The international journal of cardiovascular imaging最新文献

{"title":"Association between depressive symptoms and thoracic aortic calcification, and their independent and joint prognostic value for incident atherosclerotic cardiovascular disease in the MESA cohort.","authors":"Daiki Arai, Quinn White, Keishi Ichikawa, Robyn L McClelland, W Craig Johnson, Mio Yabuki, Spencer Hansen, Matthew J Budoff","doi":"10.1007/s10554-026-03771-0","DOIUrl":"10.1007/s10554-026-03771-0","url":null,"abstract":"<p><p>Depression is highly prevalent; however, its association with atherosclerotic cardiovascular disease (ASCVD) events remains incompletely understood. This study aimed to evaluate the association between depressive symptoms and thoracic aortic calcification (TAC) and assess their joint prognostic value for future ASCVD events. We analyzed 2,600 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) without baseline ASCVD. TAC was quantified using non-contrast chest CT as a marker of subclinical atherosclerosis. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D ≥ 16). Linear regression assessed the association between depressive symptoms and log-transformed TAC. Cox proportional hazards models evaluated independent and joint associations of depressive symptoms and TAC tertiles with incident ASCVD, adjusting for covariates. Overall, 389 participants (15%) exhibited depressive symptoms. In fully adjusted models, depressive symptoms were not associated with TAC (β = 0.08; 95% CI -0.13-0.29), without sex-specific differences. Both depressive symptoms (HR 1.63; 95% CI 1.16-2.29) and TAC (HR 1.22; 95% CI 1.13-1.33) were independently associated with ASCVD events. Individuals with depressive symptoms had significantly higher ASCVD risk in the highest tertile TAC group, whereas no difference was observed in lower TAC tertiles. Although depressive symptoms were not directly associated with TAC, their presence was significantly associated with increased ASCVD risk, particularly among participants with elevated TAC. Coexisting depressive symptoms and substantial atherosclerotic burden confer a higher ASCVD risk. Thus, evaluating depressive symptoms may provide additional context for cardiovascular risk stratification, particularly among individuals with advanced subclinical atherosclerosis.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":"1973-1981"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When amyloid chooses sides: septal affection pattern as an atypical presentation of transthyretin amyloid cardiomyopathy.","authors":"Lea A Maurer, Annina A Studer Bruengger, Muriel S Wiedemann Buser, Alain M Bernheim","doi":"10.1007/s10554-026-03725-6","DOIUrl":"10.1007/s10554-026-03725-6","url":null,"abstract":"<p><p>In the last decades, significant advancement in diagnosing transthyretin amyloid cardiomyopathy (ATTR-CM) has been achieved by using multimodality imaging. Early diagnosis is essential in these patients since early initiation of disease-specific treatment may improve prognosis. ATTR-CM is a progressive disease marked by the misfolding of transthyretin proteins synthesized mainly in the liver, which subsequently deposit as amyloid fibrils within the heart's extracellular matrix. Classically, amyloid fibril accumulation starts in the basal and midventricular segments of the left ventricle (LV) in a symmetrical fashion, resulting in the typical \"apical sparing\" pattern on transthoracic echocardiographic (TTE) strain analysis. However, the presented case illustrates that amyloid distribution may vary in its pattern, leading to unusual findings on cardiac imaging. In our 73 years old male patient, wild-type ATTR-CM resulted in Technetium-99 m-labeled 3,3-diphosphono-1,2-propanodicarboxylic acid (99mTc-DPD) uptake almost exclusively confined to the ventricular septum on scintigraphy. This atypical distribution was mirrored by cardiovascular magnetic resonance imaging (CMR), which displayed diffuse late gadolinium enhancement (LGE) and elevated extracellular volume (ECV) predominantly in the ventricular septum, and by an unusual strain pattern on transthoracic echocardiography with markedly impaired longitudinal strain values in septal LV segments.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":"2039-2044"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848236","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":"Characteristics and outcomes of patients undergoing coronary computed tomography angiography for suspected acute coronary syndrome in the emergency department.","authors":"Giuseppe Ciliberti, Paolo Compagnucci, Luca Finori, Marco Fogante, Michela Casella, Edoardo Conte, Federico Fortuni, Adelina Selimi, Nicolò Schicchi, Roberto Manfredi, Alice Frangione, Paolo Esposto Pirani, Giacomo Agliata, Samuele Principi, Maria Chiara Basile, Matteo Marcosignori, Giulio Argalia, Tobias Stephan Augustin Schnitzler, Giovanni Calogerà, Luca Bergamaschi, Matteo Oliva, Gustavo Cirese, Marco Marini, Annalisa Mattioli, Matteo Armillotta, Silvano Molini, Tommaso Piva, Marco Gigli, Monica Verdoia, Carmine Pizzi, Fabrizio Ricci, Susanna Contucci, Andrea Giovagnoni, Federico Guerra, Antonio Dello Russo","doi":"10.1007/s10554-026-03770-1","DOIUrl":"10.1007/s10554-026-03770-1","url":null,"abstract":"<p><p>Suspected acute coronary syndrome (ACS) is one of the most common reasons for urgent cardiology evaluation in the emergency department (ED). This study aimed to evaluate the characteristics and outcomes of patients with suspected ACS who were referred for coronary computed tomography angiography (CCTA) in the ED. We retrospectively enrolled consecutive patients who underwent cardiology assessment and CCTA for suspected ACS in the ED from January 2020 through December 2022. The primary endpoint was a composite of major adverse cardiovascular events (MACE) including all-cause death, acute myocardial infarction, or myocardial revascularization. The study included 198 patients, of whom 175 (51% male) had available follow-up data. Elevated high-sensitivity cardiac troponin I (hs-cTnI) was detected in 42% of patients. Compared to those with normal hs-cTnI, patients with elevated hs-cTnI showed a higher prevalence of atrial fibrillation (12% vs 1%; p < 0.001), paroxysmal supraventricular tachycardia (10% vs 0%; p < 0.001), and pericardial effusion (10% vs 2%; p = 0.023), and were more frequently referred for cardiovascular magnetic resonance (19% vs 4%; p < 0.001). Over a median follow-up of 28 months (IQR:18-34), 14 patients (8%) reached the composite endpoint. After adjusting for demographics, ECG data, and hs-cTnI levels, obstructive atherosclerosis in left main (aHR = 18.31, p = 0.004), circumflex (Cx) (aHR = 8.54, p = 0.008), right coronary artery (aHR = 5.22, p = 0.028), moderate atherosclerosis in the left anterior descending artery (aHR = 6.88, p = 0.039) and mild irregularities in the Cx (aHR = 5.86, p = 0.043) were associated with a higher incidence of MACE. Both the presence of high-risk plaque and higher CAD-RADS 2.0 categories were associated with an increased likelihood of in-hospital revascularization and a survival tree model incorporating myocardial injury markers and CCTA findings demonstrated potential utility for risk stratification. In patients with suspected ACS undergoing cardiology assessment in the ED, CCTA may support patient management.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":"1957-1971"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387877","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":"Endoleak detection with photon-counting detector CT at various radiation doses after endovascular aneurysm repair: a phantom study.","authors":"Adrian T Huber, Gergely Szucs-Farkas, Ludovic G Perrin, Badis M'Hamdi, Sofia Bespyatova, Andreas Christe, Zsolt Szucs-Farkas","doi":"10.1007/s10554-026-03765-y","DOIUrl":"10.1007/s10554-026-03765-y","url":null,"abstract":"<p><p>After endovascular aneurysm repair, patients require lifelong CT follow-ups. Photon-counting detector CT (PCD-CT) may improve detection of tiny iodinated structures at low radiation dose. The aim of this experimental study was to find the lowest dose which still provides high detectability of small endoleaks using PCD-CT with 55 keV and 50 keV virtual monoenergetic images (VMIs). An abdominal aneurysm phantom mimicking medium and large patients was scanned at 100%, 50%, 25%, and 12.5% radiation dose using PCD-CT. Besides standard 55 keV images, 50 keV VMI were reconstructed at 25% and 12.5% dose. The ninety-six CT series containing 1728 endoleaks of 2-6 mm were read by three independent observers. Areas under the alternative free-response operational characteristic curve (A₁) were analysed with the jackknife-method. In the medium phantom, A₁ for 6 mm endoleaks was similar at 100% and 50% doses (0.93 vs. 0.86; p = 0.23), but performance at 50% dose decreased in 4-6 mm endoleaks (A₁, 0.81 vs. 0.68; p = 0.02). In the large phantom, A₁ decreased at 50% dose both for 6 mm (0.72 vs. 0.42; p = 0.003) and for 4-6 mm (0.49 vs. 0.29; p = 0.02) endoleaks. Compared with standard reconstruction, 50 keV VMIs did not change A₁ at 25% dose (0.56 vs. 0.52; p = 0.38) and led to worse performance at 12.5% dose (0.30 vs. 0.19; p = 0.01). In summary, diagnostic performance for 6 mm endoleaks remained high with 50%-dose reduction using PCD-CT in simulated medium but not in large patients. 50 keV VMIs at 12.5% and 25% dose did not improve endoleak detection.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":"1933-1944"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing TI selection in LGE imaging: pharmacokinetically standardized synthetic LGE and clinical cohort validation of a fixed 400 ms TI for LGE quantification.","authors":"Yasutoshi Ohta, Tomoro Morikawa, Hare Ikeda, Yoshiaki Morita, Tatsuya Nishii, Akiyuki Kotoku, Hiroki Horinouchi, Midori Fukuyama, Emi Tateishi, Fukuda Tetsuya","doi":"10.1007/s10554-026-03761-2","DOIUrl":"10.1007/s10554-026-03761-2","url":null,"abstract":"<p><p>Purpose To evaluate the stability of late gadolinium enhancement (LGE) quantification across inversion times (TIs) around the null point (TInull) using pharmacokinetically generated synthetic LGE (sLGE) and to validate a fixed TI of 400 ms against conventional null-based LGE. Methods In the first cohort (n = 115), a two-compartment pharmacokinetic model was fitted to dynamic T1 maps acquired after gadolinium administration to predict T1 at 10 min, and sLGE images were simulated from the predicted T1 maps. LGE proportion (LGEp) was quantified from TInull - 60 to TInull + 100 ms, and LGEp was compared. In the second cohort (n = 80), LGEp with TI fixed at 400 ms (LGE400) was compared with conventional LGE using a Look-Locker-derived TI (LGEnull), and these images were visually compared. Results LGEp on sLGE was stable from TInull to TInull + 100 ms, with no significant differences across this range, and LGEp decreased significantly to approximately zero below TInull (p < 0.05). LGEp on sLGE with TI = 400 ms showed strong agreement with that from TInull to TInull + 30 ms (r = 0.979 to 1.0). In the second cohort, LGEp correlated strongly between LGE400 and LGEnull (r = 0.85), with minimal bias on Bland-Altman analysis. In participants without amyloidosis, the correlation further improved (r = 0.96), and both imaging approaches showed similar LGE findings. Conclusion Pharmacokinetically standardized sLGE showed stable LGE proportion above the myocardial null point and reduced LGE proportion below it. Under the evaluated 10-min post-contrast 2D inversion recovery-LGE conditions, fixed TI = 400 ms provided LGE quantification comparable to Look-Locker-determined TI in most patients.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":"1913-1924"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148311176","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":"Retrospective assessment of low-dose and low-contrast agent protocols for photon-counting CT angiography of the aorta.","authors":"Jan-Lucca Hennes, Kristina Krompaß, Henner Huflage, Pauline Pannenbecker, Ramin Saam Dazeh, Jan-Peter Grunz, Viktor Hartung, Thorsten Alexander Bley, Philipp Gruschwitz","doi":"10.1007/s10554-026-03757-y","DOIUrl":"10.1007/s10554-026-03757-y","url":null,"abstract":"<p><p>Our objective was to assess dedicated low-dose (LD) and low-contrast (LC) scan protocols for aortic angiography, compared to standard protocols in photon-counting CT (PCD-CT) and energy-integrating CT (EID-CT). 57 patients (23 women) who underwent aortic PCD-CT angiography (Nov. 23 - July 24) were assessed retrospectively. 19 received a low-contrast protocol (LC; 14 mg iodine, image quality level IQ64), 18 a low-dose protocol (LD; 21 mg iodine, IQ42), and 20 a combined low-dose/low-contrast protocol (LD/LC) according to defined patient characteristics. In addition, two groups of 20 BMI-matched patients were created, one of which underwent CTA using the standard PCD-CT protocol and the other using EID-CT, and these were compared with the new protocols. CNR was calculated. Overall quality, luminal contrast, vessel sharpness, and artifacts were rated by four radiologists. LD enabled ~ 40% dose-reduction compared to EID-CT (3.3 ± 0.8 versus 5.3 ± 0.4mGy; p < 0.01) but higher CNR (33.5 ± 6.1 vs. 25.1 ± 6.4; p < 0.01). CNR of LC (26.3 ± 5.6) and LD/LC (25.6 ± 9.1) did not differ significantly to EID-CT (25.1 ± 6.4; p > 0.99). Image quality of LC was deemed superior to EID-CT (5 [5-5] vs. 4 [4-4]; p < 0.01). LD (4 [4-5]) and LD/LC (4 [4-4]) demonstrated comparable image quality to EID-CT (p = 0.52/0.94). In conclusion even the LD/LC protocol provided image quality comparable to EID-CT despite substantial reduction of radiation and contrast agent dose. Special dose-reduced and contrast-reduced protocols are feasible without compromising diagnostic image quality.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":"1891-1901"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated identification of cardiac amyloidosis using cross-modal neural networks on [Formula: see text]-Pyrophosphate SPECT imaging and clinical data.","authors":"Fatih Batı, Nilüfer Bıçakcı, Musa Aydın, Zeki Kuş, Berna Kiraz","doi":"10.1007/s10554-026-03778-7","DOIUrl":"10.1007/s10554-026-03778-7","url":null,"abstract":"<p><p>Accurate, early identification of transthyretin cardiac amyloidosis (ATTR-CA) is challenging yet critical for effective treatment. In this work, the modeled endpoint is scan positivity on [Formula: see text] scintigraphy, defined by the semi-quantitative Perugini visual grade (Grade 2-3 versus Grade 0-1). Two multimodal deep-learning frameworks, including Late Fusion (LF) and Cross-Modal Fusion Network (CMF-Net), are proposed to combine [Formula: see text] scintigraphy with clinical metadata for automated detection. On a curated cohort of 109 patients (62 positive, 47 negative), fusion models consistently outperformed image-only convolutional neural networks (CNNs): CMF-Net raised average accuracy by 6.9 percentage points and LF by 5.4. EfficientNet CMF-Net achieved peak accuracy 90.9% and F1-score 91.4%. Notable gains included a +30.8 percentage points sensitivity(recall) for ResNet-34 with CMF-Net and ResNet-50 LF sensitivity of 94.9%. These results show that integrating imaging and text/numeric clinical data yields superior, reproducible detection of [Formula: see text] scan positivity and may streamline scan interpretation.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":"2011-2030"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551860","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":"Right ventricular function-pulmonary pressure interaction as a predictor of mortality in tricuspid regurgitation.","authors":"Yogev Peri, Yan Topilsky, Mohammad Alnees, Haitham Abu Khadija","doi":"10.1007/s10554-026-03753-2","DOIUrl":"10.1007/s10554-026-03753-2","url":null,"abstract":"<p><p>Right ventricular-pulmonary arterial (RV-PA) coupling reflects the ability of the right ventricle to adapt contractile performance to pulmonary afterload. Although TAPSE/PASP has been associated with outcomes across several cardiovascular conditions, its prognostic role in heterogeneous tricuspid regurgitation (TR) populations remains incompletely defined. To evaluate the association between RV-PA coupling, assessed by TAPSE/PASP, and mortality in patients with TR, and to explore whether a composite index integrating longitudinal and areal right ventricular function, (TAPSE × FAC)/PASP, provides incremental prognostic information. In this retrospective cohort study, 247 patients with any grade of TR and available echocardiographic measurements of TAPSE and PASP were included. RV-PA coupling was assessed using TAPSE/PASP, and patients were stratified according to the cohort median. A composite index, (TAPSE × FAC)/PASP, was also evaluated. The primary outcome was all-cause mortality. Cox proportional hazards regression and receiver-operating characteristic analysis were used to assess associations with mortality and discriminatory performance. A pre-specified subgroup analysis was performed in patients with moderate-to-severe TR, defined as EROA ≥ 0.30 cm². Among 247 patients, the median age was 80 years and 61% were female. Reduced TAPSE/PASP was associated with higher 1-year mortality compared with preserved TAPSE/PASP (41.9% vs. 16.3%, p < 0.001) and remained independently associated with mortality after multivariable adjustment (HR 2.15, 95% CI 1.35-3.43, p = 0.001). In the moderate-to-severe TR subgroup (n = 88), TAPSE/PASP retained prognostic significance (HR 2.74, 95% CI 1.42-5.28, p = 0.003). The composite index showed a modest improvement in discrimination compared with TAPSE/PASP alone (AUC 0.691 vs. 0.669). In this retrospective TR cohort, reduced TAPSE/PASP was independently associated with all-cause mortality, with consistent findings in patients with moderate-to-severe TR. The composite (TAPSE × FAC)/PASP index provided only modest incremental discrimination and should be considered exploratory and hypothesis-generating pending external validation.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":"1881-1890"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148255309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular imaging of atherosclerotic plaque vulnerability: a narrative review.","authors":"Victoria To, Jason Ha","doi":"10.1007/s10554-026-03724-7","DOIUrl":"10.1007/s10554-026-03724-7","url":null,"abstract":"<p><p>Atherosclerotic plaque rupture or erosion underlies most acute coronary and cerebrovascular events. Risk stratification currently relies on luminal stenosis, which poorly predicts thrombotic risk because many events arise from biologically vulnerable plaques with only mild-to-moderate narrowing. Molecular imaging enables non-invasive assessment of the biological processes that drive plaque instability. A structured narrative review of experimental and clinical studies published between 2000 and 2024 was conducted using PubMed and Ovid Embase. Searches related to atherosclerosis, vulnerable plaque, molecular imaging, inflammation, microcalcification, matrix remodelling, angiogenesis, and carotid or coronary disease identified 2,627 records, of which 38 studies were included after screening. Imaging of inflammation and microcalcification shows the greatest clinical maturity, primarily using positron emission tomography (PET). Inflammation is assessed with ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG), reflecting macrophage metabolic activity, while active microcalcification is detected with ¹⁸F-sodium fluoride (¹⁸F-NaF), which binds to hydroxyapatite in early calcific deposits. Imaging of fibrous cap degeneration and angiogenesis remains less clinically mature with limited human validation, including matrix metalloproteinase-targeted single-photon emission computed tomography (SPECT) and integrin-targeted magnetic resonance imaging (MRI) approaches. Translation is limited by technical complexity, cost, and scarce outcome-based validation. Molecular imaging provides biologically informed assessment of plaque vulnerability beyond stenosis alone. Imaging of inflammation and microcalcification currently show the greatest potential for risk stratification, although further validation and multimodal integration are required before routine clinical use.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":"1835-1844"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Troponin release, myocardial function and inflammation in patients with takotsubo syndrome: a cardiac magnetic resonance study.","authors":"Luca Arcari, Giovanni Camastra, Federica Ciolina, Matteo Sclafani, Emanuela Belmonte, Domenico De Santis, Teresa Castiello, Marco Francone, Massimiliano Danti, Stefano Sbarbati, Viviana Maestrini, Luca Cacciotti","doi":"10.1007/s10554-026-03760-3","DOIUrl":"10.1007/s10554-026-03760-3","url":null,"abstract":"<p><p>Background Takotsubo syndrome (TTS) is an acute heart failure phenotype characterized by transient left ventricular dysfunction and modest Troponin release. Mechanisms of myocardial injury remain unclear. We aimed to investigate relationships between Troponin T release, myocardial edema by cardiac magnetic resonance (CMR) T2 mapping, and systemic inflammatory biomarkers in TTS. Methods N = 94 patients with acute TTS underwent CMR (median 4 days after admission) and serial blood sampling during the index hospitalization. Patients were stratified by a previously defined prognostic relevant peak high-sensitivity Troponin T cut-off (≥ 28.8× upper limit of normal [ULN] vs. <28.8× ULN). Full blood count was obtained at admission and on the day of CMR. Results Mean age of the study population was 74 years, 7% male. Patients with higher Troponin release presented with more severe left ventricular systolic dysfunction (admission LVEF 36% vs. 41%, p = 0.005) and higher T2 mapping values (60 vs. 57 ms, p < 0.05). On the CMR day, higher NLR (3.7 ± 2.4 vs. 2.7 ± 1.4, p = 0.020) and lymphocyte-to-monocyte ratio (LMR) (3.2 ± 1.0 vs. 3.9 ± 1.6, p = 0.020) were observed in the high-Troponin release subgroup. Multivariable linear regression analysis identified admission LVEF (β=-0.524, p < 0.001), T2 mapping (β = 0.171, p = 0.045), NLR (β = 0.262, p = 0.032), and LMR (β=-0.282, p = 0.033) as independent correlates of Troponin release as a continuous variable. Conclusions Troponin release in TTS reflects an interplay between ventricular dysfunction, myocardial edema, and systemic inflammatory activation, supporting a non-ischemic pattern of myocardial injury. Troponin may serve as a simple surrogate marker of myocardial and systemic inflammation.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":"1903-1912"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348063","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}