JACC. Cardiovascular imaging最新文献

{"title":"Coronary Plaque Radiomic Phenotypes Predict Fatal or Nonfatal Myocardial Infarction","authors":"Márton Kolossváry MD, PhD ,&nbsp;Andrew Lin MBBS, BMedSc, PhD ,&nbsp;Jacek Kwiecinski MD, PhD ,&nbsp;Sebastien Cadet MS ,&nbsp;Piotr J. Slomka PhD ,&nbsp;David E. Newby MD, PhD ,&nbsp;Marc R. Dweck MD, PhD ,&nbsp;Michelle C. Williams MD, PhD ,&nbsp;Damini Dey PhD","doi":"10.1016/j.jcmg.2024.08.012","DOIUrl":"10.1016/j.jcmg.2024.08.012","url":null,"abstract":"<div><h3>Background</h3><div>Coronary computed tomography (CT) angiography–derived attenuation-based plaque burden assessments can identify patients at risk of myocardial infarction.</div></div><div><h3>Objectives</h3><div>This study sought to assess whether more detailed plaque morphology assessment using patient-based radiomic characterization could further enhance the identification of patients at risk of myocardial infarction during long-term follow-up.</div></div><div><h3>Methods</h3><div>Post hoc analysis of coronary CT angiography was performed within the SCOT-HEART (Scottish Computed Tomography of the HEART) clinical trial. Coronary plaque segmentations were used to calculate plaque burdens and eigen radiomic features that described plaque morphology. Univariable and multivariable Cox proportional hazard models were used to evaluate the association between clinical and image-based features and fatal or nonfatal myocardial infarction, whereas Harrell’s C-statistic and cumulative/dynamic area under the curve (AUC) values with cross-validation were used to evaluate prognostic performance.</div></div><div><h3>Results</h3><div>Scans from 1,750 patients (aged 58 ± 9 years; 56% male) were analyzed. Over a median of 8.6 years of follow-up, 82 patients had a fatal or nonfatal myocardial infarction. Among the eigen radiomic features, 15 were associated with myocardial infarction in univariable analysis, and 8 features retained their association following adjustment for cardiovascular risk score and plaque burden metrics. Adding plaque burden metrics to a clinical model incorporating cardiovascular risk score, Agatston score and presence of obstructive coronary artery disease had similar prediction performance (C-statistic 0.70 vs 0.70), whereas further addition of eigen radiomic features improved model performance (C-statistic 0.74). In temporal analysis, the model including eigen radiomic features had higher cumulative/dynamic AUC values following the fifth year of follow-up.</div></div><div><h3>Conclusions</h3><div>Radiomics-based precision phenotyping of coronary plaque morphology provided improvements to long-term prediction of myocardial infarction by CT angiography over and above clinical factors and plaque burden. (Scottish Computed Tomography of the HEART [SCOT-HEART]; <span><span>NCT01149590</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 3","pages":"Pages 308-319"},"PeriodicalIF":12.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545611","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":"Our Quest for the Holy Grail in Coronary Artery Disease","authors":"Armin Arbab-Zadeh MD, PhD, MPH","doi":"10.1016/j.jcmg.2024.10.012","DOIUrl":"10.1016/j.jcmg.2024.10.012","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 3","pages":"Pages 320-322"},"PeriodicalIF":12.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812979","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":"Long-Term Treatment With Mavacamten and Improved Left Atrial Strain in Obstructive Hypertrophic Cardiomyopathy","authors":"Hyun-Jung Lee MD, PhD,&nbsp;Geu-Ru Hong MD, PhD","doi":"10.1016/j.jcmg.2024.09.014","DOIUrl":"10.1016/j.jcmg.2024.09.014","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 3","pages":"Pages 263-265"},"PeriodicalIF":12.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785332","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 Intervention in Aortic Regurgitation","authors":"William A. Zoghbi MD,&nbsp;Maan Malahfji MD","doi":"10.1016/j.jcmg.2024.12.002","DOIUrl":"10.1016/j.jcmg.2024.12.002","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 3","pages":"Pages 275-277"},"PeriodicalIF":12.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535347","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 Imaging Trends: A Decade of Medicare Data.","authors":"Ahmed Sayed, Mahmoud Al Rifai, Maria Alwan, Ahmad El Yaman, Asim Shaikh, William Zoghbi, Mouaz H Al-Mallah","doi":"10.1016/j.jcmg.2024.12.011","DOIUrl":"https://doi.org/10.1016/j.jcmg.2024.12.011","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633909","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":"Association Between Physiological Significance and Vulnerable Plaque Characteristics in Patients With Myocardial Infarction: A Prospect II Substudy.","authors":"Ketina Arslani, Thomas Engstrøm, Michael Maeng, Lars Kjøller-Hansen, Akiko Maehara, Zhipeng Zhou, Ori Ben-Yehuda, Hans Erik Bøtker, Mitsuaki Matsumura, Gary S Mintz, Ole Fröbert, Jonas Persson, Rune Wiseth, Alf I Larsen, Lisette O Jensen, Jan E Nordrehaug, Øyvind Bleie, Elmir Omerovic, Claes Held, Stefan K James, Ziad A Ali, David Erlinge, Gregg W Stone","doi":"10.1016/j.jcmg.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.jcmg.2024.11.002","url":null,"abstract":"<p><strong>Background: </strong>Hemodynamically obstructive coronary plaques may contain more vulnerable plaque characteristics than nonobstructive lesions.</p><p><strong>Objectives: </strong>The authors aimed to assess whether pressure-wire-based physiologic indices in nonculprit lesions are associated with vulnerable plaque characteristics.</p><p><strong>Methods: </strong>In the PROSPECT II study, patients with recent myocardial infarction underwent coronary angiography and culprit lesion percutaneous coronary intervention plus combined near-infrared spectroscopy and intravascular ultrasound assessment of all 3 coronary arteries. Instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements were performed in intermediate lesions with angiographic stenosis >40%.</p><p><strong>Results: </strong>Among 898 patients, 319 angiographically intermediate lesions in 275 patients had matched intravascular ultrasound/near-infrared spectroscopy and FFR/iFR measurements; 96 (30.1%) lesions were physiologically significant (FFR ≤0.80 or iFR ≤0.89) and 223 (69.9%) were not. Physiologically significant lesions, compared with those that were not, more likely had a minimal lumen area ≤4.0 mm² (96.9% vs 83.9%), plaque burden ≥70% (92.7% vs 71.3%) and maximum lipid core burden index in any 4 mm segment of the lesion ≥324.7 (57.0% vs 45.4%). By multivariable analysis, lesion location in the left anterior descending artery, small minimal lumen area, and larger plaque burden were independently associated with physiologic significance, whereas maximum lipid core burden index in any 4 mm segment of the lesion was not.</p><p><strong>Conclusions: </strong>In patients with recent myocardial infarction, angiographically intermediate but physiologically significant coronary lesions were more likely to have high-risk vulnerable plaque features compared with nonphysiologically significant stenoses. However, coronary lesions without physiological significance also had a moderate-to-high prevalence of high-risk plaque characteristics, which may explain the residual risk associated with conservative noninterventional management of these lesions. (Providing Regional Observations to Study Predictors of Events in the Coronary Tree II [PROSPECT II]; NCT02171065).</p>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492142","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":"Guideline-Directed Application of Coronary Artery Calcium Scores for Primary Prevention of Atherosclerotic Cardiovascular Disease.","authors":"Jelena Pavlović, Daniel Bos, M Kamran Ikram, M Arfan Ikram, Maryam Kavousi, Maarten J G Leening","doi":"10.1016/j.jcmg.2024.12.008","DOIUrl":"https://doi.org/10.1016/j.jcmg.2024.12.008","url":null,"abstract":"<p><strong>Background: </strong>The 2018 ACC (American College of Cardiology)/AHA (American Heart Association) and 2021 ESC (European Society of Cardiology)/EAS (European Atherosclerosis Society) guidelines recommend coronary artery calcium (CAC) score for risk refinement in primary prevention of atherosclerotic cardiovascular disease (ASCVD).</p><p><strong>Objectives: </strong>The study sought to compare CAC utility as a risk-refining tool following the ACC/AHA guideline using pooled cohort equations (PCE) or PREVENT (Predicting Risk of cardiovascular disease EVENTs) equations and ESC/EAS guideline using SCORE2 (Systematic COronary Risk Evaluation 2).</p><p><strong>Methods: </strong>A total of 1,903 statin-naive participants 55 to 75 years of age, free of ASCVD and diabetes, with low-density lipoprotein cholesterol <190 mg/dL from the prospective population-based Rotterdam Study were included. Per the guidelines, we determined proportions of CAC scan-eligible and reclassified men and women, ASCVD incidence rates, and numbers needed to treat for 10 years (NNT_10y).</p><p><strong>Results: </strong>By the ACC/AHA (PCE), 18.3% of men and 11.9% of women, and by ACC/AHA (PREVENT), 13.4% of men and 3.4% of women were eligible for a CAC scan. By the ESC/EAS, 46.6% of men and 44.9% of women were CAC eligible. Proportions of uprisked and derisked individuals varied per guideline. Among ACC/AHA and ESC/EAS CAC-eligible individuals, incidence rates ranged from 9.3 to 23.8 per 1,000 person-years, and the estimated NNT_10y to prevent 1 ASCVD event, based on high-intensity statin use, varied from 11 to 26.</p><p><strong>Conclusions: </strong>The ACC/AHA and ESC/EAS guidelines differ in the selection and application of the CAC score for primary prevention of ASCVD. Guideline-directed application of CAC score in a middle-aged apparently healthy population improved risk stratification at an acceptable NNT_10y for both guidelines.</p>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567061","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":"Development of Imaging Endpoints for Clinical Trials in AL and ATTR Amyloidosis: Proceedings of the Amyloidosis Forum.","authors":"Sharmila Dorbala, Rosalyn Adigun, Kevin M Alexander, Michela Brambatti, Sarah A M Cuddy, Angela Dispenzieri, Preston Dunnmon, Michele Emdin, Omar F Abou Ezzeddine, Rodney H Falk, Mariana Fontana, Justin L Grodin, Spencer Guthrie, Michael Jerosch-Herold, A Alex Hofling, Kristen Hsu, Grace Lin, Ahmad Masri, Mathew S Maurer, Clemens Mittmann, Krishna Prasad, Cristina C Quarta, Jean-Michel Race, Joseph G Rajendran, Frederick L Ruberg, Vandana Sachdev, Vaishali Sanchorawala, James Signorovitch, Christophe Sirac, Prem Soman, Jens Sorensen, Brett W Sperry, Andrew W Stephens, Norman L Stockbridge, John Vest, Jonathan S Wall, Ashutosh Wechalekar, Cynthia Welsh, Isabelle Lousada","doi":"10.1016/j.jcmg.2024.11.003","DOIUrl":"https://doi.org/10.1016/j.jcmg.2024.11.003","url":null,"abstract":"<p><p>Light chain amyloidosis and transthyretin amyloidosis are rare protein misfolding disorders characterized by amyloid deposition in organs, varied clinical manifestations, and poor outcomes. Amyloid fibrils trigger various signaling pathways that initiate cellular, metabolic, structural, and functional changes in the heart and other organs. Imaging modalities have advanced to enable detection of amyloid deposits in involved organs and to assess organ dysfunction, disease stage, prognosis, and treatment response. The Amyloidosis Forum hosted a hybrid meeting to focus on the use of imaging endpoints in clinical trials for systemic immunoglobulin light chain amyloidosis and transthyretin amyloidosis. Stakeholders from academia and industry, together with representatives from multiple regulatory agencies reviewed the use of imaging biomarkers with a focus on cardiac amyloidosis, described applications and limitations of imaging in clinical trials, and discussed qualification of imaging as a surrogate clinical outcome. Survey results provided important patient perspectives. This review summarizes the proceedings of the Amyloidosis Forum.</p>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476597","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":"The Double Dyssynchrony Paradox: When Cardiac Discord Signals Hope.","authors":"Joost Lumens","doi":"10.1016/j.jcmg.2025.01.003","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.01.003","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523306","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":"Vulnerable or High-Risk Plaque: A JACC: Cardiovascular Imaging Position Statement.","authors":"Rocco Vergallo, Seung-Jung Park, Gregg W Stone, David Erlinge, Italo Porto, Ron Waksman, Gary S Mintz, Fabrizio D'Ascenzo, Sara Seitun, Luca Saba, Rozemarijn Vliegenthart, Fernando Alfonso, Armin Arbab-Zadeh, Peter Libby, Marcelo F Di Carli, James E Muller, Gerald Maurer, Robert J Gropler, Y S Chandrashekhar, Eugene Braunwald, Valentin Fuster, Ik-Kyung Jang","doi":"10.1016/j.jcmg.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.jcmg.2024.12.004","url":null,"abstract":"<p><p>The concept of high-risk plaque emerged from pathologic and epidemiologic studies 3 decades ago that demonstrated plaque rupture with thrombosis as the predominant mechanism of acute coronary syndrome and sudden cardiac death. Thin-cap fibroatheroma, a plaque with a large lipidic core covered by a thin fibrous cap, is the prototype of the rupture-prone plaque and has been traditionally defined as \"vulnerable plaque.\" Although knowledge on the pathophysiology of plaque instability continues to grow, the risk profile of our patients has shifted and the character of atherosclerotic disease has evolved, partly because of widespread use of lipid-lowering therapies and other preventive measures. In vivo intracoronary imaging studies indicate that superficial erosion causes up to 40% of acute coronary syndromes. This changing landscape calls for broader perspective, expanding the concept of high-risk plaque to the precursors of all major substrates of coronary thrombosis beyond plaque rupture. Other factors to take into consideration include dynamic changes in plaque composition, the importance of plaque burden, inflammatory activation (both local and systemic), healing mechanisms, regional hemodynamic pattern, properties of the fluid phase of blood, and the amount of myocardium at risk subtended by a lesion. Rather than the traditional focus limited to the thin-cap fibroatheroma, the authors advocate a more comprehensive approach that considers both morphologic features and biological activity of plaques and blood. This position paper highlights the challenges to the usual concept of high-risk plaque, proposes a broader definition, and analyzes its key morphologic features, the technological progress of plaque imaging (particularly using intracoronary imaging techniques), advances in pharmacologic therapies for plaque regression and stabilization, and the feasibility and efficacy of focal interventional treatments including preemptive plaque sealing.</p>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523372","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}