JACC. Cardiovascular imaging最新文献

{"title":"Polygenic Risk and the Progression of High-Risk Coronary Plaque","authors":"Nicholas A. Marston MD, MPH","doi":"10.1016/j.jcmg.2024.07.026","DOIUrl":"10.1016/j.jcmg.2024.07.026","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 12","pages":"Pages 1460-1462"},"PeriodicalIF":12.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251232","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 MD ,&nbsp;Paul Kim MD ,&nbsp;Haonan Wang PhD ,&nbsp;Ming-Yen Ng BMBS ,&nbsp;Andrew E. Arai MD ,&nbsp;Amita Singh MD ,&nbsp;Saima Mushtaq MD ,&nbsp;Tsun Hei Sin BSc ,&nbsp;Yuko Tada MD, PhD ,&nbsp;Elizabeth Hillier MD, PhD ,&nbsp;Ruyun Jin MD, MCR ,&nbsp;Christian Østergaard Mariager PhD ,&nbsp;Michael Salerno MD, PhD ,&nbsp;Gianluca Pontone MD ,&nbsp;Javier Urmeneta Ulloa PhD ,&nbsp;Ibrahim M. Saeed MD ,&nbsp;Hena Patel MD ,&nbsp;Victor Goh MBBS ,&nbsp;Simon Madsen MD ,&nbsp;Won Yong Kim MD ,&nbsp;Amit R. Patel MD","doi":"10.1016/j.jcmg.2024.07.023","DOIUrl":"10.1016/j.jcmg.2024.07.023","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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) (<em>P &lt;</em> 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) (<em>P &lt;</em> 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.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that sMBF and MPR using dual-sequence stress CMR can identify obCAD more accurately than qualitative analysis by experienced CMR readers.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 12","pages":"Pages 1428-1441"},"PeriodicalIF":12.8,"publicationDate":"2024-12-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harnessing SGLT2 Inhibitors","authors":"Cindy M. Martin MD","doi":"10.1016/j.jcmg.2024.09.007","DOIUrl":"10.1016/j.jcmg.2024.09.007","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 12","pages":"Pages 1409-1410"},"PeriodicalIF":12.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780169","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 Calcium Distribution and Cardiovascular Risk: MESA.","authors":"Tara Shrout Allen, Mikaila Reyes, Jonathan M Kermanshahchi, Julie O Denenberg, Joseph Yeboah, Matthew A Allison, Michael H Criqui, Harpreet S Bhatia","doi":"10.1016/j.jcmg.2024.10.005","DOIUrl":"https://doi.org/10.1016/j.jcmg.2024.10.005","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784990","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, Geu-Ru Hong","doi":"10.1016/j.jcmg.2024.09.014","DOIUrl":"https://doi.org/10.1016/j.jcmg.2024.09.014","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-11-26","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":"Leveraging a Vision Transformer Model to Improve Diagnostic Accuracy of Cardiac Amyloidosis With Cardiac Magnetic Resonance.","authors":"Joshua Cockrum, Makiya Nakashima, Carl Ammoury, Diane Rizkallah, Joseph Mauch, David Lopez, David Wolinksy, Tae Hyun Hwang, Samir Kapadia, Lars G Svensson, Richard Grimm, Mazen Hanna, W H Wilson Tang, Christopher Nguyen, David Chen, Deborah Kwon","doi":"10.1016/j.jcmg.2024.09.010","DOIUrl":"https://doi.org/10.1016/j.jcmg.2024.09.010","url":null,"abstract":"<p><strong>Background: </strong>Cardiac magnetic resonance (CMR) imaging is an important diagnostic tool for diagnosis of cardiac amyloidosis (CA). However, discrimination of CA from other etiologies of myocardial disease can be challenging.</p><p><strong>Objectives: </strong>The aim of this study was to develop and rigorously validate a deep learning (DL) algorithm to aid in the discrimination of CA using cine and late gadolinium enhancement CMR imaging.</p><p><strong>Methods: </strong>A DL model using a retrospective cohort of 807 patients who were referred for CMR for suspicion of infiltrative disease or hypertrophic cardiomyopathy (HCM) was developed. Confirmed definitive diagnosis was as follows: 252 patients with CA, 290 patients with HCM, and 265 with neither CA or HCM (other). This cohort was split 70/30 into training and test sets. A vision transformer (ViT) model was trained primarily to identify CA. The model was validated in an external cohort of 157 patients also referred for CMR for suspicion of infiltrative disease or HCM (51 CA, 49 HCM, 57 other).</p><p><strong>Results: </strong>The ViT model achieved a diagnostic accuracy (84.1%) and an area under the curve of 0.954 in the internal testing data set. The ViT model further demonstrated an accuracy of 82.8% and an area under the curve of 0.957 in the external testing set. The ViT model achieved an accuracy of 90% (n = 55 of 61), among studies with clinical reports with moderate/high confidence diagnosis of CA, and 61.1% (n = 22 of 36) among studies with reported uncertain, missing, or incorrect diagnosis of CA in the internal cohort. DL accuracy of this cohort increased to 79.1% when studies with poor image quality, dual pathologies, or ambiguity of clinically significant CA diagnosis were removed.</p><p><strong>Conclusions: </strong>A ViT model using only cine and late gadolinium enhancement CMR images can achieve high accuracy in differentiating CA from other underlying etiologies of suspected cardiomyopathy, especially in cases when reported human diagnostic confidence was uncertain in both a large single state health system and in an external CA cohort.</p>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785278","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":"Mechanism and Impact of Left Atrial Dyssynchrony on Long-Term Clinical Outcome During Cardiac Resynchronization Therapy.","authors":"Lars-Egil R Hammersboen, Marie Stugaard, Alexis Puvrez, Camilla K Larsen, Espen W Remme, Erik Kongsgård, Jürgen Duchenne, Elena Galli, Faraz H Khan, Ole Jakob Sletten, Martin Penicka, Erwan Donal, Jens-Uwe Voigt, Otto A Smiseth, John M Aalen","doi":"10.1016/j.jcmg.2024.09.008","DOIUrl":"10.1016/j.jcmg.2024.09.008","url":null,"abstract":"<p><strong>Background: </strong>Left bundle branch block (LBBB) causes left atrial (LA) dyssynchrony. It is unknown if LA dyssynchrony impacts long-term prognosis.</p><p><strong>Objectives: </strong>The purpose of this study was to determine mechanisms of LA dyssynchrony in LBBB and if LA dyssynchrony impacts long-term prognosis.</p><p><strong>Methods: </strong>In a prospective multicenter study of 168 heart failure patients with LBBB, echocardiographic strain imaging was done before and after 6 months with cardiac resynchronization therapy (CRT). Outcome was assessed after 6 years. Dyssynchrony was measured relative to septum as delay in left ventricular (LV) lateral wall shortening and LA lateral wall stretch. Response to CRT was defined as at least 15% reduction in LV end-systolic volume.</p><p><strong>Results: </strong>Before CRT, there was marked LA dyssynchrony of 105 ± 76 ms, which decreased to 37 ± 68 ms in CRT-responders (P < 0.001), whereas nonresponders showed only a modest reduction in LA dyssynchrony (P < 0.05). There was strong association between LA and LV dyssynchrony (r = 0.70), consistent with direct LV-LA mechanical interaction. CRT caused modest increase in LA reservoir strain (P < 0.01) and marked increase of LV filling time (P < 0.001) in responders. Mortality after 6 years was 21% (35 deaths). LA dyssynchrony did not independently predict mortality. However, the combination of preserved LA reservoir strain (≥18%) and resolved LA dyssynchrony (≤53 ms) after 6 months with CRT was associated with excellent long term-prognosis: HR: 0.11 (95% CI: 0.03-0.42) vs preserved reservoir strain and persistent LA dyssynchrony.</p><p><strong>Conclusions: </strong>LA dyssynchrony in LBBB was attributed to direct LV-LA mechanical interactions. CRT improved diastolic function by increasing LV filling time. Patients with preserved LA reservoir strain and resolution of LA dyssynchrony by CRT had excellent long-term prognosis. (Contractile Reserve in Dyssynchrony: A Novel Principle to Identify Candidates for Cardiac Resynchronization Therapy [CRID-CRT]; NCT02525185).</p>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681816","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":"Impact of Bariatric Surgery on Coronary Microvascular Function","authors":"Paul Poirier MD, PhD","doi":"10.1016/j.jcmg.2024.08.007","DOIUrl":"10.1016/j.jcmg.2024.08.007","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 11","pages":"Pages 1317-1319"},"PeriodicalIF":12.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371923","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":"Improving Precision and Refining Risk Prediction of CTRCD With Cardiovascular CT","authors":"Purvi J. Parwani MBBS, MPH ,&nbsp;Juan Lopez-Mattei MD","doi":"10.1016/j.jcmg.2024.09.002","DOIUrl":"10.1016/j.jcmg.2024.09.002","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 11","pages":"Pages 1348-1350"},"PeriodicalIF":12.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578846","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":"Longitudinal Evaluation of Coronary Arteries and Myocardium in Breast Cancer Using Coronary Computed Tomographic Angiography","authors":"Chunrong Tu MD ,&nbsp;Hesong Shen MD ,&nbsp;Xiaoqin Li BS,&nbsp;Xing Wang BS,&nbsp;Zhiming Miao BS,&nbsp;Wei Deng BS,&nbsp;Renwei Liu BS,&nbsp;Xiaosong Lan MD,&nbsp;Huifang Chen BS,&nbsp;Jiuquan Zhang PhD","doi":"10.1016/j.jcmg.2024.05.017","DOIUrl":"10.1016/j.jcmg.2024.05.017","url":null,"abstract":"<div><h3>Background</h3><div>The association of coronary computed tomography angiography<span> (CTA) and left ventricular (LV) myocardium measurements with cancer therapy–related cardiac dysfunction (CTRCD) is limited.</span></div></div><div><h3>Objectives</h3><div>In this study, the authors sought to evaluate the changes in coronary arteries<span> and LV myocardium in patients with left breast cancer (BC) receiving anthracycline with or without radiotherapy, with the use of coronary CTA.</span></div></div><div><h3>Methods</h3><div><span><span>Participants with left BC receiving anthracycline with or without radiotherapy were prospectively included. All participants underwent coronary CTA before and after treatment, including nonenhanced calcium-scoring scan, </span>computed tomography angiography, and dual-energy late enhancement scan. Computed tomographic </span>fractional flow reserve<span><span> (CT-FFR), pericoronary adipose tissue (PCAT) CT attenuation, and LV segments’ extracellular volume (ECV) before and after treatment were compared. </span>Logistic regression analysis was used to assess the association between baseline coronary CTA parameters and CTRCD.</span></div></div><div><h3>Results</h3><div>Eighty participants receiving anthracycline and 59 participants receiving anthracycline with radiotherapy were included. CT-FFR decreased and PCAT CT attenuation and LV global and segments’ ECV increased after treatment (all <em>P &lt;</em><span> 0.05). After chemoradiotherapy<span>, CT-FFR was lower and PCAT CT attenuation and LV myocardial ECV were higher than after chemotherapy. Twenty-four participants developed CTRCD. After adjustment by Heart Failure Association–International Cardio-Oncology Society risk in multivariable logistic regression analysis, baseline stenosis of the left anterior descending artery (LAD) (OR: 1.987 [95% CI: 1.322-2.768]; </span></span><em>P =</em> 0.021), left circumflex artery (LCX) (OR: 1.895 [95% CI: 1.281-2.802]; <em>P =</em><span> 0.031), and right coronary artery (RCA) (OR: 1.920 [95% CI: 1.405-2.811]; </span><em>P =</em> 0.028), and baseline CT-FFR of the LAD (OR: 3.425 [95% CI: 1.621-9.434]; <em>P &lt;</em> 0.001), LCX (OR: 2.058 [95% CI: 1.030-5.076]; <em>P =</em> 0.006), and RCA (OR: 2.469 [95% CI: 1.232-6.944]; <em>P =</em> 0.004) were associated with CTRCD.</div></div><div><h3>Conclusions</h3><div>Multiparameter coronary CTA contributes to comprehensive assessment of the coronary arteries and myocardium in patients with left BC receiving anthracycline with or without radiotherapy. Baseline coronary artery stenosis and CT-FFR might be imaging markers for predicting CTRCD in these patients.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 11","pages":"Pages 1335-1347"},"PeriodicalIF":12.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603658","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}