Left atrial diameter (LAD) has been considered an independent risk factor for atrial fibrillation (AF) relapse after pulmonary vein isolation (PVI). However, whether LAD or other factors are more predictive of late recurrence in patients with paroxysmal AF remains unclear. We aimed to evaluate the value of pulmonary vein (PV) parameters for predicting AF relapse 1 year after patients underwent cryoablation for paroxysmal AF. Ninety-seven patients with paroxysmal AF who underwent PVI successfully were included. PV parameters were measured through computed tomography scans prior to PVI. A total of 28 patients had recurrence of AF at one-year follow-up. The impact of several variables on recurrence was evaluated in multivariate analyses. LAD and the time from first diagnosis of AF to ablation maintained its significance in predicting the relapse of AF after relevant adjustments in multivariate analysis. When major diameter of right inferior pulmonary vein (RIPV) (net reclassification improvement (NRI) 0.179, CI=0.031–0.326, P<0.05) and cross-sectional area (CSA) of RIPV (NRI: 0.122, CI=0.004–0.240, P<0.05) entered the AF risk model separately, the added predictive capacity was large. The accuracy of the two parameters in predicting recurrence of AF were not inferior (AUC: 0.665 and 0.659, respectively) to echocardiographic LAD (AUC: 0.663). The inclusion of either RIPV major diameter or CSA of RIPV in the model increased the C-index (0.766 and 0.758, respectively). We concluded that major diameter of RIPV had predictive capacity similar to or even better than that of LAD for predicting AF relapse after cryoablation PVI.

Background: Cardiac haemangioma is a rare primary cardiac tumour. Most patients with cardiac haemangioma have no typical symptoms, and some may present with non-specific manifestations, such as shortness of breath, heart palpitations, or cardiac insufficiency, making it difficult to distinguish cardiac haemangioma from other diseases. We report a case of cardiac haemangioma that present with chest pain. This haemangioma was finally completely excised to relieve the patient’s symptoms and a avoid poor prognosis. Case summary: A 14-year-old boy presented with an intermittent and progressive non-exertional chest pain for 2 weeks. Echocardiography showed a space-occupying mass at the right ventricular apex, which was later confirmed by computed tomography angiography and magnetic resonance imaging (MRI). The mass was successfully resected, and postoperative pathology confirmed a cardiac cavernous haemangioma. The patient had an uneventful postoperative recovery at the 8-month follow-up. Discussion: Cardiac haemangioma is a benign tumour with no typical clinical manifestations, and very few patients may present with chest pain. Preoperative echocardiography, computed tomography, and MRI are helpful for diagnosis, and surgery can relieve symptoms and may improve the prognosis of patients with cardiac haemangioma.

Background: This study aims to investigate the influence of sex on age-related changes in aortic morphology using computed tomography (CT) imaging. Method: Patients who underwent contrast-enhanced chest and abdominal CT between July 2021 and April 2022 were enrolled and stratified into six groups. Sex-specific comparisons of body surface area (BSA)-adjusted aortic diameters and tortuosity were performed across different groups. To validate the consistency of sex differences on age-related arterial changes, particularly regarding stiffness, relevant data were extracted from a previously published study to analyze the correlation between age and arterial stiffness in both sexes. Results: A total of 208 participants (59.6% males, overall mean age: 60.13 ± 16.33 years) were enrolled. The BSA-adjusted diameters showed a positive correlation with age in both sexes, with females exhibiting a more rapid increase than males. In the age groups of 60–69 years and above 80 years, females had significantly larger BSA-adjusted diameters of the ascending aorta than males. Additionally, after 40 years old, females had significantly greater BSA-adjusted tortuosity in all aortic segments than males. Both aortic and descending thoracic aortic tortuosity exhibited a notable increase with aging, particularly in females. Furthermore, branchial-pulse wave velocity (baPWV) showed a similar age-related progression pattern, with baPWV increasing at an accelerated rate in females. Conclusion: A sex-based variation in the rate of aortic morphological aging is observed throughout the lifespan, with females showing more pronounced changes in aortic tortuosity. It highlights the importance of prioritizing preventive measures for females, who may benefit more due to sex-specific disparities.

Background: The effectiveness of coronary computed tomography (CT) angiography in assessing stent restenosis is hindered by heavy metal artifacts. This study aimed to evaluate the image quality of monoenergetic reconstructions and iodine density map for coronary stent imaging using an 8-cm dual-layer detector spectral CT. Methods: In this study, 8 stents with a diameter <3 mm (group A) and 10 with a diameter ≥3 mm (group B) were placed in plastic tubes filled with iodinated contrast media and scanned. The internal diameter of the prepared stents was then measured by intravascular ultrasound. The reconstructed images included iodine density maps, conventional images, and different energy levels. The visualization of the stent lumen and stent structure was subjectively assessed using a 4-point Likert scale. The objective evaluation was performed using the in-stent lumen signal-to-noise ratio (SNRis), non-stent lumen SNR (SNRns), internal diameter difference (IDD), and blooming artifact index (BAI). The Friedman test and analysis of variance were used for multiple comparisons. Results: For lumen visualization, the optimal monoenergetic images received the highest score for both group A (2.56±0.51) and group B (3.1±0.55). Multiple comparisons showed that there were significant differences between the optimal monoenergetic images and iodine density maps. However, for stent structure, iodine density maps received the highest score for group A (3.0±0.52) and group B (3.8±0.41). For quantitative assessment, the optimal monoenergetic images had the highest SNRis and SNRns, while the iodine density maps had the lowest SNRis and SNRns. For IDD and BAI, the iodine density maps yielded the smallest value. Conclusions: The monoenergetic images on the second-generation dual-layer detector CT provide better visualization of the lumen and higher SNR. However, iodine density maps are superior for evaluating stent structure and IDD and BAI compared to monoenergetic and conventional reconstructions.

Introduction: Weight gain is associated with cardiac abnormalities, but the differences in cardiac remodeling between overweight and obesity (O&O) remain unclear. This study explored the structural and functional cardiac changes associated with O&O using noninvasive imaging. Methods: A retrospective study included participants from August 2021 to July 2023. Clinical data, laboratory results, and echocardiography reports were collected, and cardiac magnetic resonance imaging was post-processed. Cardiac structural and functional parameters were compared among healthy weight, overweight, and obesity groups, and their relationships with body mass index (BMI) were analyzed. Results: A total of 275 participants were included. Significant differences in left ventricular end-diastolic/systolic diameters, left atrial diameter, left ventricular ejection fraction, and stroke volume index were observed between O&O and healthy weight groups (p < 0.05). However, no significant differences were found between the O&O groups in terms of left ventricular septum thickness, left ventricular posterior wall thickness, cardiac index, or end-systolic volume index (p > 0.05). Multivariable regression showed a positive correlation between BMI and cardiac structural/functional indicators (p < 0.05), with greater changes in obesity. Loess spline analysis revealed that cardiac remodeling was more pronounced during the overweight stage. Conclusions: Both O&O are associated with larger cardiac dimensions, increased myocardial mass, and impaired function. Cardiac remodeling accelerates during the overweight stage, emphasizing the need for early detection and intervention in overweight individuals to mitigate future health risks.