JACC. Cardiovascular imaging最新文献

英文中文

Cancer and the Heart 癌症与心脏

IF 12.8 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular imaging

Pub Date : 2024-11-01 DOI: 10.1016/j.jcmg.2024.09.003

Paaladinesh Thavendiranathan MD, SM (Associate Editor, JACC: Cardiovascular Imaging), Y. Chandrashekhar MD (Editor-in-Chief, JACC: Cardiovascular Imaging)

引用次数: 0

Unlocking Virtual Physiology Guided PCI 开启虚拟生理学引导的 PCI：护理点 CT-FFR 性能。

IF 12.8 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular imaging

Pub Date : 2024-11-01 DOI: 10.1016/j.jcmg.2024.06.018

Mariusz Kruk MD, PhD, Marcin Demkow MD, PhD, Jan Henzel MD, PhD, Mariusz Dębski MD, PhD, Piotr Rudziński MD, PhD, Jakub Czarnecki, Marek Wiśniewski MD, Adam Witkowski MD, PhD, Cezary Kępka MD, PhD

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Medium-Term Outcomes of Hospitalized COVID-19 Patients With Myocardial Injury COVID-19心肌损伤住院患者的中期预后：谨慎乐观。

IF 12.8 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular imaging

Pub Date : 2024-11-01 DOI: 10.1016/j.jcmg.2024.07.012

Mahesh K. Vidula MD , Yuchi Han MD, MMSc

引用次数: 0

Optimal Identification of Severe Aortic Stenosis in Low-Flow, Low-Gradient State 低流量、低梯度状态下严重主动脉瓣狭窄的最佳识别：陪审团仍未做出结论。

IF 12.8 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular imaging

Pub Date : 2024-11-01 DOI: 10.1016/j.jcmg.2024.06.014

Roxy Senior MD, DM , Rajdeep S. Khattar DM

引用次数: 0

Prognostic Impact of Culprit Lesion Calcified Nodule After Emergency Coronary Intervention 急诊冠状动脉介入治疗后病灶钙化结节的预后影响：TACTICS注册子分析。

IF 12.8 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular imaging

Pub Date : 2024-11-01 DOI: 10.1016/j.jcmg.2024.06.010

Masahiro Hada MD, PhD, Tsunekazu Kakuta MD, PhD, Tomoyo Sugiyama MD, PhD, Masahiro Hoshino MD, PhD, Taishi Yonetsu MD, PhD, Eisuke Usui MD, PhD, Yoshihiro Hanyu MD, Tatsuhiro Nagamine MD, Kai Nogami MD, Hiroki Ueno MD, Kazuki Matsuda MD, Kodai Sayama MD, Mirei Setoguchi MD, Tomohiro Tahara MD, Tatsuya Sakamoto MD, Takashi Mineo MD, Nobuaki Kobayashi MD, PhD, Masamichi Takano MD, PhD, Seita Kondo MD, PhD, Kohei Wakabayashi MD, PhD, Toshiro Shinke MD, PhD

引用次数: 0

Quantitative Computed Tomography Angiography for the Evaluation of Valvular Fibrocalcific Volume in Aortic Stenosis 定量计算机断层扫描血管造影术用于评估主动脉瓣狭窄的瓣膜纤维钙化体积。

IF 12.8 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular imaging

Pub Date : 2024-11-01 DOI: 10.1016/j.jcmg.2024.06.007

Maria Lembo MD, PhD , Shruti S. Joshi MBBS , Jolien Geers MD , Rong Bing MD, PhD , Lorenzo Carnevale PhD , Tania A. Pawade MBChB, PhD , Mhairi K. Doris MBChB, PhD , Evangelos Tzolos MD, PhD , Kajetan Grodecki MD, PhD , Sebastien Cadet MSc , Neil Craig MBChB , Trisha Singh MBChB, PhD , Piotr J. Slomka PhD , Audrey White BSc , Andrea Guala MD, PhD , Jose F. Rodriguez-Palomares MD, PhD , Aroa Ruiz-Muñoz MS , Lydia Dux-Santoy PhD , Gisela Teixido-Tura MD, PhD , Laura Galian-Gay MD, PhD , Marc R. Dweck MD, PhD

Background

Aortic stenosis (AS) is characterized by calcification and fibrosis. The ability to quantify these processes simultaneously has been limited with previous imaging methods.

Objectives

The purpose of this study was to evaluate the aortic valve fibrocalcific volume by computed tomography (CT) angiography in patients with AS, in particular, to assess its reproducibility, association with histology and disease severity, and ability to predict/track progression.

Methods

In 136 patients with AS, fibrocalcific volume was calculated on CT angiograms at baseline and after 1 year. CT attenuation distributions were analyzed using Gaussian-mixture-modeling to derive thresholds for tissue types enabling the quantification of calcific, noncalcific, and fibrocalcific volumes. Scan-rescan reproducibility was assessed and validation provided against histology and in an external cohort.

Results

Fibrocalcific volume measurements took 5.8 ± 1.0 min/scan, demonstrating good correlation with ex vivo valve weight (r = 0.51; P < 0.001) and excellent scan-rescan reproducibility (mean difference −1%, limits of agreement −4.5% to 2.8%). Baseline fibrocalcific volumes correlated with mean gradient on echocardiography in both male and female participants (rho = 0.64 and 0.69, respectively; both P < 0.001) and in the external validation cohort (n = 66, rho = 0.58; P < 0.001). The relationship was driven principally by calcific volume in men and fibrotic volume in women. After 1 year, fibrocalcific volume increased by 17% and correlated with progression in mean gradient (rho = 0.32; P = 0.003). Baseline fibrocalcific volume was the strongest predictor of subsequent mean gradient progression, with a particularly strong association in female patients (rho = 0.75; P < 0.001).

Conclusions

The aortic valve fibrocalcific volume provides an anatomic assessment of AS severity that can track disease progression precisely. It correlates with disease severity and hemodynamic progression in both male and female patients.

背景：主动脉瓣狭窄（AS）的特点是钙化和纤维化。以往的成像方法无法同时量化这些过程：本研究的目的是通过计算机断层扫描（CT）血管造影评估主动脉瓣纤维钙化体积，尤其是评估其再现性、与组织学和疾病严重程度的关联以及预测/追踪疾病进展的能力：在136名强直性脊柱炎患者中，计算基线和1年后CT血管造影的纤维钙化体积。使用高斯混合模型分析CT衰减分布，得出组织类型的阈值，从而量化钙化、非钙化和纤维钙化体积。评估了扫描-扫描再现性，并根据组织学和外部队列进行了验证：纤维钙化体积测量耗时 5.8 ± 1.0 分钟/扫描，与活体瓣膜重量（r = 0.51；P < 0.001）呈良好相关性，扫描-扫描再现性极佳（平均差-1%，一致性范围-4.5% 至 2.8%）。在男性和女性参与者中，基线纤维钙化体积与超声心动图的平均梯度相关（rho = 0.64 和 0.69，均 P < 0.001），在外部验证队列中也是如此（n = 66，rho = 0.58；P < 0.001）。这种关系主要由男性的钙化体积和女性的纤维化体积决定。1 年后，纤维钙化体积增加了 17%，并与平均梯度的进展相关（rho = 0.32；P = 0.003）。基线纤维钙化体积是随后平均梯度进展的最强预测因子，女性患者的相关性尤其强（rho = 0.75；P < 0.001）：主动脉瓣纤维钙化体积提供了对强直性脊柱炎严重程度的解剖评估，可精确追踪疾病进展。它与男性和女性患者的疾病严重程度和血流动力学进展相关。

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引用次数: 0

The Impact of Bariatric Surgery on Coronary Microvascular Function Assessed Using Automated Quantitative Perfusion CMR 使用自动定量灌注 CMR 评估减肥手术对冠状动脉微血管功能的影响

IF 12.8 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular imaging

Pub Date : 2024-11-01 DOI: 10.1016/j.jcmg.2024.05.022

James D. Crane BMBS , George Joy PhD , Kristopher D. Knott MBBS , João B. Augusto MD , Clement Lau PhD , Anish N. Bhuva PhD , Andreas Seraphim PhD , Timothée Evain PhD , Louise A.E. Brown PhD , Amrit Chowdhary PhD , Tushar Kotecha PhD , Marianna Fontana PhD , Sven Plein PhD , Sasindran Ramar MS , Francesco Rubino MD , Peter Kellman PhD , Hui Xue PhD , Iain Pierce PhD , Rhodri H. Davies PhD , James C. Moon MD , Charlotte Manisty PhD

Background

Coronary microvascular function is impaired in patients with obesity, contributing to myocardial dysfunction and heart failure. Bariatric surgery decreases cardiovascular mortality and heart failure, but the mechanisms are unclear.

Objectives

The authors studied the impact of bariatric surgery on coronary microvascular function in patients with obesity and its relationship with metabolic syndrome.

Methods

Fully automated quantitative perfusion cardiac magnetic resonance and metabolic markers were performed before and 6 months after bariatric surgery.

Results

Compared with age- and sex-matched healthy volunteers, 38 patients living with obesity had lower stress myocardial blood flow (MBF) (P = 0.001) and lower myocardial perfusion reserve (P < 0.001). A total of 27 participants underwent paired follow-up 6 months post-surgery. Metabolic abnormalities reduced significantly at follow-up including mean body mass index by 11 ± 3 kg/m² (P < 0.001), glycated hemoglobin by 9 mmol/mol (Q1-Q3: 4-19 mmol/mol; P < 0.001), fasting insulin by 142 ± 131 pmol/L (P < 0.001), and hepatic fat fraction by 5.6% (Q1-Q3: 2.6%-15.0%; P < 0.001). Stress MBF increased by 0.28 mL/g/min (Q1-Q3: −0.02 to 0.75 mL/g/min; P = 0.003) and myocardial perfusion reserve by 0.13 (Q1-Q3: −0.25 to 1.10; P = 0.036). The increase in stress MBF was lower in those with preoperative type 2 diabetes mellitus (0.1 mL/g/min [Q1-Q3: −0.09 to 0.46 mL/g/min] vs 0.75 mL/g/min [Q1-Q3: 0.31-1.25 mL/g/min]; P = 0.002). Improvement in stress MBF was associated with reduction in fasting insulin (beta = −0.45 [95% CI: −0.05 to 0.90]; P = 0.03).

Conclusions

Coronary microvascular function is impaired in patients with obesity, but can be improved significantly with bariatric surgery. Improvements in microvascular function are associated with improvements in insulin resistance but are attenuated in those with preoperative type 2 diabetes mellitus.

背景：肥胖症患者的冠状动脉微血管功能受损，导致心肌功能障碍和心力衰竭。减肥手术可降低心血管死亡率和心力衰竭，但其机制尚不清楚：作者研究了减肥手术对肥胖症患者冠状动脉微血管功能的影响及其与代谢综合征的关系：方法：在减肥手术前和手术后6个月进行全自动定量灌注心脏磁共振和代谢指标检查：结果：与年龄和性别匹配的健康志愿者相比，38 名肥胖症患者的应激心肌血流量（MBF）较低（P = 0.001），心肌灌注储备较低（P < 0.001）。共有 27 名参与者在手术后 6 个月进行了配对随访。随访期间，代谢异常明显减少，包括平均体重指数降低了 11 ± 3 kg/m2 （P < 0.001），糖化血红蛋白降低了 9 mmol/mol（Q1-Q3：4-19 mmol/mol；P 结论：肥胖症患者的冠状动脉微血管功能受损，但通过减肥手术可以显著改善。微血管功能的改善与胰岛素抵抗的改善有关，但对于术前患有 2 型糖尿病的患者，改善效果会减弱。

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引用次数: 0

Myocardial Characteristics, Cardiac Structure, and Cardiac Function in Systemic Light-Chain Amyloidosis 全身性轻链淀粉样变性的心肌特征、心脏结构和心脏功能

IF 12.8 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular imaging

Pub Date : 2024-11-01 DOI: 10.1016/j.jcmg.2024.05.004

Olivier F. Clerc MD, MPH , Sarah A.M. Cuddy MD , Michael Jerosch-Herold PhD , Dominik C. Benz MD , Ethan Katznelson MD , Jocelyn Canseco Neri MS , Alexandra Taylor BS , Marie Foley Kijewski PhD , Giada Bianchi MD , Frederick L. Ruberg MD , Marcelo F. Di Carli MD , Ronglih Liao PhD , Raymond Y. Kwong MD, MPH , Rodney H. Falk MD , Sharmila Dorbala MD, MPH

Background

In systemic light-chain (AL) amyloidosis, cardiac involvement portends poor outcomes.

Objectives

The authors’ objectives were to detect early myocardial alterations, to analyze longitudinal changes with therapy, and to predict major adverse cardiac events (MACE) in participants with AL amyloidosis using cardiac magnetic resonance imaging (MRI).

Methods

Recently diagnosed participants were prospectively enrolled. AL amyloidosis with and without cardiomyopathy (AL-CMP, AL-non-CMP) were defined based on abnormal cardiac biomarkers and wall thickness. MRI was performed at baseline, 6 months in all participants, and 12 months in participants with AL-CMP. MACE were defined as all-cause death, heart failure hospitalization, and cardiac transplantation. Mayo stage was based on troponin T, N-terminal pro–B-type natriuretic peptide, and difference in free light chains.

Results

This study included 80 participants (median age 62 years, 58% men). Extracellular volume (ECV) was abnormal (>32%) in all participants with AL-CMP and in 47% of those with AL-non-CMP. ECV tended to increase at 6 months (median +2%; AL-CMP P = 0.120; AL-non-CMP P = 0.018) and returned to baseline values at 12 months in participants with AL-CMP. Global longitudinal strain (GLS) improved at 6 months (median −0.6%; P = 0.048) and 12 months (median −1.2%; P < 0.001) in participants with AL-CMP. ECV and GLS were strongly associated with MACE (P < 0.001) and improved the prognostic value when added to Mayo stage (P ≤ 0.002). No participant with ECV ≤32% had MACE, while 74% of those with ECV >48% had MACE.

Conclusions

In patients with systemic AL amyloidosis, ECV detects subclinical myocardial alterations. With therapy, ECV tends to increase at 6 months and returns to values unchanged from baseline at 12 months, whereas GLS improves at 6 and 12 months in participants with AL-CMP. ECV and GLS offer additional prognostic performance over Mayo stage. (Molecular Imaging of Primary Amyloid Cardiomyopathy [MICA]; NCT02641145)

背景：在全身性轻链（AL）淀粉样变性中，心脏受累预示着不良结局：在全身性轻链（AL）淀粉样变性中，心脏受累预示着不良预后：作者的目的是利用心脏磁共振成像（MRI）检测AL淀粉样变性患者的早期心肌改变，分析治疗后的纵向变化，并预测主要不良心脏事件（MACE）：方法：对最近确诊的患者进行前瞻性登记。根据异常的心脏生物标志物和心肌壁厚度来定义伴有和不伴有心肌病的 AL 淀粉样变性（AL-CMP、AL-non-CMP）。所有参与者在基线期、6个月期和12个月期分别进行磁共振成像。MACE定义为全因死亡、心衰住院和心脏移植。梅奥分期基于肌钙蛋白T、N末端前B型钠尿肽和游离轻链的差异：这项研究包括 80 名参与者（中位年龄 62 岁，58% 为男性）。所有 AL-CMP 患者和 47% 的 AL-non-CMP 患者的细胞外体积（ECV）均异常（>32%）。在 6 个月时，ECV 呈上升趋势（中位数 +2%；AL-CMP P = 0.120；AL-non-CMP P = 0.018），而在 12 个月时，AL-CMP 患者的 ECV 恢复到基线值。AL-CMP 患者的总体纵向应变（GLS）在 6 个月（中位数 -0.6%；P = 0.048）和 12 个月（中位数 -1.2%；P <0.001）时有所改善。ECV和GLS与MACE密切相关（P＜0.001），与梅奥分期相加可提高预后价值（P≤0.002）。ECV≤32%的患者没有发生MACE，而ECV>48%的患者中有74%发生了MACE：结论：在全身性AL淀粉样变性患者中，ECV可检测到亚临床心肌改变。随着治疗的进行，ECV 在 6 个月时趋于增加，在 12 个月时恢复到与基线值持平，而 GLS 在 6 个月和 12 个月时在 AL-CMP 患者中有所改善。与梅奥分期相比，ECV和GLS提供了额外的预后性能。(原发性淀粉样心肌病的分子成像 [MICA]；NCT02641145）。

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Cardiac Magnetic Resonance Evaluation of LV Remodeling Post-Myocardial Infarction 心肌梗死后左心室重塑的心脏磁共振评估：预后、监测和试验终点。

IF 12.8 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular imaging

Pub Date : 2024-11-01 DOI: 10.1016/j.jcmg.2024.03.012

Adverse left ventricular remodeling (ALVR) and subsequent heart failure after myocardial infarction (MI) remain a major cause of patient morbidity and mortality worldwide. Overt inflammation has been identified as the common pathway underlying myocardial fibrosis and development of ALVR post-MI. With its ability to simultaneously provide information about cardiac structure, function, perfusion, and tissue characteristics, cardiac magnetic resonance (CMR) is well poised to inform prognosis and guide early surveillance and therapeutics in high-risk cohorts. Further, established and evolving CMR-derived biomarkers may serve as clinical endpoints in prospective trials evaluating the efficacy of novel anti-inflammatory and antifibrotic therapies. This review provides an overview of post-MI ALVR and illustrates how CMR may help clinical adoption of novel therapies via mechanistic or prognostic imaging markers.

心肌梗死（MI）后的左心室不良重塑（ALVR）和随后的心力衰竭仍然是全球患者发病和死亡的主要原因。显性炎症已被确定为心肌纤维化和心肌梗死后 ALVR 发生的共同途径。心脏磁共振（CMR）能同时提供有关心脏结构、功能、灌注和组织特征的信息，因此能很好地为预后提供信息，并指导高危人群的早期监测和治疗。此外，在评估新型抗炎和抗纤维化疗法疗效的前瞻性试验中，已建立和不断发展的 CMR 衍生生物标志物可作为临床终点。本综述概述了心肌梗死后 ALVR 的情况，并说明了 CMR 可如何通过机理或预后成像标志物帮助临床采用新型疗法。

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IF 12.8 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular imaging

Pub Date : 2024-11-01 DOI: 10.1016/S1936-878X(24)00411-X

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