JACC. Cardiovascular imaging最新文献

{"title":"Parsing the Shades of Gray of Myocardial Fibrosis in Aortic Stenosis","authors":"Tom Kai Ming Wang MBChB, MD, Tiffany Dong MD","doi":"10.1016/j.jcmg.2024.09.006","DOIUrl":"10.1016/j.jcmg.2024.09.006","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 2","pages":"Pages 192-194"},"PeriodicalIF":12.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620985","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 “Moderate” Aortic Stenosis","authors":"William A. Zoghbi MD","doi":"10.1016/j.jcmg.2024.10.013","DOIUrl":"10.1016/j.jcmg.2024.10.013","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 2","pages":"Pages 177-179"},"PeriodicalIF":12.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140428","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":"Imaging Topic of the Year","authors":"Thomas H. Marwick MBBS, PhD, MPH (Executive Editor, JACC: Cardiovascular Imaging), Y. Chandrashekhar MD, DM (Editor-in-Chief, JACC: Cardiovascular Imaging)","doi":"10.1016/j.jcmg.2025.01.001","DOIUrl":"10.1016/j.jcmg.2025.01.001","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 2","pages":"Pages 248-250"},"PeriodicalIF":12.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140363","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 MD, PhD ,&nbsp;Anvesha Singh MBChB, PhD ,&nbsp;Jaehyun Lim MD ,&nbsp;Neil Craig MD ,&nbsp;Rong Bing MD ,&nbsp;Lionel Tastet PhD ,&nbsp;Jun-Bean Park MD, PhD ,&nbsp;Hyung-Kwan Kim MD, PhD ,&nbsp;Yong-Jin Kim MD, PhD ,&nbsp;Marie-Annick Clavel DVM, PhD ,&nbsp;Bernhard L. Gerber MD, PhD ,&nbsp;Gerry P. McCann MBChB, MD ,&nbsp;Marc R. Dweck MD, PhD ,&nbsp;Phillipe Pibarot DVM, PhD ,&nbsp;Seung-Pyo Lee MD, PhD","doi":"10.1016/j.jcmg.2024.08.003","DOIUrl":"10.1016/j.jcmg.2024.08.003","url":null,"abstract":"<div><h3>Background</h3><div>Patients with moderate or asymptomatic severe aortic stenosis (AS) are at risk of cardiovascular events.</div></div><div><h3>Objectives</h3><div>The authors investigated the utility of cardiac magnetic resonance (CMR) to identify drivers of outcome in patients with moderate or asymptomatic severe AS.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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%; <em>P =</em> 0.003). Patients in the highest ECV% tertiles (ECV% &gt;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; <em>P =</em> 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 (<em>P &lt;</em> 0.05).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 2","pages":"Pages 180-191"},"PeriodicalIF":12.8,"publicationDate":"2025-02-01","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":"Definition and Validation of Prognostic Phenotypes in Moderate Aortic Stenosis","authors":"Jonathan Sen MBBS ,&nbsp;Sudhir Wahi MD ,&nbsp;William Vollbon BS, BAppS, GradDipCardiac (Ultrasound) ,&nbsp;Marcus Prior HSC ,&nbsp;Alex G.C. de Sá PhD ,&nbsp;David B. Ascher PhD ,&nbsp;Quan Huynh BMed, PhD ,&nbsp;Thomas H. Marwick MBBS, PhD, MPH","doi":"10.1016/j.jcmg.2024.06.013","DOIUrl":"10.1016/j.jcmg.2024.06.013","url":null,"abstract":"<div><h3>Background</h3><div>Adverse outcomes from moderate aortic stenosis (AS) may be caused by progression to severe AS or by the effects of comorbidities. In the absence of randomized trial evidence favoring aortic valve replacement (AVR) in patients with moderate AS, phenotyping patients according to risk may assist decision making.</div></div><div><h3>Objectives</h3><div>This study sought to identify and validate clusters of moderate AS that may be used to guide patient management.</div></div><div><h3>Methods</h3><div>Unsupervised clustering algorithms were applied to demographics, comorbidities, and echocardiographic parameters in a training data set in patients with moderate AS (n = 2,469). External validation was obtained by assigning the defined clusters to an independent group with moderate AS (n = 1,358). The primary outcome, a composite of cardiac death, heart failure hospitalization, or aortic valve (AV) intervention after 5 years, was assessed between clusters in both data sets.</div></div><div><h3>Results</h3><div>Four distinct clusters—cardiovascular (CV)-comorbid, low-flow, calcified AV, and low-risk—with significant outcomes (log-rank <em>P &lt;</em> 0.0001 in both data sets) were identified and replicated. The highest risk was in the CV-comorbid cluster (validation HR: 2.00 [95% CI: 1.54-2.59]; <em>P &lt;</em> 0.001). The effect of AVR on cardiac death differed among the clusters. There was a significantly lower rate of outcomes after AVR in the calcified AV cluster (validation HR: 0.21 [95% CI: 0.08-0.57]; <em>P =</em> 0.002), but no significant effect on outcomes in the other 3 clusters. These analyses were limited by the low rate of AVR.</div></div><div><h3>Conclusions</h3><div>Moderate AS has several phenotypes, and multiple comorbidities are the key drivers of adverse outcomes in patients with moderate AS. Outcomes of patients with noncalcified moderate AS were not altered by AVR in these groups. Careful attention to subgroups of moderate AS may be important to define treatable risk.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 2","pages":"Pages 133-149"},"PeriodicalIF":12.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995758","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":"High-Risk Lesion-Level Physiology and Morphology","authors":"Amir Ahmadi MD ,&nbsp;Jagat Narula MD, PhD","doi":"10.1016/j.jcmg.2024.09.013","DOIUrl":"10.1016/j.jcmg.2024.09.013","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 2","pages":"Pages 207-210"},"PeriodicalIF":12.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965081","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 MD, PhD ,&nbsp;Rohan Shah MD ,&nbsp;Ankush Jamthikar MTech, PhD ,&nbsp;Neil Craig MD ,&nbsp;Yasmin Hamirani MD ,&nbsp;Grace Casaclang-Verzosa MD, MBA ,&nbsp;Rebecca T. Hahn MD ,&nbsp;Marc R. Dweck MD, PhD ,&nbsp;Philippe Pibarot DVM, PhD ,&nbsp;Naveena Yanamala MSc, PhD ,&nbsp;Partho P. Sengupta MD, DM","doi":"10.1016/j.jcmg.2024.07.017","DOIUrl":"10.1016/j.jcmg.2024.07.017","url":null,"abstract":"<div><h3>Background</h3><div>The development and progression of aortic stenosis (AS) from aortic valve (AV) sclerosis is highly variable and difficult to predict.</div></div><div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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]; <em>P &lt;</em> 0.001) and subsequent mortality or AV interventions (adjusted HR: 7.033 [95% CI: 3.036-16.290]; <em>P &lt;</em> 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 (<em>r</em> = 0.62; <em>P =</em> 0.008).</div></div><div><h3>Conclusions</h3><div>Assessment of DD using DL can stratify the latent risk associated with the progression of early-stage AS.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 2","pages":"Pages 150-165"},"PeriodicalIF":12.8,"publicationDate":"2025-02-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Gradient Aortic Stenosis With Valve Area >1.0 cm2","authors":"Saki Ito MD, MSc ,&nbsp;Jae K. Oh MD ,&nbsp;Hector I. Michelena MD ,&nbsp;Alexander C. Egbe MBBS, MPH ,&nbsp;Heidi M. Connolly MD ,&nbsp;Patricia A. Pellikka MD ,&nbsp;Vuyisile T. Nkomo MD, MPH ,&nbsp;Bradley R. Lewis MSc ,&nbsp;William R. Miranda MD","doi":"10.1016/j.jcmg.2024.07.025","DOIUrl":"10.1016/j.jcmg.2024.07.025","url":null,"abstract":"<div><h3>Background</h3><div>Clinical features and outcomes in severe aortic stenosis (AS) have been described according to the hemodynamic phenotypes.</div></div><div><h3>Objectives</h3><div>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) &gt;1.0 cm².</div></div><div><h3>Methods</h3><div>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 &gt;1 = &gt;1.0, ≥4, and ≥40, HG-AVA ≤1 = ≤1.0, ≥4, and ≥40; LG-AVA ≤1 (low-gradient) = ≤1.0, &lt;4, and &lt;40; moderate AS = 1.0 &lt;AVA ≤1.5, 3 ≤ peak velocity &lt;4, and 20 ≤ MG &lt;40.</div></div><div><h3>Results</h3><div>HG-AVA &gt;1 accounted for 230 individuals (7.2%). Compared with others, patients with HG-AVA &gt;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 &gt;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 &gt;1 group, patients with aortic valve replacement had better survival outcomes than those without aortic valve replacement (<em>P &lt;</em> 0.001) after balancing the 2 groups.</div></div><div><h3>Conclusions</h3><div>The underlying relative high-flow status is responsible for HG in patients with HG-AVA &gt;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.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 2","pages":"Pages 166-176"},"PeriodicalIF":12.8,"publicationDate":"2025-02-01","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":"Association Between Coronary Artery Spasm and Atherosclerotic Disease","authors":"Denise Peeters MSc ,&nbsp;Eva Woelders MD ,&nbsp;Tijn Jansen MD ,&nbsp;Regina Konst MD, PhD ,&nbsp;Caïa Crooijmans MD ,&nbsp;Tim van de Hoef MD, PhD ,&nbsp;Frans Mensink MD ,&nbsp;Jonathan Los MD ,&nbsp;Dario Pellegrini MD, PhD ,&nbsp;Jan Hein Cornel MD, PhD ,&nbsp;Peter Ong MD, PhD ,&nbsp;Niels van Royen MD, PhD ,&nbsp;Aukelien Leen MD, PhD ,&nbsp;Suzette Elias-Smale MD, PhD ,&nbsp;Robert Jan van Geuns MD, PhD ,&nbsp;Peter Damman MD, PhD","doi":"10.1016/j.jcmg.2024.05.024","DOIUrl":"10.1016/j.jcmg.2024.05.024","url":null,"abstract":"<div><div>In at least one-half of the patients with angina or ischemia and nonobstructive coronary arteries undergoing coronary function testing, coronary artery spasm (CAS) is detected. CAS is associated with an adverse prognosis regarding recurrent complaints and ischemic events. Current treatment options are mainly focused on the complaints, not on the underlying pathophysiological process. In this review we discuss available evidence regarding the presence, amount, and morphology of atherosclerosis in CAS patients. The reviewed evidence confirmed that atherosclerosis and vulnerable plaque characteristics are often detected in patients with CAS. The amount of atherosclerosis is higher in patients with focal CAS compared with patients with diffuse CAS. Severity of atherosclerosis is associated with the presence of CAS and the prognosis in CAS patients with atherosclerotic stenosis is worse. Therefore, CAS patients with atherosclerosis might benefit from targeted atherosclerotic treatment. Longitudinal studies are needed to elucidate the exact relation between atherosclerosis and CAS.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 2","pages":"Pages 226-239"},"PeriodicalIF":12.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901828","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":"Full Issue PDF","authors":"","doi":"10.1016/S1936-878X(25)00015-4","DOIUrl":"10.1016/S1936-878X(25)00015-4","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 2","pages":"Pages I-CXXII"},"PeriodicalIF":12.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140364","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}