European heart journal. Imaging methods and practice最新文献

{"title":"Real-time guidance and automated measurements using deep learning to improve echocardiographic assessment of left ventricular size and function.","authors":"Sigbjorn Sabo, Håkon Pettersen, Gunn C Bøen, Even O Jakobsen, Per K Langøy, Hans O Nilsen, David Pasdeloup, Erik Smistad, Andreas Østvik, Lasse Løvstakken, Stian Stølen, Bjørnar Grenne, Håvard Dalen, Espen Holte","doi":"10.1093/ehjimp/qyaf094","DOIUrl":"10.1093/ehjimp/qyaf094","url":null,"abstract":"<p><strong>Aims: </strong>The low reproducibility of echocardiographic measurements challenges the identification of subtle changes in left ventricular (LV) function. Deep learning (DL) methods enable real-time analysis of acquisitions and may improve echocardiography. The aim of this study was to evaluate the impact of DL-based guidance and automated measurements on the reproducibility of LV global longitudinal strain (GLS), end-diastolic (EDV) and end-systolic (ESV) volume, and ejection fraction (EF).</p><p><strong>Methods and results: </strong>Forty-six patients (24 breast cancer and 22 general cardiology patients) were included and underwent four consecutive echocardiograms. Six were included twice, totalling 52 inclusions and 208 echocardiograms. One sonographer-cardiologist pair used DL guidance and measurements (DL group), while another did not use DL tools and performed manual measurements (manual group). DL group recordings were also measured using a commercially available DL-based EF tool. For GLS, the DL group had a 30% lower test-retest variability than the manual group (minimal detectable change 2.0 vs. 2.9, <i>P</i> = 0.036). LV volumes had ∼40% lower minimal detectable changes in the DL group vs. the manual group (32 mL vs. 52 mL for EDV and 18 mL vs. 32 mL for ESV, <i>P</i> ≤ 0.006). This did not translate to a significant improvement in EF reproducibility in the DL group. The benchmarking method showed similar results compared with the manual group.</p><p><strong>Conclusion: </strong>Combining real-time DL guidance with automated measurements improved the reproducibility of LV size and function measurements compared with usual care, but future studies are needed to evaluate its clinical effect.</p><p><strong>Trial registration number: </strong>NCT06310330.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 2","pages":"qyaf094"},"PeriodicalIF":0.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12311362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762944","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":"European Association of Cardiovascular Imaging survey on imaging for myocardial viability.","authors":"V C Wilzeck, G E Mandoli, A Demirkiran, E Androulakis, H Soliman Aboumarie, A A Giannopoulos, S Joshi, S Bhattacharyya, J F Palomares, T Podlesnikar, M R Dweck, R Manka","doi":"10.1093/ehjimp/qyaf095","DOIUrl":"10.1093/ehjimp/qyaf095","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the current role and practice patterns in myocardial viability assessment through a European Association of Cardiovascular Imaging (EACVI) survey.</p><p><strong>Methods and results: </strong>A total of 179 participants from 54 countries completed the survey. Most participants worked in tertiary centres (60.3%). Transthoracic echocardiography (TTE) was the most widely available modality (98.3%), followed by stress echocardiography (86.6%), cardiac computed tomography angiography (87.7%), and cardiovascular magnetic resonance (CMR, 84.9%). Single-photon emission computed tomography and positron emission tomography were less accessible (59.8 and 40.2%, respectively). CMR was the preferred imaging modality (76.0%), followed by TTE (41.9%), which were also the most frequently used techniques in clinical practice (42.7 and 38.7%, respectively). Viability imaging was regularly used by most respondents in patients with chronic ischaemic heart disease (57.0%) and prior to revascularization for chronic total occlusions (58.7%). Among late-presenting ST-elevation myocardial infarction patients, 60.7% of respondents assessed viability within index hospitalization or the first month, whereas 28.3% performed viability imaging after 1-3 months. However, considerable variation exists between respondents. Revascularization decisions were guided by viability findings with revascularization of only viable segments in 49.1% of cases, while 40.0% reported revascularizing all high-grade stenoses if any viable myocardium was present.</p><p><strong>Conclusion: </strong>This study highlights the variability in myocardial viability imaging practices across Europe, with differences in availability, preferred modalities, and clinical application. While CMR and TTE remain the dominant modalities, standardization of imaging protocols and further research are needed to optimize viability assessment and its impact on revascularization decisions.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 2","pages":"qyaf095"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984844","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 ventricular wall thickness heterogeneity improves cardiovascular disease diagnosis and prognosis: a UK Biobank cardiovascular magnetic resonance cohort study.","authors":"Kerrick Hesse, Mohammed Y Khanji, C Anwar A Chahal, Steffen E Petersen, Nay Aung","doi":"10.1093/ehjimp/qyaf092","DOIUrl":"10.1093/ehjimp/qyaf092","url":null,"abstract":"<p><strong>Aims: </strong>Left ventricular hypertrophy (LVH) regionality carries diagnostic and prognostic importance. Mean absolute deviation of maximum segmental wall thickness (<i>MadWT</i>) is a novel left ventricular wall thickness (LVWT) heterogeneity biomarker from cardiovascular magnetic resonance imaging (CMR).</p><p><strong>Objectives: </strong>To compare <i>MadWT</i> to indexed LV mass (<i>LVMi</i>), maximum (<i>MaxWT</i>) and mean (<i>MeanWT</i>) wall thickness to predict incident cardiovascular disease (CVD) and differentiate physiological from pathological LVH in highly physically active individuals.</p><p><strong>Methods and results: </strong>Deep learning-assisted analysis of 44 930 UK Biobank CMR scans produced WT indices. Cox regression modelled major adverse cardiovascular events (MACE), heart failure (HF), arrhythmia, and all-cause death against LVWT indices. In the top 1% most physically active biomarker differences between propensity score matched hypertensive and non-hypertensive groups were compared. Over median (Q1, Q3) follow-up of 5.7 (4.9, 7.1) years, <i>MadWT, MaxWT, MeanWT</i>, and <i>LVMi</i> were associated with greater risk of MACE, HF, arrhythmia (<i>P</i> < 0.05), but not all-cause death (<i>P</i> > 0.05). After adjusting for CMR biomarkers, including <i>LVMi</i>, <i>MadWT</i> remained independently prognostic of the greatest number of endpoints, including MACE, HF, and arrhythmia [HR 1.13 (1.04-1.23); HR 1.15 (1.01-1.32); and HR 1.26 (1.18-1.35) respectively]. In the top 1% most physically active by three metrics, <i>MadWT</i> was the only significantly different biomarker between hypertensive and non-hypertensive participants (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong><i>MadWT</i> is important prognostically beyond LV mass and may be useful when differentiating physiological from hypertensive LVH. Although findings require confirmation in athletic and diseased cohorts, <i>MadWT</i> is readily translatable to deep learning-assisted clinical CMR reporting, especially in early unexplained LVH.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 2","pages":"qyaf092"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755543","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":"Mitral annular calcification score by computed tomography in patients undergoing mitral valve surgery.","authors":"Yuichiro Okushi, Shinya Unai, Gösta B Pettersson, Haytham Elgharably, A Marc Gillinov, Richard A Grimm, Brian P Griffin, Bo Xu","doi":"10.1093/ehjimp/qyaf093","DOIUrl":"10.1093/ehjimp/qyaf093","url":null,"abstract":"<p><strong>Aims: </strong>Mitral annular calcification (MAC) increases the difficulty of mitral valve (MV) surgery and is associated with mortality. However, there is no standardized classification of MAC severity. A multi-parametric MAC score has been proposed using computed tomography. We evaluated the prognostic effect of MAC severity classification using the MAC score.</p><p><strong>Methods and results: </strong>We included 331 patients with MAC who underwent MV surgery from 2011 through 2019. We calculated the MAC score based on five main components (range: 2-12): MAC Agatston calcium score, MAC angle, extension to left ventricular outflow tract, the involvement of trigones, and myocardial infiltration. According to the proposed MAC score, we classified the top tertile into the severe MAC group (scores: 9-12, <i>n</i> = 63) and the others into non-severe MAC group (scores: 2-8, <i>n</i> = 268). Propensity scores (PS) were estimated using seven clinical variables (age, sex, body mass index, hypertension, diabetes mellitus, heart failure, and chronic kidney disease), with severe MAC as the dependent variable. The median age was 74 years and 57.1% were female. During a median follow-up duration of 220 days, 47 patients (14.2%) died. After PS matching, there were 60 patients in each group. There were no significant differences in in-hospital mortality between the two groups, but patients with severe MAC had statistically significantly higher all-cause mortality compared to patients with non-severe MAC (25.0% vs. 8.3%, <i>P</i> = 0.026).</p><p><strong>Conclusion: </strong>In patients undergoing MV surgery, systematic classification of MAC severity by MAC score helps predict prognosis.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 2","pages":"qyaf093"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12290508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736483","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":"Imaging cardio-obstetrics: a multidisciplinary model of care.","authors":"Monica Baroni, Pierluigi Festa, Francesca Chesi, Sabrina Costa","doi":"10.1093/ehjimp/qyaf083","DOIUrl":"10.1093/ehjimp/qyaf083","url":null,"abstract":"","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 2","pages":"qyaf083"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610857","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":"Estimation of toe brachial index based on forefoot Doppler waveforms.","authors":"Alexander D Rodway, Rachael Jarrett, Darren Cheal, Gary D Maytham, Benjamin C T Field, Martin B Whyte, Justin Read, Philip J Aston, Simon S Skene, Jenny Harris, Christian Heiss","doi":"10.1093/ehjimp/qyaf057","DOIUrl":"10.1093/ehjimp/qyaf057","url":null,"abstract":"<p><strong>Aims: </strong>The toe brachial index (TBI) is a standard diagnostic tool for assessing distal perfusion in peripheral arterial disease (PAD) but has several limitations. Doppler waveform characteristics of forefoot arteries, such as acceleration index (AccI), peak systolic velocity (PSV), and acceleration time (AT), present a potentially reliable and more accessible alternative for estimating TBI. This study evaluated the association between Doppler waveform characteristics and standard TBI, developed empirical equations for estimating TBI (eTBI), and assessed their accuracy, reproducibility, and clinical applicability.</p><p><strong>Methods and results: </strong>This study presents a prospective analysis of angle-corrected Doppler AccI, PSV, and AT in forefoot metatarsal arteries together with standard automated TBI in 155 limbs of PAD patients treated at Surrey and Sussex Healthcare NHS Trust, Redhill, UK. Doppler-derived AccI, PSV, and AT were significantly associated with standard TBI (<i>R</i> ² = 0.88, 0.58, 0.62; each <i>P</i> < 0.001). Empirical equations for eTBI calculation demonstrated excellent agreement with standard TBI, with minimal average deviations [-0.01 ± 0.10 (SD) for AccI]. Multivariable analysis confirmed that eTBI derived from AccI predicted TBI largely independent of age, sex, diabetes mellitus, Fontaine stage, diastolic blood pressure, and kidney function (<i>R</i> ² = 0.89). After revascularization, both eTBI and standard TBI increased significantly, with strong correlation (<i>r</i> = 0.95, <i>P</i> < 0.001). Inter- and intra-observer and inter-device variability for eTBI measurements was low, outperforming standard TBI.</p><p><strong>Conclusion: </strong>Doppler waveform-derived eTBI, particularly using AccI, provides a reproducible, accurate, and clinically responsive alternative to standard TBI. These findings support its integration into routine vascular diagnostics, enhancing accessibility and diagnostic precision in PAD care. Automated eTBI acquisition could enhance screening efficiency in non-specialist settings.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 2","pages":"qyaf057"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610856","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":"Multimodal imaging in a case of quadricuspid aortic valve regurgitation and stenosis: diagnostic challenges before transfemoral aortic valve replacement implantation.","authors":"Louise Sakowski, Vladyslav Kavalerchyk","doi":"10.1093/ehjimp/qyaf087","DOIUrl":"https://doi.org/10.1093/ehjimp/qyaf087","url":null,"abstract":"","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 2","pages":"qyaf087"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839654","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":"How we scan cardiac anatomy and function using cardiovascular magnetic resonance: a practical video guide.","authors":"Jennifer Erley, Corinna Else, Wiebke Dieckhoff, Paulius Bucius, Patrick Doeblin, Collin Götze, Katja Berkmann, Christian Stehning, Sebastian Kelle","doi":"10.1093/ehjimp/qyaf090","DOIUrl":"10.1093/ehjimp/qyaf090","url":null,"abstract":"<p><strong>Aims: </strong>Fast Strain-encoding (fSENC) is a pulse sequence that enables the acquisition of cardiovascular magnetic resonance images within a few heartbeats and at free breathing to quantify myocardial strain, a deformation parameter of the heart muscle. Strain is gaining importance in heart failure diagnostics, but implementing fast strain-encoding into a routine magnetic resonance protocol has not been thoroughly explored from a practical viewpoint. This video manuscript aims to provide a simple guide for the acquisition of cardiovascular magnetic resonance exams in cardiac patients and to determine the scan-rescan reproducibility of segmental strain analyses.</p><p><strong>Methods and results: </strong>A volunteer was scanned for demonstration purposes on a 1.5T MRI Scanner ('Ingenia, Philips Healthcare, Best, The Netherlands'). The acquisition of cine steady-state free precession (SSFP) and fSENC sequences is demonstrated in a step-by-step fashion, accompanied by a multilingual video tutorial and an image guide. Scan-rescan reproducibility of acquisition-based strain values was excellent between subsequent scans for segmental longitudinal (SLS) [0.93 (0.91-0.95) and circumferential strain (SCS) [0.78 (0.73-0.82) to 0.84 (0.80-0.87)], and good to excellent between scans that were interrupted by a break for SLS [0.80 (0.74-0.85) to 0.84 (0.79-0.87)] and SCS [0.57 (0.46-0.66) to 0.65 (0.56-0.77)].</p><p><strong>Conclusion: </strong>This multilingual video manuscript provides a practical guide to conducting cardiovascular magnetic resonance exams including SSFP and fSENC, useful for further quantitative analysis to grasp heart function on a global and regional basis.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 2","pages":"qyaf090"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12287925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710440","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":"EACVI survey on evaluation and quantification of aortic regurgitation by multi-modality imaging.","authors":"Sanjeev Bhattacharyya, Simona Beatrice Botezatu, Giulia Elena Mandoli, Giulia Vinco, Tor Biering-Sørensen, Robert Manka, Emmanuel Androulakis, Jose Rodriguez-Palomares, Jadranka Separovic Hanzevacki, Jolien Geers, Maria Lembo, Anna Baritussio, Tomaž Podlesnikar, Marc R Dweck","doi":"10.1093/ehjimp/qyaf058","DOIUrl":"10.1093/ehjimp/qyaf058","url":null,"abstract":"<p><strong>Aims: </strong>To investigate the real-world, current clinical practice of the assessment and management of aortic regurgitation (AR).</p><p><strong>Methods and results: </strong>An electronic survey was distributed to cardiovascular imaging specialists by the European Society Association of Cardiovascular Imaging Scientific Initiatives Committee. Three hundred respondents from 66 countries completed the survey. In patients where initial qualitative evaluation suggested moderate AR, regurgitation severity was further characterized using vena contracta in 83%, pressure half-time in 70%, jet width/outflow tract diameter in 59%, regurgitant volume/effective orifice area 57% and three-dimensional vena contract in 20% of respondents. Cardiac magnetic resonance (CMR) was used by 72% of respondents when transthoracic echocardiographic (TTE) image quality was poor and 74% of respondents when there was discordance between Doppler findings and ventricular assessments. CMR 4-dimensional flow was performed by 19% of respondents. Left ventricular (LV) diameters were measured at the mitral valve level by 52% and at the mid LV by 43% of respondents. LV volumes were measured using TTE by 70%, with CMR by 40% and with CT by 2% of respondents.</p><p><strong>Conclusion: </strong>There is heterogeneity in the echocardiographic methods used to quantify AR. The vena-contracta is the most commonly used for assessment of AR severity with relative underutilisation of quantitative methods. CMR is widely used to assess AR severity when echocardiographic assessments are uncertain. There is variation in the anatomical location to measure LV dilatation and variable use of LV volumes which may impact decision making for intervention.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf058"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532356","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":"Towards clinical integration of real-time 3D coronary stent reconstruction using contrast-free rotational angiography in percutaneous coronary intervention.","authors":"Ioannis Skalidis, Ioannis Kachrimanidis, Leonidas Koliastasis, Michalis Hamilos, Emmanouil Skalidis","doi":"10.1093/ehjimp/qyaf085","DOIUrl":"https://doi.org/10.1093/ehjimp/qyaf085","url":null,"abstract":"","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 2","pages":"qyaf085"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577511","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}