Journal of Cardiovascular Computed Tomography最新文献

{"title":"Association between symptom characteristics and disease severity in patients suspected of coronary artery disease","authors":"Oliver Buchhave Pedersen ,&nbsp;Laust Dupont Rasmussen ,&nbsp;Louise Nissen ,&nbsp;June Anita Ejlersen ,&nbsp;Jesper Mortensen ,&nbsp;Lars Christian Gormsen ,&nbsp;Ashkan Eftekhari ,&nbsp;Jelmer Westra ,&nbsp;Evald Høj Christiansen ,&nbsp;Daniel B. Mark ,&nbsp;Morten Bøttcher ,&nbsp;Pamela S. Douglas ,&nbsp;Simon Winther","doi":"10.1016/j.jcct.2025.01.004","DOIUrl":"10.1016/j.jcct.2025.01.004","url":null,"abstract":"<div><h3>Background</h3><div>Discrepancies often exist between patient-reported symptoms and diagnostic test findings in patients with suspected obstructive coronary artery disease (CAD).</div></div><div><h3>Objectives</h3><div>To quantify the association between patient-reported symptoms and the diagnosis of severe stenosis in patients with suspected obstructive CAD.</div></div><div><h3>Methods</h3><div>Two large-scale cohorts of patients with new-onset symptoms suggestive of obstructive CAD were evaluated. Chest discomfort was assessed by typicality, location, type, exertional/stress factors, and relief with rest/nitroglycerine. Patients underwent non-invasive diagnostic testing (coronary computed tomographic angiography (CCTA) or functional testing), followed by test-result-driven invasive coronary angiography (ICA). Severe stenosis was defined as ≥70 ​% diameter stenosis on ICA. Sensitivity analyses included CCTA stenosis, functional abnormalities, and revascularization.</div></div><div><h3>Results</h3><div>Of 14,410 patients, 2093 (14.5 ​%) were referred for ICA, and 765 (5.3 ​%) were diagnosed with severe stenosis. Patients with typical angina (n ​= ​224) had higher odds of being diagnosed with severe stenosis on ICA (OR and 95 ​% CIs: 2.84 [2.40–3.34]) than those with atypical or non-anginal symptoms. In patients diagnosed with severe stenosis on ICA, those with exertional/stress factors (n ​= ​418; OR [95 ​% CI]: 2.50 [2.16–2.90]) and relief with rest/nitroglycerine (n ​= ​318, 2.28; [1.96–2.65]) had higher odds compared to those without. Patients reporting pressure or burning pain had higher odds of severe stenosis. Associations were consistent across sex and age groups, and sensitivity references.</div></div><div><h3>Conclusions</h3><div>Exertional/stress-related chest discomfort and relief with rest/nitroglycerine increased the odds of severe stenosis in patients with suspected CAD undergoing test-result-driven ICA, while location and type of chest pain were less associated, with no differences across sex or age groups.</div></div>","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"19 2","pages":"Pages 215-223"},"PeriodicalIF":5.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting mortality after transcatheter aortic valve replacement using AI-based fully automated left atrioventricular coupling index","authors":"Emese Zsarnoczay ,&nbsp;Akos Varga-Szemes ,&nbsp;U. Joseph Schoepf ,&nbsp;Saikiran Rapaka ,&nbsp;Daniel Pinos ,&nbsp;Gilberto J. Aquino ,&nbsp;Nicola Fink ,&nbsp;Milan Vecsey-Nagy ,&nbsp;Giuseppe Tremamunno ,&nbsp;Dmitrij Kravchenko ,&nbsp;Muhammad Taha Hagar ,&nbsp;Nicholas S. Amoroso ,&nbsp;Daniel H. Steinberg ,&nbsp;Athira Jacob ,&nbsp;Jim O’Doherty ,&nbsp;Puneet Sharma ,&nbsp;Pal Maurovich-Horvat ,&nbsp;Tilman Emrich","doi":"10.1016/j.jcct.2024.12.082","DOIUrl":"10.1016/j.jcct.2024.12.082","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to determine whether artificial intelligence (AI)–based automated assessment of left atrioventricular coupling index (LACI) can provide incremental value above other traditional risk factors for predicting mortality among patients with severe aortic stenosis (AS) undergoing coronary CT angiography (CCTA) before transcatheter aortic valve replacement (TAVR).</div></div><div><h3>Methods</h3><div>This retrospective study evaluated patients with severe AS who underwent CCTA examination before TAVR between September 2014 and December 2020. An AI-prototype software fully automatically calculated left atrial and left ventricular end-diastolic volumes and LACI was defined by the ratio between them. Uni- and multivariate Cox proportional hazard methods were used to identify the predictors of mortality in models adjusting for relevant significant parameters and Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM) score.</div></div><div><h3>Results</h3><div>A total of 656 patients (77 years [IQR, 71–84 years]; 387 [59.0 ​%] male) were included in the final cohort. The all-cause mortality rate was 21.6 ​% over a median follow-up time of 24 (10–40) months. When adjusting for clinical confounders, LACI ≥43.7 ​% independently predicted mortality (adjusted HR, 1.52, [95 ​% CI: 1.03, 2.22]; p ​= ​0.032). After adjusting for the STS-PROM score in a separate model, LACI ≥43.7 ​% remained an independent prognostic parameter (adjusted HR, 1.47, [95 ​% CI: 1.03–2.08]; p ​= ​0.031). In a sub-analysis of patients with preserved left ventricular ejection fraction, LACI remained a significant predictor (adjusted HR, 1.72 [95 ​% CI: 1.02, 2.89]; p ​= ​0.042).</div></div><div><h3>Conclusions</h3><div>AI-based fully automated assessment of LACI can be used independently to predict mortality in patients undergoing TAVR, including those with preserved LVEF.</div></div>","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"19 2","pages":"Pages 201-207"},"PeriodicalIF":5.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Very severe aortic valve stenosis: Diagnostic value of computed tomography aortic valve calcium scoring","authors":"Matthias Hammerer ,&nbsp;Christoph Knapitsch ,&nbsp;Nikolaos Schörghofer ,&nbsp;Michael Lichtenauer ,&nbsp;Moritz Mirna ,&nbsp;Erika Prinz ,&nbsp;Wilfried Wintersteller ,&nbsp;Klaus Hergan ,&nbsp;Uta C. Hoppe ,&nbsp;Bernhard Scharinger ,&nbsp;Elke Boxhammer","doi":"10.1016/j.jcct.2024.11.004","DOIUrl":"10.1016/j.jcct.2024.11.004","url":null,"abstract":"<div><h3>Background</h3><div>(A) <em>Very severe aortic valve stenosis</em> (VSAS; Vmax ≥ 5 ​m/s, MPG ≥60 ​mmHg) is a critical condition with unfavorable clinical outcomes. Guidelines regard VSAS as one criterion for considering valve replacement in asymptomatic patients. (B) Guidelines recommend the use of <em>aortic valve calcium</em> (AVC) scoring as a parameter to differentiate between moderate and severe aortic valve stenosis (SAS). The aim of our study is to propose AVC thresholds for the discrimination between SAS and VSAS.</div></div><div><h3>Methods</h3><div>Data of patients from a single center who underwent transcatheter aortic valve implantation (n ​= ​523) were retrospectively analyzed. Patients with concordant AS (n ​= ​430) were divided into SAS (n ​= ​344) and VSAS (n ​= ​86) groups and compared in terms of absolute AVC and indexed AVC (body surface area; aortic valve annulus area).</div></div><div><h3>Results</h3><div>Mean AVC was significantly higher in men (m) than in women (w), and significantly higher in VSAS than in SAS (m: SAS 3572.0 AU; VSAS 5465.0 AU; w: SAS 2252.5 AU; VSAS 3064.5 AU; all p ​&lt; ​0,001). ROC curve analyses showed AVC to be a predictor of VSAS in both sexes (m: AUC 0.794; p ​&lt; ​0.001; w: AUC 0.725; p ​&lt; ​0.001), with optimal cut-off values of 3706.5 AU (m) and 2374.5 (w). Some indexed AVC had a slightly, but not relevantly, better predictive value.</div></div><div><h3>Conclusion</h3><div>The proposed AVC thresholds – approximately 3700 AU (m) and 2400 AU (w) - showed significant predictive power to differentiate SAS from VSAS in the study cohort.</div></div>","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"19 2","pages":"Pages 191-200"},"PeriodicalIF":5.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of diabetes mellitus on coronary artery plaque characteristics and outcomes in the SCOT-HEART trial","authors":"Zuzanna M. Gebert ,&nbsp;Jacek Kwiecinski ,&nbsp;Jonathan R. Weir-McCall ,&nbsp;Philip D. Adamson ,&nbsp;Nicholas L. Mills ,&nbsp;Giles Roditi ,&nbsp;Edwin J.R. van Beek ,&nbsp;Edward D. Nicol ,&nbsp;Daniel S. Berman ,&nbsp;Piotr J. Slomka ,&nbsp;Marc R. Dweck ,&nbsp;Damini Dey ,&nbsp;David E. Newby ,&nbsp;Michelle C. Williams","doi":"10.1016/j.jcct.2024.12.083","DOIUrl":"10.1016/j.jcct.2024.12.083","url":null,"abstract":"<div><h3>Background</h3><div>Diabetes mellitus is an established cardiovascular risk factor. We assessed the impact of diabetes mellitus on quantitative plaque and long-term outcomes in patients with and without diabetes mellitus in the Scottish COmputed Tomography of the HEART (SCOT-HEART) trial.</div></div><div><h3>Methods</h3><div>Coronary artery calcium (CAC) was assessed on non-contrast computed tomography (CT). Coronary stenoses, visually assessed adverse plaque characteristics and quantitative plaque burdens (calcified, non-calcified, low attenuation and total, Autoplaque 2.5) were assessed on coronary CT angiography. Multivariable and survival analyses were performed.</div></div><div><h3>Results</h3><div>Images of 1769 patients were assessed (56 ​% male, 58 ​± ​9 years). Diabetes mellitus was present in 196 (11 ​%) patients. Patients with diabetes mellitus had higher 10-year cardiovascular risk score (29 [interquartile range 21, 40] versus 15 [9, 21] %, p ​&lt; ​0.001) and CAC score (71 [1, 447] versus 17 [0, 209] Agatston units, p ​&lt; ​0.001), but were not more likely to have obstructive disease or visually assessed adverse plaque characteristics. Patients with diabetes mellitus had higher quantitatively assessed calcified, non-calcified, low attenuation and total plaque burdens. After adjustment for age and sex, diabetes mellitus was an independent predictor of calcified plaque burden (p ​= ​0.009), but not the other plaque types. During 8.7 [IQR 8, 9.6] years follow-up, diabetes mellitus was associated with an increased risk of fatal or non-fatal myocardial infarction, adjusted for age and sex (hazard ratio 1.85, 95 ​% confidence interval 1.09 to 3.17, p ​= ​0.024).</div></div><div><h3>Conclusion</h3><div>Diabetes mellitus was an independent predictor of quantitatively assessed plaque burden, particularly calcified plaque, and was associated with an increased risk of myocardial infarction.</div></div>","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"19 2","pages":"Pages 208-214"},"PeriodicalIF":5.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical impact of CCT-FFR as first-strategy in patients with symptomatic stable coronary artery disease: A systematic review and meta-analysis","authors":"Gianluca Di Pietro ,&nbsp;Riccardo Improta ,&nbsp;Ovidio De Filippo ,&nbsp;Francesco Bruno ,&nbsp;Lucia Ilaria Birtolo ,&nbsp;Emanuele Bruno ,&nbsp;Nicola Galea ,&nbsp;Marco Francone ,&nbsp;Marc Dewey ,&nbsp;Fabrizio D'Ascenzo ,&nbsp;Massimo Mancone","doi":"10.1016/j.jcct.2025.02.006","DOIUrl":"10.1016/j.jcct.2025.02.006","url":null,"abstract":"<div><div>Aims: Despite the promising results, the clinical implications of the CCT-FFR is already debated. This metanalysis aimed to determine the potential benefits of incorporating FFRCT into stable CAD management.</div><div>Methods: After searching for studies comparing outcomes of patients with suspected stable CAD who underwent CCT-FFR as a first strategy versus non-urgent cardiovascular testing after a clinical judgment, we calculated odds ratios (ORs) and 95 ​% confidence intervals (CIs) using a random-effects or fixed-effects meta-analysis model depending on heterogeneity significance.</div><div>Results: 5 studies (3 RCTs and 2 observational studies) globally encompassing 5282 patients (CCT-FFR ​= ​2604 patients, Control Group ​= ​2678 patients) were included in the quantitative analysis. The rates of ICA overall (OR 1.57, 95%CI 1.36–1.81, p value ​&lt; ​0.001) and those without obstructive CAD (OR 6.63, 95%CI 4.79–9.16, p value ​&lt; ​0.001) were reduced in the CCTAFFR group, as compared to the control group. Moreover, CCT-FFR patients underwent coronary revascularization more frequently than patients in the control arm (OR 0.48,CI 0.38–0.62, p value ​&lt; ​0.001). There was no significance difference between the two strategies in terms of 1 year MACE (OR 1.11,CI 0.86–1.44, p value 0.42), nonfatal MI (OR 0.73, CI 0.41–1.33, p value 0.31), all-cause mortality (OR 1.29,CI 0.47–3.54, p value 0.63) and unplanned revascularization for angina (OR 0.99, 95%CI 0.65–1.49, p value 0.95).</div><div>Conclusions: In conclusion, in the management of stable CAD, the use of CCT-FFR was associated with lower overall rates of ICA but higher rates of coronary revascularization with comparable 1-year clinical impact.</div></div>","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"19 2","pages":"Pages 174-182"},"PeriodicalIF":5.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cover 1/spine update","authors":"","doi":"10.1016/S1934-5925(25)00065-6","DOIUrl":"10.1016/S1934-5925(25)00065-6","url":null,"abstract":"","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"19 2","pages":"Page OFC"},"PeriodicalIF":5.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spring, renewal, and growth in the SCCT","authors":"Maros Ferencik (President, Society of Cardiovascular Computed Tomography)","doi":"10.1016/j.jcct.2025.04.001","DOIUrl":"10.1016/j.jcct.2025.04.001","url":null,"abstract":"","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"19 2","pages":"Page 173"},"PeriodicalIF":5.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the feasibility and accuracy of an on-site prototype workstation in assessing CT derived fractional flow reserve in severe aortic stenosis","authors":"Harsh V. Thakkar,&nbsp;Sean Tan,&nbsp;Jasmine Chan,&nbsp;Abdul R. Ihdayhid,&nbsp;Michael Michail,&nbsp;Adam J. Brown,&nbsp;Brian Ko","doi":"10.1016/j.jcct.2024.10.015","DOIUrl":"10.1016/j.jcct.2024.10.015","url":null,"abstract":"","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"19 2","pages":"Pages 267-268"},"PeriodicalIF":5.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"JCCT PULSE_BW_FP","authors":"","doi":"10.1016/S1934-5925(25)00076-0","DOIUrl":"10.1016/S1934-5925(25)00076-0","url":null,"abstract":"","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"19 2","pages":"Page IBC"},"PeriodicalIF":5.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SCCT Learning Center_BW_FP","authors":"","doi":"10.1016/S1934-5925(25)00066-8","DOIUrl":"10.1016/S1934-5925(25)00066-8","url":null,"abstract":"","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"19 2","pages":"Page IFC"},"PeriodicalIF":5.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}