JACC. Cardiovascular imaging最新文献

{"title":"Predicting Acute Coronary Syndromes From Coronary CT Angiography","authors":"","doi":"10.1016/j.jcmg.2024.04.019","DOIUrl":"10.1016/j.jcmg.2024.04.019","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 9","pages":"Pages 1077-1078"},"PeriodicalIF":12.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432029","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 Specificity of Left Ventricular Bite-Like Fibrofatty Replacement for Diagnosis of Arrhythmogenic Right Ventricular Cardiomyopathy","authors":"","doi":"10.1016/j.jcmg.2024.03.011","DOIUrl":"10.1016/j.jcmg.2024.03.011","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 9","pages":"Pages 1113-1115"},"PeriodicalIF":12.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897315","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":"Left Atrial Improvement in Patients With Secondary Mitral Regurgitation and Heart Failure","authors":"","doi":"10.1016/j.jcmg.2024.03.016","DOIUrl":"10.1016/j.jcmg.2024.03.016","url":null,"abstract":"<div><h3>Background</h3><p>Functional mitral regurgitation induces adverse effects on the left ventricle and the left atrium. Left atrial (LA) dilatation and reduced LA strain are associated with poor outcomes in heart failure (HF). Transcatheter edge-to-edge repair (TEER) of the mitral valve reduces heart failure hospitalization (HFH) and all-cause death in selected HF patients.</p></div><div><h3>Objectives</h3><p>The aim of this study was to evaluate the impact of LA strain improvement 6 months after TEER on the outcomes of patients enrolled in the COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation) trial.</p></div><div><h3>Methods</h3><p>The difference in LA strain between baseline and the 6-month follow-up was calculated. Patients with at least a 15% improvement in LA strain were labeled as “LA strain improvers.” All-cause death and HFH were assessed between the 6- and 24-month follow-up.</p></div><div><h3>Results</h3><p>Among 347 patients (mean age 71 ± 12 years, 63% male), 106 (30.5%) showed improvement of LA strain at the 6-month follow-up (64 [60.4%] from the TEER + guideline-directed medical therapy [GDMT] group and 42 [39.6%] from the GDMT alone group). An improvement in LA strain was significantly associated with a reduction in the composite of death or HFH between the 6-month and 24-month follow-up, with a similar risk reduction in both treatment arms (<em>P</em>_interaction = 0.27). In multivariable analyses, LA strain improvement remained independently associated with a lower risk of the primary composite endpoint both as a continuous variable (adjusted HR: 0.94 [95% CI: 0.89-1.00]; <em>P =</em> 0.03) and as a dichotomous variable (adjusted HR: 0.49 [95% CI: 0.27-0.89]; <em>P =</em> 0.02). The best outcomes were observed in patients treated with TEER in whom LA strain improved.</p></div><div><h3>Conclusions</h3><p>In symptomatic HF patients with severe mitral regurgitation, improved LA strain at the 6-month follow-up is associated with subsequently lower rates of the composite endpoint of all-cause mortality or HFH, both after TEER and GDMT alone. (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation [COAPT]; <span><span>NCT01626079</span><svg><path></path></svg></span>)</p></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 9","pages":"Pages 1015-1027"},"PeriodicalIF":12.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1936878X24001517/pdfft?md5=b8fdb7c62ad2faf637d2c6a93783ecf2&pid=1-s2.0-S1936878X24001517-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141097036","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":"NSTEMI","authors":"Barbara Lawson MD,&nbsp;W. Gregory Hundley MD","doi":"10.1016/j.jcmg.2024.06.021","DOIUrl":"10.1016/j.jcmg.2024.06.021","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 9","pages":"Pages 1059-1061"},"PeriodicalIF":12.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142128452","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":"What Is New With Understanding the Left Atrium and What It Can Tell Us","authors":"Thomas H. Marwick MBBS, PhD, MPH (Executive Editor, JACC: Cardiovascular Imaging),&nbsp;Y. Chandrashekhar MD (Editor-in-Chief, JACC: Cardiovascular Imaging)","doi":"10.1016/j.jcmg.2024.08.001","DOIUrl":"10.1016/j.jcmg.2024.08.001","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 9","pages":"Pages 1128-1130"},"PeriodicalIF":12.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142128594","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":"Characterization of Medical Professional Liability Claims Associated With Noninvasive Stress Testing","authors":"","doi":"10.1016/j.jcmg.2024.04.006","DOIUrl":"10.1016/j.jcmg.2024.04.006","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 9","pages":"Pages 1124-1127"},"PeriodicalIF":12.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283761","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":"Uncovering Subclinical Atherosclerosis: Assessment of Low-Attenuation Plaques in Low Risk Group","authors":"","doi":"10.1016/j.jcmg.2024.04.004","DOIUrl":"10.1016/j.jcmg.2024.04.004","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 9","pages":"Pages 1116-1117"},"PeriodicalIF":12.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179386","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":"Cardiovascular Magnetic Resonance Before Invasive Coronary Angiography in Suspected Non–ST-Segment Elevation Myocardial Infarction","authors":"","doi":"10.1016/j.jcmg.2024.05.007","DOIUrl":"10.1016/j.jcmg.2024.05.007","url":null,"abstract":"<div><h3>Background</h3><p>In suspected non–ST-segment elevation myocardial infarction (NSTEMI), this presumed diagnosis may not hold true in all cases, particularly in patients with nonobstructive coronary arteries (NOCA). Additionally, in multivessel coronary artery disease, the presumed infarct-related artery may be incorrect.</p></div><div><h3>Objectives</h3><p>This study sought to assess the diagnostic utility of cardiac magnetic resonance (CMR) before invasive coronary angiogram (ICA) in suspected NSTEMI.</p></div><div><h3>Methods</h3><p>A total of 100 consecutive stable patients with suspected acute NSTEMI (70% male, age 62 ± 11 years) prospectively underwent CMR pre-ICA to assess cardiac function (cine), edema (T₂-weighted imaging, T₁ mapping), and necrosis/scar (late gadolinium enhancement). CMR images were interpreted blinded to ICA findings. The clinical care and ICA teams were blinded to CMR findings until post-ICA.</p></div><div><h3>Results</h3><p>Early CMR (median 33 hours postadmission and 4 hours pre-ICA) confirmed only 52% (52 of 100) of patients had subendocardial infarction, 15% transmural infarction, 18% nonischemic pathologies (myocarditis, takotsubo, and other forms of cardiomyopathies), and 11% normal CMR; 4% were nondiagnostic. Subanalyses according to ICA findings showed that, in patients with obstructive coronary artery disease (73 of 100), CMR confirmed only 84% (61 of 73) had MI, 10% (7 of 73) nonischemic pathologies, and 5% (4 of 73) normal. In patients with NOCA (27 of 100), CMR found MI in only 22% (6 of 27 true MI with NOCA), and reclassified the presumed diagnosis of NSTEMI in 67% (18 of 27: 11 nonischemic pathologies, 7 normal). In patients with CMR-MI and obstructive coronary artery disease (61 of 100), CMR identified a different infarct-related artery in 11% (7 of 61).</p></div><div><h3>Conclusions</h3><p>In patients presenting with suspected NSTEMI, a CMR-first strategy identified MI in 67%, nonischemic pathologies in 18%, and normal findings in 11%. Accordingly, CMR has the potential to affect at least 50% of all patients by reclassifying their diagnosis or altering their potential management.</p></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 9","pages":"Pages 1044-1058"},"PeriodicalIF":12.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1936878X24001967/pdfft?md5=784ed5b4acaae5ab3bfd0c70509258ff&pid=1-s2.0-S1936878X24001967-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141329641","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":"Cardiac Damage in Early Aortic Stenosis","authors":"","doi":"10.1016/j.jcmg.2024.05.003","DOIUrl":"10.1016/j.jcmg.2024.05.003","url":null,"abstract":"<div><h3>Background</h3><p><span>Despite the close association between aortic stenosis (AS) and cardiac damage (CD), it is unclear if CD is limited to patients with moderate and severe AS and which factors affect its progression. Although altered valvular </span>hemodynamic status may drive the development of CD in AS, commonly occurring comorbidities may contribute.</p></div><div><h3>Objectives</h3><p>The aim of this study was to determine the prevalence of and factors associated with CD in mild AS.</p></div><div><h3>Methods</h3><p><span>This retrospective study included 9,611 patients with mild AS (peak aortic valve velocity [V</span>_max] 2-3 m/s and description of abnormal aortic valve) from 2010 through 2021. CD was staged using the Genereux classification.</p></div><div><h3>Results</h3><p><span><span><span>All but 20% (n = 1,901; stage 0) of patients with mild AS demonstrated CD: 1,613 (17%) stage 1, 4,843 (50%) stage 2, 891 (9%) stage 3, and 363 (4%) stage 4. Patients with higher stages had more comorbidities (hypertension, heart failure, ischemic heart disease, stroke, </span>peripheral arterial disease<span>, chronic kidney disease, </span></span>chronic pulmonary disease, and diabetes mellitus) but had valvular hemodynamic status similar to those without CD. CD stage did not worsen with higher V</span>_max range (stage &gt;1 in 64% with V_max &lt;2.5 m/s vs 61% with V_max ≥2.5 m/s) but increased with the number of comorbidities, with stage &gt;1 occurring in 50%, 53%, 60%, 66%, 72%, and 73% in the presence of 0, 1, 2, 3, 4, and 5 or more comorbidities, respectively.</p></div><div><h3>Conclusions</h3><p>CD was highly prevalent in patients with mild AS. Among patients with mild AS, there was no relationship between the degree of CD and AS severity; instead, CD was highly associated with comorbidities.</p></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 9","pages":"Pages 1031-1040"},"PeriodicalIF":12.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432028","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":"Risk Stratification in Cardiac Sarcoidosis With Cardiac Positron Emission Tomography","authors":"Tahir S. Kafil MD ,&nbsp;Omar M. Shaikh MD ,&nbsp;Yehia Fanous MD ,&nbsp;Joseph Benjamen MD ,&nbsp;Muhammad M. Hashmi MD ,&nbsp;Abdulazeez Jawad MD ,&nbsp;Tahir Dahrouj MD ,&nbsp;Rami M. Abazid MD ,&nbsp;Mina Swiha MD ,&nbsp;Jonathan Romsa MD ,&nbsp;Rob S.B. Beanlands MD ,&nbsp;Terrence D. Ruddy MD ,&nbsp;Lisa Mielniczuk MD ,&nbsp;David H. Birnie MD ,&nbsp;Nikolaos Tzemos MD","doi":"10.1016/j.jcmg.2024.05.013","DOIUrl":"10.1016/j.jcmg.2024.05.013","url":null,"abstract":"<div><h3>Background</h3><p>Although positron emission tomography (PET) imaging is well established for its diagnostic role in cardiac sarcoidosis, less is known about the prognostic value of PET and its use in risk stratification for major adverse cardiac events (MACE).</p></div><div><h3>Objectives</h3><p>The goal of this study was to perform a systematic review and meta-analysis looking at the prognostic value of PET imaging in patients with cardiac sarcoidosis.</p></div><div><h3>Methods</h3><p>Study investigators systematically searched EMBASE (Excerpta Medica dataBASE), MEDLINE, PubMed, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, CINAHL (Cumulative Index to Nursing and Allied Health Literature), ClinicalTrials.gov, and the European Union Clinical Trial Registry for cardiac sarcoidosis and PET imaging. The primary outcome of interest was MACE.</p></div><div><h3>Results</h3><p>The search revealed 3,010 records, of which 55 studies were included. This represented 5,250 patients. Factors associated with MACE included the following: the combination of abnormal fluorodeoxyglucose (FDG) uptake and perfusion defect, which had an OR of 2.86 (95% CI: 1.74-4.71; <em>P &lt;</em> 0.0001); abnormal perfusion or FDG uptake, which had an OR of 2.69 (95% CI: 1.67-4.33); abnormal FDG uptake, which had an OR of 2.61 (95% CI: 1.51-4.50); focal abnormal right ventricular uptake, which had an OR of 6.27 (95% CI: 3.19-12.32; <em>P &lt;</em> 0.00001); and a lack of response to immunosuppression on serial PET, which had an OR of 8.43 (95% CI: 3.25-21.85; <em>P &lt;</em> 0.0001). A QUIPS (Quality in Prognostic Studies) tool analysis found a low to moderate risk of bias, particularly given the small sample sizes in the individual studies.</p></div><div><h3>Conclusions</h3><p>Multiple cardiac PET parameters provide risk stratification value in cardiac sarcoidosis. Focal right ventricular uptake and a lack of response to immunosuppressive therapy on serial PET imaging were particularly predictive of MACE.</p></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 9","pages":"Pages 1079-1097"},"PeriodicalIF":12.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901834","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}