Journal of cardiovascular computed tomography最新文献

{"title":"Determinants of myocardial extracellular volume fraction derived from coronary CT angiography in patients with chronic coronary syndrome.","authors":"Kodai Sayama, Yoshihisa Kanaji, Eisuke Usui, Hiroki Ueno, Takumi Watanabe, Tomohiro Tahara, Takahiro Watanabe, Riko Murakami, Shunta Hiroi, Kaisei Hosokawa, Kai Nogami, Masahiro Hada, Masahiro Hoshino, Tomoyo Sugiyama, Taishi Yonetsu, Tetsuo Sasano, Tsunekazu Kakuta","doi":"10.1016/j.jcct.2026.06.010","DOIUrl":"https://doi.org/10.1016/j.jcct.2026.06.010","url":null,"abstract":"<p><strong>Background: </strong>Although myocardial extracellular volume fraction (ECV) derived from coronary computed tomography angiography (CCTA) is a robust prognostic marker across diverse cardiovascular pathologies, its precise pathophysiological determinants in patients with chronic coronary syndrome (CCS) remain poorly elucidated.</p><p><strong>Methods: </strong>This retrospective study aimed to identify clinical and imaging factors independently associated with myocardial ECV in CCS patients. We analyzed 290 consecutive patients (mean age 66.6 ​± ​12.6 years) who underwent clinically indicated CCTA with a dedicated ECV protocol. Key exclusion criteria included prior coronary revascularization, acute or prior myocardial infarction, known cardiomyopathy, severe valvular disease, or arrhythmias to isolate CCS-specific associations.</p><p><strong>Results: </strong>The median global myocardial ECV was 31.6% (IQR: 28.5-34.9%). Multivariable linear regression analysis identified female sex (β ​= ​2.610), H2FPEF score (β ​= ​0.909), left ventricular end-systolic diameter (LVDs; β ​= ​0.182), and coronary artery calcium score (CACS; β ​= ​0.001) as independent determinants of expanded ECV (all P ​< ​0.01). Notably, myocardial ECV exhibited a significant stepwise increase corresponding to the cumulative presence of these predictors (P ​< ​0.001), particularly in male patients. This relationship persisted regardless of the presence or anatomical severity of epicardial coronary artery stenosis, suggesting that ECV reflects myocardial interstitial remodeling that occurs independently of macrovascular obstruction.</p><p><strong>Conclusion: </strong>In patients with CCS, myocardial ECV is independently driven by female sex, H2FPEF score, LVDs, and CACS. These findings underscore that CCTA-derived ECV represents a multifactorial marker of myocardial health, necessitating an integrated interpretation of clinical and structural variables. Understanding these complex associations is crucial for refining the role of ECV in the risk stratification and personalized clinical management of patients with chronic coronary syndrome.</p>","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297753","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":"Added value of photon-counting CT for triple rule-out imaging: A propensity-matched comparison with energy-integrating CT.","authors":"Sardi Hyska, Milán Vecsey-Nagy, Tilman Emrich, José Osoria-Velasquez, Moritz C Halfmann, Jens Ricke, Nicola Fink, Fabian Bamberg, Ismail Mikdat Kabakus, Pál Maurovich-Horvat, Akos Varga-Szemes, Muhammad Taha Hagar","doi":"10.1016/j.jcct.2026.06.006","DOIUrl":"https://doi.org/10.1016/j.jcct.2026.06.006","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the technical performance of photon-counting detector (PCD)-CT and energy-integrating detector (EID)-CT in triple rule-out (TRO) imaging.</p><p><strong>Methods: </strong>In this IRB-approved single-center study, consecutive TRO-CT patients underwent dual-source EID-CT or PCD-CT with 75 or 98.5 ​mL iopromide. Propensity score matching generated four groups: EID-75, EID-98.5, PCD-75 and PCD-98.5. Axial polychromatic images were reconstructed at 1.0 ​mm for whole-thorax and 0.6 ​mm for coronary assessment using a vascular kernel (Bv36). Volume CT dose index (CTDI_vol), contrast-to-noise ratio (CNR), and diagnostic confidence (Likert 4, excellent) were compared across vascular territories. Diagnostic performance for coronary stenosis was assessed in patients undergoing invasive coronary angiography.</p><p><strong>Results: </strong>A total of 96 subjects (mean age 62.0 ​± ​13.1 years; 62.5% female, n ​= ​24 per group) were included. TRO-CT ruled out aortic, coronary and pulmonary pathology in 69/96 (71.9%) patients. PCD-CT showed 32.3% lower CTDIvol than EID-CT (29.3 [23.5-41.4] vs 43.3 [36.6-51.0] mGy; p ​< ​0.001). PCD-98.5 yielded the highest CNR (aorta, 32.2 [25.5-44.1]; coronaries, 24.5 [19.5-31.3]; and pulmonary arteries, 36.8 [28.0-45.3]; all p ​< ​0.001). Pulmonary CNR with PCD-75 was comparable to EID-98.5 despite lower contrast volume (22.4 [19.1-28.8] vs 24.2 [20.3-29.6]; p ​= ​0.437). Segmental pulmonary diagnostic confidence increased from fair (2 [1-3]) with EID-98.5 to excellent (4 [3-4]) with PCD-98.5 (p ​< ​0.001). TRO-CT showed coronary segment-based sensitivity of 94.4% (17/18) and specificity of 93.2% (218/234), with no AUC difference between EID-CT and PCD-CT (0.961 vs 0.936; p ​= ​0.361).</p><p><strong>Conclusion: </strong>PCD-CT enabled robust TRO imaging with lower radiation dose, higher multi-territory CNR, and greater segmental pulmonary diagnostic confidence, addressing key limitations of conventional TRO protocols.</p>","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148285003","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":"Main pulmonary artery diameter and atrial arrhythmia recurrence after atrial fibrillation ablation.","authors":"Jack Tiahnybik, Takeki Suzuki","doi":"10.1016/j.jcct.2026.06.003","DOIUrl":"https://doi.org/10.1016/j.jcct.2026.06.003","url":null,"abstract":"","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148274452","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 the Statin responders with radiomics.","authors":"Sang-Eun Lee, Youngtaek Hong, Juyeong Jung, Ji Min Sung, Daniele Andreini, Mouaz H Al-Mallah, Matthew J Budoff, Filippo Cademartiri, Kavitha Chinnaiyan, Jung Hyun Choi, Eun Ju Chun, Edoardo Conte, Ilan Gottlieb, Martin Hadamitzky, Yong Jin Kim, Byoung Kwon Lee, Jonathon A Leipsic, Erica Maffei, Hugo Marques, Pedro de Araújo Gonçalves, Gianluca Pontone, Sanghoon Shin, Peter H Stone, Habib Samady, Renu Virmani, Jagat Narula, Leslee J Shaw, Jeroen J Bax, Fay Y Lin, James K Min, Hyuk-Jae Chang","doi":"10.1016/j.jcct.2026.05.010","DOIUrl":"https://doi.org/10.1016/j.jcct.2026.05.010","url":null,"abstract":"<p><strong>Background: </strong>Statins are a cornerstone medication for coronary atherosclerosis. This study assessed whether radiomic analysis of coronary computed tomography angiography (CCTA) could predict patient response to statin therapy.</p><p><strong>Methods: </strong>Patients from a multinational registry with serial CCTA (≥2-year intervals) on statin therapy were analyzed. Radiomic scores were calculated, categorizing patients as statin responders or non-responders (≥1.0% increase in percent atheroma volume (PAV) per year indicated non-response). Data were split into training (79%) and test (21%) sets based on sites. Four predictive models were developed: Model 1 used clinical risk factors (CRF), Model 2 included CRF, calcified and non-calcified PAV, and number of high-risk plaques. Model 3 used only the radiomic score, and Model 4 combined Models 2 and 3.</p><p><strong>Results: </strong>A total of 386 statin responders (mean age 61.2 ​± ​8.4 years, 60.1% male) and 177 statin non-responders (mean age 63.2 ​± ​9.0 years, 44.1% male) were analyzed. Model 3, based solely on the radiomic score, demonstrated superior predictive power compared to Model 1 (area under the receiver operating characteristic curve [AUC] [95% confidence interval (CI)]: 0.75 [0.67-0.83] vs 0.54 [0.45-0.63], p ​< ​0.05) and was comparable to Model 2 (AUC [95% CI]: 0.82 [0.74-0.88], p ​> ​0.05) in the test set. Model 4 exhibited the highest power (AUC [95% CI]: 0.84 [0.77-0.90], all p ​< ​0.05 compared to Model 2 and Model 3).</p><p><strong>Conclusion: </strong>CCTA radiomic features show proof-of-concept for predicting statin response, warranting further validation.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov NCT0280341.</p>","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148166169","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":"Optimal heart rate threshold for phase selection in beta-blocker-free coronary CT angiography using second-generation motion correction.","authors":"Tomoro Morikawa, Rina Sakai, Tatsuya Saito, Yuji Matsuzaki, Takara Namboku, Tatsuya Nishii, Akiyuki Kotoku, Hiroki Horinouchi, Yasutoshi Ohta, Teruo Noguchi, Tetsuya Fukuda","doi":"10.1016/j.jcct.2026.05.008","DOIUrl":"https://doi.org/10.1016/j.jcct.2026.05.008","url":null,"abstract":"<p><strong>Purpose: </strong>Beta-blocker-free coronary CT angiography (CCTA) improves workflow, but is often limited by motion artifacts at higher heart rates (HRs). Advances such as faster gantry rotation and second-generation motion correction (SSF2) may overcome these limitations. We aimed to determine the optimal HR cutoff for phase selection using SSF2.</p><p><strong>Methods: </strong>We retrospectively analyzed 368 patients who underwent CCTA without beta-blockers using a 256-row CT scanner (rotation time, 0.234 ​s). Systolic and diastolic phases were acquired over two consecutive heartbeats, with images reconstructed with and without SSF2. Image quality was graded on a 5-point Likert scale across seven coronary segments: proximal and distal portions of the three main coronary arteries and the left main trunk. Exams were deemed evaluable when all segments scored ≥3, allowing one distal segment to score 2. Receiver operating characteristic (ROC) curve analysis identified the optimal HR cutoff. Diagnostic performance for ≥50% stenosis was assessed in patients undergoing invasive coronary angiography (ICA).</p><p><strong>Results: </strong>Among 279 patients (median HR, 64 bpm), SSF2 significantly improved image quality and evaluability in both phases (all P ​< ​0.001). The optimal HR cutoff was 67 bpm, yielding 91.8% evaluability. At HR ​≤ ​67 bpm, diastolic SSF2+ images were superior (P ​≤ ​0.01); at HR ​> ​67 bpm, systolic SSF2+ images were optimal (P ​< ​0.001). In 50 patients with ICA, HR-guided phase selection achieved sensitivity, specificity, and accuracy of 91.3%, 88.3%, and 89.0%, respectively.</p><p><strong>Conclusion: </strong>SSF2 enabled reliable beta-blocker-free CCTA. An HR cutoff of 67 bpm effectively guided phase selection, achieving 91.8% evaluability.</p>","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059067","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":"Prognostic value of semi-quantitative scoring systems for CCTA: A systematic review and meta-analysis.","authors":"Gurkeerat Mann, Ashish Sood, Shaun Khanna, Rhea Machado, Joshua Kovoor, Sean Tan, Aditya Bhat, Nitesh Nerlekar, Jason Kaplan, Tej Dugal","doi":"10.1016/j.jcct.2026.05.005","DOIUrl":"https://doi.org/10.1016/j.jcct.2026.05.005","url":null,"abstract":"<p><p>Semi-quantitative coronary computed tomography angiography (CCTA) scoring systems - including the Segment Involvement Score (SIS), Segment Stenosis Score (SSS), CT-adapted Leaman score (CT-LeSc), Leiden score, Coronary Artery Calcium Score (CACS) and the Coronary Artery Disease-Reporting and Data System (CAD-RADS);are used to quantify coronary atherosclerotic burden. However, their relative performance and suitability for standardized clinical application remain uncertain. We performed a systematic review and meta-analysis for studies reporting associations between semi-quantitative CCTA scores and major adverse cardiovascular events (MACE). Random-effects models were used to derive pooled hazard ratios (HRs) for SIS, SSS, CACS, CT-LeSc, and Leiden scores, and risk ratios (RRs) for CAD-RADS. Thirty-seven studies, examining 54,719 patients, were analysed, and all scoring systems were significantly associated with MACE. Among hard MACE predictors, SIS (HR 1.18, p ​< ​0.001) and SSS (HR 1.24, p ​< ​0.001) performed comparably, as did the anatomically weighted CT-LeSc (HR 1.10, p ​< ​0.001) and Leiden scores (HR 1.11, p ​< ​0.001). For broad MACE, both CAD-RADS (RR 1.71, p ​< ​0.001) and CACS (HR 1.73, p ​< ​0.001) categories showed similar stepwise gradients. Overall, all five semi-quantitative CCTA scoring systems demonstrated consistent and significant associations with hard cardiovascular events, and given broadly similar performance across metrics, simpler tools such as SIS or CAD-RADS may offer practical advantages for routine clinical use. Further within-cohort, head-to-head comparisons and evaluation of clinically actionable thresholds are warranted.</p>","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990600","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 cardiac computed tomography and transthoracic echocardiography in evaluation of cardiovascular anatomy in neonates with heterotaxy syndrome.","authors":"Yaw K Owusu, Marcos Mills, Chelsea Dennison, Mohan John, Timothy Slesnick, Hunter C Wilson","doi":"10.1016/j.jcct.2026.05.004","DOIUrl":"https://doi.org/10.1016/j.jcct.2026.05.004","url":null,"abstract":"","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944262","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":"Left ventricular remodeling after redo transcatheter aortic valve replacement: A first-in-human computed tomography analysis.","authors":"Takayuki Onishi, Sahil Khera, Marcos Ferrandez-Escarabajal, Lucy M Safi, Amit Hooda, George D Dangas, Samin K Sharma, Annapoorna S Kini, Gilbert H L Tang, Stamatios Lerakis","doi":"10.1016/j.jcct.2026.05.001","DOIUrl":"https://doi.org/10.1016/j.jcct.2026.05.001","url":null,"abstract":"","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944238","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":"AI-based detection of coronary artery calcium score in non-gated chest computed tomography of patients who decline statin therapy: A missed opportunity for prevention.","authors":"Rhanderson Cardoso, Stephanie A Besser, Milena Petranovic, Daniel Huck, Arthur Shiyovich, Camila V Blair, David W Biery, C Justin Brown, Nisarg Shah, Alexander Turchin, Ron Blankstein","doi":"10.1016/j.jcct.2026.03.013","DOIUrl":"https://doi.org/10.1016/j.jcct.2026.03.013","url":null,"abstract":"","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793109","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":"RedoTAVR coronary obstruction risk in small annuli: A post-TAVR CT study.","authors":"Gaetano Liccardo, Ioannis Skalidis, Luca Esposito, Nicolas Amabile, Hakim Benamer, Stephane Champagne, Bernard Chevalier, Livio D'Angelo, Jerome Garot, Philippe Garot, Thomas Hovasse, Pietro Laforgia, Francesca Sanguineti, Neila Sayah, Thierry Unterseeh, Mariama Akodad, Antoinette Neylon","doi":"10.1016/j.jcct.2026.04.002","DOIUrl":"https://doi.org/10.1016/j.jcct.2026.04.002","url":null,"abstract":"<p><strong>Introduction: </strong>Redo-transcatheter aortic valve replacement (redoTAVR) is increasingly relevant as younger patients undergo TAVR. Patients with small annuli may present anatomical constraints.</p><p><strong>Methods: </strong>This study evaluated predicted coronary obstruction (CO) risk in case of redoTAVR in small versus non-small annuli using post-TAVR computed tomography (CT) in patients treated by supra-annular self-expanding valves (SEVs) or balloon-expandable valves (BEVs). 167 post-TAVR CT scans were analyzed. Patients were stratified into small annuli (≤430 ​mm²) and non-small annuli groups (>430 ​mm²). Risk plane for redoTAVR was assessed at node 4, 5 and 6 for SEVs and at the transcatheter heart valve (THV) outflow for BEVs. The minimal valve-to-coronary (VTC) and valve-to-aorta (VTA) distances were measured from the THV to the left main stem (LM)/right coronary artery (RCA) ostia and from the THV to the aorta above the LM/RCA respectively. High CO risk was defined as VTC <4 ​mm or VTA <2 ​mm when the coronary ostium lay below the risk plane.</p><p><strong>Results: </strong>In small annuli, SEVs were associated with increased predicted CO risk after redoTAVR compared to BEVs, considering risk plane at node 6 (OR ​= ​15.52, p ​< ​0.001) or node 5 (OR ​= ​3.13, p ​= ​0.03), while not at node 4. In non-small annuli, SEVs did not increase predicted CO risk versus BEVs.</p><p><strong>Conclusion: </strong>Predicted CO risk at redoTAVR in small annuli depends on index valve type and redo implantation height. Our findings support accurate index-procedure planning and meticulous planning and execution of redoTAVR, particularly in small annuli.</p>","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793090","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}