Journal of Cardiovascular Computed Tomography最新文献

{"title":"Filler advert Pharmapendium_2021_210x280.pdf","authors":"","doi":"10.1016/S1934-5925(26)00065-1","DOIUrl":"10.1016/S1934-5925(26)00065-1","url":null,"abstract":"","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"20 2","pages":"Page IFC"},"PeriodicalIF":5.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147707107","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":"Response to Letter – referencing JCCT-D-25-426 ‘‘Integrating radiomics into coronary computed tomography angiography: Enhancing prognostic value after percutaneous coronary intervention’’ by Macit Kalçık et al.","authors":"Yunosuke Matsuura , Soichi Komaki , Yoshikazu Uchiyama , Koichi Kaikita","doi":"10.1016/j.jcct.2025.09.015","DOIUrl":"10.1016/j.jcct.2025.09.015","url":null,"abstract":"","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"20 2","pages":"Page 207"},"PeriodicalIF":5.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260256","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":"Reassessing pretest probability: Coronary artery calcium alone predicts obstructive CAD","authors":"Alan Rozanski, Robert J.H. Miller, Heidi Gransar, Donghee Han, Sean W. Hayes, John D. Friedman, Leslee J. Shaw, Daniel S. Berman","doi":"10.1016/j.jcct.2025.08.011","DOIUrl":"10.1016/j.jcct.2025.08.011","url":null,"abstract":"","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"20 2","pages":"Pages 202-203"},"PeriodicalIF":5.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058840","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":"Feasibility and utility of anatomical and physiological evaluation of coronary artery disease with cardiac CT in severe aortic stenosis (FUTURE-AS registry)","authors":"Abdul Rahman Ihdayhid ,&nbsp;Stephanie L. Sellers ,&nbsp;Venkateshwar Polsani ,&nbsp;Timothy Fairbairn ,&nbsp;John Khoo ,&nbsp;Timothy P. Fitzgibbons ,&nbsp;Frank Corrigan ,&nbsp;Brian Ko ,&nbsp;Robert Gooley ,&nbsp;Esad Vucic ,&nbsp;Shizhen Liu ,&nbsp;Fionn Coughlan ,&nbsp;Gerald Yong ,&nbsp;Sharad Shetty ,&nbsp;Andrew Chatfield ,&nbsp;Mariama Akodad ,&nbsp;Arash Mohammadi ,&nbsp;Vikram Raju ,&nbsp;Stephen Lewin ,&nbsp;Philipp Blanke ,&nbsp;Jonathon Leipsic","doi":"10.1016/j.jcct.2025.12.012","DOIUrl":"10.1016/j.jcct.2025.12.012","url":null,"abstract":"<div><h3>Background</h3><div>Coronary artery disease (CAD) is common in patients with severe aortic stenosis (AS) and may impact transcatheter aortic valve replacement (TAVR) procedural and long-term outcomes. CT coronary angiography (CTA) and CT-derived fractional flow reserve (FFR_CT) are tools used to assess CAD. However, adoption in the TAVR population is hindered by safety concerns with nitroglycerin and beta-blockers. The safety, accuracy, and utility of CTA and FFR_CT optimised with these medications for TAVR have not been established.</div></div><div><h3>Methods</h3><div>This international, multi-center, prospective registry included severe AS patients referred for TAVR, assessed for CAD with CTA and FFR_CT. Patients all received nitroglycerin and beta-blockers as needed to optimise image quality. Severe ventricular dysfunction, recent syncope/heart failure, critical hemodynamics, or prior revascularization were excluded. Significant CAD was defined as CTA stenosis ≥50 ​% and FFR_CT≤0.75. Primary endpoint was per-patient sensitivity and negative predictive value (NPV) of CTA compared to invasive coronary angiography (ICA). Secondary endpoints included specificity and positive predictive value (PPV) of CTA and FFR_CT, safety, feasibility (non-evaluable rate), and the modelled potential of CTA ​+ ​FFR_CT to reduce pre-TAVR ICA.</div></div><div><h3>Results</h3><div>327 patients (75.9 ​± ​9.7 years, 53 ​% male) underwent CTA. CTA was safe and well tolerated in nearly all patients, with transient hypotension in 4 (1.2 ​%). CTA was evaluable in 326 patients (99.7 ​%), with 9 (2.8 ​%) having a non-evaluable vessel. FFR_CT and ICA were performed in 110 (33.6 ​%) and 133 (40.7 ​%) patients, respectively. Per-patient sensitivity, specificity, NPV, and PPV of CTA were 100 ​%, 71.4 ​%, 100 ​%, and 75.9 ​% and per-vessel 82.7 ​%, 78.9 ​%, 92.3 ​%, and 59.9 ​%. FFR_CT improved specificity and PPV to 88.9 ​% and 88.0 ​% for per-patient and 95.1 ​% and 81.8 ​% for per-vessel analysis. Using a simulated triage model deferring ICA in patients with CTA &lt;50 ​% or ≥50 ​% stenosis with FFR_CT &gt;0.75, 267 patients (81.7 ​%) could potentially have avoided ICA.</div></div><div><h3>Conclusion</h3><div>Coronary CTA performed with nitroglycerin and selective use of beta-blockers is safe and effective for assessing CAD in stable severe AS patients. Combining CTA and FFR_CT enhances diagnostic accuracy, potentially reducing the need for invasive angiography and streamlining TAVR workup.</div></div>","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"20 2","pages":"Pages 148-156"},"PeriodicalIF":5.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021258","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(26)00064-X","DOIUrl":"10.1016/S1934-5925(26)00064-X","url":null,"abstract":"","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"20 2","pages":"Page OFC"},"PeriodicalIF":5.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147707106","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":"Novel deep learning CCTA-FFR for detecting functionally significant coronary stenosis: Comparison with iFR","authors":"Mona P. Roshan ,&nbsp;Grayson V. Gigliotti ,&nbsp;Jeffrey Gonzalez ,&nbsp;Ricardo A. Cury ,&nbsp;Chrisnel Lamy ,&nbsp;Karl Sayegh ,&nbsp;Ricardo C. Cury","doi":"10.1016/j.jcct.2025.12.007","DOIUrl":"10.1016/j.jcct.2025.12.007","url":null,"abstract":"<div><h3>Background</h3><div>Deep learning–based fractional flow reserve derived from coronary CT angiography (CT-FFR) enables noninvasive assessment of lesion-specific ischemia. Onsite CT-FFR systems provide near–real-time physiologic evaluation at the workstation, potentially reducing unnecessary invasive testing. This study evaluated the diagnostic performance of a novel onsite deep learning CT-FFR algorithm compared with invasive instantaneous wave-free ratio (iFR).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 44 patients (44 lesions) who underwent clinically indicated coronary CT angiography (CCTA) and invasive iFR. CT-FFR values were generated using an onsite deep learning algorithm (cFFR v6) 1–2 ​cm distal to visually identified stenoses. Physiologic significance was defined as CT-FFR ≤0.80 or iFR ≤0.89. Diagnostic performance metrics were calculated overall and within CCTA stenosis strata (&lt;50 ​%, 50–70 ​%, &gt;70 ​%). ROC analysis and Pearson correlation assessed discriminative ability and linear association. Additional comparative analyses evaluated diagnostic accuracy of CCTA ≥50 ​% and ≥70 ​% thresholds relative to iFR and quantified incremental diagnostic value of CT-FFR over CCTA alone.</div></div><div><h3>Results</h3><div>Of 44 lesions, 28 (63.6 ​%) were iFR-positive and 30 (68.2 ​%) were CT-FFR–positive. CT-FFR demonstrated a sensitivity of 89.3 ​%, specificity of 68.8 ​%, positive predictive value of 83.3 ​%, negative predictive value of 78.6 ​%, and accuracy of 81.8 ​%; the area under the ROC curve was 0.79 (95 ​% CI, 0.66–0.92). CT-FFR and iFR showed a modest but significant correlation (r ​≈ ​0.37). Performance remained favorable in moderate (40–70 ​%) stenoses (AUC 0.73) and severe (&gt;70 ​%) stenoses (AUC 0.84). In contrast, CCTA ≥50 ​% and ≥70 ​% thresholds showed limited discriminatory ability versus iFR (AUC 0.44 and 0.52, respectively). Compared with CCTA alone, CT-FFR improved both sensitivity and specificity and substantially increased AUC across both thresholds.</div></div><div><h3>Conclusion</h3><div>The onsite deep learning CT-FFR algorithm demonstrated good diagnostic agreement with invasive iFR and maintained performance across stenosis severity categories, while providing clear incremental value over CCTA stenosis assessment alone. These findings support the feasibility of rapid, workstation-integrated physiologic assessment during CCTA interpretation. Larger multicenter studies are needed to validate these results and clarify the clinical role of onsite CT-FFR.</div></div>","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"20 2","pages":"Pages 132-139"},"PeriodicalIF":5.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949190","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":"Disease progression and plaque composition in patients with non-obstructive coronary artery disease (THRONE): A coronary computed tomography angiography follow-up study","authors":"Karim D. Mahmoud ,&nbsp;Simran P. Sharma ,&nbsp;Ricardo P.J. Budde ,&nbsp;Admir Dedic ,&nbsp;Kaneshka Masdjedi ,&nbsp;Miguel E. Lemmert ,&nbsp;Joost Daemen ,&nbsp;Jonathan A. Leipsic ,&nbsp;Rafael J. de Windt ,&nbsp;Paul Cummins ,&nbsp;Isabella Kardys ,&nbsp;Maarten J.G. Leening ,&nbsp;Alexander Hirsch ,&nbsp;Nicolas M. Van Mieghem","doi":"10.1016/j.jcct.2026.01.006","DOIUrl":"10.1016/j.jcct.2026.01.006","url":null,"abstract":"<div><h3>Background</h3><div>Fractional flow reserve (FFR)-negative coronary lesions are usually managed medically. Lesion-specific plaque characterization and FFR changes over time remain elusive.</div></div><div><h3>Aims</h3><div>To assess disease progression in FFR-negative lesions over a two-year period using FFR derived from coronary CT angiography (CCTA) (FFRct) and to investigate whether FFR decline over a two-year period is associated with plaque characteristics.</div></div><div><h3>Methods</h3><div>This single-center prospective study included patients undergoing coronary angiography with one or more invasive intermediate lesions (FFR 0.81–0.90) in non-stented, non-culprit coronary arteries. Two years after the index procedure, patients underwent CCTA with FFRct and quantitative plaque analysis.</div></div><div><h3>Results</h3><div>We enrolled 131 patients (152 vessels). Two-year follow-up with FFRct and plaque analysis was available in 68 (52 ​%) patients (73 vessels). Compared to invasive FFR at baseline, FFRct at 2y follow-up was significantly lower (median difference −0.06) at vessel level analysis (p ​&lt; ​0.001). FFR declined in 55 (75 ​%) lesions. The 35 study vessels with an FFRct≤0.80 ​at 2-year follow-up had higher total percent atheroma volume (PAV) (41 ​% vs. 23 ​%; p ​= ​0.002) and more high-risk plaque composition, including noncalcified PAV (30 ​% vs. 18 ​%; p ​= ​0.002), and low-attenuation PAV (1.1 ​% vs. 0.7 ​%; p ​= ​0.046) compared to vessels with an FFRct&gt;0.80 (n ​= ​38). Rates of study vessel revascularization in the 131 patients were 6.9 ​% at 2 years and 15.1 ​% after 4.9 years of follow-up after index procedure.</div></div><div><h3>Conclusions</h3><div>Rates of coronary revascularization are substantial in patients with medically managed intermediate lesions. In this selected cohort, an FFRct ≤0.80 ​at two-year follow-up was associated with higher plaque burden and presence of high-risk plaque composition.</div></div>","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"20 2","pages":"Pages 177-184"},"PeriodicalIF":5.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115402","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":"Strengthening the evidence on air pollution and coronary heart diseases: Exposure and confounding challenges","authors":"Macit Kalçık,&nbsp;Mucahit Yetım","doi":"10.1016/j.jcct.2025.08.010","DOIUrl":"10.1016/j.jcct.2025.08.010","url":null,"abstract":"","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"20 2","pages":"Page 201"},"PeriodicalIF":5.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994858","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":"Disproportionate atherosclerotic burden in the left anterior descending coronary artery in participants without standard modifiable cardiovascular risk factors: The multi-ethnic study of atherosclerosis (MESA)","authors":"Michael P. Gray ,&nbsp;Kristy P. Robledo ,&nbsp;Anthony C. Keech ,&nbsp;Stephen T. Vernon ,&nbsp;Matthew J. Budoff ,&nbsp;Gemma A. Figtree","doi":"10.1016/j.jcct.2026.01.004","DOIUrl":"10.1016/j.jcct.2026.01.004","url":null,"abstract":"<div><h3>Background</h3><div>Standard modifiable cardiovascular risk factors (SMuRF) have been identified for coronary artery disease (CAD) and targeted in primary prevention efforts, resulting in significantly improved outcomes. However, an increasing proportion of individuals present with ST elevation myocardial infarction (STEMI) in the absence of conventionally elevated levels of modifiable risk factors (“SMuRFless”), with significantly worse short-term outcomes. Culprit lesions of the left anterior descending artery (LAD) are more frequently implicated in SMuRFless STEMI patients than those with at least one risk factor. Differences in segmental-level coronary disease burden outside the acute setting in SMuRFless individuals are largely unknown.</div></div><div><h3>Objectives</h3><div>To characterise vessel-level coronary calcification, comparing SMuRFless to SMuRF≥1 participants.</div></div><div><h3>Methods</h3><div>Secondary analysis of the Multi-Ethnic Study of Atherosclerosis (MESA) was completed. Coronary artery calcium score (CACS) was measured at baseline and follow-up (median 6.3 years).</div></div><div><h3>Results</h3><div>6792 participants were included, with 20.6 ​% classified as SMuRFless. Among participants with detectable coronary calcification at baseline, SMuRFless participants had a significantly higher proportion of their total coronary calcium localised to the LAD, compared to SMuRF≥1 participants (74.2 ​% vs. 58.9 ​%, p ​&lt; ​0.0001). This difference was most pronounced in individuals with higher baseline total CACS (CACS 100–400 Agatston units [AU] and CACS 401+), but attenuated after multivariable adjustment and was not statistically significant in best-subsets modelling. LAD CACS progressed in both groups during follow-up; however, annualised progression rates were similar between SMuRFless and SMuRF≥1 participants after adjustment for total coronary calcium progression and follow-up duration.</div></div><div><h3>Conclusion</h3><div>SMuRFless MESA participants had a higher unadjusted proportion of coronary calcification in the LAD compared SMuRF≥1 participants; however, this associated attenuated after multivariable adjustment. Further research is warranted to better understand the development of atherosclerotic CAD in SMuRFless individuals, and biological relevance and potentially different susceptibility at the epicardial segment level.</div></div>","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"20 2","pages":"Pages 164-170"},"PeriodicalIF":5.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097783","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":"CCTA and CTO-PCI – ‘see’ beyond the blind end","authors":"A. Aldajani,&nbsp;Z. Ahmed,&nbsp;A.Y. Chong","doi":"10.1016/j.jcct.2026.01.013","DOIUrl":"10.1016/j.jcct.2026.01.013","url":null,"abstract":"","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"20 2","pages":"Pages 130-131"},"PeriodicalIF":5.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183989","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}