JACC. Cardiovascular imaging最新文献

{"title":"Quantification and Timing of Epicardial Vasodilation by Sublingual Nitrates","authors":"Konstantinos Bermpeis MD, Fabian A. Pauwels MD, Michele Mattia Viscusi MD, Thabo Mahendiran BMBCh, MD, Dario T. Bertolone MD, Giulia Botti MD, Sofie Brouwers MD, PhD, Carlos Collet MD, PhD, Bernard de Bruyne MD, PhD, Takuya Mizukami MD, PhD","doi":"10.1016/j.jcmg.2024.05.018","DOIUrl":"10.1016/j.jcmg.2024.05.018","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 10","pages":"Pages 1255-1257"},"PeriodicalIF":12.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603661","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":"Right Ventricular Systolic Strain Reference Ranges Across Contemporary Vendor-Neutral Echocardiography Software in Healthy Patients.","authors":"Elio Haroun, Ankit Agrawal, Joseph El Dahdah, Tiffany Dong, Aro Daniela Arockiam, Muhammad Majid, Sharmeen Sorathia, Richard A Grimm, L Leonardo Rodriguez, Zoran B Popovic, Brian P Griffin, Tom Kai Ming Wang","doi":"10.1016/j.jcmg.2024.08.008","DOIUrl":"https://doi.org/10.1016/j.jcmg.2024.08.008","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465943","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 for Vulnerable Plaque in Functionally Significant Lesions","authors":"Seokhun Yang MD, Doyeon Hwang MD, Koshiro Sakai MD PhD, Takuya Mizukami MD PhD, Jonathon Leipsic MD, Marta Belmonte MD, Jeroen Sonck MD PhD, Bjarne L. Nørgaard MD PhD, Hiromasa Otake MD PhD, Brian Ko MD PhD, Michael Maeng MD PhD, Jesper Møller Jensen MD PhD, Dimitri Buytaert MSc, Daniel Munhoz MD PhD, Daniele Andreini MD PhD, Hirofumi Ohashi MD PhD, Toshiro Shinke MD PhD, Charles A. Taylor PhD, Emanuele Barbato MD PhD, Bernard De Bruyne MD PhD, Carlos Collet MD PhD, Bon-Kwon Koo MD PhD","doi":"10.1016/j.jcmg.2024.07.021","DOIUrl":"https://doi.org/10.1016/j.jcmg.2024.07.021","url":null,"abstract":"Vulnerable plaque presents prognostic implications in addition to functional significance. The aim of this study was to identify relevant features of vulnerable plaque in functionally significant lesions. In this multicenter, prospective study conducted across 5 countries, including patients who had invasive fractional flow reserve (FFR) ≤0.80, a total of 95 patients with available pullback pressure gradient (PPG) and plaque analysis on coronary computed tomographic angiography and optical coherence tomography were analyzed. Vulnerable plaque was defined as the presence of plaque rupture or thin-cap fibroatheroma on optical coherence tomography. Among the 25 clinical characteristics, invasive angiographic findings, physiological indexes, and coronary computed tomographic angiographic findings, significant predictors of vulnerable plaque were identified. Mean percentage diameter stenosis, FFR, and PPG were 77.8% ± 14.6%, 0.66 ± 0.13, and 0.65 ± 0.13, respectively. Vulnerable plaque was present in 53 lesions (55.8%). PPG and FFR were identified as significant predictors of vulnerable plaque ( 0.05 for all). PPG >0.65 and FFR ≤0.70 were significantly related to a higher probability of vulnerable plaque after adjustment for each other (OR: 6.75 [95% CI: 2.39-19.1]; 0.001] for PPG >0.65; OR: 4.61 [95% CI: 1.66-12.8]; 0.003 for FFR ≤0.70). When categorizing lesions according to combined PPG >0.65 and FFR ≤0.70, the prevalence of vulnerable plaque was 20.0%, 57.1%, 66.7%, and 88.2% in the order of PPG ≤0.65 and FFR >0.70, PPG ≤0.65 and FFR ≤0.70, PPG >0.65 and FFR >0.70, and PPG >0.65 and FFR ≤0.70 ( for trend < 0.001), respectively. Among low-FFR lesions, the presence of vulnerable plaque can be predicted by PPG combined with FFR without additional anatomical or plaque characteristics. (Precise Percutaneous Coronary Intervention Plan [P3] Study; )","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"5 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142231788","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":"Head-to-Head Comparison of Near-Infrared Spectroscopy-Intravascular Ultrasound and Coronary Computed Tomography Angiography in Assessing Atheroma Characteristics.","authors":"Anantharaman Ramasamy,Francesca Pugliese,Ibrahim Halil Tanboga,Pieter Kitslaar,Jouke Dijkstra,Anthony Mathur,Ryo Torii,James C Moon,Andreas Baumbach,Christos V Bourantas","doi":"10.1016/j.jcmg.2024.07.005","DOIUrl":"https://doi.org/10.1016/j.jcmg.2024.07.005","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"1 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251231","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":"Diffuse Interstitial Fibrosis of the Myocardium Predicts Outcome in Moderate and Asymptomatic Severe Aortic Stenosis.","authors":"Hyun-Jung Lee, Anvesha Singh, Jaehyun Lim, Neil Craig, Rong Bing, Lionel Tastet, Jun-Bean Park, Hyung-Kwan Kim, Yong-Jin Kim, Marie-Annick Clavel, Bernhard L Gerber, Gerry P McCann, Marc R Dweck, Phillipe Pibarot, Seung-Pyo Lee","doi":"10.1016/j.jcmg.2024.08.003","DOIUrl":"https://doi.org/10.1016/j.jcmg.2024.08.003","url":null,"abstract":"<p><strong>Background: </strong>Patients with moderate or asymptomatic severe aortic stenosis (AS) are at risk of cardiovascular events.</p><p><strong>Objectives: </strong>The authors investigated the utility of cardiac magnetic resonance (CMR) to identify drivers of outcome in patients with moderate or asymptomatic severe AS.</p><p><strong>Methods: </strong>A prospective, international, multicenter cohort (n = 457) of patients with moderate (aortic valve area [AVA]: 1.0-1.5 cm²) or asymptomatic severe AS (AVA ≤1.0 cm² and NYHA functional class I-II) patients underwent CMR. Diffuse interstitial fibrosis and scar in the myocardium were analyzed with extracellular volume fraction (ECV%) and late gadolinium enhancement (LGE). The outcome was a composite of mortality and heart failure admission.</p><p><strong>Results: </strong>Median ECV% was 26.6% (IQR: 24.4%-29.9%), and LGE was present in 31.5% (median 0.8%; IQR: 0.1%-1.7%). Greater AS severity was associated with greater left ventricular mass and diastolic dysfunction, but not with ECV% or LGE. During a median 5.7 years of follow-up, 83 events occurred. Patients with events had higher ECV% (median ECV% 26.3% vs 28.2%; P = 0.003). Patients in the highest ECV% tertiles (ECV% >28.6%) had worse outcomes both in the entire cohort and in those with NYHA functional class I moderate or severe AS, and ECV% was independently associated with outcome (adjusted HR: 1.05; P = 0.039). The ECV% had significant incremental prognostic value when added to parameters of AS severity and cardiac function, comorbidities, aortic valve replacement, and LGE (P < 0.05).</p><p><strong>Conclusions: </strong>Increased diffuse interstitial fibrosis of the myocardium is associated with poor outcomes in patients with moderate and asymptomatic severe AS and can help identify those who require closer surveillance for adverse outcomes.</p>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347048","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":"Myocardial Blood Flow Quantification Using Stress Cardiac Magnetic Resonance Improves Detection of Coronary Artery Disease.","authors":"Shuo Wang, Paul Kim, Haonan Wang, Ming-Yen Ng, Andrew E Arai, Amita Singh, Saima Mushtaq, Tsun Hei Sin, Yuko Tada, Elizabeth Hillier, Ruyun Jin, Christian Østergaard Mariager, Michael Salerno, Gianluca Pontone, Javier Urmeneta Ulloa, Ibrahim M Saeed, Hena Patel, Victor Goh, Simon Madsen, Won Yong Kim, Mayil Singram Krishnam, Vicente Martínez de Vega, Alicia M Maceira, Jose V Monmeneu, Aju P Pazhenkottil, Alborz Amir-Khalili, Mitchel Benovoy, Silke Friedrich, Martin A Janich, Matthias G Friedrich, Amit R Patel","doi":"10.1016/j.jcmg.2024.07.023","DOIUrl":"https://doi.org/10.1016/j.jcmg.2024.07.023","url":null,"abstract":"<p><strong>Background: </strong>Myocardial blood flow (MBF) and myocardial perfusion reserve (MPR) using stress cardiovascular magnetic resonance (CMR) have been shown to identify epicardial coronary artery disease. However, comparative analysis between quantitative perfusion and conventional qualitative assessment (QA) remains limited.</p><p><strong>Objectives: </strong>The aim of this multicenter study was to test the hypothesis that quantitative stress MBF (sMBF) and MPR analysis can identify obstructive coronary artery disease (obCAD) with comparable performance as QA of stress CMR performed by experienced physicians in interpretation.</p><p><strong>Methods: </strong>The analysis included 127 individuals (mean age 62 ± 16 years, 84 men [67%]) who underwent stress CMR. obCAD was defined as the presence of stenosis ≥50% in the left main coronary artery or ≥70% in a major vessel. Each patient, coronary territory, and myocardial segment was categorized as having either obCAD or no obCAD (noCAD). Global, per coronary territory, and segmental MBF and MPR values were calculated. QA was performed by 4 CMR experts.</p><p><strong>Results: </strong>At the patient level, global sMBF and MPR were significantly lower in subjects with obCAD than in those with noCAD, with median values of sMBF of 1.5 mL/g/min (Q1-Q3: 1.2-1.8 mL/g/min) vs 2.4 mL/g/min (Q1-Q3: 2.1-2.7 mL/g/min) (P < 0.001) and median values of MPR of 1.3 (Q1-Q3: 1.0-1.6) vs 2.1 (Q1-Q3: 1.6-2.7) (P < 0.001). At the coronary artery level, sMBF and MPR were also significantly lower in vessels with obCAD compared with those with noCAD. Global sMBF and MPR had areas under the curve (AUCs) of 0.90 (95% CI: 0.84-0.96) and 0.86 (95% CI: 0.80-0.93). The AUCs for QA by 4 physicians ranged between 0.69 and 0.88. The AUC for global sMBF and MPR was significantly better than the average AUC for QA.</p><p><strong>Conclusions: </strong>This study demonstrates that sMBF and MPR using dual-sequence stress CMR can identify obCAD more accurately than qualitative analysis by experienced CMR readers.</p>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287687","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":"Deep Learning Model of Diastolic Dysfunction Risk Stratifies the Progression of Early-Stage Aortic Stenosis.","authors":"Márton Tokodi, Rohan Shah, Ankush Jamthikar, Neil Craig, Yasmin Hamirani, Grace Casaclang-Verzosa, Rebecca T Hahn, Marc R Dweck, Philippe Pibarot, Naveena Yanamala, Partho P Sengupta","doi":"10.1016/j.jcmg.2024.07.017","DOIUrl":"https://doi.org/10.1016/j.jcmg.2024.07.017","url":null,"abstract":"<p><strong>Background: </strong>The development and progression of aortic stenosis (AS) from aortic valve (AV) sclerosis is highly variable and difficult to predict.</p><p><strong>Objectives: </strong>The authors investigated whether a previously validated echocardiography-based deep learning (DL) model assessing diastolic dysfunction (DD) could identify the latent risk associated with the development and progression of AS.</p><p><strong>Methods: </strong>The authors evaluated 898 participants with AV sclerosis from the ARIC (Atherosclerosis Risk In Communities) cohort study and associated the DL-predicted probability of DD with 2 endpoints: 1) the new diagnosis of AS; and 2) the composite of subsequent mortality or AV interventions. Validation was performed in 2 additional cohorts: 1) in 50 patients with mild-to-moderate AS undergoing cardiac magnetic resonance (CMR) imaging and serial echocardiographic assessments; and 2) in 18 patients with AV sclerosis undergoing ¹⁸F-sodium fluoride (NaF) and ¹⁸F-fluorodeoxyglucose positron emission tomography (PET) combined with computed tomography (CT) to assess valvular inflammation and calcification.</p><p><strong>Results: </strong>In the ARIC cohort, a higher DL-predicted probability of DD was associated with the development of AS (adjusted HR: 3.482 [95% CI: 2.061-5.884]; P < 0.001) and subsequent mortality or AV interventions (adjusted HR: 7.033 [95% CI: 3.036-16.290]; P < 0.001). The multivariable Cox model (incorporating the DL-predicted probability of DD) derived from the ARIC cohort efficiently predicted the progression of AS (C-index: 0.798 [95% CI: 0.648-0.948]) in the CMR cohort. Moreover, the predictions of this multivariable Cox model correlated positively with valvular ¹⁸F-NaF mean standardized uptake values in the PET/CT cohort (r = 0.62; P = 0.008).</p><p><strong>Conclusions: </strong>Assessment of DD using DL can stratify the latent risk associated with the progression of early-stage AS.</p>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287685","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":"High-Gradient Aortic Stenosis With Valve Area >1.0 cm²: The \"Forgotten\" Discordant Hemodynamic Phenotype.","authors":"Saki Ito, Jae K Oh, Hector I Michelena, Alexander C Egbe, Heidi M Connolly, Patricia A Pellikka, Vuyisile T Nkomo, Bradley R Lewis, William R Miranda","doi":"10.1016/j.jcmg.2024.07.025","DOIUrl":"https://doi.org/10.1016/j.jcmg.2024.07.025","url":null,"abstract":"<p><strong>Background: </strong>Clinical features and outcomes in severe aortic stenosis (AS) have been described according to the hemodynamic phenotypes.</p><p><strong>Objectives: </strong>The aim of this study was to investigate the clinical features and prognosis of patients with high-gradient (HG) AS with aortic valve area (AVA) >1.0 cm².</p><p><strong>Methods: </strong>A total of 3,209 patients were identified according to AVA (cm²), peak velocity (m/s), systolic mean pressure gradient (MG) (mm Hg): HG-AVA >1 = >1.0, ≥4, and ≥40, HG-AVA ≤1 = ≤1.0, ≥4, and ≥40; LG-AVA ≤1 (low-gradient) = ≤1.0, <4, and <40; moderate AS = 1.0 <AVA ≤1.5, 3 ≤peak velocity <4, and 20 ≤MG <40.</p><p><strong>Results: </strong>HG-AVA >1 accounted for 230 individuals (7.2%). Compared with others, patients with HG-AVA >1 were younger (70.2 ± 12.0 years), more frequently male (85.7%), had fewer comorbidities, larger body surface area and stroke volume (115 ± 19.3 mL), and had higher prevalence of bicuspid valve (39.6%). After a follow-up of 944 days (Q1-Q3: 27-2,212 days), 1,523 deaths occurred. Compared with the HG-AVA >1 group, all-cause mortality was higher in HG-AVA ≤1 (HR: 1.4; 95% CI: 1.1-1.7), LG-AVA ≤1 (HR: 2.8; 95% CI: 2.2-3.6), and moderate AS (HR: 1.4; 95% CI: 1.1-1.7). These differences were no longer significant after adjustment for age, comorbidities, bicuspid valve, and cardiac function. In the HG-AVA >1 group, patients with aortic valve replacement had better survival outcomes than those without aortic valve replacement (P < 0.001) after balancing the 2 groups.</p><p><strong>Conclusions: </strong>The underlying relative high-flow status is responsible for HG in patients with HG-AVA >1. This profile has better prognosis than others, being related to underlying younger age and better general and cardiac conditions, but aortic valve replacement may still benefit these patients.</p>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287686","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":"Treatment Strategy of Atrial Functional Mitral Regurgitation: Consideration of the Mechanistic Subtypes.","authors":"Nobuyuki Kagiyama","doi":"10.1016/j.jcmg.2024.07.027","DOIUrl":"https://doi.org/10.1016/j.jcmg.2024.07.027","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"64 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233472","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":"Mavacamten-Associated Temporal Changes in Left Atrial Function in Obstructive HCM: Insights From the VALOR-HCM Trial","authors":"Milind Y. Desai MD MBA, Yuichiro Okushi MD, Kathy Wolski MPH, Jeffrey B. Geske MD, Anjali Owens MD, Sara Saberi MD MS, Andrew Wang MD, Paul C. Cremer MD MS, Mark Sherrid MD, Neal K. Lakdawala MD, Albree Tower-Rader MD, David Fermin MD, Srihari S. Naidu MD, Kathy L. Lampl MD, Amy J. Sehnert MD, Steven E. Nissen MD, Zoran B. Popovic MD PhD, VALOR-HCM Investigators, M. Desai, J. Geske, M. Sherrid, A.T. Owens, S. Saberi, A. Wang, A. Tower-Rader, D. Fermin, N. Lakdawala, A. Masri, M. Zenker, J. Stendahl, M. Wheeler, R. Bach, J. Orford, S. Naidu, F. Rader, P. Bajona","doi":"10.1016/j.jcmg.2024.08.005","DOIUrl":"https://doi.org/10.1016/j.jcmg.2024.08.005","url":null,"abstract":"In severely symptomatic patients with obstructive hypertrophic cardiomyopathy (HCM), the VALOR-HCM (A Study to Evaluate Mavacamten in Adults With Symptomatic Obstructive Hypertrophic Cardiomyopathy Who Are Eligible for Septal Reduction Therapy) trial showed that mavacamten reduced the eligibility for septal reduction therapy with sustained improvement in left ventricular outflow tract gradients. Mavacamten also resulted in favorable cardiac remodeling, including improvement in biomarkers (eg, N-terminal pro–B-type natriuretic peptide). However, the impact of mavacamten on left atrial (LA) function is unknown. The aim of this study was to assess serial changes in LA strain measures in patients enrolled in the VALOR-HCM trial. VALOR-HCM included 112 symptomatic patients with obstructive HCM (mean age 60 years; 51% male). Patients assigned to receive mavacamten at baseline (n = 56) continued therapy for 56 weeks and those assigned to placebo transitioned to mavacamten (n = 52) from week 16 to week 56. Echocardiographic LA strain (reservoir, conduit, and contraction) was measured by using a vendor-neutral postprocessing software. At baseline, the mean LA volume index (LAVI) and LA strain values (conduit, contraction, and reservoir) were 41.3 ± 16.5 mL/m, –11.8% ± 6.5%, –8.7% ± 5.0%, and 20.5% ± 8.7%, respectively (all worse than reported normal). LAVI significantly improved by –5.6 ± 9.7 mL/m from baseline to week 56 ( 0.001). There was a significant ( 0.05) improvement in absolute LA strain values from baseline to week 56 (conduit [–1.7% ± 6%], contraction [–1.2% ± 4.5%], and reservoir [2.8% ± 7.7%]). Patients originally receiving placebo had no differences in LA measurements up to week 16. There was no significant improvement in LA strain values (conduit [–0.9% ± 3.8%], contraction [–0.4% ± 3.4%], and reservoir [1.4% ± 6.1]; all; NS) from baseline to week 56 in patients with history of atrial fibrillation. In VALOR-HCM, mavacamten resulted in an improvement in LAVI and LA strain at week 56, suggesting sustained favorable LA remodeling and improved function, except in the atrial fibrillation subgroup. Whether the advantageous LA remodeling associated with long-term treatment with mavacamten results in a favorable impact on the observed high burden of atrial tachyarrhythmias in HCM remains to be proven. (A Study to Evaluate Mavacamten in Adults With Symptomatic Obstructive Hypertrophic Cardiomyopathy Who Are Eligible for Septal Reduction Therapy [VALOR-HCM]; )","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"40 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142144083","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}