Journal of cardiovascular computed tomography最新文献

{"title":"Association between circulating ketone bodies and subclinical atherosclerosis: Multi-Ethnic Study of Atherosclerosis (MESA).","authors":"Parag Anilkumar Chevli, Alexander C Razavi, Joni K Evans, Richard Kazibwe, Margery A Connelly, Sadiya S Khan, Ambarish Pandey, Matthew C Tattersall, James H Stein, Michael D Shapiro","doi":"10.1016/j.jcct.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.jcct.2025.02.001","url":null,"abstract":"","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-risk plaque features and perivascular inflammation.","authors":"Daisuke Kinoshita, Keishi Suzuki, Daichi Fujimoto, Takayuki Niida, Yoshiyasu Minami, Damini Dey, Hang Lee, Iris McNulty, Junya Ako, Maros Ferencik, Tsunekazu Kakuta, Ik-Kyung Jang","doi":"10.1016/j.jcct.2025.01.010","DOIUrl":"https://doi.org/10.1016/j.jcct.2025.01.010","url":null,"abstract":"<p><strong>Background: </strong>The association between high-risk plaque (HRP) on coronary computed tomography angiography (CTA) and the level of perivascular inflammation has not been fully investigated.</p><p><strong>Methods: </strong>Patients who underwent both CTA and optical coherence tomography (OCT) were included. The level of perivascular inflammation was assessed by pericoronary adipose tissue (PCAT) attenuation at two levels: lesion-specific and the proximal segment of the culprit vessel. HRP features included positive remodeling (PR), low-attenuation plaque (LAP), napkin-ring sign (NRS), and spotty calcification (SC).</p><p><strong>Results: </strong>OCT features of plaque vulnerability were evaluated in culprit vessels. A total of 1360 lesions (413 culprit lesions and 947 non-culprit lesions) from 413 patients were evaluated. Lesion-specific PCAT attenuation was higher in lesions with any HRP feature except SC (present vs. absent: PR -71.3 ​± ​10.1 vs. -74.1 ​± ​11.7, P ​< ​0.001; LAP -71.7 ​± ​9.9 vs. -73.0 ​± ​11.4, P ​= ​0.025; NRS -70.3 ​± ​9.6 vs. -72.9 ​± ​11.1, P ​= ​0.001; and SC -71.9 ​± ​9.9 vs. -73.0 ​± ​11.5, P ​= ​0.082). After adjusting for confounders, only PR was associated with higher lesion-specific PCAT attenuation. The number of lesions with PR significantly correlated with higher levels of perivascular inflammation measured by culprit vessel PCAT attenuation. The number of lesions with PR was associated with higher lipid index and macrophage grade at culprit vessels.</p><p><strong>Conclusions: </strong>Among 4 HRP features, only PR was significantly associated with higher lesion-specific PCAT attenuation. The number of plaques with PR correlated with the level of perivascular inflammation and vulnerability.</p><p><strong>Trial registration: </strong>clinicaltrials.gov Identifier: NCT04523194.</p>","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143375064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual-layer spectral CT reference values for myocardial static resting perfusion. Exploring sex differences through machine learning.","authors":"Cristian Herrera Flores, Antonio Sánchez-Puente, Jesús Rodríguez Nieto, Javier Maillo-Seco, Rosa Ana López-Jiménez, Ana Martín-García, Soraya Merchán-Gómez, María Gallego-Delgado, Rocio Eiros, Leyre Álvarez-Rodríguez, Leticia Nieto-García, Leticia Vicente-Pacho, M Carmen García-García, Pablo Pérez-Sánchez, David Álvarez-Herrero, Luis M Rincón, Pedro L Sánchez, Candelas Pérez Del Villar","doi":"10.1016/j.jcct.2025.01.009","DOIUrl":"https://doi.org/10.1016/j.jcct.2025.01.009","url":null,"abstract":"","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel CT-derived markers for enhanced long-term risk stratification in the planning of TAVR for aortic stenosis.","authors":"Daniel Lorenzatti, Annalisa Filtz, Jolien Geers, Kajetan Grodecki, Vita Jaspan, Colin Pierce, Matthew J Miller, Christine Park, Alexandrina Danilov, Ron Blankstein, Thomas A Treibel, João L Cavalcante, Leslee J Shaw, Marc R Dweck, Piotr J Slomka, Damini Dey, Leandro Slipczuk","doi":"10.1016/j.jcct.2025.01.008","DOIUrl":"https://doi.org/10.1016/j.jcct.2025.01.008","url":null,"abstract":"<p><p>In an era of rapidly expanding use of transcatheter aortic valve replacement (TAVR), cardiovascular computed tomography (CCT) has become an essential component in the evaluation process for the growing number of patients. Because of the nature of the guideline-recommended protocol -involving several different CCT acquisitions-it represents a unique dataset for comprehensive phenotyping of the patient with significant aortic stenosis. A substantial body of data has established CCT as a central tool in pre-procedural implantation planning. However, emerging evidence suggests a potential new role for CCT in phenotyping patient risk beyond the index procedure. This new role could represent a unique opportunity in patient selection, medication optimization and follow up post TAVR aiming to improve long-term prognosis. This review highlights emerging data on CCT imaging features for risk stratification in patients during long-term follow-up after TAVR. We summarize the existing literature on this topic and explore whether comprehensive CCT-derived information could be integrated into clinical practice, potentially enhancing TAVR patient selection and post-procedural care.</p>","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of cine cardiac CT and echocardiography for assessment of ventricular function late after the Fontan operation.","authors":"Surachai Kongrat, Daniel A Castellanos, Nao Sasaki, Stuart Lipsitz, David Schidlow, Rebecca Beroukhim, Rahul H Rathod, Ashwin Prakash, Sunil J Ghelani","doi":"10.1016/j.jcct.2025.01.006","DOIUrl":"https://doi.org/10.1016/j.jcct.2025.01.006","url":null,"abstract":"","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of obstructive coronary artery disease using coronary calcification and epicardial adipose tissue assessments from CT calcium scoring scans.","authors":"Juhwan Lee, Tao Hu, Michelle C Williams, Ammar Hoori, Hao Wu, Justin N Kim, David E Newby, Robert Gilkeson, Sanjay Rajagopalan, David L Wilson","doi":"10.1016/j.jcct.2025.01.007","DOIUrl":"https://doi.org/10.1016/j.jcct.2025.01.007","url":null,"abstract":"<p><strong>Background: </strong>Low-cost/no-cost non-contrast CT calcium scoring (CTCS) exams can provide direct evidence of coronary atherosclerosis. In this study, using features from CTCS images, we developed a novel machine learning model to predict obstructive coronary artery disease (CAD), as defined by the coronary artery disease-reporting and data system (CAD-RADS).</p><p><strong>Methods: </strong>This study analyzed 1324 patients from the SCOT-HEART trial who underwent both CTCS and CT angiography. Obstructive CAD was defined as CAD-RADS 4A-5, while CAD-RADS 0-3 were considered non-obstructive CAD. We analyzed clinical, Agatston-score-derived, and epicardial fat-omics features to predict obstructive CAD. The most predictive features were selected using elastic net logistic regression and used to train a CatBoost model. Model performance was evaluated using 1000 repeated five-fold cross-validation and survival analyses to predict major adverse cardiovascular event (MACE) and revascularization. Generalizability was assessed using an external validation set of 2316 patients for survival predictions.</p><p><strong>Results: </strong>Among the 1324 patients, obstructive CAD was identified in 334 patients (25.2 ​%). Elastic net regression identified the top 14 features (5 clinical, 2 Agatston-score-derived, and 7 fat-omics). The proposed method achieved excellent performance for classifying obstructive CAD, with an AUC of 90.1 ​± ​0.9 ​% and sensitivity/specificity/accuracy of 83.5 ​± ​5.5 ​%/93.7 ​± ​1.9 ​%/82.4 ​± ​2.0 ​%. The inclusion of Agatston-score-derived and fat-omics features significantly improved classification performance. Survival analyses showed that both actual and predicted obstructive CAD significantly differentiated patients who experienced MACE and revascularization.</p><p><strong>Conclusions: </strong>We developed a novel machine learning model to predict obstructive CAD from non-contrast CTCS scans. Our findings highlight the potential clinical benefits of CTCS imaging in identifying patients likely to benefit from advanced imaging.</p>","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between symptom characteristics and disease severity in patients suspected of coronary artery disease.","authors":"Oliver Buchhave Pedersen, Laust Dupont Rasmussen, Louise Nissen, June Anita Ejlersen, Jesper Mortensen, Lars Christian Gormsen, Ashkan Eftekhari, Jelmer Westra, Evald Høj Christiansen, Daniel B Mark, Morten Bøttcher, Pamela S Douglas, Simon Winther","doi":"10.1016/j.jcct.2025.01.004","DOIUrl":"https://doi.org/10.1016/j.jcct.2025.01.004","url":null,"abstract":"<p><strong>Background: </strong>Discrepancies often exist between patient-reported symptoms and diagnostic test findings in patients with suspected obstructive coronary artery disease (CAD).</p><p><strong>Objectives: </strong>To quantify the association between patient-reported symptoms and the diagnosis of severe stenosis in patients with suspected obstructive CAD.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variability in technical fee billing for cardiac CT across congenital cardiac centers.","authors":"Spencer Barfuss, Corinne Ballard, Bethany Marullo, Jake Zimmerli, Luke Linscott, Cody Coonradt, B Kelly Han","doi":"10.1016/j.jcct.2024.12.089","DOIUrl":"https://doi.org/10.1016/j.jcct.2024.12.089","url":null,"abstract":"<p><strong>Background: </strong>Cardiac Computed Tomography (CCT) is increasingly used to provide 2D, 3D and 4D information in patients with congenital heart disease of all ages. Historically, negotiated rates for professional and technical fees associated with cardiac imaging were confidential, with variability in professional, technical and global charges, reimbursement and cost to patients for the same current procedural terminology (CPT) code at different institutions. Billing transparency is a key component of both the CARE act passed in 2020 and the Health Care PRICE Transparency Act 2.0 passed in 2021. Institutional technical fees and negotiated insurance rates by CPT billing code are now publicly available and can be compared between institutions.</p><p><strong>Methods: </strong>A cohort of congenital heart disease programs was identified as the top 50 programs by procedural volume (Society of Thoracic Surgeons database) and by national rankings (US News and World Report). The publicly available negotiated reimbursement rates for the technical component of billing for CPT codes used for CHD CCT (75572, 75573, and 75574) at each center was determined (trybilly.app). The cash price, average insured price and the range of negotiated insured prices for the technical component of CHD CCT were recorded. The variability of technical fee charges for programs were calculated as median, IQR and range. Technical fee correlation to RVUs was also calculated. Professional fee and global procedural fees are not available for comparison.</p><p><strong>Results: </strong>For the 75572 code, the median charge was $1209.50, IQR (783.50, 1673.75), and range was (49,2618). For the 75573 code, the median charge was $958, IQR (718,1403), and range (60,2622). For the 75574 code the median charge was $1060, IQR (833.5,1604), and range (61,2948). There was a 53-fold difference in technical fee charges for C CT between low and high negotiated insurance prices. Charges for CCT in CHD were not correlated with US News rankings or surgical center volume. There was no correlation between RVUs and technical fees.</p><p><strong>Conclusion: </strong>There is significant variability in the charges for the technical component of CCT in CHD, not correlated with national ranking or surgical volume. Variability in charges for identical services across centers may have a disproportionate impact on uninsured and underinsured populations. and lead to inequity. This data may inform negotiations for reimbursement for this time-consuming skill set. The variability of technical fee associated with CT for CHD has not been previously analyzed or compared by national ranking or surgical volumes.</p>","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proposed resources required for a comprehensive program for CCT CHD imaging.","authors":"B Kelly Han, Cynthia K Rigsby, Tarique Hussain, Anthony Hlavacek, Anjali Chelliah, Kanwal M Farooqi, Jennifer Cohen, Timothy Slesnick, Rajesh Krishnamurthy, Taylor Chung, Prachi P Agarwal, Ashwin Prakash, Sunil Ghelani, Aurelio Secinaro, Brian Ghoshhadra, Shazia Mohsin, Aloha Maeve, Mahesh Kappanayil, Renee P Bullock-Palmer, Cristina Fuss, James Shambrook, Thomas Semple, Angela M Kelle, Li San Lynette Teo, Lorna P Browne, Edward D Nicol","doi":"10.1016/j.jcct.2025.01.003","DOIUrl":"https://doi.org/10.1016/j.jcct.2025.01.003","url":null,"abstract":"<p><strong>Background: </strong>Cardiac Computed Tomography (CCT) is increasingly used for evaluation of congenital heart disease (CHD) in patients of all ages. Pediatric and adult congenital heart disease (ACHD) surgical programs require high quality CCT imaging as part of the multimodality imaging support expected of comprehensive care centers. Despite these expectations, there are no benchmarks or defined programmatic elements specific to the performance of CCT in patients with CHD. To address this deficit, this manuscript is written by a group of current CHD CCT practitioners and provides a collective opinion regarding the clinical components required, and essential resources needed, to deliver a comprehensive CCT CHD imaging program. Resource allocation was divided into CCT technology, imaging technologist, physician and programmatic support. The group is inclusive of pediatric and adult cardiologists and radiologists and includes practitioners from high and lower resourced programs and countries. Imaging settings are inclusive of academic and private practice, heart centers and combined radiology/cardiology service lines. Challenges and areas for future advocacy to support this growing specialty are proposed to improve performance standards that will consider the expected widespread variation in technical and staffing resources, skillsets, and practice settings for CT in CHD.</p><p><strong>Summary: </strong>High quality cardiovascular computed tomography is an essential component of pediatric and adult congenital programs and surgical centers. Program growth outpaces resource allocation in most institutions. This opinion paper outlines essential components for technical, technologist and physician resources and programmatic support to develop and maintain a successful CCT in CHD program. Although a small component of most cardiac imaging programs, it is an essential component particularly in complex cases. Institutional and imaging societal commitment is essential to support this emerging field at highest quality.</p>","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disrupting diastole toward consistency in systole: Iterations to increase CCTA protocol standardization.","authors":"Brian Ghoshhajra","doi":"10.1016/j.jcct.2024.12.085","DOIUrl":"https://doi.org/10.1016/j.jcct.2024.12.085","url":null,"abstract":"","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}