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1. Progression of non-obstructive coronary plaque: a practical CCTA-based risk score from the PARADIGM registry

Author

Pontone, Gianluca, Rossi, Alexia, Baggiano, Andrea, Andreini, Daniele, Conte, Edoardo, Fusini, Laura, Gebhard, Chaterine, Rabbat, Mark G., Guaricci, Andrea, Guglielmo, Marco, Muscogiuri, Giuseppe, Mushtaq, Saima, Al-Mallah, Mouaz H., Berman, Daniel S., Budoff, Matthew J., Cademartiri, Filippo, Chinnaiyan, Kavitha, Choi, Jung Hyun, Chun, Eun Ju, de Araújo Gonçalves, Pedro, Gottlieb, Ilan, Hadamitzky, Martin, Kim, Yong Jin, Lee, Byoung Kwon, Lee, Sang-Eun, Maffei, Erica, Marques, Hugo, Samady, Habib, Shin, Sanghoon, Sung, Ji Min, van Rosendael, Alexander, Virmani, Renu, Bax, Jeroen J., Leipsic, Jonathon A., Lin, Fay Y., Min, James K., Narula, Jagat, Shaw, Leslee J., and Chang, Hyuk-Jae

Published
2024
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4. Risk factors based vessel‐specific prediction for stages of coronary artery disease using Bayesian quantile regression machine learning method: Results from the PARADIGM registry

Author

Park, Hyung‐Bok, Lee, Jina, Hong, Yongtaek, Byungchang, So, Kim, Wonse, Lee, Byoung K, Lin, Fay Y, Hadamitzky, Martin, Kim, Yong‐Jin, Conte, Edoardo, Andreini, Daniele, Pontone, Gianluca, Budoff, Matthew J, Gottlieb, Ilan, Chun, Eun Ju, Cademartiri, Filippo, Maffei, Erica, Marques, Hugo, de A. Gonçalves, Pedro, Leipsic, Jonathon A, Shin, Sanghoon, Choi, Jung H, Virmani, Renu, Samady, Habib, Chinnaiyan, Kavitha, Stone, Peter H, Berman, Daniel S, Narula, Jagat, Shaw, Leslee J, Bax, Jeroen J, Min, James K, Kook, Woong, and Chang, Hyuk‐Jae

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Atherosclerosis, Heart Disease - Coronary Heart Disease, Prevention, Cardiovascular, Heart Disease, Humans, Angina Pectoris, Bayes Theorem, Coronary Angiography, Coronary Artery Disease, Coronary Vessels, Machine Learning, Registries, Risk Factors, cardiovascular risk factors, coronary artery disease, machine learning, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, Cardiovascular medicine and haematology
Abstract

Background and hypothesisThe recently introduced Bayesian quantile regression (BQR) machine-learning method enables comprehensive analyzing the relationship among complex clinical variables. We analyzed the relationship between multiple cardiovascular (CV) risk factors and different stages of coronary artery disease (CAD) using the BQR model in a vessel-specific manner.MethodsFrom the data of 1,463 patients obtained from the PARADIGM (NCT02803411) registry, we analyzed the lumen diameter stenosis (DS) of the three vessels: left anterior descending (LAD), left circumflex (LCx), and right coronary artery (RCA). Two models for predicting DS and DS changes were developed. Baseline CV risk factors, symptoms, and laboratory test results were used as the inputs. The conditional 10%, 25%, 50%, 75%, and 90% quantile functions of the maximum DS and DS change of the three vessels were estimated using the BQR model.ResultsThe 90th percentiles of the DS of the three vessels and their maximum DS change were 41%-50% and 5.6%-7.3%, respectively. Typical anginal symptoms were associated with the highest quantile (90%) of DS in the LAD; diabetes with higher quantiles (75% and 90%) of DS in the LCx; dyslipidemia with the highest quantile (90%) of DS in the RCA; and shortness of breath showed some association with the LCx and RCA. Interestingly, High-density lipoprotein cholesterol showed a dynamic association along DS change in the per-patient analysis.ConclusionsThis study demonstrates the clinical utility of the BQR model for evaluating the comprehensive relationship between risk factors and baseline-grade CAD and its progression.

Published
2023

9. Temporal Trends in Takotsubo Syndrome: Results From the International Takotsubo Registry

Author

Schweiger, Victor, Cammann, Victoria L., Crisci, Giulia, Gilhofer, Thomas, Schlenker, Rabea, Niederseer, David, Chen, Shaojie, Ebrahimi, Ramin, Wenzl, Florian, Würdinger, Michael, Citro, Rodolfo, Vecchione, Carmine, Gili, Sebastiano, Neuhaus, Michael, Franke, Jennifer, Meder, Benjamin, Jaguszewski, Miłosz, Noutsias, Michel, Knorr, Maike, Jansen, Thomas, D’Ascenzo, Fabrizio, Dichtl, Wolfgang, von Lewinski, Dirk, Burgdorf, Christof, Kherad, Behrouz, Tschöpe, Carsten, Sarcon, Annahita, Shinbane, Jerold, Rajan, Lawrence, Michels, Guido, Pfister, Roman, Cuneo, Alessandro, Jacobshagen, Claudius, Karakas, Mahir, Koenig, Wolfgang, Pott, Alexander, Meyer, Philippe, Roffi, Marco, Banning, Adrian, Wolfrum, Mathias, Cuculi, Florim, Kobza, Richard, Fischer, Thomas A., Vasankari, Tuija, Airaksinen, K.E. Juhani, Napp, L. Christian, Dworakowski, Rafal, MacCarthy, Philip, Kaiser, Christoph, Osswald, Stefan, Galiuto, Leonarda, Chan, Christina, Bridgman, Paul, Beug, Daniel, Delmas, Clément, Lairez, Olivier, Gilyarova, Ekaterina, Shilova, Alexandra, Gilyarov, Mikhail, El-Battrawy, Ibrahim, Akin, Ibrahim, Poledniková, Karolina, Toušek, Petr, Winchester, David E., Massoomi, Michael, Galuszka, Jan, Ukena, Christian, Poglajen, Gregor, Carrilho-Ferreira, Pedro, Hauck, Christian, Paolini, Carla, Bilato, Claudio, Kobayashi, Yoshio, Kato, Ken, Ishibashi, Iwao, Himi, Toshiharu, Din, Jehangir, Al-Shammari, Ali, Prasad, Abhiram, Rihal, Charanjit S., Liu, Kan, Schulze, P. Christian, Bianco, Matteo, Jörg, Lucas, Rickli, Hans, Pestana, Gonçalo, Nguyen, Thanh H., Böhm, Michael, Maier, Lars S., Pinto, Fausto J., Widimský, Petr, Felix, Stephan B., Braun-Dullaeus, Ruediger C., Rottbauer, Wolfgang, Hasenfuß, Gerd, Pieske, Burkert M., Schunkert, Heribert, Budnik, Monika, Opolski, Grzegorz, Thiele, Holger, Bauersachs, Johann, Horowitz, John D., Di Mario, Carlo, Kong, William, Dalakoti, Mayank, Imori, Yoichi, Münzel, Thomas, Liberale, Luca, Montecucco, Fabrizio, Bax, Jeroen J., Crea, Filippo, Ruschitzka, Frank, Lüscher, Thomas F., Ghadri, Jelena R., Bossone, Eduardo, Templin, Christian, and Di Vece, Davide

Published
2024
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10. Pulmonary Vein Systolic Flow Reversal and Outcomes in Patients From the Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation (COAPT) Trial

Author

Bohra, Chandrashekar, Asch, Federico M., Lerakis, Stamatios, Little, Stephen H., Redfors, Björn, Zhou, Zhipeng, Li, Yanru, Weissman, Neil J., Grayburn, Paul A., Kar, Saibal, Lim, D. Scott, Abraham, William T., Lindenfeld, JoAnn, Mack, Michael J., Bax, Jeroen J., and Stone, Gregg W.

Published
2024
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12. Artificial Intelligence–Enabled Quantitative Coronary Plaque and Hemodynamic Analysis for Predicting Acute Coronary Syndrome

Author

Koo, Bon-Kwon, Yang, Seokhun, Jung, Jae Wook, Zhang, Jinlong, Lee, Keehwan, Hwang, Doyeon, Lee, Kyu-Sun, Doh, Joon-Hyung, Nam, Chang-Wook, Kim, Tae Hyun, Shin, Eun-Seok, Chun, Eun Ju, Choi, Su-Yeon, Kim, Hyun Kuk, Hong, Young Joon, Park, Hun-Jun, Kim, Song-Yi, Husic, Mirza, Lambrechtsen, Jess, Jensen, Jesper M., Nørgaard, Bjarne L., Andreini, Daniele, Maurovich-Horvat, Pal, Merkely, Bela, Penicka, Martin, de Bruyne, Bernard, Ihdayhid, Abdul, Ko, Brian, Tzimas, Georgios, Leipsic, Jonathon, Sanz, Javier, Rabbat, Mark G., Katchi, Farhan, Shah, Moneal, Tanaka, Nobuhiro, Nakazato, Ryo, Asano, Taku, Terashima, Mitsuyasu, Takashima, Hiroaki, Amano, Tetsuya, Sobue, Yoshihiro, Matsuo, Hitoshi, Otake, Hiromasa, Kubo, Takashi, Takahata, Masahiro, Akasaka, Takashi, Kido, Teruhito, Mochizuki, Teruhito, Yokoi, Hiroyoshi, Okonogi, Taichi, Kawasaki, Tomohiro, Nakao, Koichi, Sakamoto, Tomohiro, Yonetsu, Taishi, Kakuta, Tsunekazu, Yamauchi, Yohei, Bax, Jeroen J., Shaw, Leslee J., Stone, Peter H., and Narula, Jagat

Published
2024
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15. Longitudinal quantitative assessment of coronary atherosclerosis related to normal systolic blood pressure maintenance in the absence of established cardiovascular disease.

Author

Won, Ki-Bum, Park, Hyung-Bok, Heo, Ran, Lee, Byoung Kwon, Lin, Fay Y, Hadamitzky, Martin, Kim, Yong-Jin, Sung, Ji Min, Conte, Edoardo, Andreini, Daniele, Pontone, Gianluca, Budoff, Matthew J, Gottlieb, Ilan, Chun, Eun Ju, Cademartiri, Filippo, Maffei, Erica, Marques, Hugo, Gonçalves, Pedro de Araújo, Leipsic, Jonathon A, Lee, Sang-Eun, Shin, Sanghoon, Choi, Jung Hyun, Virmani, Renu, Samady, Habib, Chinnaiyan, Kavitha, Berman, Daniel S, Narula, Jagat, Bax, Jeroen J, Min, James K, and Chang, Hyuk-Jae

Subjects
Humans, Cardiovascular Diseases, Disease Progression, Polyvinyl Chloride, Coronary Angiography, Risk Factors, Blood Pressure, Female, Male, Coronary Artery Disease, Plaque, Atherosclerotic, Computed Tomography Angiography, atherosclerosis, coronary artery disease, coronary computed tomography angiography, systolic blood pressure, Aging, Clinical Research, Cardiovascular, Heart Disease, Atherosclerosis, Heart Disease - Coronary Heart Disease, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology
Abstract

BackgroundAtherosclerosis-related adverse events are commonly observed even in conditions with low cardiovascular (CV) risk. Longitudinal data regarding the association of normal systolic blood pressure maintenance (SBPmaintain ) with coronary plaque volume changes (PVC) has been limited in adults without traditional CV disease.HypothesisNormal SBPmaintain is important to attenuate coronary atherosclerosis progression in adults without baseline CV disease.MethodsWe analyzed 95 adults (56.7 ± 8.5 years; 40.0% men) without baseline CV disease who underwent serial coronary computed tomographic angiography with mean 3.5 years of follow-up. All participants were divided into two groups of normal SBPmaintain (follow-up SBP

Published
2022

16. Longitudinal Quantitative Assessment of Coronary Atherosclerotic Plaque Burden Related to Serum Hemoglobin Levels

Author

Won, Ki-Bum, Lee, Byoung Kwon, Heo, Ran, Park, Hyung-Bok, Lin, Fay Y, Hadamitzky, Martin, Kim, Yong-Jin, Sung, Ji Min, Conte, Edoardo, Andreini, Daniele, Pontone, Gianluca, Budoff, Matthew J, Gottlieb, Ilan, Chun, Eun Ju, Cademartiri, Filippo, Maffei, Erica, Marques, Hugo, de Araújo Gonçalves, Pedro, Leipsic, Jonathon A, Lee, Sang-Eun, Shin, Sanghoon, Choi, Jung Hyun, Virmani, Renu, Samady, Habib, Chinnaiyan, Kavitha, Berman, Daniel S, Narula, Jagat, Bax, Jeroen J, Min, James K, and Chang, Hyuk-Jae

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Heart Disease, Clinical Research, Cardiovascular, Hematology, Atherosclerosis, Heart Disease - Coronary Heart Disease, Evaluation of treatments and therapeutic interventions, 6.1 Pharmaceuticals, CCTA, coronary computed tomographic angiography, CV, cardiovascular, PVC, plaque volume changes, atherosclerosis, coronary computed tomography angiography, hemoglobin, Δ hemoglobin, hemoglobin level changes
Abstract

BackgroundDespite a potential role of hemoglobin in atherosclerosis, data on coronary plaque volume changes (PVC) related to serum hemoglobin levels are limited.ObjectivesThe authors sought to evaluate coronary atherosclerotic plaque burden changes related to serum hemoglobin levels using serial coronary computed tomographic angiography (CCTA).MethodsA total of 830 subjects (age 61 ± 10 years, 51.9% male) who underwent serial CCTA were analyzed. The median interscan period was 3.2 (IQR: 2.5-4.4) years. Quantitative assessment of coronary plaques was performed at both scans. All participants were stratified into 4 groups based on the quartile of baseline hemoglobin levels. Annualized total PVC (mm3/year) was defined as total PVC divided by the interscan period.ResultsBaseline total plaque volume (mm3) was not different among all groups (group I [lowest]: 34.1 [IQR: 0.0-127.4] vs group II: 28.8 [IQR: 0.0-123.0] vs group III: 49.9 [IQR: 5.6-135.0] vs group IV [highest]: 34.3 [IQR: 0.0-130.7]; P = 0.235). During follow-up, serum hemoglobin level changes (Δ hemoglobin; per 1 g/dL) was related to annualized total PVC (β = -0.114) in overall participants (P < 0.05). After adjusting for age, sex, traditional risk factors, baseline hemoglobin and creatinine levels, baseline total plaque volume, and the use of aspirin, beta-blocker, angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, and statin, Δ hemoglobin significantly affected annualized total PVC in only the composite of groups I and II (β = -2.401; P = 0.004).ConclusionsSerial CCTA findings suggest that Δ hemoglobin has an independent effect on coronary atherosclerosis. This effect might be influenced by baseline hemoglobin levels. (Progression of Atherosclerotic Plaque Determined by Computed Tomographic Angiography Imaging [PARADIGM]; NCT02803411).

Published
2022

17. Diagnostic Value of Aortic Valve Calcification Levels in the Assessment of Low-Gradient Aortic Stenosis

Author

Adrichem, Rik, Hokken, Thijmen W., Bouwmeester, Sjoerd, Abdelkarim, Ola, Vogel, Birgit, Blusztein, David I., Veulemans, Verena, Kuneman, Jurrien H., Geleijnse, Marcel L., Verhemel, Sarah, Van den Dorpel, Mark M.P., Kardys, Isabella, Tonino, Pim A.L., Chang, Su Min, Faza, Nadeen N., Jou, Stephanie, Ueyama, Hiroki A., Bartkowiak, Joanna, Zeus, Tobias, Bax, Jeroen J., Bertrand, Philippe B., Hahn, Rebecca T., Kodali, Susheel K., Lerakis, Stamatios, Mehran, Roxana, Little, Stephen H., Houthuizen, Patrick, and Van Mieghem, Nicolas M.

Published
2024
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18. Development and Validation of a Quantitative Coronary CT Angiography Model for Diagnosis of Vessel-Specific Coronary Ischemia

Author

Heo, Ran, Park, Hyung-Bok, Marques, Hugo, Stuijfzand, Wijnand J., Choi, Jung Hyun, Doh, Joon-Hyung, Her, Ae-Young, Koo, Bon-Kwon, Nam, Chang-Wook, Shin, Sang-Hoon, Cole, Jason, Gimelli, Alessia, Khan, Muhammad Akram, Lu, Bin, Gao, Yang, Nabi, Faisal, Al-Mallah, Mouaz H., Nakazato, Ryo, Schoepf, U. Joseph, Thompson, Randall C., Jang, James J., Ridner, Michael, Rowan, Chris, Avelar, Erick, Généreux, Philippe, de Waard, Guus A., Sprengers, Ralf W., Raijmakers, Pieter G., Nurmohamed, Nick S., Danad, Ibrahim, Jukema, Ruurt A., de Winter, Ruben W., de Groot, Robin J., Driessen, Roel S., Bom, Michiel J., van Diemen, Pepijn, Pontone, Gianluca, Andreini, Daniele, Chang, Hyuk-Jae, Katz, Richard J., Stroes, Erik S.G., Wang, Hao, Chan, Chung, Crabtree, Tami, Aquino, Melissa, Min, James K., Earls, James P., Bax, Jeroen J., Choi, Andrew D., Knaapen, Paul, and van Rosendael, Alexander R.

Published
2024
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22. Prognostic Value of Follow-up Measures of Left Ventricular Global Longitudinal Strain in Patients With ST-Segment Elevation Myocardial Infarction

Author

Caunite, Laima, Myagmardorj, Rinchyenkhand, Galloo, Xavier, Laenens, Dorien, Stassen, Jan, Nabeta, Takeru, Yedidya, Idit, Meucci, Maria C., Kuneman, Jurrien H., van den Hoogen, Inge J., van Rosendael, Sophie E., Wu, Hoi Wai, van den Brand, Victor M., Giuca, Adrian, Trusinskis, Karlis, van der Bijl, Pieter, Bax, Jeroen J., and Ajmone Marsan, Nina

Published
2024
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25. Aspirin and Statin Therapy for Nonobstructive Coronary Artery Disease: Five-year Outcomes from the CONFIRM Registry

Author

Indraratna, Praveen, Naoum, Christopher, Ben Zekry, Sagit, Gransar, Heidi, Blanke, Philipp, Sellers, Stephanie, Achenbach, Stephan, Al-Mallah, Mouaz H, Andreini, Daniele, Berman, Daniel S, Budoff, Matthew J, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Chinnaiyan, Kavitha, Chow, Benjamin JW, Cury, Ricardo C, DeLago, Augustin, Feuchtner, Gudrun, Hadamitzky, Martin, Hausleiter, Joerg, Kaufmann, Philipp A, Kim, Yong-Jin, Maffei, Erica, Marques, Hugo, Gonçalves, Pedro de Araújo, Pontone, Gianluca, Raff, Gilbert L, Rubinshtein, Ronen, Villines, Todd C, Lin, Fay Y, Shaw, Leslee J, Narula, Jagat, Bax, Jeroen J, and Leipsic, Jonathon A

Subjects
Epidemiology, Biomedical and Clinical Sciences, Health Sciences, Clinical Research, Cardiovascular, Heart Disease - Coronary Heart Disease, Heart Disease, Clinical Trials and Supportive Activities, Atherosclerosis, 4.2 Evaluation of markers and technologies, Detection, screening and diagnosis, Good Health and Well Being, Aspirin, CT Angiography, Coronary Artery Disease, Nonobstructive Coronary Artery Disease, Statin
Abstract

PurposeIn this cohort study, 5-year data from the Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry (ie, CONFIRM) were examined to identify associations of baseline aspirin and statin use with mortality, major adverse cardiovascular events (MACE), and myocardial infarction (MI) in individuals without substantial (≥50%) stenosis.Materials and methodsIn this prospective cohort study, all participants in the registry underwent coronary CT angiography and were classified as having no detectable coronary plaque or having nonobstructive coronary artery disease (CAD) (1%-49% stenosis). Participants with obstructive (≥50%) stenosis were excluded from analysis. The study commenced in June 2003 and was completed in March 2016. All unadjusted and risk-adjusted analyses utilized the Cox proportional hazard model with hospital sites modeled using shared frailty.ResultsA total of 6386 participants with no detectable plaque or with nonobstructive CAD were included (mean age, 56.0 years ± 13.3 [SD], 52% men). The mean follow-up period was 5.66 years ± 1.10. Nonobstructive CAD (n = 2815, 44% of all participants included in the study) was associated with a greater risk of all-cause mortality (10.6% [298 of 2815] vs 4.8% [170 of 3571], P < .001) compared to those without CAD (n = 3571, 56%). Baseline aspirin and statin use was documented for 1415 and 1429 participants, respectively, with nonobstructive CAD, and for 1560 and 1565 participants without detectable plaque, respectively. In individuals with nonobstructive CAD, baseline aspirin use was not associated with a reduction in MACE (10.9% [102 of 936] vs 14.7% [52 of 355], P = .06), all-cause mortality (9.6% [95 of 991] vs 10.9% [46 of 424], P = .468), or MI (4.4% [41 of 936] vs 6.2% [22 of 355], P = .18). On multivariate risk-adjusted analysis, baseline statin use was associated with a lower rate of MACE (hazard ratio, 0.59; 95% CI: 0.40, 0.87; P = .007). Neither therapy improved clinical outcomes for participants with no detectable plaque.ConclusionIn participants with nonobstructive CAD, baseline use of statins, but not of aspirin, was associated with improved clinical outcomes. Neither therapy was associated with benefit in participants without plaque.Keywords: Aspirin, Statin, Coronary Artery Disease, CT Angiography, Nonobstructive Coronary Artery DiseaseClinical trial registration no. NCT01443637 Supplemental material is available for this article. © RSNA, 2022See also the commentary by Canan and Navar in this issue.

Published
2022

26. Echocardiography

Author

Debonnaire, Philippe, additional, Delgado, Victoria, additional, Edvardsen, Thor, additional, Popescu, Bogdan A, additional, and Bax, Jeroen J, additional

Published
2023
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28. Prediction of the development of new coronary atherosclerotic plaques with radiomics

Author

Lee, Sang-Eun, Hong, Youngtaek, Hong, Jongsoo, Jung, Juyeong, Sung, Ji Min, Andreini, Daniele, Al-Mallah, Mouaz H., Budoff, Matthew J., Cademartiri, Filippo, Chinnaiyan, Kavitha, Choi, Jung Hyun, Chun, Eun Ju, Conte, Edoardo, Gottlieb, Ilan, Hadamitzky, Martin, Kim, Yong Jin, Lee, Byoung Kwon, Leipsic, Jonathon A., Maffei, Erica, Marques, Hugo, Gonçalves, Pedro de Araújo, Pontone, Gianluca, Shin, Sanghoon, Stone, Peter H., Samady, Habib, Virmani, Renu, Narula, Jagat, Shaw, Leslee J., Bax, Jeroen J., Lin, Fay Y., Min, James K., and Chang, Hyuk-Jae

Published
2024
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29. Associations between dyspnoea, coronary atherosclerosis, and cardiovascular outcomes: results from the long-term follow-up CONFIRM registry.

Author

van Rosendael, Alexander R, Bax, A Maxim, van den Hoogen, Inge J, Smit, Jeff M, Al'Aref, Subhi J, Achenbach, Stephan, Al-Mallah, Mouaz H, Andreini, Daniele, Berman, Daniel S, Budoff, Matthew J, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Chinnaiyan, Kavitha, Chow, Benjamin JW, Cury, Ricardo C, DeLago, Augustin, Feuchtner, Gudrun, Hadamitzky, Martin, Hausleiter, Joerg, Kaufmann, Philipp A, Kim, Yong-Jin, Leipsic, Jonathon A, Maffei, Erica, Marques, Hugo, de Araújo Gonçalves, Pedro, Pontone, Gianluca, Raff, Gilbert L, Rubinshtein, Ronen, Villines, Todd C, Gransar, Heidi, Lu, Yao, Peña, Jessica M, Lin, Fay Y, Shaw, Leslee J, Narula, Jagat, Min, James K, and Bax, Jeroen J

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Atherosclerosis, Cardiovascular, Clinical Research, Biomedical Imaging, Heart Disease, Heart Disease - Coronary Heart Disease, 4.2 Evaluation of markers and technologies, Detection, screening and diagnosis, Aged, Coronary Angiography, Coronary Artery Disease, Dyspnea, Follow-Up Studies, Humans, Male, Middle Aged, Predictive Value of Tests, Prognosis, Prospective Studies, Registries, Risk Factors, coronary artery disease, coronary computed tomography angiography, dyspnoea, prognosis, Cardiovascular medicine and haematology
Abstract

AimsThe relationship between dyspnoea, coronary artery disease (CAD), and major cardiovascular events (MACE) is poorly understood. This study evaluated (i) the association of dyspnoea with the severity of anatomical CAD by coronary computed tomography angiography (CCTA) and (ii) to which extent CAD explains MACE in patients with dyspnoea.Methods and resultsFrom the international COronary CT Angiography EvaluatioN for Clinical Outcomes: An InteRnational Multicenter (CONFIRM) registry, 4425 patients (750 with dyspnoea) with suspected but without known CAD were included and prospectively followed for ≥5 years. First, the association of dyspnoea with CAD severity was assessed using logistic regression analysis. Second, the prognostic value of dyspnoea for MACE (myocardial infarction and death), and specifically, the interaction between dyspnoea and CAD severity was investigated using Cox proportional-hazard analysis. Mean patient age was 60.3 ± 11.9 years, 63% of patients were male and 592 MACE events occurred during a median follow-up duration of 5.4 (IQR 5.1-6.0) years. On uni- and multivariable analysis (adjusting for age, sex, body mass index, chest pain typicality, and risk factors), dyspnoea was associated with two- and three-vessel/left main (LM) obstructive CAD. The presence of dyspnoea increased the risk for MACE [hazard ratio (HR) 1.57, 95% confidence interval (CI): 1.29-1.90], which was modified after adjusting for clinical predictors and CAD severity (HR 1.26, 95% CI: 1.02-1.55). Conversely, when stratified by CAD severity, dyspnoea did not provide incremental prognostic value in one-, two-, or three-vessel/LM obstructive CAD, but dyspnoea did provide incremental prognostic value in non-obstructive CAD.ConclusionIn patients with suspected CAD, dyspnoea was independently associated with severe obstructive CAD on CCTA. The severity of obstructive CAD explained the elevated MACE rates in patients presenting with dyspnoea, but in patients with non-obstructive CAD, dyspnoea portended additional risk.

Published
2022

30. Glycemic control is independently associated with rapid progression of coronary atherosclerosis in the absence of a baseline coronary plaque burden: a retrospective case–control study from the PARADIGM registry

Author

Won, Ki-Bum, Lee, Byoung Kwon, Lin, Fay Y, Hadamitzky, Martin, Kim, Yong-Jin, Sung, Ji Min, Conte, Edoardo, Andreini, Daniele, Pontone, Gianluca, Budoff, Matthew J, Gottlieb, Ilan, Chun, Eun Ju, Cademartiri, Filippo, Maffei, Erica, Marques, Hugo, de Araújo Gonçalves, Pedro, Leipsic, Jonathon A, Lee, Sang-Eun, Shin, Sanghoon, Choi, Jung Hyun, Virmani, Renu, Samady, Habib, Chinnaiyan, Kavitha, Berman, Daniel S, Narula, Jagat, Shaw, Leslee J, Bax, Jeroen J, Min, James K, and Chang, Hyuk-Jae

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Aging, Heart Disease - Coronary Heart Disease, Atherosclerosis, Cardiovascular, Heart Disease, Biomedical Imaging, Clinical Research, Prevention, Humans, Male, Middle Aged, Aged, Female, Plaque, Atherosclerotic, Coronary Artery Disease, Retrospective Studies, Coronary Angiography, Case-Control Studies, Glycemic Control, Glycated Hemoglobin, Prospective Studies, Disease Progression, Computed Tomography Angiography, Coronary Vessels, Registries, Predictive Value of Tests, Hemoglobin A1c, Coronary artery disease, Progression, Coronary computed tomography angiography, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, Cardiovascular medicine and haematology
Abstract

The baseline coronary plaque burden is the most important factor for rapid plaque progression (RPP) in the coronary artery. However, data on the independent predictors of RPP in the absence of a baseline coronary plaque burden are limited. Thus, this study aimed to investigate the predictors for RPP in patients without coronary plaques on baseline coronary computed tomography angiography (CCTA) images. A total of 402 patients (mean age: 57.6 ± 10.0 years, 49.3% men) without coronary plaques at baseline who underwent serial coronary CCTA were identified from the Progression of Atherosclerotic Plaque Determined by Computed Tomographic Angiography Imaging (PARADIGM) registry and included in this retrospective study. RPP was defined as an annual change of ≥ 1.0%/year in the percentage atheroma volume (PAV). During a median inter-scan period of 3.6 years (interquartile range: 2.7-5.0 years), newly developed coronary plaques and RPP were observed in 35.6% and 4.2% of the patients, respectively. The baseline traditional risk factors, i.e., advanced age (≥ 60 years), male sex, hypertension, diabetes mellitus, hyperlipidemia, obesity, and current smoking status, were not significantly associated with the risk of RPP. Multivariate linear regression analysis showed that the serum hemoglobin A1c level (per 1% increase) measured at follow-up CCTA was independently associated with the annual change in the PAV (β: 0.098, 95% confidence interval [CI]: 0.048-0.149; P

Published
2022

31. Interaction of AI-Enabled Quantitative Coronary Plaque Volumes on Coronary CT Angiography, FFRCT, and Clinical Outcomes: A Retrospective Analysis of the ADVANCE Registry

Author

Dundas, James, Leipsic, Jonathon, Fairbairn, Timothy, Ng, Nicholas, Sussman, Vida, Guez, Ilana, Rosenblatt, Rachael, Hurwitz Koweek, Lynne M., Douglas, Pamela S., Rabbat, Mark, Pontone, Gianluca, Chinnaiyan, Kavitha, de Bruyne, Bernard, Bax, Jeroen J., Amano, Tetsuya, Nieman, Koen, Rogers, Campbell, Kitabata, Hironori, Sand, Niels P.R., Kawasaki, Tomohiro, Mullen, Sarah, Huey, Whitney, Matsuo, Hitoshi, Patel, Manesh R., Norgaard, Bjarne L., Ahmadi, Amir, and Tzimas, Georgios

Published
2024
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33. Lesion delivery and scar formation in catheter ablation for atrial fibrillation: The DECAAF II trial

Author

Akoum, Nazem, Mekhael, Mario, Bisbal, Felipe, Wazni, Oussama, McGann, Christopher, Lee, Hyejung, Bardsley, Tyler, Greene, Tom, Dean, J. Michael, Dagher, Lilas, Kholmovski, Eugene, Mansour, Moussa, Marchlinski, Francis, Wilber, David, Hindricks, Gerhard, Mahnkopf, Christian, Wells, Darryl, Jaïs, Pierre, Sanders, Prashanthan, Brachmann, Johannes, Bax, Jeroen J., Morrison-de Boer, Leonie, Deneke, Thomas, Calkins, Hugh, Sohns, Christian, and Marrouche, Nassir

Published
2024
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35. Rationale and design of the CONFIRM2 (Quantitative COroNary CT Angiography Evaluation For Evaluation of Clinical Outcomes: An InteRnational, Multicenter Registry) study

Author

van Rosendael, Alexander R., Crabtree, Tami, Bax, Jeroen J., Nakanishi, Rine, Mushtaq, Saima, Pontone, Gianluca, Andreini, Daniele, Buechel, Ronny R., Gräni, Christoph, Feuchtner, Gudrun, Patel, Toral R., Choi, Andrew D., Al-Mallah, Mouaz, Nabi, Faisal, Karlsberg, Ronald P., Rochitte, Carlos E., Alasnag, Mirvat, Hamdan, Ashraf, Cademartiri, Filippo, Marques, Hugo, Kalra, Dinesh, German, David M., Gupta, Himanshu, Hadamitzky, Martin, Deaño, Roderick C., Khalique, Omar, Knaapen, Paul, Hoffmann, Udo, Earls, James, Min, James K., and Danad, Ibrahim

Published
2024
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37. Tricuspid Regurgitation: From Imaging to Clinical Trials to Resolving the Unmet Need for Treatment

Author

Grapsa, Julia, Praz, Fabien, Sorajja, Paul, Cavalcante, Joao L., Sitges, Marta, Taramasso, Maurizio, Piazza, Nicolo, Messika-Zeitoun, David, Michelena, Hector I., Hamid, Nadira, Dreyfus, Julien, Benfari, Giovanni, Argulian, Edgar, Chieffo, Alaide, Tchetche, Didier, Rudski, Lawrence, Bax, Jeroen J., von Bardeleben, Ralph Stephan, Patterson, Tiffany, Redwood, Simon, Bapat, Vinayak N., Nickenig, Georg, Lurz, Philipp, Hausleiter, Jörg, Kodali, Susheel, Hahn, Rebecca T., Maisano, Francesco, and Enriquez-Sarano, Maurice

Published
2024
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38. Differential progression of coronary atherosclerosis according to plaque composition: a cluster analysis of PARADIGM registry data.

Author

Yoon, Yeonyee E, Baskaran, Lohendran, Lee, Benjamin C, Pandey, Mohit Kumar, Goebel, Benjamin, Lee, Sang-Eun, Sung, Ji Min, Andreini, Daniele, Al-Mallah, Mouaz H, Budoff, Matthew J, Cademartiri, Filippo, Chinnaiyan, Kavitha, Choi, Jung Hyun, Chun, Eun Ju, Conte, Edoardo, Gottlieb, Ilan, Hadamitzky, Martin, Kim, Yong Jin, Lee, Byoung Kwon, Leipsic, Jonathon A, Maffei, Erica, Marques, Hugo, de Araújo Gonçalves, Pedro, Pontone, Gianluca, Shin, Sanghoon, Narula, Jagat, Bax, Jeroen J, Lin, Fay Yu-Huei, Shaw, Leslee, and Chang, Hyuk-Jae

Subjects
Heart Disease - Coronary Heart Disease, Cardiovascular, Heart Disease, Biomedical Imaging, Aging, Atherosclerosis, 2.1 Biological and endogenous factors
Abstract

Patient-specific phenotyping of coronary atherosclerosis would facilitate personalized risk assessment and preventive treatment. We explored whether unsupervised cluster analysis can categorize patients with coronary atherosclerosis according to their plaque composition, and determined how these differing plaque composition profiles impact plaque progression. Patients with coronary atherosclerotic plaque (n = 947; median age, 62 years; 59% male) were enrolled from a prospective multi-national registry of consecutive patients who underwent serial coronary computed tomography angiography (median inter-scan duration, 3.3 years). K-means clustering applied to the percent volume of each plaque component and identified 4 clusters of patients with distinct plaque composition. Cluster 1 (n = 52), which comprised mainly fibro-fatty plaque with a significant necrotic core (median, 55.7% and 16.0% of the total plaque volume, respectively), showed the least total plaque volume (PV) progression (+ 23.3 mm3), with necrotic core and fibro-fatty PV regression (- 5.7 mm3 and - 5.6 mm3, respectively). Cluster 2 (n = 219), which contained largely fibro-fatty (39.2%) and fibrous plaque (46.8%), showed fibro-fatty PV regression (- 2.4 mm3). Cluster 3 (n = 376), which comprised mostly fibrous (62.7%) and calcified plaque (23.6%), showed increasingly prominent calcified PV progression (+ 21.4 mm3). Cluster 4 (n = 300), which comprised mostly calcified plaque (58.7%), demonstrated the greatest total PV increase (+ 50.7mm3), predominantly increasing in calcified PV (+ 35.9 mm3). Multivariable analysis showed higher risk for plaque progression in Clusters 3 and 4, and higher risk for adverse cardiac events in Clusters 2, 3, and 4 compared to that in Cluster 1. Unsupervised clustering algorithms may uniquely characterize patient phenotypes with varied atherosclerotic plaque profiles, yielding distinct patterns of progressive disease and outcome.

Published
2021

39. Impact of COVID-19 on the imaging diagnosis of cardiac disease in Europe.

Author

Williams, Michelle Claire, Shaw, Leslee, Hirschfeld, Cole B, Maurovich-Horvat, Pal, Nørgaard, Bjarne L, Pontone, Gianluca, Jimenez-Heffernan, Amelia, Sinitsyn, Valentin, Sergienko, Vladimir, Ansheles, Alexey, Bax, Jeroen J, Buechel, Ronny, Milan, Elisa, Slart, Riemer HJA, Nicol, Edward, Bucciarelli-Ducci, Chiara, Pynda, Yaroslav, Better, Nathan, Cerci, Rodrigo, Dorbala, Sharmila, Raggi, Paolo, Villines, Todd C, Vitola, Joao, Malkovskiy, Eli, Goebel, Benjamin, Cohen, Yosef, Randazzo, Michael, Pascual, Thomas NB, Dondi, Maurizio, Paez, Diana, Einstein, Andrew J, and INCAPS COVID Investigators Group

Subjects
INCAPS COVID Investigators Group, Humans, Heart Diseases, Health Care Surveys, Predictive Value of Tests, Europe, Healthcare Disparities, Cardiac Imaging Techniques, Practice Patterns, Physicians', Cardiologists, COVID-19, cardiac imaging techniques, coronary artery disease, Cardiovascular
Abstract

We aimed to explore the impact of the COVID-19 pandemic on cardiac diagnostic testing and practice and to assess its impact in different regions in Europe. The online survey organised by the International Atomic Energy Agency Division of Human Health collected information on changes in cardiac imaging procedural volumes between March 2019 and March/April 2020. Data were collected from 909 centres in 108 countries. Centres in Northern and Southern Europe were more likely to cancel all outpatient activities compared with Western and Eastern Europe. There was a greater reduction in total procedure volumes in Europe compared with the rest of the world in March 2020 (45% vs 41%, p=0.003), with a more marked reduction in Southern Europe (58%), but by April 2020 this was similar in Europe and the rest of the world (69% vs 63%, p=0.261). Regional variations were apparent between imaging modalities, but the largest reductions were in Southern Europe for nearly all modalities. In March 2020, location in Southern Europe was the only independent predictor of the reduction in procedure volume. However, in April 2020, lower gross domestic product and higher COVID-19 deaths were the only independent predictors. The first wave of the COVID-19 pandemic had a significant impact on care of patients with cardiac disease, with substantial regional variations in Europe. This has potential long-term implications for patients and plans are required to enable the diagnosis of non-COVID-19 conditions during the ongoing pandemic.

Published
2021

40. Topological Data Analysis of Coronary Plaques Demonstrates the Natural History of Coronary Atherosclerosis

Author

Hwang, Doyeon, Kim, Haneol J, Lee, Seung-Pyo, Lim, Seonhee, Koo, Bon-Kwon, Kim, Yong-Jin, Kook, Woong, Andreini, Daniele, Al-Mallah, Mouaz H, Budoff, Matthew J, Cademartiri, Filippo, Chinnaiyan, Kavitha, Choi, Jung Hyun, Conte, Edoardo, Marques, Hugo, de Araújo Gonçalves, Pedro, Gottlieb, Ilan, Hadamitzky, Martin, Leipsic, Jonathon A, Maffei, Erica, Pontone, Gianluca, Raff, Gilbert L, Shin, Sanghoon, Lee, Byoung Kwon, Chun, Eun Ju, Sung, Ji Min, Lee, Sang-Eun, Berman, Daniel S, Lin, Fay Y, Virmani, Renu, Samady, Habib, Stone, Peter H, Narula, Jagat, Bax, Jeroen J, Shaw, Leslee J, Min, James K, and Chang, Hyuk-Jae

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Sciences, Atherosclerosis, Cardiovascular, Heart Disease, Biomedical Imaging, Heart Disease - Coronary Heart Disease, Clinical Research, Coronary Artery Disease, Data Analysis, Exercise, Humans, Predictive Value of Tests, coronary computed tomography angiography, coronary plaque, topological data analysis, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences
Abstract

ObjectivesThis study sought to identify distinct patient groups and their association with outcome based on the patient similarity network using quantitative coronary plaque characteristics from coronary computed tomography angiography (CTA).BackgroundCoronary CTA can noninvasively assess coronary plaques quantitatively.MethodsPatients who underwent 2 coronary CTAs at a minimum of 24 months' interval were analyzed (n = 1,264). A similarity Mapper network of patients was built by topological data analysis (TDA) based on the whole-heart quantitative coronary plaque analysis on coronary CTA to identify distinct patient groups and their association with outcome.ResultsThree distinct patient groups were identified by TDA, and the patient similarity network by TDA showed a closed loop, demonstrating a continuous trend of coronary plaque progression. Group A had the least coronary plaque amount (median 12.4 mm3 [interquartile range (IQR): 0.0 to 39.6 mm3]) in the entire coronary tree. Group B had a moderate coronary plaque amount (31.7 mm3 [IQR: 0.0 to 127.4 mm3]) with relative enrichment of fibrofatty and necrotic core (32.6% [IQR: 16.7% to 46.2%] and 2.7% [IQR: 0.1% to 6.9%] of the total plaque, respectively) components. Group C had the largest coronary plaque amount (187.0 mm3 [IQR: 96.7 to 306.4 mm3]) and was enriched for dense calcium component (46.8% [IQR: 32.0% to 63.7%] of the total plaque). At follow-up, total plaque volume, fibrous, and dense calcium volumes increased in all groups, but the proportion of fibrofatty component decreased in groups B and C, whereas the necrotic core portion decreased in only group B (all p

Published
2021

45. Effects of renin-angiotensin-aldosterone-system inhibitors on coronary atherosclerotic plaques: The PARADIGM registry

Author

Williams, Curtis, Han, Donghee, Takagi, Hidenobu, Fordyce, Christopher B., Sellers, Stephanie, Blanke, Philipp, Lin, Fay Y., Shaw, Leslee J., Lee, Sang-Eun, Andreini, Daniele, Al-Mallah, Mouaz H., Budoff, Matthew J., Cademartiri, Filippo, Chinnaiyan, Kavitha, Choi, Jung Hyun, Conte, Edoardo, Marques, Hugo, de Araújo Gonçalves, Pedro, Gottlieb, Ilan, Hadamitzky, Martin, Maffei, Erica, Pontone, Gianluca, Shin, Sanghoon, Kim, Yong-Jin, Lee, Byoung Kwon, Chun, Eun Ju, Sung, Ji Min, Virmani, Renu, Samady, Habib, Stone, Peter H., Berman, Daniel S., Narula, Jagat, Bax, Jeroen J., Leipsic, Jonathon A., and Chang, Hyuk-Jae

Published
2023
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46. Relation of Gender to Atherosclerotic Plaque Characteristics by Differing Angiographic Stenosis Severity

Author

Jonas, Rebecca, Patel, Toral, Crabtree, Tami R., Jennings, Robert S., Heo, Ran, Park, Hyung-Bok, Marques, Hugo, Chang, Hyuk-Jae, Stuijfzand, Wijnand J., van Rosendael, Alexander R., Choi, Jung Hyun, Doh, Joon-Hyung, Her, Ae-Young, Koo, Bon-Kwon, Nam, Chang-Wook, Shin, Sang-Hoon, Cole, Jason, Gimelli, Alessia, Khan, Muhammad Akram, Lu, Bin, Gao, Yang, Nabi, Faisal, Al-Mallah, Mouaz H., Nakazato, Ryo, Schoepf, U. Joseph, Driessen, Roel S., Bom, Michiel J., Thompson, Randall C., Jang, James J., Ridner, Michael, Rowan, Chris, Avelar, Erick, Généreux, Philippe, Knaapen, Paul, de Waard, Guus A., Pontone, Gianluca, Andreini, Daniele, Bax, Jeroen J., Choi, Andrew D., Earls, James P., Hoffmann, Udo, Min, James K., and Villines, Todd C.

Published
2023
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48. When Does a Calcium Score Equate to Secondary Prevention?: Insights From the Multinational CONFIRM Registry

Author

Budoff, Matthew J., Kinninger, April, Gransar, Heidi, Achenbach, Stephan, Al-Mallah, Mouaz, Bax, Jeroen J., Berman, Daniel S., Cademartiri, Filippo, Callister, Tracy Q., Chang, Hyuk-Jae, Chow, Benjamin J.W., Cury, Ricardo C., Feuchtner, Gudrun, Hadamitzky, Martin, Hausleiter, Joerg, Kaufmann, Philipp A., Leipsic, Jonathon, Lin, Fay Y., Kim, Yong-Jin, Marques, Hugo, Pontone, Gianluca, Rubinshtein, Ronen, Shaw, Leslee J., Villines, Todd C., and Min, James K.

Published
2023
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49. The Relationship Between Coronary Calcification and the Natural History of Coronary Artery Disease

Author

Jin, Han-Young, Weir-McCall, Jonathan R, Leipsic, Jonathon A, Son, Jang-Won, Sellers, Stephanie L, Shao, Michael, Blanke, Philipp, Ahmadi, Amir, Hadamitzky, Martin, Kim, Yong-Jin, Conte, Edoardo, Andreini, Daniele, Pontone, Gianluca, Budoff, Matthew J, Gottlieb, Ilan, Lee, Byoung Kwon, Chun, Eun Ju, Cademartiri, Filippo, Maffei, Erica, Marques, Hugo, de Araujo Goncalves, Pedio, Shin, Sanghoon, Choi, Jung Hyun, Virmani, Renu, Samady, Habib, Stone, Peter H, Berman, Daniel S, Narula, Jagat, Shaw, Leslee J, Bax, Jeroen J, Chinnaiyan, Kavitha, Raff, Gilbert, Al-Mallah, Mouaz H, Lin, Fay Y, Min, James K, Sung, Ji Min, Lee, Sang-Eun, and Chang, Hyuk-Jae

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Sciences, Biomedical Imaging, Heart Disease, Cardiovascular, Heart Disease - Coronary Heart Disease, Atherosclerosis, Clinical Research, Aetiology, 2.1 Biological and endogenous factors, Computed Tomography Angiography, Coronary Angiography, Coronary Artery Disease, Coronary Vessels, Disease Progression, Humans, Plaque, Atherosclerotic, Predictive Value of Tests, Risk Factors, Vascular Calcification, atherosclerosis, coronary artery calcium, coronary artery disease, coronary computed tomography angiography, statins, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences
Abstract

ObjectivesThe aim of the current study was to explore the impact of plaque calcification in terms of absolute calcified plaque volume (CPV) and in the context of its percentage of the total plaque volume at a lesion and patient level on the progression of coronary artery disease.BackgroundCoronary artery calcification is an established marker of risk of future cardiovascular events. Despite this, plaque calcification is also considered a marker of plaque stability, and it increases in response to medical therapy.MethodsThis analysis included 925 patients with 2,568 lesions from the PARADIGM (Progression of Atherosclerotic Plaque Determined by Computed Tomographic Angiography Imaging) registry, in which patients underwent clinically indicated serial coronary computed tomography angiography. Plaque calcification was examined by using CPV and percent CPV (PCPV), calculated as (CPV/plaque volume) × 100 at a per-plaque and per-patient level (summation of all individual plaques).ResultsCPV was strongly correlated with plaque volume (r = 0.780; p

Published
2021

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