The international journal of cardiovascular imaging最新文献

{"title":"Non-invasive derivation of instantaneous free-wave ratio from invasive coronary angiography using a new deep learning artificial intelligence model and comparison with human operators' performance.","authors":"Catarina Oliveira, Marta Vilela, João Silva Marques, Cláudia Jorge, Tiago Rodrigues, Ana Rita Francisco, Rita Marante de Oliveira, Beatriz Silva, João Lourenço Silva, Arlindo L Oliveira, Fausto J Pinto, Miguel Nobre Menezes","doi":"10.1007/s10554-025-03369-y","DOIUrl":"10.1007/s10554-025-03369-y","url":null,"abstract":"<p><p>Invasive coronary physiology is underused and carries risks/costs. Artificial Intelligence (AI) might enable non-invasive physiology from invasive coronary angiography (CAG), possibly outperforming humans, but has seldom been explored, especially for instantaneous wave-free Ratio (iFR). We aimed to develop binary iFR lesion classification AI models and compare them with human performance. single-center retrospective study of patients undergoing CAG and iFR. A validated encoder-decoder convolutional neural network (CNN) performed segmentation. Manual annotation of target vessel and pressure sensor location on a segmented telediastolic frame followed. Three AI models classified lesions as positive (≤ 0.89) or negative (> 0.89). Model 1 uses preprocessed vessel diameters with a transformer. Models 2/3 are EfficientNet-B5 CNNs using concatenated angiography and segmentation - Model 3 employs class-frequency-weighted Cross-Entropy Loss. Previous findings demonstrated Model 3's superiority for left anterior descending (LAD) and Model 1's for circumflex (Cx)/right coronary artery (RCA) - they were therefore unified into a vessel-based model. Ten-fold patient-level cross-validation enabled full sample training/testing. Three experienced operators performed binary iFR classification using single frames of raw/segmented images. Comparison metrics were accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Across 250 measurements, AI accuracy was 72%, PPV 48%, NPV 90%, sensitivity 77%, and specificity 71%. Human accuracy ranged from 54 to 74%. NPV was high for the Cx/RCA (AI: 96/98%; operators: 94/97%), but AI significantly outperformed humans in the LAD (78% vs. 60-64%). An AI model capable of binary iFR lesions classification mildly outperformed interventional cardiologists, supporting further validation studies.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":"755-771"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11982120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598685","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":"Intramyocardial fatty infiltration lesion in sporadic inclusion body myositis: a case report.","authors":"Betim Redzepi, Marie Théaudin, Samir Bengueddache, Sofia Petropoulou-Natsou, Ambra Masi, David Rodrigues, Georgios Tzimas, Juerg Schwitter, Panagiotis Antiochos","doi":"10.1007/s10554-024-03271-z","DOIUrl":"10.1007/s10554-024-03271-z","url":null,"abstract":"<p><p>Sporadic inclusion body myositis (sIBM), the most common inflammatory muscle disorder in adults over 50 years, is often misdiagnosed due to its gradual onset and its common but unspecific muscle weakness in older adults. Diagnosis relies on clinical, radiological, and pathological features. Cardiac involvement is rare, prompting this case description and a comprehensive literature analysis. A 73-year-old woman diagnosed with sIBM in 2021 through muscle biopsy had been experiencing muscular symptoms since 2015. Her condition progressively worsened, affecting daily activities. Annual follow-ups revealed a moderate obstructive syndrome on respiratory testing, prompting a cardiac evaluation. Cardiac magnetic resonance (CMR) imaging identified intramyocardial lesions consistent with fatty infiltration, highlighting the interest of advanced imaging in sIBM management. Cardiac involvement in sIBM is presumed rare compared to other idiopathic inflammatory myopathies, though the exact frequency remains unclear. Early identification of heart alterations by CMR in sIBM can be prognostically valuable, guiding follow-up and interventions. However, literature on this subject is limited to small cohort studies and case reports describing complications. Given the slow progression of sIBM and the limited efficacy of current treatments, the discovery of myocardial lesions could warrant closer cardiological monitoring. Larger cohort studies are needed to explore potential new therapeutic approaches. Our case underscores the importance of CMR in detecting subtle cardiac manifestations in sIBM and illustrates the potential prognostic value of cardiac assessment in the management of sIBM.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":"799-805"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11982099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142524031","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":"Predicting the need for calcium modification techniques using computed tomography coronary angiography.","authors":"David Murphy, Benjamin Hudson, Stephen Lyen, Robert Lowe, Kevin Carson, Sri Raveen Kandan, Daniel McKenzie, Ali Khavandi, Jonathan Carl Luis Rodrigues","doi":"10.1007/s10554-025-03371-4","DOIUrl":"10.1007/s10554-025-03371-4","url":null,"abstract":"<p><p>Calcified coronary arteries pose a challenge to percutaneous coronary intervention (PCI). Calcium modification techniques (CMTs) increase procedural length, complexity and risk. Computed tomography coronary angiography (CTCA) is well suited to calcium identification and quantification and may offer valuable pre-procedural information. We hypothesised that CTCA could predict cases where CMT would be required during PCI. A single centre retrospective review (2021/2022) of consecutive patients who underwent PCI with a preceding CTCA demonstrating a calcified lesion in a major epicardial vessel. Blinded to the PCI strategy CTCA images were re-reviewed and calcium thickness, length, density and circumferential arc quantified. Receiver operating characteristic (ROC) curve for CMT defined optimum cut-off values. Calcium density (> 1000 HU) and calcific arc (> 180°) were proposed as a calcium planning score (CPS_CTCA), with 1 point assigned per criteria met. 76 PCI procedures were included (72 patients). CMT was used in 53% at the discretion of the operator. Calcific arc, density, length and thickness had an area under the curve (AUC) of 0.74, 0.7, 0.67 and 0.63 respectively. There was a step-wise increase in the proportion of cases requiring CMT with increasing CPS_CTCA. 0 vs. 1 point; OR 9 (1.1-82, p =.04), RR 5 (0.8-36, p =.09), 1 vs. 2 points; OR 3.2 (1.1-9.3, p =.03), RR 1.6 (1-2.3, p =.04), 0 vs. 2 points; OR 30 (3.3-272, p =.003), RR of 8 (1.3-54, p =.03). The incorporation of CTCA measured calcium density > 1000 HU and calcium arc > 180° into a calcium planning score may help with predicting the need for CMT at the time of PCI.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":"773-781"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11982065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598686","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":"The prognostic value of preoperative CAD-RADS classification in patients undergoing isolated aortic valve surgery.","authors":"Kitae Kim, Byeong A Yoo, Hyun Jung Koo, Hong Rae Kim, Ho Jin Kim, Jae Suk Yoo, Joon Bum Kim, Cheol Hyun Chung, Sung-Ho Jung","doi":"10.1007/s10554-025-03358-1","DOIUrl":"10.1007/s10554-025-03358-1","url":null,"abstract":"<p><p>To investigate the association between preoperative coronary artery disease (CAD) severity, as classified by the Coronary Artery Disease Reporting and Data System (CAD-RADS), and clinical outcomes in patients undergoing isolated aortic valve replacement (AVR). A total of 897 patients (452 women; mean age, 66.1 ± 9.3 years) who underwent isolated AVR and preoperative coronary computed tomography angiography (CCTA) between 2004 and 2022 were stratified by the CAD-RADS score. The outcomes of interest were all-cause death and major adverse cardiac and cerebrovascular events (MACCE). The CAD-RADS score was 0 in 290 (32%) patients, 1 in 208 (23%), 2 in 255 (29%), 3 in 82 (9%), and 4 in 62 (7%) patients. The rates of all-cause death and MACCE tended to increase in parallel with CAD-RADS score (4%, 10.5%, 8.2%, 18.2%, 28.1% at 5 years and 14.4%, 15.1%, 16.7%, 26.9%, 38.4% at 5 years, both P < 0.001). CAD-RADS score ≥ 3 was associated with a higher risk of all-cause death (HR 2.44, 95% CI: 1.52-3.93) and MACCE (HR 1.79, 95% CI: 1.27-2.52) after adjusting for potential confounders. Notably, patients with CAD-RADS ≥ 3 who received medical therapy in addition to coronary angiography (CAG) improved overall survival compared to those who did not undergo CAG. Preoperative CCTA with CAD-RADS assessment would be useful for screening concomitant CAD and predicting long-term clinical outcomes including all-cause death and MACCE in patients undergoing isolated AVR. For patients with CAD-RADS ≥ 3, it is essential to implement medicinal therapy or intervention along with CAG.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":"709-720"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485221","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":"\"Triple threat endocarditis: a perfect storm of severe aortic regurgitation complicated by pseudoaneurysm, gerbode defect, and right atrial vegetation\".","authors":"Chelsea Meloche, Srikanth Koneru, Luba Frank","doi":"10.1007/s10554-025-03349-2","DOIUrl":"10.1007/s10554-025-03349-2","url":null,"abstract":"<p><p>Infective endocarditis (IE) remains a life-threatening condition. Perivalvular complications, such as pseudoaneurysms and intracardiac fistulae are life-threatening if untreated (Delgado in Eur Heart J 44:3948-4042, 2023). Multimodality imaging provides key information to assess and guide management of local IE complications (Delgado in Eur Heart J 44:3948-4042, 2023; Hubers et al. in Mayo Clin Proc 95:982-997, 2020).</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":"809-810"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722905","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":"Effect of sampling rate during dynamic myocardial CT perfusion on coronary flow reserve and ischemia analysis.","authors":"Nobuo Tomizawa, Hiromi Ozu, Satoru Kamio, Shinichiro Fujimoto, Yui O Nozaki, Ruiheng Fan, Yuko O Kawaguchi, Kazuhisa Takamura, Makoto Hiki, Tadao Aikawa, Satoshi Kadowaki, Fuki Ikeda, Kanako K Kumamaru, Hirotaka Watada, Tohru Minamino, Shigeki Aoki","doi":"10.1007/s10554-025-03361-6","DOIUrl":"10.1007/s10554-025-03361-6","url":null,"abstract":"<p><p>Radiation dose is a major concern in dynamic myocardial CT perfusion scan. The purpose of this study was to investigate the effect of reducing the sampling rate on quantitative and semi-quantitative values. This single-center prospective study included 45 patients with type 2 diabetes mellitus (mean age, 58 ± 10 years [SD]; 30 men). Stress and rest dynamic CT perfusion scans were performed every heartbeat for 25 s. Coronary flow reserve (CFR) was calculated as the ratio of stress to rest myocardial blood flow. The summed difference score (SDS) was evaluated using stress and rest myocardial blood flow. CFR and SDS values were compared using the original dataset (1RR) and datasets with reduced sampling rates of 2 and 3 RR intervals (2RR and 3RR). Simulated effective doses were also compared. The mean CFR using the 1RR dataset was 5.89 ± 2.53, unchanged using the 2RR dataset (5.67 ± 2.42, p = 0.08) and decreased to 5.47 ± 2.45 (p = 0.001) using the 3RR dataset. The median SDS (interquartile range) using the 1RR, 2RR and 3RR datasets were 0 (0, 5.75), 0.5 (0, 7) and 0 (0, 6), respectively, with no difference (p > 0.05). The effective doses simulated using the 2RR and 3RR data were 6.7 ± 1.4 mSv and 5.8 ± 1.3 mSv, respectively, significantly lower than the original dose (9.2 ± 1.8 mSv, p < 0.001). A sampling rate of 2RR might be feasible for both semi-quantitative and quantitative evaluation in dynamic myocardial CT perfusion exams.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":"743-753"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485216","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":"Redundant and aneurysmal interatrial septum motion: a commentary on anatomical factors and clinical implications.","authors":"Altair Heidemann, Murilo Foppa","doi":"10.1007/s10554-025-03340-x","DOIUrl":"10.1007/s10554-025-03340-x","url":null,"abstract":"","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":"807"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076750","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":"Diagnosis of bicuspid aortic valves: CT vs. TTE.","authors":"Amy Sylivris, Zhao Feng Liu, James Theuerle, Ruth P Lim","doi":"10.1007/s10554-024-03290-w","DOIUrl":"10.1007/s10554-024-03290-w","url":null,"abstract":"<p><p>Bicuspid aortic valfves (BAV) are a relatively common cardiac abnormality, with an associated risk of aortic stenosis, aortic regurgitation and aortopathy. First-line diagnosis is via transthoracic echocardiography (TTE), which may be impacted by valve calcification and operator variability. Electrocardiogram-gated computed tomography (CT) offers an alternative form of assessment. The aim of this systematic review and meta-analysis is to evaluate the diagnostic performance of TTE versus CT for BAV. Eligible studies were retrieved from inception through to March 2024 on OVID Medline, Embase and Cochrane Library. All primary studies regarding the diagnostic performance of TTE and/or CT with regards to BAV were included. The QUADAS-2 tool was utilized for quality assessment. Sensitivity and specificity data were statistically analyzed. Of 4698 records, 19 were eligible for inclusion, and 16 had sufficient data for inclusion in the meta-analysis. There was only data regarding TTE vs. retrospectively ECG-gated CT. There was a significant difference between the sensitivity of retrospectively ECG-gated cardiac CT (95.5% (95% CI: [91.3-97.5%]) and TTE (79.7%, 95% CI: [71.6-86.0%]) for identifying BAV. The specificity was high and not significantly different for both CT and TTE (96%, 95% CI: [92.5-98.2%] and 91.3%, 95% CI: [87.3-93.8%], respectively). Retrospectively ECG-gated CT demonstrates greater sensitivity for diagnosis of BAV compared to TTE. Both modalities are non-invasive and demonstrate good specificity for excluding BAV. Given that CT scans are easily accessible, they offer a reasonable second-line investigation for diagnosis of BAV when an initial TTE is inconclusive.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":"659-667"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804162","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":"Visualization of complex mitral valve anatomy using real-time three-dimensional computer graphics.","authors":"Kunihiko Joo, Yoshie Ochiai, Shigehiko Tokunaga","doi":"10.1007/s10554-024-03319-0","DOIUrl":"10.1007/s10554-024-03319-0","url":null,"abstract":"","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":"821-822"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916749","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":"Aortic pseudoaneurysm closure by combination of LAA occluder and covered stent.","authors":"Luca Oechslin, Roberto Corti, Hasan Hadzalic, Patric Biaggi","doi":"10.1007/s10554-025-03334-9","DOIUrl":"10.1007/s10554-025-03334-9","url":null,"abstract":"","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":"813-814"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019118","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}