The international journal of cardiovascular imaging最新文献

{"title":"Ruptured coronary aneurysm with fatal bleeding: a tricky differential diagnosis.","authors":"Pietro G Lacaita, Gudrun M Feuchtner","doi":"10.1007/s10554-025-03402-0","DOIUrl":"https://doi.org/10.1007/s10554-025-03402-0","url":null,"abstract":"<p><p>A 50 year-old-male presented with NSTEMI, a coronary fistula and a ruptured coronary aneurysm, which lead to fatal bleeding. The case highlights the pivotal role of coronary computed tomography angiography (CTA) in establishing the correct diagnosis based on CTA imaging findings.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004369","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":"Heart of stone.","authors":"Inês Conde, Carla Ferreira, Cátia Oliveira","doi":"10.1007/s10554-025-03400-2","DOIUrl":"https://doi.org/10.1007/s10554-025-03400-2","url":null,"abstract":"","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065429","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":"Plaque burden improves the detection of ischemic CAD over stenosis from coronary computed tomography angiography.","authors":"Tanja Kero, Sarah Bär, Antti Saraste, Riku Klén, Jeroen J Bax, Juhani Knuuti, Teemu Maaniitty","doi":"10.1007/s10554-025-03396-9","DOIUrl":"https://doi.org/10.1007/s10554-025-03396-9","url":null,"abstract":"<p><p>In symptomatic patients undergoing coronary CTA for suspected coronary artery disease (CAD), we assessed if quantification of plaque burden, in addition to luminal narrowing and clinical risk factors, offers incremental value for the identification of ischemic CAD on a per patient level. We evaluated 2145 patients who underwent coronary CTA for suspected CAD with sequential selective downstream ¹⁵O-water positron emission tomography (PET) myocardial perfusion imaging. Coronary CTA scans were analyzed using Artificial Intelligence-guided Quantitative Computed Tomography (AI-QCT), with measurement of maximum diameter stenosis, percent atheroma volume (PAV), percent calcified plaque volume (CPV) and percent noncalcified plaque volume (NCPV). Ischemic CAD was defined as the presence of abnormal stress perfusion on ¹⁵O-water PET. PAV on top of the clinical variables and ≥ 50% stenosis improved the prediction of ischemic CAD on a per patient level as compared to clinical variables and ≥ 50% stenosis (AUC = 0.91 vs. AUC = 0.87, p < 0.001). The best diagnostic performance was achieved when PAV with a cut-off value of 12.2% was applied in patients with intermediate (30-70%) stenosis; using this approach, the sensitivity, specificity, positive and negative predictive values and diagnostic accuracy for ischemic CAD were 76%, 91%, 64%, 95% and 88%. The addition of quantitative plaque volume on top of clinical variables and ≥ 50% diameter stenosis improves the detection of ischemic CAD as defined by PET perfusion imaging. Applying a PAV threshold of 12.2% in patients with intermediate stenosis provided the best diagnostic performance.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016341","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":"Incremental value of coronary computed tomography angiography in addition to invasive coronary angiography in MINOCA.","authors":"Oscar Winnberg, Elin Brolin, Shams Y-Hassan, Loghman Henareh, Peder Sörensson, Olov Collste, Christina Ekenbäck, Magnus Lundin, Kenneth Caidahl, Stefan Agewall, Kerstin Cederlund, Jannike Nickander, Martin G Sundqvist, Claes Hofman-Bang, Patrik Lyngå, Eva Maret, Nondita Sarkar, Jonas Spaak, Rehana Parvin Roshnee, Martin Ugander, Irene Santos-Pardo, Per Tornvall, Jens Jensen","doi":"10.1007/s10554-025-03401-1","DOIUrl":"https://doi.org/10.1007/s10554-025-03401-1","url":null,"abstract":"<p><p>Patients with the working diagnosis myocardial infarction with nonobstructive coronary arteries (MINOCA) have diverse underlying causes warranting further investigations. Despite the documented superiority of coronary computed tomography angiography (CCTA) over invasive coronary angiography (ICA) in plaque detection, the former is not routinely recommended for MINOCA patients, highlighting a knowledge gap regarding CCTA's incremental value. The objective of this study is to assess the prevalence and extent of coronary atherosclerosis in MINOCA patients using CCTA, and to evaluate the incremental value of CCTA over ICA alone in detecting coronary atherosclerosis. The data from 163 MINOCA patients who underwent both CCTA and ICA in two prospective studies were retrospectively analyzed to compare the occurrence and distribution of coronary atherosclerotic plaques detected with ICA versus CCTA, evaluating CCTA's incremental value. CCTA detected coronary atherosclerosis in 48% of subjects; ICA did so in 47%. Notable disagreement, reflected by kappa values of 0.34 (95% confidence interval [CI] 0.19-0.48) across all segments and 0.41 (95% CI 0.27-0.55) for proximal segments (both p < 0.0001), highlighted discrepancies between CCTA and ICA in the detection of atherosclerosis presence and location. Combining CCTA with ICA provided significant incremental value in detecting atherosclerosis in coronary segments (p < 0.001). MINOCA patients frequently exhibit non-obstructive coronary plaques. Agreement between CCTA and ICA is poor. CCTA provides valuable additional information on atherosclerotic segments. Therefore, CCTA should be recognized as a complementary tool to ICA, aiding risk assessment and treatment decisions in the context of MINOCA.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059385","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":"Correction: Beyond hypertrophic cardiomyopathy: unmasking alternative causes of LVOT obstruction on CMR.","authors":"Tanushree Banerjee, Avanti Gulhane, Aarohi Bhatt, Mathew Cham","doi":"10.1007/s10554-025-03399-6","DOIUrl":"https://doi.org/10.1007/s10554-025-03399-6","url":null,"abstract":"","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055854","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":"Multiparametric quantitative structural and functional cardiac MRI in orthotopic heart transplant recipients with cardiac allograft vasculopathy.","authors":"Sandra Quinn, Roberto Sarnari, Andrew Zbihley, Daniel Sherlock, Connor Raikar, Joshua Engel, Havisha Pedamallu, Kai Lin, Kambiz Ghafourian, Daniel C Lee, Esther E Vorovich, Clyde W Yancy, Vera H Rigolin, Jon W Lomasney, James C Carr, Bradley D Allen, Michael Markl","doi":"10.1007/s10554-025-03384-z","DOIUrl":"https://doi.org/10.1007/s10554-025-03384-z","url":null,"abstract":"<p><p>The aim of this study was to verify if multiparametric quantitative CMR can detect mild-to-moderate cardiac allograft vasculopathy (CAV) in patients post-orthotopic heart transplant (OHT). 51 patients (age = 50.0 ± 13.6 years, 29% female) post-OHT 0-6 years (mean 3.2 ± 1.5 years) who underwent CMR from 2011 to 2019 were retrospectively included. Multiparametric CMR included CINE imaging covering the left ventricle (LV), pre- and post-contrast T1 mapping, and T2 mapping, extracellular volume fraction (ECV) calculation, and 2D-feature tracking strain. CAV0 ('CAV negative') patient variables were compared with CAV1-CAV2 ('CAV positive') variables. Logistic regression was used to determine predictors of CAV status. Myocardial T2 was higher in CAV positive compared with CAV negative patients (54.5 ± 7.7 ms vs. 50.2 ± 3.3 ms, p < 0.05), as was ECV (31.3 ± 5.3% vs. 27.4 ± 4.1%, p < 0.05). Radial and circumferential peak systolic strain rates were attenuated in CAV positive vs. CAV negative patients (radial: 1.4 ± 0.4 s-1 vs. 1.8 ± 0.3 s-1, circumferential: -0.9 ± 0.2 s-1 vs. -1.1 ± 0.1 s-1, p < 0.05),as well as circumferential and longitudinal peak diastolic strain rates (0.7 ± 0.7 s-1 vs. 1.0 ± 0.5 s-1, and 0.8 ± 0.3 s-1 vs. 0.9 ± 0.3 s-1, p < 0.05, respectively). CAV positive vs. negative status correlated with ECV (rho 0.41, P < 0.01), T2 (rho 0.29, p < 0.05), radial and circumferential peak systolic strain rate (rho - 0.48, P < 0.01 and rho 0.47, p < 0.001, respectively), and circumferential and longitudinal peak diastolic strain rates (rho - 0.34, p < 0.05 and rho - 0.35, p < 0.01, respectively). Logistic regression revealed that a model including ECV, peak radial and circumferential systolic strain rates and longitudinal diastolic strain rate was significant for distinguishing CAV positive vs. negative status with a receiver operator characteristic area under curve of 0.85 ± 0.06 (CI 0.73-0.97), p < 0.005. A model combining functional (strain) and tissue parameters (ECV) was predictive of CAV status, indicating the potential of multiparametric CMR for non-invasive prediction of CAV status in OHT recipients.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046857","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":"Myocardial flow reserve and resting contractility modulate the impact of contractile reserve in patients undergoing rubidum-82 positron emission tomography.","authors":"Ahmed Sayed, Kershaw Patel, Mahmoud Al Rifai, Maria Alwan, Ahmad El Yaman, Faisal Nabi, Mouaz H Al-Mallah","doi":"10.1007/s10554-025-03395-w","DOIUrl":"https://doi.org/10.1007/s10554-025-03395-w","url":null,"abstract":"<p><p>Although ejection fraction reserve (EFR) harbors prognostic value in patients undergoing positron emission tomography (PET) myocardial perfusion imaging (MPI), whether resting EF and myocardial flow reserve (MFR) modulate its prognostic value has not been studied. Consecutive patients undergoing stress/rest MPI using Rb-82 PET between 2019 and 2024 were included. The primary outcome was a composite of death and heart failure (HF) hospitalizations. Multivariable Andersen-Gill Cox models were used to assess the association of EFR with the primary outcome across the spectrum of resting EF and MFR. Restricted cubic splines were used to allow non-linearity. The 50th percentile of EFR served as the reference, with the 25th and 75th percentiles representing low and high EFR. The analysis included 7,737 consecutive patients among whom 463 deaths and 821 HF hospitalizations occurred over a median follow-up of 554 days. A low EFR was associated with a 25% greater risk of the primary outcome (HR: 1.25; 95% CI: 1.16 to 1.35). The association was stronger at higher values of resting EF (HR at EFs of 40% and 70%: 0.99 and 1.21 respectively) and MFR (HR at MFRs of 1 and 3: 1.06 and 1.27 respectively). Similarly, a high EFR carried a protective association that was more pronounced at a higher resting EF and MFR. The prognostic implications of contractile reserve, as measured by EFR, are most pronounced in patients with a higher resting EF and MFR.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056847","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":"Assessing beam hardening artifacts in coronary stent imaging using different CT acquisition parameters on photon-counting detector computed tomography.","authors":"Rafael Adolf, Isabelle Ried, Albrecht Will, Eva Hendrich, Keno Bressem, Leif-Christoph Engel, Martin Hadamitzky","doi":"10.1007/s10554-025-03392-z","DOIUrl":"https://doi.org/10.1007/s10554-025-03392-z","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether different scan protocols using a first-generation dual-source photon-counting CT (PCD-CT) can reduce coronary stent artifacts and improve image quality in patients with chronic coronary artery disease (CAD) and in-stent restenosis (ISR).</p><p><strong>Materials and methods: </strong>Patients undergoing CCTA for suspected ISR or progression of CAD were consecutively enrolled between November 2021 and February 2023. Patients were scanned on a dual-source PCD-CT using standard acquisition mode with collimation of 144 × 0.4 mm or ultra-high-resolution (UHR) mode with collimation of 120 × 0.2 mm. Tube voltages were set at 120 or 140 kV. Scans were reconstructed using a standard kernel (Bv48), with UHR scans also reconstructed using a sharper kernel (Bv56).</p><p><strong>Results: </strong>A total of 25 patients were included in the study, of whom 80% were male, with a mean age of 68 ± 8 years (IQR 64.8-75.3). UHR mode, particularly with Bv56 kernels, provided significantly thinner vessel walls and reduced beam hardening artifacts compared to standard mode and Bv48 kernel, especially at lower tube voltages. Noise levels varied, with generally lower noise in UHR scans.</p><p><strong>Conclusion: </strong>UHR mode with Bv56 kernels improves artifact reduction and vessel visualization in coronary stents, offering advantages over standard CCTA protocols. These findings may enhance the clinical diagnosis of ISR, leading to better patient outcomes through improved treatment planning.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061826","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":"Assessment of left ventricular systolic function and pathological changes using layer-specific strain in rats with myocardial hypertrophy at various disease stages.","authors":"Li Cui, Qinghui Wang, Qingyi Luo, Xuan Su, Jian Zhang, Yunchuan Ding","doi":"10.1007/s10554-025-03393-y","DOIUrl":"https://doi.org/10.1007/s10554-025-03393-y","url":null,"abstract":"<p><strong>Purpose: </strong>Although layer-specific strains are effective for assessing cardiac function, their application in rat models at different stages of myocardial hypertrophy (MH) is immature, and their relationship with MH and myocardial fibrosis (MF) is unclear. This study aimed to investigate changes in layer-specific strains across different disease stages and analyze their association with pathological changes.</p><p><strong>Methods: </strong>A progressive MH rat model was established using isoproterenol injection and categorized into baseline, 1-week, 2-week, 3-week, and 4-week groups. Echocardiographic indices and pathological differences between the five groups were assessed. The correlation between layer-specific strain parameters and cardiomyocyte hypertrophy and MF was analyzed.</p><p><strong>Results: </strong>As the disease progressed, the left ventricular (LV) dilated, with the LV wall thickening and then thinning. The left ventricular ejection fraction declined significantly in the fourth week. The endo-myocardial, mid-myocardium and epi-myocardial global longitudinal strain, along with endo-myocardial global circumferential strain (GCS) and the transmural gradient, significantly decreased in the first week, the mid-myocardium GCS in the second week, and continued to decrease as the disease progressed. The epi-myocardial GCS increased in the first week, but then decreased, becoming significantly lower than the baseline group in the third week. The degrees of MH and MF were correlated with the layer-specific strain parameters.</p><p><strong>Conclusion: </strong>Layer-specific strains maybe are valuable for early and effective monitoring of LV systolic function and pathological changes in rats with MH. Longitudinal strain is more sensitive to functional changes; endomyocardial strain reflects early LV remodeling and circumferential strain perhaps indicates disease progression and severity.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032638","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":"Prevalence of low-flow state by automated machine-learning 3D echocardiography in patients with moderate-to-severe aortic stenosis and normal ejection-fraction.","authors":"Andrea Barbieri, Vera Laus, Francesca Bursi, Silvia Bonatti, Mattia Malaguti, Matteo Paolini, Giuseppe Boriani","doi":"10.1007/s10554-025-03398-7","DOIUrl":"https://doi.org/10.1007/s10554-025-03398-7","url":null,"abstract":"<p><strong>Background: </strong>In aortic valve stenosis (AS), measurement of stroke volume index (SVi) by the 2D Doppler- technique is required to calculate the aortic valve area (AVA) and determine flow status but is prone to systematic errors.</p><p><strong>Purpose: </strong>To investigate the prevalence of low-flow (LF) state (SVi ≤ 35 ml/m²) in patients with AS and concurrent SVi quantification by a validated 3D left ventricular volumetric method and standard 2D Doppler methods and its potential repercussions on flow status reclassification.</p><p><strong>Methods: </strong>Consecutive patients with moderate or severe AS (≤1.5 cm² by continuity equation) and ejection fraction ≥ 50% underwent concurrent Dynamic Heart Model (DHM) evaluation with larger settings of the boundary detection sliders (end-diastolic position = 60/60; end-systolic position = 30/30).</p><p><strong>Results: </strong>We included 57 patients (median 78 years [70-85]); 40% were women. The mean AVA was 1.03 ± 0.37 cm², median 1.00 [0.73-1.20] cm². We found a significant but modest correlation between SVi assessed by DHM and 2D Doppler (Pearson corr.=0.48, p < 0.001). In the 25 patients with severe AS (AVA < 1 cm²) subgroup, 75% of patients categorized as LF by 2D Doppler were reclassified as normal flow by DHM. The observed proportion of overall agreement in these patients was 60% (Cohen's kappa = 0.178, p = 0.238), without significant correlation (Pearson coeff.: 0.358; p = 0.166).</p><p><strong>Conclusions: </strong>In patients with moderate or severe AS and normal EF, the prevalence of LF state defined as SVi ≤ 35 ml/m² may be significantly lower than previously reported when the LV volumetric metrics by DHM are employed, and the AVA is close to the replacement referral cut-off.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016342","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}