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In This Issue of the Journal.

September 2019 1 Robert J. Gropler, MD Editor-in-Chief, Circulation: Cardiovascular Imaging I want to welcome you to the September 2019 issue of Circulation: Cardiovascular Imaging. In addition to the wide range of topics presented in this issue, the editors are most pleased to announce the journal will now be offering Continuing Medical Education credit for selected original articles. This effort has been led by our Continuing Medical Education Section Editors, Paul Cremer, MD, and Karen Ordovas, MD, and is designed to enhance the value of the journal for our readers. Continuing Medical Education credit will be offered for one article per issue. Paul and Karen have designated the article by Alshahrani et al to be the first article to offer this credit. Although coronary artery calcium score of zero identifies a population at low risk for future cardiovascular events, its negative predictive value is not high enough to preclude further testing in symptomatic patients suspected of having obstructive coronary artery disease. To help in this regard, Alshahrani et al describe a scoring tool that when applied to symptomatic patients with coronary artery calcium of zero may be useful in guiding further testing. In their editorial, Ramchand, Jaber, and Hachamovitch do a superb job of summarizing the strengths and weaknesses of the study results. Moreover, they raise the important question: in this patient population, where does coronary artery calcium scoring fit in relation to the more comprehensive plaque morphology information provided by cardiac computed tomographic angiography? Studies of the cardiac remodeling of diabetes mellitus have typically focused on abnormalities of the left ventricle (LV) and left atrium. Leveraging the UK Biobank using a variety of cardiac magnetic resonance (CMR) imaging techniques, Jensen and colleagues present data to suggest that the earliest cardiac manifestations of diabetes mellitus also involve the right atrium and right ventricle, not just the left heart. In their commentary, Xie and Lima nicely contextualize the reported results with our current knowledge of the cardiac effects of diabetes mellitus. Results of previous studies using CMR have suggested the LV hypertrophy due to athletic training reflects an increase in the intracellular myocardial compartment and decrease in the extracellular volume. However, these studies were cross-sectional by design and thus could not prove causality. Employing a serial CMR study design, Swoboda et al report that detraining of just 1 month results in LV mass regression that is the result in a decrease in the intracellular myocardial compartment, thus providing further evidence to support the role of changes in cardiomyocyte size mediating exercise-induced LV hypertrophy with exercise. The absence of cardiovascular risk factors in young adults confers a lower risk for cardiovascular disease later in life. Using multicontrast carotid magnetic resonance imaging, Berry and colleagues provide evidence to support that this lower risk factor status in young adulthood is protective by both lowering the burden and the probability of high-risk atherosclerotic plaque features later in life. © 2019 American Heart Association, Inc. EDITOR'S NOTE