Pub Date : 2025-12-08DOI: 10.1016/j.jcmg.2025.11.007
Paul Leeson,Sadie Bennett
{"title":"Could Artificial Intelligence Change Our View on Left Ventricular Mass Measured by Echocardiography?","authors":"Paul Leeson,Sadie Bennett","doi":"10.1016/j.jcmg.2025.11.007","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.11.007","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"79 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145704401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-05DOI: 10.1016/j.jcmg.2025.10.015
Raymond Y Kwong,Bobby Heydari,Siddique Abbasi,Francois-Pierre Mongeon,Francois Marcotte,Matthias Friedrich,Leslee J Shaw,Yifan Xu,Rebecca Anthopolos,Raffi Bekeredjian,Lorenzo Monti,Joseph Selvanayagam,Maciej Lesiak,Michael H Picard,Daniel S Berman,Sripal Bangalore,John A Spertus,Gregg W Stone,William E Boden,James Min,G B John Mancini,Jonathan Leipsic,Matthew Budoff,Cameron Hague,Judith S Hochman,David J Maron,Harmony R Reynolds,
BACKGROUNDResearch comparing the prognostic value of stress cardiac magnetic resonance (CMR) to other stress modalities in patients with coronary disease is limited.OBJECTIVESThe authors compared the prognostic value of stress CMR vs alternative testing by either single-photon emission computed tomography or stress echocardiography (SPECT/echo) in the ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial.METHODSCMR vs SPECT/echo was compared in 3,909 patients randomized in ISCHEMIA after sites' interpretation of moderate to severe ischemia. Ischemia and infarct extent, measured by either CMR or SPECT/echo, were each associated with the trial's primary outcome of cardiovascular death, nonfatal myocardial infarction (MI), or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest, at a median follow-up of 3.37 years (Q1-Q3: 2.20-4.56 years).RESULTSCompared with SPECT/echo (n = 5,627), CMR participants (n = 313) were not different in key demographic factors but were more likely to have severe ischemia (57% vs 38%; P < 0.001) and to be randomized (n = 257, 82%, vs n = 3,652, 65%; P < 0.001). Ischemia severity (no/mild, moderate, severe) by CMR core laboratory was associated with cumulative 4-year event rates of all trial-specific endpoints, including the primary outcome (P = 0.042), cardiovascular death/MI (P = 0.041), and nonfatal MI (P = 0.03), but SPECT/echo ischemia severity was not. No/mild, moderate, and severe ischemia by CMR were associated with 0%, 14%, and 23% 4-year primary outcome rates, respectively, compared with 18%, 15%, and 16%, by SPECT/echo. After adjustment for age, estimated glomerular filtration rate, and diabetes, the association between ischemia extent and the primary endpoint differed by imaging modality, with each additional ischemic segment on CMR associated with a 13% increase in hazard (interaction P = 0.02). In participants assigned to initial conservative management who had no/mild ischemia on imaging, 4-year rates of invasive referral and coronary revascularization were lower in the CMR than SPECT/echo group (16.7% and 0%, respectively, for CMR; and 31% and 13.3%, respectively, for SPECT/echo).CONCLUSIONSIschemia severity by CMR had a stronger association with all ISCHEMIA trial endpoints compared with SPECT/echo.
背景：比较应激性心脏磁共振（CMR）与其他应激方式对冠心病患者预后价值的研究是有限的。目的在缺血试验中，作者比较应激CMR与单光子发射计算机断层扫描或应激超声心动图（SPECT/echo）替代检测的预后价值（医学和侵入性方法的比较健康有效性国际研究）。方法对3909例局部缺血患者进行scmr与SPECT/echo对比分析。CMR或SPECT/echo测量的缺血和梗死程度均与试验的主要结局相关，心血管死亡、非致死性心肌梗死（MI）或因不稳定型心绞痛、心力衰竭或复苏性心脏骤停住院，中位随访时间为3.37年（一季度至第三季度：2.20-4.56年）。结果与SPECT/echo （n = 5,627）相比，CMR参与者（n = 313）在关键人口统计学因素上没有差异，但更有可能发生严重缺血（57% vs 38%; P < 0.001）和随机化（n = 257, 82% vs n = 3,652, 65%; P < 0.001）。CMR核心实验室检测的缺血严重程度（无/轻度、中度、重度）与所有试验特定终点的累积4年事件发生率相关，包括主要终点（P = 0.042）、心血管死亡/心肌梗死（P = 0.041）和非致死性心肌梗死（P = 0.03），但SPECT/回声缺血严重程度与此无关。CMR无/轻度、中度和重度缺血的4年主要转归率分别为0%、14%和23%，而SPECT/echo的4年主要转归率分别为18%、15%和16%。在调整了年龄、肾小球滤过率和糖尿病等因素后，缺血程度和主要终点之间的关系因成像方式而异，CMR上每增加一个缺血段，风险增加13%（相互作用P = 0.02）。在被分配到初始保守治疗的、在影像学上没有或轻微缺血的参与者中，CMR组的4年有创转诊和冠状动脉血运重建率低于SPECT/echo组（CMR组分别为16.7%和0%；SPECT/echo组分别为31%和13.3%）。结论与SPECT/echo相比，CMR测量的缺血严重程度与所有缺血试验终点的相关性更强。
{"title":"Stress Cardiac Magnetic Resonance Ischemia Burden and Cardiovascular Events: Post-Hoc Analysis From the ISCHEMIA Trial.","authors":"Raymond Y Kwong,Bobby Heydari,Siddique Abbasi,Francois-Pierre Mongeon,Francois Marcotte,Matthias Friedrich,Leslee J Shaw,Yifan Xu,Rebecca Anthopolos,Raffi Bekeredjian,Lorenzo Monti,Joseph Selvanayagam,Maciej Lesiak,Michael H Picard,Daniel S Berman,Sripal Bangalore,John A Spertus,Gregg W Stone,William E Boden,James Min,G B John Mancini,Jonathan Leipsic,Matthew Budoff,Cameron Hague,Judith S Hochman,David J Maron,Harmony R Reynolds, ","doi":"10.1016/j.jcmg.2025.10.015","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.10.015","url":null,"abstract":"BACKGROUNDResearch comparing the prognostic value of stress cardiac magnetic resonance (CMR) to other stress modalities in patients with coronary disease is limited.OBJECTIVESThe authors compared the prognostic value of stress CMR vs alternative testing by either single-photon emission computed tomography or stress echocardiography (SPECT/echo) in the ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial.METHODSCMR vs SPECT/echo was compared in 3,909 patients randomized in ISCHEMIA after sites' interpretation of moderate to severe ischemia. Ischemia and infarct extent, measured by either CMR or SPECT/echo, were each associated with the trial's primary outcome of cardiovascular death, nonfatal myocardial infarction (MI), or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest, at a median follow-up of 3.37 years (Q1-Q3: 2.20-4.56 years).RESULTSCompared with SPECT/echo (n = 5,627), CMR participants (n = 313) were not different in key demographic factors but were more likely to have severe ischemia (57% vs 38%; P < 0.001) and to be randomized (n = 257, 82%, vs n = 3,652, 65%; P < 0.001). Ischemia severity (no/mild, moderate, severe) by CMR core laboratory was associated with cumulative 4-year event rates of all trial-specific endpoints, including the primary outcome (P = 0.042), cardiovascular death/MI (P = 0.041), and nonfatal MI (P = 0.03), but SPECT/echo ischemia severity was not. No/mild, moderate, and severe ischemia by CMR were associated with 0%, 14%, and 23% 4-year primary outcome rates, respectively, compared with 18%, 15%, and 16%, by SPECT/echo. After adjustment for age, estimated glomerular filtration rate, and diabetes, the association between ischemia extent and the primary endpoint differed by imaging modality, with each additional ischemic segment on CMR associated with a 13% increase in hazard (interaction P = 0.02). In participants assigned to initial conservative management who had no/mild ischemia on imaging, 4-year rates of invasive referral and coronary revascularization were lower in the CMR than SPECT/echo group (16.7% and 0%, respectively, for CMR; and 31% and 13.3%, respectively, for SPECT/echo).CONCLUSIONSIschemia severity by CMR had a stronger association with all ISCHEMIA trial endpoints compared with SPECT/echo.","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"28 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145680574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-03DOI: 10.1016/j.jcmg.2025.11.003
Charalambos Antoniades,Kenneth Chan
{"title":"Coronary Inflammatory Risk: A New Therapeutic Target in HIV?","authors":"Charalambos Antoniades,Kenneth Chan","doi":"10.1016/j.jcmg.2025.11.003","DOIUrl":"https://doi.org/10.1016/j.jcmg.2025.11.003","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"1 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145680582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jcmg.2025.06.019
Hamed Tavolinejad MD , Cameron Beeche BSc , Marie-Joe Dib PhD , Bianca Pourmussa BA , Scott M. Damrauer MD , John DePaolo MD PhD , Joe David Azzo MD , Oday Salman MD , Jeffrey Duda PhD , James Gee PhD , Seavmeiyin Kun BSc , Walter R. Witschey PhD
Background
Ascending aortic (AscAo) dimensions partially depend on body size. Ratiometric (linear) indexing of AscAo dimensions to height and body surface area (BSA) are currently recommended, but it is unclear whether these allometric relationships are indeed linear.
Objectives
This study aimed to evaluate allometric relations, normative values, and the prognostic performance of AscAo dimension indices.
Methods
The authors studied UK Biobank (UKB) (n = 49,271) and Penn Medicine BioBank (PMBB) (n = 8,426) participants. A convolutional neural network was used to segment the thoracic aorta from available magnetic resonance and computed tomography thoracic images. Normal allometric exponents of AscAo dimensions were derived from log-log models among healthy reference subgroups. Prognostic associations of AscAo dimensions were assessed with the use of Cox models.
Results
Among reference subgroups of both UKB (n = 11,310; age 52 ± 8 years; 37% male) and PMBB (n = 799; age 50 ± 16 years; 41% male), diameter/height, diameter/BSA, and area/BSA exhibited highly nonlinear relationships. In contrast, the allometric exponent of the area/height index was close to unity (UKB: 1.04; PMBB: 1.13). Accordingly, the linear ratio of area/height index did not exhibit residual associations with height (UKB: R2 = 0.04 [P = 0.411]; PMBB: R2 = 0.08 [P = 0.759]). Across quintiles of height and BSA, area/height was the only ratiometric index that consistently classified aortic dilation, whereas all other indices systematically underestimated or overestimated AscAo dilation at the extremes of body size. Area/height was robustly associated with thoracic aorta events in the UKB (HR: 3.73; P < 0.001) and the PMBB (HR: 1.83; P < 0.001).
Conclusions
Among AscAo indices, area/height was allometrically correct, did not exhibit residual associations with body size, and was consistently associated with adverse events.
{"title":"Ascending Aortic Dimensions and Body Size","authors":"Hamed Tavolinejad MD , Cameron Beeche BSc , Marie-Joe Dib PhD , Bianca Pourmussa BA , Scott M. Damrauer MD , John DePaolo MD PhD , Joe David Azzo MD , Oday Salman MD , Jeffrey Duda PhD , James Gee PhD , Seavmeiyin Kun BSc , Walter R. Witschey PhD","doi":"10.1016/j.jcmg.2025.06.019","DOIUrl":"10.1016/j.jcmg.2025.06.019","url":null,"abstract":"<div><h3>Background</h3><div>Ascending aortic (AscAo) dimensions partially depend on body size. Ratiometric (linear) indexing of AscAo dimensions to height and body surface area (BSA) are currently recommended, but it is unclear whether these allometric relationships are indeed linear.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate allometric relations, normative values, and the prognostic performance of AscAo dimension indices.</div></div><div><h3>Methods</h3><div>The authors studied UK Biobank (UKB) (n = 49,271) and Penn Medicine BioBank (PMBB) (n = 8,426) participants. A convolutional neural network was used to segment the thoracic aorta from available magnetic resonance and computed tomography thoracic images. Normal allometric exponents of AscAo dimensions were derived from log-log models among healthy reference subgroups. Prognostic associations of AscAo dimensions were assessed with the use of Cox models.</div></div><div><h3>Results</h3><div>Among reference subgroups of both UKB (n = 11,310; age 52 ± 8 years; 37% male) and PMBB (n = 799; age 50 ± 16 years; 41% male), diameter/height, diameter/BSA, and area/BSA exhibited highly nonlinear relationships. In contrast, the allometric exponent of the area/height index was close to unity (UKB: 1.04; PMBB: 1.13). Accordingly, the linear ratio of area/height index did not exhibit residual associations with height (UKB: <em>R</em><sup>2</sup> = 0.04 [<em>P</em> = 0.411]; PMBB: <em>R</em><sup>2</sup> = 0.08 [<em>P</em> = 0.759]). Across quintiles of height and BSA, area/height was the only ratiometric index that consistently classified aortic dilation, whereas all other indices systematically underestimated or overestimated AscAo dilation at the extremes of body size. Area/height was robustly associated with thoracic aorta events in the UKB (HR: 3.73; <em>P</em> < 0.001) and the PMBB (HR: 1.83; <em>P</em> < 0.001).</div></div><div><h3>Conclusions</h3><div>Among AscAo indices, area/height was allometrically correct, did not exhibit residual associations with body size, and was consistently associated with adverse events.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 12","pages":"Pages 1315-1327"},"PeriodicalIF":15.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jcmg.2025.07.010
Hidesato Fujito MD, PhD, Billy Lin MD, Heidi Gransar MS, Alan Rozanski MD, Damini Dey PhD, Piotr Slomka PhD, Sean W. Hayes MD, John D. Friedman MD, Daniel S. Berman MD, Donghee Han MD
{"title":"Comparison of Plaque Burden Assessment Between Coronary Artery Calcium Score and Segment Involvement Score","authors":"Hidesato Fujito MD, PhD, Billy Lin MD, Heidi Gransar MS, Alan Rozanski MD, Damini Dey PhD, Piotr Slomka PhD, Sean W. Hayes MD, John D. Friedman MD, Daniel S. Berman MD, Donghee Han MD","doi":"10.1016/j.jcmg.2025.07.010","DOIUrl":"10.1016/j.jcmg.2025.07.010","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 12","pages":"Pages 1408-1409"},"PeriodicalIF":15.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jcmg.2025.06.020
Simon Hellwig MD , Ana Catarina Fonseca MD, Thomas R. Meinel MD, Santosh B. Murthy MD, Annerose Mengel MD, Shadi Yaghi MD, Patrick Krumm MD, Eric D. Goldstein MD, Helena Stengl MD, Ramanan Ganeshan MD, Regina von Rennenberg MD, Edyta Blaszczyk MD, Ana G. Almeida MD, João Pedro Marto MD, Jonathan Schütze MD, Annina Selina Notz MD, Christoph Gräni MD, Jochen B. Fiebach MD, Simon Greulich MD, Matthias Endres MD, Jan F. Scheitz MD
{"title":"Unrecognized Myocardial Fibrosis Detected by Contrast-Enhanced Cardiovascular MRI in Patients With Ischemic Stroke","authors":"Simon Hellwig MD , Ana Catarina Fonseca MD, Thomas R. Meinel MD, Santosh B. Murthy MD, Annerose Mengel MD, Shadi Yaghi MD, Patrick Krumm MD, Eric D. Goldstein MD, Helena Stengl MD, Ramanan Ganeshan MD, Regina von Rennenberg MD, Edyta Blaszczyk MD, Ana G. Almeida MD, João Pedro Marto MD, Jonathan Schütze MD, Annina Selina Notz MD, Christoph Gräni MD, Jochen B. Fiebach MD, Simon Greulich MD, Matthias Endres MD, Jan F. Scheitz MD","doi":"10.1016/j.jcmg.2025.06.020","DOIUrl":"10.1016/j.jcmg.2025.06.020","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 12","pages":"Pages 1399-1401"},"PeriodicalIF":15.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jcmg.2025.07.009
Simran P. Sharma MD , Judith van der Bie MSc , Annemieke C. Ziedses des Plantes BSc, Adriaan Coenen MD, PhD, Marcel L. Dijkshoorn BSc, Daniel Bos MD, PhD, Joost Daemen MD, PhD, Nicolas M. van Mieghem MD, PhD, Alexander Hirsch MD, PhD , Ricardo P.J. Budde MD, PhD
{"title":"Diagnostic Accuracy of Ultra-High-Resolution Photon-Counting Detector Computed Tomography for Detecting Coronary In-Stent Restenosis","authors":"Simran P. Sharma MD , Judith van der Bie MSc , Annemieke C. Ziedses des Plantes BSc, Adriaan Coenen MD, PhD, Marcel L. Dijkshoorn BSc, Daniel Bos MD, PhD, Joost Daemen MD, PhD, Nicolas M. van Mieghem MD, PhD, Alexander Hirsch MD, PhD , Ricardo P.J. Budde MD, PhD","doi":"10.1016/j.jcmg.2025.07.009","DOIUrl":"10.1016/j.jcmg.2025.07.009","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 12","pages":"Pages 1405-1407"},"PeriodicalIF":15.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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