Pub Date : 2026-01-01DOI: 10.1016/j.jcct.2025.10.017
Patrick W. Serruys , Tsung-Ying Tsai , Shigetaka Kageyama , Pruthvi Chenniganahosahalli Revaiah , Daniëlle C.J. Keulards , Adam Updegrove , Charles A. Taylor , Matthew Sinclair , Sarah Mullen , Campbell Rogers , Brian Thomsen , Scot Garg , Albert Chinhenzva , John D. Puskas , Jagat Narula , Himanshu Gupta , Vikram Agarwal , Kaoru Tanaka , Johan De Mey , Mark La Meir , Yoshinobu Onuma
Background
Complete coronary revascularization has significant clinical outcome implications; however, there is no objective, quantitative, or universal definition.
Aim
To provide a quantitative personalized assessment of myocardium at risk before and after coronary artery bypass grafting (CABG) surgery.
Methods
Percent left ventricular myocardial blood flow distribution (LV%MYO) was derived from coronary CT angiography (CCTA) and used to quantify the myocardium at risk of ischemia in the 16 SYNTAX coronary segments of the 114 patients in the multicenter, prospective FASTTRACK CABG trial. Given each point of the fixed SYNTAX myocardial weighting factor represents 16.7 % (1/6) of myocardial blood flow, the myocardial weighting factor of each coronary segment was calculated as 6 × LV%MYO. The patency of bypass grafts was assessed on 30-day follow-up CCTA, and the residual LV%MYO was obtained by subtracting the LV%MYO in segments anastomosed with non-stenotic grafts from the pre-CABG global LV%MYO.
Results
LV%MYO were analyzable in 106 patients (mean age 65.6 (8.9) years, 87 % male); 53 had ≥1 total occlusion. The fixed myocardial weighting factor for most SYNTAX coronary segments differs significantly from the weighting factor derived from LV%MYO. The pre-CABG global LV%MYO, and the residual LV%MYO in 96 patients with post-CABG CCTA were 70.1 (18.8)% and 14.0 (15.3)%, respectively. Complete revascularization (residual LV%MYO ≤10 %) was achieved in 42 patients (43.8 %). The operator's discretion not to graft was the main reason that 106 coronary segments were not revascularized, with graft occlusion accounting for 22.6 %.
Conclusion
CCTA-derived LV%MYO allows an objective and individualized quantification of the myocardium at risk, facilitating prospective prediction and retrospective assessment of the completeness of revascularization in CABG patients.
{"title":"Percentage of left ventricular myocardial blood flow distribution and revascularization completeness in FASTTRACK CABG","authors":"Patrick W. Serruys , Tsung-Ying Tsai , Shigetaka Kageyama , Pruthvi Chenniganahosahalli Revaiah , Daniëlle C.J. Keulards , Adam Updegrove , Charles A. Taylor , Matthew Sinclair , Sarah Mullen , Campbell Rogers , Brian Thomsen , Scot Garg , Albert Chinhenzva , John D. Puskas , Jagat Narula , Himanshu Gupta , Vikram Agarwal , Kaoru Tanaka , Johan De Mey , Mark La Meir , Yoshinobu Onuma","doi":"10.1016/j.jcct.2025.10.017","DOIUrl":"10.1016/j.jcct.2025.10.017","url":null,"abstract":"<div><h3>Background</h3><div>Complete coronary revascularization has significant clinical outcome implications; however, there is no objective, quantitative, or universal definition.</div></div><div><h3>Aim</h3><div>To provide a quantitative personalized assessment of myocardium at risk before and after coronary artery bypass grafting (CABG) surgery.</div></div><div><h3>Methods</h3><div>Percent left ventricular myocardial blood flow distribution (LV%MYO) was derived from coronary CT angiography (CCTA) and used to quantify the myocardium at risk of ischemia in the 16 SYNTAX coronary segments of the 114 patients in the multicenter, prospective FASTTRACK CABG trial. Given each point of the fixed SYNTAX myocardial weighting factor represents 16.7 % (1/6) of myocardial blood flow, the myocardial weighting factor of each coronary segment was calculated as 6 × LV%MYO. The patency of bypass grafts was assessed on 30-day follow-up CCTA, and the residual LV%MYO was obtained by subtracting the LV%MYO in segments anastomosed with non-stenotic grafts from the pre-CABG global LV%MYO.</div></div><div><h3>Results</h3><div>LV%MYO were analyzable in 106 patients (mean age 65.6 (8.9) years, 87 % male); 53 had ≥1 total occlusion. The fixed myocardial weighting factor for most SYNTAX coronary segments differs significantly from the weighting factor derived from LV%MYO. The pre-CABG global LV%MYO, and the residual LV%MYO in 96 patients with post-CABG CCTA were 70.1 (18.8)% and 14.0 (15.3)%, respectively. Complete revascularization (residual LV%MYO ≤10 %) was achieved in 42 patients (43.8 %). The operator's discretion not to graft was the main reason that 106 coronary segments were not revascularized, with graft occlusion accounting for 22.6 %.</div></div><div><h3>Conclusion</h3><div>CCTA-derived LV%MYO allows an objective and individualized quantification of the myocardium at risk, facilitating prospective prediction and retrospective assessment of the completeness of revascularization in CABG patients.</div></div>","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"20 1","pages":"Pages 50-62"},"PeriodicalIF":5.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jcct.2025.11.081
Kyung An Kim, Hae-Ok Jung, Mi-Jeong Kim, So-Young Lee, Dong-Hyeon Lee, Donghee Han, Hyuk-Jae Chang, Su-Yeon Choi, Jidong Sung, Eun Ju Chun
{"title":"Response to “Reassessing the role of serum phosphate in coronary artery calcification progression”","authors":"Kyung An Kim, Hae-Ok Jung, Mi-Jeong Kim, So-Young Lee, Dong-Hyeon Lee, Donghee Han, Hyuk-Jae Chang, Su-Yeon Choi, Jidong Sung, Eun Ju Chun","doi":"10.1016/j.jcct.2025.11.081","DOIUrl":"10.1016/j.jcct.2025.11.081","url":null,"abstract":"","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"20 1","pages":"Pages 102-103"},"PeriodicalIF":5.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jcct.2025.11.010
A. Gupta, J. Dhingra
{"title":"A One Stop Shop - Role Of Triple Rule-out CT In Acute Chest Pain","authors":"A. Gupta, J. Dhingra","doi":"10.1016/j.jcct.2025.11.010","DOIUrl":"10.1016/j.jcct.2025.11.010","url":null,"abstract":"","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"20 1","pages":"Page S3"},"PeriodicalIF":5.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145996173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jcct.2025.11.070
P. NGUYEN
{"title":"Coronary Inflammatory Assessment - Fibrous Burden Of Coronary Plaque On Coronary Computed Tomography Angiography In The Prognosis Of Cardiovascular Events","authors":"P. NGUYEN","doi":"10.1016/j.jcct.2025.11.070","DOIUrl":"10.1016/j.jcct.2025.11.070","url":null,"abstract":"","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"20 1","pages":"Pages S27-S28"},"PeriodicalIF":5.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145996232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jcct.2025.11.074
Q. Meng, L. Zhao, Y. Gao, B. Lu
{"title":"Computed Tomography-based Radiomic Features For Predicting The Prognosis Of Cardiac Amyloidosis: A Multicenter Study","authors":"Q. Meng, L. Zhao, Y. Gao, B. Lu","doi":"10.1016/j.jcct.2025.11.074","DOIUrl":"10.1016/j.jcct.2025.11.074","url":null,"abstract":"","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"20 1","pages":"Page S29"},"PeriodicalIF":5.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145996278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jcct.2025.11.053
S. Settasopon, N. Chaosuwannakit
{"title":"Validity And Reliability Of Coronary Artery Calcium Ordinal Scoring On Ct Scans Of The Chest And The Prediction Of Mortality","authors":"S. Settasopon, N. Chaosuwannakit","doi":"10.1016/j.jcct.2025.11.053","DOIUrl":"10.1016/j.jcct.2025.11.053","url":null,"abstract":"","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"20 1","pages":"Page S21"},"PeriodicalIF":5.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145996520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}