European heart journal. Imaging methods and practice最新文献

{"title":"How to behave with paediatric myocarditis: imaging methods and clinical considerations.","authors":"Rosalba De Sarro, Nunzia Borrelli, Giulia Pelaia, Alessia Mendicino, Sara Moscatelli, Isabella Leo, Giulia La Vecchia, Giuseppe Mazza, Lucy Castaldo, Antonio Strangio, Martina Avesani, Salvatore De Rosa, Daniele Torella, Giovanni Di Salvo, Jolanda Sabatino","doi":"10.1093/ehjimp/qyaf025","DOIUrl":"10.1093/ehjimp/qyaf025","url":null,"abstract":"<p><p>Paediatric myocarditis is a challenging and heterogeneous condition, with varied clinical presentations ranging from mild symptoms to life-threatening complications such as heart failure, arrhythmias, and sudden cardiac death. Effective management hinges on early diagnosis, appropriate treatment, and ongoing monitoring, which can be significantly enhanced through multimodal imaging techniques. This review emphasizes the crucial role of advanced imaging in the diagnosis, prognostication, and management of paediatric myocarditis. While traditional echocardiography remains the first-line imaging tool, it is often insufficient in detecting subtle myocardial changes and it does not allow the identification of myocardial inflammation and fibrosis, particularly in cases with preserved left ventricular function. Recent advancements, including speckle-tracking echocardiography, provide enhanced sensitivity for detecting early signs of myocardial dysfunction, even in the absence of overt abnormalities. Cardiovascular magnetic resonance (CMR) has emerged as a cornerstone in the non-invasive evaluation of myocarditis, offering unparalleled tissue characterization. Indeed, CMR provides critical insights into myocardial oedema, necrosis, and fibrosis, which are essential for confirming the diagnosis, stratifying prognosis, and guiding therapy. Parametric mapping techniques allow for highly accurate detection of myocardial fibrosis (native T1 mapping) and inflammation (T2 mapping), even in the absence of gadolinium contrast, making it particularly valuable in paediatric patients. In conclusion, multimodality imaging, integrating echocardiography and CMR, allows for a comprehensive understanding of disease severity, guiding treatment decisions and optimizing long-term outcomes. This review underscores the importance of a tailored, imaging-driven approach to managing paediatric myocarditis, ensuring the best possible care for this special population.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf025"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797535","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":"Understanding statistical analysis in randomized trials: tips and tricks for effective review.","authors":"Paolo Frumento, Alessia Gimelli","doi":"10.1093/ehjimp/qyaf036","DOIUrl":"10.1093/ehjimp/qyaf036","url":null,"abstract":"<p><p>This review explores the critical role of statistical analysis in interpreting randomized controlled trials (RCTs), focusing on how these methods are used to evaluate the efficacy and safety of clinical interventions. RCTs are considered the gold standard in clinical research, yet their statistical complexity can make interpretation challenging. Understanding key statistical concepts, such as <i>P</i>-values, hazard ratios, and confidence intervals, is essential for distinguishing between statistical significance and clinical relevance. It is important to assess study design elements, including randomization methods, sample size calculations, and the handling of missing data, as these factors directly influence the validity of the findings. Additionally, the analysis plan-whether it follows an intention-to-treat approach or uses per-protocol analysis-can impact the interpretation of trial outcomes. Readers should also be aware of the distinction between pre-specified and <i>post hoc</i> analyses, as the latter can increase the risk of false positives. The appropriate interpretation of these elements ensures a balanced understanding of trial results, allowing clinicians and researchers to make evidence-based decisions.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf036"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805242","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":"Shear wave elastography to unmask differences in myocardial stiffness between athletes and sedentary non-athletes.","authors":"Karim Taha, Youri Bekhuis, Ruben de Bosscher, Christophe Dausin, Marta Orlowska, Ahmed S Youssef, Stéphanie Bézy, Véronique Cornelissen, Lieven Herbots, Rik Willems, Jens-Uwe Voigt, Jan D'hooge, Guido Claessen","doi":"10.1093/ehjimp/qyaf023","DOIUrl":"10.1093/ehjimp/qyaf023","url":null,"abstract":"<p><strong>Aims: </strong>Myocardial stiffening naturally occurs with aging and contributes to diastolic dysfunction. Assessing myocardial stiffness non-invasively could improve the sensitivity of diastolic function evaluation in clinical practice. Shear wave (SW) elastography is a non-invasive tool for quantifying myocardial stiffness, where higher SW velocities indicate increased stiffness. We investigated whether SW elastography could detect differences in myocardial stiffness between athletes and sedentary non-athletes and, during exercise, reveal differences in operational stiffness that may indicate diastolic dysfunction.</p><p><strong>Methods and results: </strong>We enrolled 20 master athletes (median age 60 [IQR 59-66] years) and 17 sedentary non-athletes (median age 58 [IQR 52-71] years). Standard exercise echocardiography revealed no significant differences in diastolic function between the groups. Additionally, ultra-high frame rate imaging was used to measure SW velocities after mitral valve closure (MVC) and aortic valve closure (AVC) at rest and during exercise. At rest, athletes had lower SW velocities after MVC compared to sedentary non-athletes (3.2 ± 0.4 m/s vs. 3.9 ± 0.7 m/s, respectively, <i>P</i> = 0.003). During exercise, SW velocities after AVC significantly increased in sedentary non-athletes but not in athletes (+1.6 ± 1.6 cm/s increase per 1% power output increase vs. 0.0 ± 0.8 cm/s, respectively, <i>P</i> = 0.006). An inverse correlation was found between the increase of SW velocity after AVC during exercise and VO₂max (<i>r</i> = -0.51, <i>P</i> = 0.003).</p><p><strong>Conclusion: </strong>SW elastography reveals reduced myocardial stiffness in athletes compared to sedentary non-athletes at rest and during exercise, which is not detected by conventional echocardiographic measurements. Exercise-induced changes in SW velocities after AVC may potentially serve as an early marker for detecting diastolic dysfunction.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"2 4","pages":"qyaf023"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694987","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":"Sex differences in cardiac remodelling in ischaemic cardiomyopathy and functional mitral regurgitation: impact on prognosis.","authors":"Duygu Kocyigit Burunkaya, Nancy A Obuchowski, Natalie Ho, Zoran B Popovic, David Chen, Christopher Nguyen, W H Wilson Tang, Deborah H Kwon","doi":"10.1093/ehjimp/qyaf021","DOIUrl":"10.1093/ehjimp/qyaf021","url":null,"abstract":"<p><strong>Aims: </strong>Sex differences in prognosis of functional mitral regurgitation (FMR) associated with ischaemic cardiomyopathy (ICM) demonstrate the need to identify sex differences in cardiac remodelling. This study aimed to characterize sex differences in cardiac remodelling associated with FMR in the setting of ICM, sex interactions with cardiac remodelling and FMR severity, and predictors of all-cause mortality or heart transplantation using cardiac magnetic resonance (CMR) imaging.</p><p><strong>Methods and results: </strong>Consecutive patients with ICM referred to CMR between 2002 and 2017 were reviewed. Eligible 790 patients [mean age: 62.0 (standard deviation = 11.2] years and 24.7% females] were evaluated over a median follow-up of 5.8 years. There were 773 subjects with complete data for survival analysis, with 449 primary events. Coronary artery disease risk factors, medications, and previous coronary revascularization were similar in females and males (all <i>P</i> > 0.05). Indexed left ventricular and right ventricular (LV and RV) volumes were larger in males (<i>P</i> < or =0.005 for all comparisons) with similar slope of increasing LV and RV volumes in the setting of increasing FMR (all <i>P</i> > 0.05, for interactions). However, indexed left atrial volume was similar in males and females (<i>P</i> = 0.696), after adjusting for FMR severity. After adjusting for medical risk factors and post-CMR procedural interventions, females demonstrated increased risk of primary clinical composite point with enlarging LV volumes [hazard ratio: 1.04 (95% confidence interval: 1.01-1.06), <i>P</i> = 0.034].</p><p><strong>Conclusion: </strong>Because females with increasing LV size and FMR severity demonstrated significantly increased risk of adverse outcomes, our findings suggest the importance of deriving sex-specific CMR selection criteria for therapeutic management of FMR in the setting of ICM.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf021"},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665788","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 five times sit-to-stand test predicts achievable exercise intensity during stress echocardiography.","authors":"Yasuhide Mochizuki, Yui Kuroki, Mina Shibakai, Ayaka Oda, Sakiko Gohbara, Yumi Yamamoto, Saaya Ichikawa-Ogura, Rumi Hachiya, Eiji Toyosaki, Hiroto Fukuoka, Toshiro Shinke","doi":"10.1093/ehjimp/qyaf030","DOIUrl":"10.1093/ehjimp/qyaf030","url":null,"abstract":"<p><strong>Aims: </strong>Exercise stress echocardiography (ESE) is becoming increasingly important in assessing heart failure and valvular diseases; however, determining optimal exercise intensity remains challenging, particularly in patients with physical disorders.</p><p><strong>Methods and results: </strong>A total of 94 patients scheduled for ESE were enrolled in the study. Physical capability was assessed using the five times sit-to-stand test (5-STS), Clinical Frailty Scale, acronyms of the five components, namely strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F) questionnaire, grip strength test, and bioelectrical impedance analysis. In the derivation cohort (<i>n</i> = 43), we determined the 5-STS cut-off value to achieving a 25 W load. The effectiveness of this cut-off value was prospectively evaluated in a validation cohort (<i>n</i> = 51). In the derivation cohort, the 5-STS predicted achieving a 25 W load using a cut-off of 11.7 s with 91% sensitivity and 70% specificity. In the validation cohort, using 12.0 s as the cut-off demonstrated 98% sensitivity and 88% specificity. The multivariate analysis identified age, sex (female), brain natriuretic peptide, SARC-F, and 5-STS as independent predictors of maximum achieved load. In a multivariate model including bioelectrical impedance parameters, lower limb muscle mass independently influenced maximum achievable load, regardless of age. Patients with optimized 5-STS-based load selection achieved significantly higher peak heart rates and maximum loads than those without.</p><p><strong>Conclusion: </strong>Sarcopenia-related indices, particularly the 5-STS, effectively and simply predicted achievable exercise intensity during ESE, independent of age and sex. The use of these indices to determine the initial load may help optimize ESE protocols for individual patients.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf030"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766288","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":"Chronic coronary syndrome with suspected Takayasu's arteritis.","authors":"Adriana Złahoda-Huzior, Maria Kundzierewicz, Katarzyna Kołodziej, Robert Banys, Jacek Godlewski, Dariusz Dudek, Małgorzata Urbańczyk-Zawadzka","doi":"10.1093/ehjimp/qyaf028","DOIUrl":"https://doi.org/10.1093/ehjimp/qyaf028","url":null,"abstract":"","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf028"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756585","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":"Left atrial strain by vendor-neutral echocardiography software in healthy subjects: vendor comparisons and associated factors.","authors":"Tiffany Dong, Aro Daniela Arockiam, Ankit Agrawal, Joseph El Dahdah, Elio Haroun, Muhammad Majid, Richard A Grimm, Luis L Rodriguez, Zoran B Popovic, Brian P Griffin, Wael A Jaber, Tom Kai Ming Wang","doi":"10.1093/ehjimp/qyaf029","DOIUrl":"10.1093/ehjimp/qyaf029","url":null,"abstract":"<p><strong>Aims: </strong>Left atrial strains [reservoir (LASr), conduit (LAScd), and contractile (LASct)] are increasingly utilized, primarily in the areas of heart failure and valvulopathy. Commercially available software to measure strain are marketed as imaging machine vendor independent, although the normal ranges of their performance and external validation studies are lacking. We evaluated and compared LAS values, reference ranges, and associated factors using contemporary strain software.</p><p><strong>Methods and results: </strong>Healthy subjects (<i>n</i> = 100) undergoing transthoracic echocardiography during January to April 2023 were studied, with equal number by age groups, sex, and GE vs. Philips equipment. LASs were quantified using TomTec version 51.02 (AutoStrain LA), EchoPAC version 206 (AFILA), velocity vector imaging (VVI) version 2.00, and Epsilon version 5.0.2.11295 software. Means and lower limits of normal [95% confidence interval (CI)] of LASr (%) were 44.1 (41.9, 46.3) and 30.3 (26.4, 34.1) for TomTec; 34.8 (33.6, 36.0) and 26.3 (24.2, 28.4) for EchoPAC (on GE scans only); 42.5 (40.2, 44.8) and 28.4 (24.4, 32.4) for VVI; and 37.0 (34.9, 39.1) and 25.2 (21.5, 28.8) for Epsilon. Factors significantly associated with variability in LASr measurements and their beta-coefficients (95% CI) were age -2.37 (-3.41, -1.33) per 10 years, EchoPAC (vs. TomTec) -9.63 (-12.75, -6.51), and Epsilon (vs. TomTec) -7.04 (-9.40, -4.67). Reference ranges and factors significantly associated with LAScd and LASct were reported. LAS measurements and normal ranges by strain software and associated clinical and echocardiographic factors were determined.</p><p><strong>Conclusion: </strong>EchoPAC and Epsilon have lower magnitude mean LAS values compared with TomTec and VVI, and all software were vendor neutral except EchoPAC.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf029"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782344","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":"Myocardial extracellular volume fraction by computed tomography vs. cardiovascular magnetic resonance imaging in patients with stable chest pain.","authors":"Bunny Saberwal, Kush Patel, Ernst Klotz, Anna Herrey, Andreas Seraphim, Sebastian Vandermolen, George D Thornton, Mohammed Y Khanji, Thomas A Treibel, Francesca Pugliese","doi":"10.1093/ehjimp/qyaf019","DOIUrl":"10.1093/ehjimp/qyaf019","url":null,"abstract":"<p><strong>Aims: </strong>Computed tomography (CT) is increasingly being recognized as a diagnostic modality across a range of cardiovascular conditions. Myocardial late enhancement imaging has shown value as an imaging biomarker for the identification and prognostication of disease. The objective of this study was to compare extracellular volume fraction by CT (ECVCT) against cardiovascular magnetic resonance (ECVCMR), the latter considered as reference standard for this study.</p><p><strong>Methods and results: </strong>Consecutive patients with an index history of cardiac chest pain referred for invasive angiography were prospectively recruited. In addition to late gadolinium enhancement (LGE) imaging, patients underwent 1.5 T CMR with T1-mapping [by MOdified Look-Locker Inversion (MOLLI) recovery]. Pre- and post-contrast CT was performed for whole-heart ECVCT quantification. Averaged and segmental ECVCT was compared in patients with and without LGE, as well as between mid-ventricular averaged ECVCT and ECVCMR. Bland-Altman analysis was used to determine limits of agreement and identify differences between ECVCT and ECVCMR. A total of 88 participants (74% male, mean age 59.8 ± 9.1 years) underwent ECVCT and LGE; 49 of these also underwent mid-ventricular ECVCMR. For these, the CMR and CTECV fractions were 27.6 ± 2.4 and 26.8 ± 2.2, respectively. Patients with LGE findings on CMR (<i>n</i> = 24) had a significantly higher ECVCT than those without (<i>n</i> = 64): 27.2 [25.8, 28.7] vs. 26.1 [25.0, 27.7] (<i>P</i> = 0.02). Segments with LGE demonstrated a consistently higher ECV: 30.8 [25.7, 35.9] (<i>P</i> = 0.008) (endocardial LGE) and 30.9 [27.9, 33.1] (<i>P</i> = 0.0001) (transmural LGE) vs. 26.1 [25.0, 27.4].</p><p><strong>Conclusion: </strong>ECVCT obtained from 5 min post-contrast CT protocols shows good agreement with CMR in a stable chest pain cohort. Such a protocol could be seamlessly introduced into a CT workflow for the identification of significant secondary pathologies.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf019"},"PeriodicalIF":0.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598713","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 effect of respiratory motion compensation in intracardiac 4D flow magnetic resonance imaging on left ventricular flow dynamics, multicomponent particle tracing, and valve tracking.","authors":"Paul R Roos, Thomas In de Braekt, Hildo J Lamb, Jos J M Westenberg","doi":"10.1093/ehjimp/qyaf020","DOIUrl":"10.1093/ehjimp/qyaf020","url":null,"abstract":"<p><strong>Aims: </strong>4D flow magnetic resonance imaging (MRI) has enabled evaluation of intracardiac flow dynamics by particle tracing for visualizing and quantifying complex flow patterns. The aim of this study was to assess the impact of respiratory motion compensation on 4D flow MRI-based left ventricular four-component particle tracing, valve tracking, and haemodynamics.</p><p><strong>Methods and results: </strong>In this prospective cohort study, 4D flow MRI with and without respiratory motion compensation was performed in 15 healthy volunteers. Intracardiac particle tracing considered four components: direct flow, delayed ejection flow (DEF), retained inflow (RI), and residual volume. Data quality was assessed by comparing DEF and RI components. Particle tracing, valve tracking, kinetic energy (KE), and vorticity were compared between scan methods. Paired sample <i>t</i>-tests and intraclass correlation analysis were performed with an alpha of 0.05. DEF, RI, ejection fraction, and stroke volume were different between scan methods. Five participants showed DEF-RI mismatch > 10%. After excluding these, differences in flow fractions were non-significant. Differences in stroke volume, ejection fraction, and valvular flow mismatch between scan methods remained. Valve tracking was comparable between scan methods and correlated well with particle tracing. Absolute mismatch between particle tracing- and valve tracking-based mitral flow, and KE and vorticity at A-peak, was higher for non-compensated MRI.</p><p><strong>Conclusion: </strong>Respiratory motion compensation can improve accuracy of intracardiac particle tracing based on 4D flow MRI by decreasing mismatch to retrospective valve tracking. For intracardiac particle tracing, respiratory motion compensation is advised. Robust data quality assessment for particle tracing-based analyses is equally crucial.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf020"},"PeriodicalIF":0.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598715","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":"Identification of atrial myopathy and atrial fibrillation recurrence after ablation using 3D left atrial phasic strain from retrospective gated computed tomography.","authors":"Charles Sillett, Orod Razeghi, Tiffany M G Baptiste, Angela W C Lee, Jose Alonso Solis Lemus, Cristobal Rodero, Caroline H Roney, Ruibin Feng, Prasanth Ganesan, Hui Ju Chang, Paul Clopton, Nick Linton, Ronak Rajani, A J Rogers, Sanjiv M Narayan, Steven A Niederer","doi":"10.1093/ehjimp/qyaf027","DOIUrl":"10.1093/ehjimp/qyaf027","url":null,"abstract":"<p><strong>Aims: </strong>Reduced left atrial (LA) mechanical function associates with atrial myopathy and adverse clinical endpoints in atrial fibrillation (AF) patients; however, conventional 2D imaging modalities are limited by atrial foreshortening and sub-optimally capture 3D LA motion.</p><p><strong>Objectives: </strong>We set out to test the hypothesis that 3D LA motion features from 4D (3D + time) retrospective gated computed tomography (RGCT) associate with AF phenotypes and predict AF recurrence in patients undergoing catheter ablation.</p><p><strong>Methods and results: </strong>Sixty-nine AF patients (60.8 ± 12.2 years, 39% female, 30% non-paroxysmal AF) who were indicated for CT coronary angiography including a RGCT protocol in sinus rhythm prior to ablation were included. We measured 3D LA endocardial motion by optimized 3D feature tracking and calculated 3D global and regional phasic strain and peak strain rates (SRs). AF recurrence was observed in 18 patients (26%) at 1-year. Global reservoir strain (<i>P</i> < 0.05) and contractile strain and SR (both <i>P</i> < 0.01) were reduced in patients with vs. those without recurrent AF. Global and anterior wall contractile SR were more predictive of recurrent AF than LA volume index (area under the curve, AUC: 0.74, 0.77, and 0.68, respectively). Reduced global conduit SR and septal reservoir strain were more strongly associated with non-paroxysmal AF than CHADS2-VASc (AUCs: 0.74, 0.75, and 0.59, respectively).</p><p><strong>Conclusion: </strong>Reduced passive and active 3D LA motion from 4D RGCT associates with more advanced AF and AF recurrence post-ablation, respectively. Future work should extend this approach to larger populations, with new low-radiation CT technologies to widen its applicability.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf027"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766286","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}