JACC. Cardiovascular imaging最新文献

{"title":"Disease Progression in Exercise-Induced Arrhythmogenic Cardiomyopathy Compared With Arrhythmogenic Right Ventricular Cardiomyopathy.","authors":"Linda T Aaserud, Christine Rootwelt-Norberg, Paul A S Olsen, Christian K Five, Anna I Castrini, Eivind W Aabel, Kristina H Haugaa, Øyvind H Lie","doi":"10.1016/j.jcmg.2025.03.018","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.03.018","url":null,"abstract":"<p><strong>Background: </strong>Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inheritable heart disease, whereas exercise-induced arrhythmogenic cardiomyopathy (EiAC) is a proposed acquired similar phenotype in athletes. The differences in disease progression between these entities are not well understood.</p><p><strong>Objectives: </strong>This study aims to assess structural, functional, and arrhythmic disease progression in EiAC compared with ARVC.</p><p><strong>Methods: </strong>This longitudinal cohort study included EiAC patients who were competitive endurance athletes (>24 MET-hours/week for >6 consecutive years) referred due to ventricular arrhythmias (VA), without inherited or genetic factors or other evident causes, and genotype-positive ARVC patients with a definite diagnosis and their genotype-positive family members for comparison. Disease progression was assessed by repeated echocardiographic examinations and incident VA during long-term follow-up.</p><p><strong>Results: </strong>The authors included 125 ARVC patients (61 women, aged 38 ± 17 years) and 41 EiAC patients (6 women, aged 45 ± 13 years) and followed them for 96 months (Q1-Q3: 73-132 months) and 82 months (Q1-Q3: 50-118 months), respectively. The authors analyzed 730 echocardiographic examinations (538 ARVC, 192 EiAC). Right ventricular (RV) structure and function remained stable in EiAC patients, whereas those in ARVC patients deteriorated during follow-up. The 5-year and 10-year cumulative incidences of VA were similar between EiAC and ARVC patients.</p><p><strong>Conclusions: </strong>RV structure and function deteriorated in ARVC patients but remained stable in EiAC patients during follow-up. The incidence of VA was high in both populations. These results indicate that EiAC patients should be followed closely over time regardless of structural and functional progression.</p>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600454","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 Prognosis by Stress ECG and Stress Imaging: Results From the ISCHEMIA Trial.","authors":"Leslee J Shaw, Lawrence M Phillips, Jonathon Leipsic, Samuel Broderick, Jennifer H Mieres, Thomas H Marwick, Matthias G Friedrich, Todd Miller, Renato D Lopes, Benjamin Chow, Rodrigo Cerci, Ron Blankstein, Marcelo DiCarli, David J Maron, Judith S Hochman, Karen P Alexander, Gregg W Stone, Sean O'Brien, Bernard R Chaitman, Raymond Y Kwong, Michael H Picard, Daniel S Berman, Harmony R Reynolds","doi":"10.1016/j.jcmg.2025.03.016","DOIUrl":"10.1016/j.jcmg.2025.03.016","url":null,"abstract":"<p><strong>Background: </strong>Limited contemporary evidence exists on risk prediction by stress imaging and exercise electrocardiography (ECG) among patients with chronic coronary syndromes (CCS). Objectives From the ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) study, prognosis was examined by core laboratory-defined stress imaging and exercise ECG findings in CCS patients.</p><p><strong>Methods: </strong>A total of 5,179 patients (qualifying by stress nuclear imaging [n = 2,567], echocardiography [n = 1,085], cardiac magnetic resonance [CMR] [n = 257], and ECG [n = 1,270]) were randomized. Cox models assessed associations between trial endpoints and the number of scarred and ischemic segments, rest/stress left ventricular ejection fraction (LVEF), and ST-segment depression. HRs and 95% CIs were calculated per millimeter, segment, or 5% of LVEF. We examined prognostic models for the following trial endpoints: 1) the trial's primary endpoint of cardiovascular (CV) death, myocardial infarction (MI), resuscitated cardiac arrest, or hospitalization for unstable angina or heart failure; 2) CV death; 3) spontaneous MI; 4) procedural MI; and 5) type 2 MI.</p><p><strong>Results: </strong>The number of scarred segments (HR: 1.07 [95% CI: 1.02-1.13]; P = 0.0209), rest LVEF (HR: 0.88 [95% CI: 0.83-0.93]; P < 0.001), and stress LVEF (HR: 0.87 [95% CI: 0.83-0.91]; P < 0.001) predicted the trial's primary endpoint of CV death, MI, resuscitated cardiac arrest, or hospitalization for unstable angina or heart failure. The extent of scar and rest/stress LVEF on echocardiography and nuclear imaging predicted several trial endpoints. The number of ischemic segments predicted spontaneous (HR: 1.08 [95% CI: 1.03-1.14]; P = 0.0104) and procedural MI (HR: 1.14 [95% CI: 1.03-1.25]; P = 0.0015) but was of borderline significance for the trial's primary endpoint (P = 0.0746). Ischemia extent by CMR predicted the trial's primary endpoint (P = 0.0068) and spontaneous MI (P = 0.0042).</p><p><strong>Conclusions: </strong>ISCHEMIA trial findings from 320 worldwide centers revealed that stress imaging and exercise ECG measures exhibited a variable association with key trial endpoints delineating risk patterns for ischemia and infarction. Stress CMR ischemia predicted several trial endpoints, supporting an expanded role in the evaluation of patients with CCS (ISCHEMIA [International Study of Comparative Health Effectiveness With Medical and Invasive Approaches]; NCT01471522).</p>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12252255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600432","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":"Myocardial Scar and Arrhythmic Risk Stratification in Ischemic Left Ventricular Systolic Dysfunction.","authors":"Holly Morgan, Amedeo Chiribiri, Muhummad Sohaib Nazir, Hassan Zaidi, Jennifer Mancio, Ebraham Alskaf, Matthew Dodd, Martin Bishop, Christopher Aldo Rinaldi, Divaka Perera","doi":"10.1016/j.jcmg.2025.05.012","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.05.012","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600455","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":"Uncertain Clinical Relevance of Serial Bone Scintigraphy Findings in Treated Transthyretin Amyloid Cardiomyopathy.","authors":"Yousuf Razvi, Aldostefano Porcari, David F Hutt, Jonathan Lazari, Adam Ioannou, Rishi K Patel, Muhammad Umaid Rauf, Tamer Rezk, Oliver Hague, Stefano Filisetti, Helen J Lachmann, Ashutosh D Wechalekar, Aviva Petrie, Carol J Whelan, Lucia Venneri, Ana Martinez-Naharro, Janet A Gilbertson, Dorota Rowczenio, William E Moody, Richard Steeds, Jennifer H Pinney, Philip N Hawkins, Marianna Fontana, Julian D Gillmore","doi":"10.1016/j.jcmg.2025.03.014","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.03.014","url":null,"abstract":"<p><strong>Background: </strong>Technetium-99m-labeled 3,3-diphosphono-1,2-propanodicarboxylic acid (^99mTc-DPD) scintigraphy is a critical part of the validated nonbiopsy diagnostic algorithm for transthyretin amyloid cardiomyopathy (ATTR-CM). With the advent of novel disease-modifying therapies for ATTR-CM, there is intense interest in establishing the utility of DPD scans as an indicator of treatment response.</p><p><strong>Objectives: </strong>The authors conducted a retrospective multimodality imaging study to determine the utility of ^99mTc-DPD to track treatment response in ATTR-CM.</p><p><strong>Methods: </strong>ATTR-CM patients from the United Kingdom National Amyloidosis Centre who were receiving amyloid-specific disease-modifying therapy (DMT) and underwent pre- and post-treatment ^99mTc-DPD/single-photon emission computed tomography-computed tomography scans were included. Myocardial percentage injected dose (PID), a proposed scintigraphic indicator of cardiac amyloid burden, was measured at baseline and follow-up. Change from baseline in this variable was compared with that of other validated biomarkers of disease severity.</p><p><strong>Results: </strong>A total of 66 patients with ATTR-CM who received DMT underwent serial ^99mTc-DPD scans. At follow-up, with a median time between ^99mTc-DPD scans of 27.5 months (Q1-Q3: 21.9-33.1 months), there was a mean reduction from pre-DMT myocardial PID on ^99mTc-DPD scintigraphy of 1.5 ± 1.5%. No statistically significant correlation between the change in PID at follow-up and change in echocardiographic, biochemical, or cardiac magnetic resonance parameters was identified. Discordance in which there was an improvement on follow-up ^99mTc-DPD scintigraphy despite disease progression was observed in 28/66 patients (42.4%).</p><p><strong>Conclusions: </strong>Our study indicates a poor correlation between reduction in ^99mTc-DPD uptake at follow-up and numerous established biomarkers of ATTR-CM treatment response. Changes in DPD uptake in ATTR-CM patients receiving DMT should be interpreted with caution.</p>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600457","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":"Focal Takotsubo Syndrome: Prevalence and Patterns Distribution.","authors":"Francesco Santoro,Luca Arcari,Iván J Núñez Gil,Ilaria Ragnatela,Nicola Di Nunno,Ibrahim El-Battrawy,Federico Guerra,Giuseppina Novo,Beatrice Musumeci,Luca Cacciotti,Enrica Mariano,Giuseppe Parisi,Roberta Montisci,Maria Francesca Marchetti,Damiano D'Alessandro,Francesco Paolo Niglio,Annalisa Matera,Matteo Gravina,Aitor Uribarri,Fernando Alfonso,Hernan Mejía,Emilia Blanco-Ponce,Miguel Corbí-Pascual,Ibrahim Akin,Holger Thiele,Ingo Eitel,Thomas Stiermaier,Natale Daniele Brunetti","doi":"10.1016/j.jcmg.2025.05.015","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.05.015","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"36 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547969","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":"Tricuspid Valve Transcatheter Edge-to-Edge Repair in Challenging Scenarios: Role of Imaging for Guidance.","authors":"Lucy M Safi,Gilbert H L Tang,Parasuram Krishnamoorthy,Annapoorna S Kini,Samin K Sharma,Sahil Khera,Stamatios Lerakis","doi":"10.1016/j.jcmg.2025.05.013","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.05.013","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"21 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144488073","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":"Nonischemic Septal Fibrosis in Functional Tricuspid Regurgitation Provides Incremental Stratification of Adverse Remodeling and Prognosis.","authors":"Pablo Villar-Calle,Varun Pai,Robert S Zhang,Mahniz Reza,Lily Jin,Rachel Axman,Zachary Falk,Giorgia Falco,Arindam RoyChoudhury,Shmuel Chen,Bobak Mosadegh,Susheel K Kodali,Omar K Khalique,Evelyn M Horn,Jonathan W Weinsaft,Jiwon Kim","doi":"10.1016/j.jcmg.2025.03.015","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.03.015","url":null,"abstract":"BACKGROUNDFunctional tricuspid regurgitation (TR) arises from impaired valve integrity resulting from contractile dysfunction, chamber dilation, or myocardial tissue alterations. Whereas right ventricular (RV) dysfunction is a recognized driver of adverse outcomes in TR, the impact of myocardial tissue injury, particularly nonischemic septal fibrosis (NIsF), remains largely unexplored.OBJECTIVESThis study aims to evaluate the association of NIsF with adverse right-sided chamber remodeling and to assess its incremental prognostic value for mortality in patients with functional TR.METHODSPatients with advanced (≥ moderate) functional TR underwent comprehensive cardiac magnetic resonance (CMR) evaluation. Late gadolinium enhancement (LGE) was used to identify NIsF, defined as hyperenhancement in the midmyocardial or epicardial regions of the interventricular septum. Cine CMR measured functional and geometric indices of the left and right sides of the heart. Follow-up data were obtained for all-cause mortality.RESULTSA total of 663 patients with advanced TR (mean age: 63.8 ± 16.0 years; 53% male) were studied, and 29.4% were found to have NIsF. NIsF was strongly associated with adverse chamber remodeling, including larger left ventricular and RV volumes, reduced systolic function, and increased TR severity (all P < 0.001). TR regurgitant fraction increased stepwise with NIsF extent (no NIsF, 34.9% ± 1.5%; 1 segment, 38.1% ± 13.0%; 2 segments, 40.8% ± 13.8%; P < 0.001). Over a mean follow-up of 4.3 ± 4.3 years, 25.3% of patients died. NIsF was independently associated with mortality (HR: 1.79 [95% CI: 1.26-2.56]; P = 0.001), even after adjusting for conventional risk markers, including age, TR severity, RV dysfunction, and dilation. Kaplan-Meier analysis demonstrated significantly higher mortality risk among patients with NIsF compared with patients without NIsF (P < 0.001).CONCLUSIONSAmong patients with advanced TR, NIsF is an important marker of adverse right-sided chamber remodeling and provides incremental prognostic utility beyond conventional risk markers.","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"6 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547998","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 Flow Ratio for Detecting Significant Coronary Artery Disease: Validation by Cardiovascular Magnetic Resonance.","authors":"Simran Shergill, Mohamed Elshibly, Anju Velvet, Aida Moafi, Kelly S Parke, David Adlam, Peter Kellman, Andrew Ladwiniec, Gerry P McCann, J Ranjit Arnold","doi":"10.1016/j.jcmg.2025.05.009","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.05.009","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553616","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":"Evolution and Clinical Relevance of Left Atrial Appendage Residual Patency After Percutaneous Closure: A Prespecified Analysis of the SWISS-APERO Trial.","authors":"Roberto Galea, Juan Perich Krsnik, Alan Arthur Peters, Federico de Marco, Adel Aminian, Nicolas Meneveau, Konstantina Chalkou, Christoph Gräni, Frederic Anselme, Anna Franzone, Pascal Vranckx, Urs Fischer, Francesco Bedogni, Lorenz Räber, Marco Valgimigli","doi":"10.1016/j.jcmg.2025.05.004","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.05.004","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553614","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":"Primary Left Atrial Cardiopathy in Transthyretin Amyloidosis Cardiomyopathy by Multimodality Imaging: Implications for Thrombotic Events.","authors":"Benay Ozbay, Corey Rearick, Bharadwaj S Satyavolu, Prem Soman, Timothy C Wong, Matthew Starr, Bharat Pillai, Jianhui Zhu, Abdullah Z Azhar, William E Katz, Leyla Elif Sade","doi":"10.1016/j.jcmg.2025.04.007","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.04.007","url":null,"abstract":"<p><strong>Background: </strong>Thrombotic event (TE) risk is high in transthyretin amyloid cardiomyopathy (ATTR-CM).</p><p><strong>Objectives: </strong>The authors sought to explore left atrial (LA) remodeling in ATTR-CM and its association with TE risk in comparison to other phenotypes of left ventricular hypertrophy (LVH).</p><p><strong>Methods: </strong>Subjects who underwent speckle tracking echocardiography, Tc-99m pyrophosphate scintigraphy, serum and urine immune electrophoresis, per registry protocol, were retrospectively identified (n = 405). Cardiac magnetic resonance and endomyocardial biopsy were used per clinical indication. Subjects with cardiac amyloidosis other than ATTR-CM were excluded, those with nonamyloid LVH served as controls. Propensity score matching was performed for age, sex, coronary artery disease, and diabetes. Longitudinal follow-up was performed over 5 years for TEs.</p><p><strong>Results: </strong>In all ATTR-CM (n =149) and LVH (n =165) in a propensity matched cohort (104:104), ATTR-CM subjects had decreased left atrial reservoir strain (LASr), smaller left atrial volume index, more intense late gadolinium hyperenhancement, and increased LA stiffness as compared to LVH. In ATTR-CM, LASr correlated poorly with E/e', was severely depressed regardless of the diastolic dysfunction grade (in those with sinus rhythm), and did not correlate with left atrial volume index, in contrast to the LVH group. LASr and LA stiffness were associated with ATTR-CM independently of diastolic dysfunction and atrial fibrillation (AF) (OR: 1.2 and OR: 1.9, respectively; P < 0.001 and P = 0.002). Furthermore, LASr and LA stiffness were independently associated with TEs (n = 20) during follow-up, regardless of CHA₂DS₂-VASc or prevalent AF at baseline, in ATTR-CM.</p><p><strong>Conclusions: </strong>Primary LA cardiopathy seems to be associated with TEs in ATTR-CM, independently of AF, CHA₂DS₂-VASc, and LA dilatation, unlike other LVH phenotypes.</p>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553615","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}