JACC. Cardiovascular imaging最新文献

{"title":"Mechanistic Basis for Differential Effects of Interatrial Shunt Treatment in HFrEF vs HFpEF: The RELIEVE-HF Trial.","authors":"Michael R Zile, William T Abraham, JoAnn Lindenfeld, Stefan D Anker, Josep Rodés-Cabau, Michael P Pfeiffer, John P Boehmer, Sheldon Litwin, Catalin F Baicu, Julio Núñez Villota, Elizabeth C Lee, Richard Holcomb, Patrick O'Keefe, Neal L Eigler, Gregg W Stone","doi":"10.1016/j.jcmg.2025.08.005","DOIUrl":"10.1016/j.jcmg.2025.08.005","url":null,"abstract":"<p><strong>Background: </strong>The RELIEVE-HF (REducing Lung congestion symptoms using the v-wavE shunt in adVancEd Heart Failure) trial randomized 508 patients with heart failure (HF) to interatrial shunt treatment vs placebo procedure. Randomization was stratified into 2 patient groups: heart failure with reduced ejection fraction (HFrEF) (left ventricular ejection fraction [LVEF] ≤40%); and heart failure with preserved ejection fraction (HFpEF) (LVEF >40%). HF event rates (all-cause death, transplantation or left ventricular (LV) assist device, HF hospitalization or outpatient worsening) after shunt treatment during 2-year follow-up were directionally opposite: decreased by 51% in HFrEF, increased by 69% in HFpEF.</p><p><strong>Objectives: </strong>This study aims to examine differences in cardiac structure and function before and after interatrial shunt placement in patients with HFrEF vs HFpEF that could underlie these discordant clinical outcomes.</p><p><strong>Methods: </strong>Serial changes from baseline to 12 months in 17 transthoracic echocardiographic parameters in shunt-treated vs control patients in HFrEF vs HFpEF were assessed and compared by ANCOVA (analysis of covariance).</p><p><strong>Results: </strong>In shunt-treated vs control patients with HFrEF, there were reductions in median LV end-diastolic volumes (-11.9 mL/m² [Q1-Q3: -21.3 to -2.5 mL/m²]; P = 0.01) and LV end-systolic volumes (-8.9 mL/m² [Q1-Q3: -17.2 to -20.7 mL/m²]; P = 0.01) indicative of reverse LV remodeling. There were no significant changes in right ventricular (RV), right atrial, or inferior vena cava sizes or pulmonary artery systolic pressure (PASP). In contrast, shunt-treated vs control patients with HFpEF did not have LV remodeling, but they had increased RV, right atrial, and inferior vena cava dimensions, and PASP also increased (4.7 mm Hg [Q1-Q3: 0.9-8.5 mm Hg]; P = 0.02). LV and RV diastolic compliance were decreased in HFpEF vs HFrEF at baseline and decreased further after shunt treatment in HFpEF.</p><p><strong>Conclusions: </strong>Differential changes in left-sided and right-sided heart remodeling and PASP following interatrial shunt placement in patients with HFrEF vs HFpEF provide a mechanistic basis for the variable effects on clinical outcomes observed in RELIEVE-HF. (REducing Lung congestion symptoms using the v-wavE shunt in adVancEd Heart Failure [RELIEVE-HF]; NCT03499236).</p>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":15.2,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954555","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":"Synergistic Effect of Risk Factors and Cardiotoxic Cancer Therapies: Implications for Heart Failure Screening in Cancer Survivors.","authors":"Joshua Wong, Cheng Hwee Soh, Joel Smith, Quan Huynh, Wojciech Kosmala, Thomas H Marwick","doi":"10.1016/j.jcmg.2025.08.007","DOIUrl":"10.1016/j.jcmg.2025.08.007","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":15.2,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954979","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 Favorable Cardiac Remodeling in Obstructive Hypertrophic Cardiomyopathy Patients Treated With Mavacamten for up to 128 Weeks: Insights From the VALOR-HCM Trial.","authors":"Milind Y Desai, Yuichiro Okushi, Kathy Wolski, Jeffrey B Geske, Anjali Tiku Owens, Qiuqing Wang, Sara Saberi, Andrew Wang, Paul Cremer, Neal K Lakdawala, Mark V Sherrid, Albree Tower-Rader, David R Fermin, Mark A Zenker, Srihari S Naidu, Kathy Lampl, Steven E Nissen, Zoran Popovic","doi":"10.1016/j.jcmg.2025.07.019","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.07.019","url":null,"abstract":"<p><strong>Background: </strong>In the VALOR-HCM (A Study to Evaluate Mavacamten in Adults With Symptomatic Obstructive HCM Who Are Eligible for Septal Reduction Therapy; NCT04349072) trial, patients with severely symptomatic obstructive hypertrophic cardiomyopathy (HCM) treated with mavacamten demonstrated significant improvement in left ventricular outflow tract (LVOT) gradients and echocardiographic indices of cardiac remodeling in the short term.</p><p><strong>Objectives: </strong>The authors sought to assess whether mavacamten results in sustained favorable long-term cardiac remodeling at 128 weeks (end of trial).</p><p><strong>Methods: </strong>A total of 112 adult symptomatic obstructive HCM patients (mean age: 60.3 years; 50% men; and 94% NYHA functional class III/IV) who were referred for septal reduction therapy were randomized 1:1 to mavacamten or placebo for 16 weeks. Subsequently, placebo patients transitioned to and received 112 weeks of mavacamten, and the original mavacamten group received 128 weeks of mavacamten. All patients had comprehensive echocardiographic assessments (including LV and left atrial [LA] global longitudinal strain measurements using vendor neutral software [TOMTEC-ARENA TTA2, Philips Healthcare]) at baseline and 128-week follow-up.</p><p><strong>Results: </strong>At week 128, there was a sustained improvement (mean percentage of change from baseline, all P < 0.05) in LVOT gradients (resting [-61%], post-Valsalva [-72%], and postexercise [-53%]), LV mass index (-11%), septal E/e' (-18%), LV global longitudinal strain (4.5%), LA volume index (-6%), and LA strain (conduit strain [16%], contraction [35%], and reservoir [32%]). In 71 patients with ≥5 point improvement in the Kansas City Cardiomyopathy Questionnaire 23-item Clinical Summary Score (KCCQ-23-CSS), there was a significant and sustained improvement (all P < 0.05), whereas in 25 patients with <5 point improvement in the KCCQ-23-CSS, there was no significant improvement in various LA and LV strain values.</p><p><strong>Conclusions: </strong>In the VALOR-HCM trial, treatment with mavacamten resulted in sustained favorable cardiac remodeling, including improvement in LVOT gradients, cardiac volumes, cardiac hypertrophy, diastolic function, and markers of LA and LV strain from baseline through week 128, suggesting disease modification. These favorable changes also occurred in association with meaningful improvement in quality of life.</p>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":15.2,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069498","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 Artery Calcification Scoring and Plaque Types in Sudden Deaths.","authors":"Teruo Sekimoto,Tatsuya Shiraki,Takamasa Tanaka,Takao Konishi,Fay Y Lin,Ali H Dakroub,Kenji Kawai,Rika Kawakami,Renu Virmani,Aloke V Finn","doi":"10.1016/j.jcmg.2025.08.009","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.08.009","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"123 1-4 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068392","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":"Predictors and Prognostic Implications of Progressive Systemic Ventricular Dysfunction in Adults With Fontan Palliation.","authors":"Ali Ali,William R Miranda,Christopher Francois,Sara ElZalabany,Amr Moustafa,Heidi M Connolly,Alexander C Egbe","doi":"10.1016/j.jcmg.2025.08.008","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.08.008","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"53 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068393","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":"Changes in Myocardial Light Chain Amyloid Burden After Plasma Cell Therapy.","authors":"Dominik C Benz,Olivier F Clerc,Sarah A M Cuddy,Vasvi Singh,Marie Foley Kijewski,Giada Bianchi,Andrew J Yee,Frederick L Ruberg,Michael Jerosch-Herold,Raymond Y Kwong,Marcelo F Di Carli,Ronglih Liao,Rodney H Falk,Sharmila Dorbala","doi":"10.1016/j.jcmg.2025.07.017","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.07.017","url":null,"abstract":"BACKGROUNDCurrent therapies for light chain (AL) amyloidosis target the plasma cell dyscrasia, but their effect on myocardial amyloid fibril burden remains poorly defined.OBJECTIVESThe authors aimed to assess longitudinal changes in myocardial amyloid burden after plasma cell-directed chemotherapy.METHODSThis prospective study included 81 patients (58 with AL amyloid cardiomyopathy and 23 with AL amyloidosis without cardiomyopathy) with recently diagnosed, biopsy-proven AL amyloidosis, who underwent serial 18F-florbetapir positron emission tomography/computed tomography and cardiac magnetic resonance (including extracellular volume [ECV]) at baseline, 6 months (n = 52), and/or 12 months (n = 37). Molecular amyloid burden was estimated as 18F-florbetapir percentage injected dose (%ID), and changes are presented as absolute and relative %ID changes. Cardiac biomarker response was defined as a reduction in N-terminal pro-B-type natriuretic peptide (NT-proBNP) >30% and >300 ng/L when baseline NT-proBNP ≥650 ng/L. All change comparisons were paired within patients.RESULTSIn AL amyloid cardiomyopathy, amyloid burden decreased significantly at 6 and 12 months after therapy initiation (median absolute [relative] change %ID: -0.3% [-13%]; P = 0.002; and -0.3% [15%]; P = 0.003). Changes in %ID correlated moderately with changes in NT-proBNP at 12 months (ρ = 0.531). Of note, %ID decreased significantly among biomarker responders (P < 0.001), whereas there was no change in nonresponders (P = 0.542). In contrast, ECV did not change in biomarker responders (P = 0.193) or nonresponders (P = 0.695). In AL amyloidosis without cardiomyopathy, %ID did not change (P = 0.523), whereas ECV increased (P = 0.011).CONCLUSIONSMyocardial AL amyloid burden estimated by 18F-florbetapir %ID decreases in participants undergoing plasma cell therapy and is detectable at 6 months. Molecular amyloid and ECV changes probably reflect distinct aspects of myocardial remodeling in AL amyloidosis. (Molecular Imaging of Primary Amyloid Cardiomyopathy [MICA]: NCT02641145).","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"73 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035792","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 CTA vs Stress Testing in Stable Angina With Moderate Renal Dysfunction: Insights From the PROMISE Trial.","authors":"Vignesh Chidambaram,Amudha Kumar,Munthir Mansour,Ryan Pohlkamp,Marie Gilbert Majella,Joshua Mueller,Jawahar L Mehta,Mark G Rabbat,Armin Arbab-Zadeh,Ron Blankstein,Roger S Blumenthal,Pamela S Douglas,Subhi J Al'Aref","doi":"10.1016/j.jcmg.2025.08.002","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.08.002","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"130 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032099","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":"Peripulmonary Vein Adipose Tissue Attenuation as a Novel Marker of Atrial Fibrillation Risk.","authors":"Michael W Lim,Rahul G Muthalaly,Geoffrey R Wong,Ahmed M Al-Kaisey,Damini Dey,Thomas H Marwick,Peter M Kistler,Jonathan M Kalman,Nitesh Nerlekar","doi":"10.1016/j.jcmg.2025.07.020","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.07.020","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"71 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017868","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":"Clinical Integration of AI-Enabled Plaque Quantification to Improve Cardiovascular Risk Stratification.","authors":"Leslee J Shaw,Ron Blankstein,Jonathon A Leipsic,Partho P Sengupta,Koen Nieman,Jeroen Bax,William A Zoghbi,Y Chandrashekhar","doi":"10.1016/j.jcmg.2025.09.001","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.09.001","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"59 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032152","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":"Outcomes of Left Atrial Appendage Patency After Device Closure Detected by Cardiac CT: A Meta-Analysis.","authors":"Xander Jacquemyn,Michel Pompeu Sá,Kasper Korsholm,Jens Erik Nielsen-Kudsk,Xavier Iriart,Jacqueline Saw,Mohamad Alkhouli,Sandeep Jain,Marcio Sommer Bittencourt,Ibrahim Sultan","doi":"10.1016/j.jcmg.2025.07.018","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.07.018","url":null,"abstract":"BACKGROUNDResidual leaks are common after left atrial appendage occlusion (LAAO).OBJECTIVESThe authors aimed to systematically evaluate the prognostic implications of residual left atrial appendage (LAA) patency and peridevice leaks (PDLs) detected by cardiac computed tomography (CT) following LAAO.METHODSThe authors used traditional meta-analytical methods and a Bayesian framework to assess the probability of increased risks associated with these residual leaks.RESULTSSeventeen studies encompassing 2,036 patients met the inclusion criteria. During follow-up, the presence of any LAA patency was significantly associated with an almost 2-fold increased OR of thromboembolism (pooled OR: 1.87, 95% CI: 1.08-3.24), corresponding to 28 (95% CI: 3-68) additional events per 1,000 patients. Although PDL showed a similar trend, it was not significantly associated with increased thromboembolism risk (pooled OR: 1.50, 95% CI: 0.85-2.65). For thromboembolism with LAA patency, under a noninformative prior, the mean logOR was 0.59 (95% credible interval [Crl]: 0.06-1.15), and translated median OR of 1.87 (95% CrI: 1.06-3.14) and a mean absolute risk difference (ARD) of 2.8% (95% CrI: 0.2%-6.8%). The posterior probability of ARD >0% was 98.5%. For any PDL, the mean logOR was 0.38 (95% CrI: -0.22 to 0.95), with a median OR of 1.53 (95% CrI: 0.80-2.59) and mean ARD of 1.9% (95% CrI: -0.7% to 5.4%). The posterior probability of ARD >0% was 89.8%.CONCLUSIONSLAA patency and PDL identified by CT may be associated with an increased risk of thromboembolism. These findings indicate that residual leaks detected by CT may be clinically significant and should not be regarded as benign.","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"164 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017869","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}