myocardial stiffness.</div></div><div><h3>Objectives</h3><div>This study investigated whether shear wave velocity at MVC is related to invasively measured LVFP.</div></div><div><h3>Methods</h3><div>Eighty-five patients were prospectively enrolled. Left ventricular mid-diastolic pressure (LVMDP) and left ventricular end-diastolic pressure (LVEDP) were invasively measured. HFR (average frame rate: 1,050 ± 220 Hz) and conventional echocardiography were performed immediately after catheterization. Shear wave velocity at MVC was measured in the anteroseptal wall. The findings were compared with conventional echocardiographic parameters and the multiparametric 2021 guideline-recommended algorithm for the estimation of LVFP. The direct response of shear wave velocity at MVC on changing LV filling pressures was tested in a group of 16 patients with acutely decompensated heart failure (DHF) on admission and after diuretic therapy.</div></div><div><h3>Results</h3><div>Single conventional echocardiographic parameters correlated moderately with LVFP (Pearson <em>r</em> between 0.39 and 0.58) and had a moderate ability to detect elevated LVFP (AUC between 0.66 and 0.79). This was similar for the multiparametric guideline algorithm (LVMDP AUC: 0.78; LVEDP AUC: 0.60). In comparison, shear wave velocities at MVC as a single measure correlated strongly with LVEDP (<em>r</em> = 0.71; <em>P</em> &lt; 0.001) and had an similar ability to predict elevated LVMDP (AUC: 0.79; sensitivity: 87%; specificity: 65%) and an excellent ability to predict elevated LVEDP (AUC: 0.95; sensitivity: 92%; specificity: 94%) when a cutoff value of 4.8 m/s was used. In DHF patients, we observed a significant decrease in shear wave velocity after diuretic therapy (7.1 ± 1.7 m/s vs 5.3 ± 1.3 m/s; <em>P &lt;</em> 0.002).</div></div><div><h3>Conclusions</h3><div>In comparison with the multivariable guideline approach, end-diastolic shear wave velocity as a single measure had similar accuracy in detecting elevated LVMDP and a higher accuracy for LVEDP. Shear wave elastography might therefore be a promising new tool for the noninvasive assessment of diastolic function.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 10","pages":"Pages 1071-1089"},"PeriodicalIF":15.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753412","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}