Journal of Cardiovascular Magnetic Resonance最新文献

{"title":"Visualization of post-STEMI myocardial infarction and microvascular obstruction with non-contrast, free-breathing whole- heart iT₂prep-IR BOOST.","authors":"Xin Liu, Jifang He, Bowen Zhang, Lu Liang, Bin Sun, Boqia Xie, Xiuqin Jia, Xiaojuan Guo, Jing An, Chen Zhang, René M Botnar, Claudia Prieto, Karl P Kunze, Rohan Dharmakumar, Hsin-Jung Yang, Qi Yang","doi":"10.1016/j.jocmr.2026.102814","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102814","url":null,"abstract":"<p><strong>Background: </strong>Clinical adoption of cardiovascular magnetic resonance (CMR) for risk stratification in ST-elevation myocardial infarction (STEMI) is often limited by long scan times and the requirement for breath-holding and contrast agents.</p><p><strong>Objectives: </strong>This study aimed to validate a non-contrast, free-breathing 3D whole-heart T1/T2 CMR method (iT₂prep-IR BOOST) for rapid assessment of myocardial injury in STEMI patients, hypothesizing that this technique provides promising diagnostic accuracy and quantitative assessment to conventional contrast-enhanced CMR.</p><p><strong>Methods: </strong>A free-breathing 3D isotropic whole-heart iT₂prep-IR BOOST sequence was performed with a scan time of <8minutes. Sixty-four STEMI patients underwent CMR, including iT₂prep-IR BOOST, clinical T2-STIR, late gadolinium enhancement (LGE) and T1/T2 mapping. The diagnostic performance of iT₂prep-IR BOOST was evaluated against LGE and T2-STIR to assess myocardial infarction (MI), microvascular obstruction (MVO), and edema. Subgroup analyses further investigated the association between MVO detected by iT₂prep-IR BOOST and left ventricular (LV) remodeling at 1-year follow-up.</p><p><strong>Results: </strong>In 60 STEMI patients, the acquisition was completed in 7.2 ± 0.6min as a single free-breathing 3D whole-heart scan. Patient-level analysis showed high sensitivity and specificity for MVO (100.0% / 87.5%) and segmental MVO detection (95.8% / 97.8%). T₂prep-IR BOOST yielded robust image contrast for MI comparable to LGE, while offering comparable edema visualization to T2-STIR. Volumetric and transmurality quantifications of MVO, MI, and edema showed excellent agreement with reference standards (all r > 0.90, p < 0.001), supported by significant biophysical correlations with native T1/T2 values (p < 0.001). Furthermore, in a 1-year follow-up cohort (n=51), baseline T₂prep-IR BOOST-derived MVO volume was associated with adverse left ventricular remodeling, showing significant correlations with both ΔLVEDVI (r = 0.305, p = 0.029) and ΔLVESVI (r = 0.293, p = 0.037).</p><p><strong>Conclusions: </strong>In this preliminary single-center study, iT₂prep-IR BOOST showed promising diagnostic performance and close quantitative agreement with conventional LGE and T2-STIR in stable STEMI patients. Further prospective validation in larger, independent, and more heterogeneous cohorts, including patients unable to undergo contrast-enhanced CMR, is required before this technique can be considered an alternative to standard LGE and T2-weighted sequences.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102814"},"PeriodicalIF":5.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224153","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}

{"title":"Native cardiac T₁ mapping in the era of population imaging.","authors":"Roman Roy, Andrew Tyler","doi":"10.1016/j.jocmr.2026.102816","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102816","url":null,"abstract":"","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102816"},"PeriodicalIF":5.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224222","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}

{"title":"Multi-center study of CMR versus cardiac catheterization with endomyocardial biopsy for pediatric transplant surveillance: study protocol.","authors":"Aspen T Heimerl, Kimberly Crum, Carly A Lockard, Ke Yan, Gail Stendahl, Kristen George-Durrett, Steve Kindel, David Bearl, Paula North, Aoy Mitchell, Janet Nicotera, Scott Auerbach, Brian Fonseca, Markus Renno, Kenneth Knecht, Tiffanie Johnson, John J Parent, Nicholas Brown, Erin Albers, Jon Detterich, Jondavid Menteer, Rebecca Beroukhim, Kevin Daly, Nazia Husain, Defne Magnetta, Marc V Lee, Valerie Settersten, Michael DiLorenzo, Warren Zuckerman, Jimmy C Lu, Heang M Lim, Arene Butto, Timothy Slesnick, Beth J Printz, Gabrielle Vaughn, Kae Watanabe, Lazaro Hernandez, Shiraz Maskatia, Bruce M Damon, Jonathan H Soslow, Margaret M Samyn","doi":"10.1016/j.jocmr.2026.102819","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102819","url":null,"abstract":"<p><p>Notwithstanding advances in post-transplant care, acute allograft rejection (AR) remains the leading cause of mortality in pediatric heart transplant recipients (PHTX). Endomyocardial biopsy (EMB) continues to be the standard of care for AR detection, despite being invasive, costly, and associated with patient discomfort and potential complications. Non-invasive alternatives, including cardiac magnetic resonance imaging (CMR) with T1 and T2 parametric mapping and blood biomarkers (BB) such as cell-free DNA (cfDNA) and microRNA (miRNA), have shown promise in the adult transplant population, but their validation in the pediatric transplant population is lacking. The \"Predictive Modeling of Acute Rejection in Pediatric Heart Transplant Recipients\" (PEACE) study is a prospective, multicenter trial aiming to assess the diagnostic accuracy of CMR and BB in comparison to EMB. The goal of this manuscript is to describe the purpose and experimental protocol of the PEACE study. The PEACE study's overarching hypothesis is that CMR and BB can consistently and accurately detect myocardial abnormalities, potentially guiding the need for EMB. Secondary objectives include cost-analyses of CMR and BB, as well as a biomarker performance evaluation in biopsy-negative, but symptomatic and suspected AR cases. PEACE will enroll PHTX ages 6-25 years, across approximately 20 U.S. pediatric hospitals. All subjects will undergo EMB for surveillance or suspected AR as standard of care. As part of the research protocol, subjects will undergo blood collection for BB prior to the EMB and CMR within 5 days of EMB. Central core labs will conduct blinded analysis for imaging, pathology, and biomarkers to ensure consistent data interpretation. PEACE represents a critical step in reducing reliance on invasive biopsies in the clinical care of PHTX. By validating non-invasive tools in a large, diverse population, the PEACE study could transform AR detection, resulting in improvement of the patient experience and outcomes in this vulnerable population. (Trial Registration: ClinicalTrials.gov Identifier: NCT07770659, Non-invasive Prediction of EArly Cardiac rEjection (PEACE)).</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102819"},"PeriodicalIF":5.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220131","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}

{"title":"Prospective Cardiac MRI study comparing Recovered COVID-19 patients with Recovered Non-COVID-19 Viral Respiratory Infection Patients (R-COVID-CMR).","authors":"Lam Kwok Ho, Sin Tsun Hei, Ho Shui Yan, Ip Niki Hiu Yee, Ng Wing Kei Carol, Ling Wood-Hay Ian, Lee Ming Hin, Liu Wai To Raymond, Lung Kwok Cheung, Wu Ka Lun Alan, Chan Wai Man Johnny, Chan Wing Sze Carmen, Wu Tak Chiu, Siu David Chung Wah, Mok Tsz Yan Janice, Tam Cheuk Hang, Yiu Kai Hang, Chan Man Chun Jacky, Wan Eric Yuk Fai, Hung Fan Ngai Ivan, Andrew T Yan, Cheung Chi Wai Stephen, N G Ming-Yen","doi":"10.1016/j.jocmr.2026.102812","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102812","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Coronavirus disease 2019 (COVID-19) has been associated with subclinical myocardial inflammation. Post-COVID-19 infection, there are concerns about subsequent heart failure and persistent myocarditis. It is unknown how COVID-19 infection compares with non-COVID-19 viral infections in terms of myocardial inflammation based on cardiovascular magnetic resonance (CMR) assessment. This prospective longitudinal study aims to determine and compare the extent and severity of myocardial involvement in patients with COVID-19 infection versus non-COVID-19 viral respiratory infections (control).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;Recruited recovered COVID-19 (RCOVID) patients and recovered non-COVID (non-COVID) patients from several hospitals and COVID-19-designated clinic underwent three CMR examinations for functional assessment, native T1, T2, and extracellular volume (ECV) quantification, with corroborating blood markers (NT-proBNP, white cell count, c-reactive protein, lactate dehydrogenase, and high sensitivity cardiac troponin T). CMR scans took place (i) within 2-week of confirmed recovery, (ii) 3-month, and (iii) 12-month post-recovery. Linear mixed model with Bonferroni correction was used for analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;152 participants were recruited, 112 RCOVID outpatients (mean age: 41.0; 58.9% female) and 40 non-COVID inpatients (mean age:45.0; 37.5% female). Non-COVID infections included influenza virus, rhinovirus/enterovirus, parainfluenza virus, respiratory syncytial virus, and human metapneumovirus. At all three time points, blood results and cardiac function parameters were not significantly different between RCOVID and non-COVID patient groups (p-value not significant). Both patient groups had no significant differences for native T1/T2 values, ECV, late gadolinium enhancement, T2 short tau inversion recovery, and overall fulfilment of the 2018 revised Lake Louise Criteria at each time points.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In this prospective longitudinal study with CMR examinations, COVID-19 infection does not cause a worse myocardial inflammatory response than non-COVID-19 viral respiratory infection in terms of CMR parameters, and blood markers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain english summary: &lt;/strong&gt;During the coronavirus disease 2019 (COVID-19) outbreaks, some COVID-19 patients were incidentally found to have inflammation of the muscular layer of the heart. Healthcare professionals were concerned the inflammation will lead to heart not delivering enough blood to meet body demands (ie. heart failure) in the long run. Therefore, we designed this study to better understand the extent and severity of cardiac involvement in patients with COVID-19 by comparing them to patients with other types of viral respiratory infections, such as influenza, which we were more familiar with. We recruited two groups of patients, one group with patients recovered from COVID-19, the other group with patients recovered ","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102812"},"PeriodicalIF":5.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207002","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}

{"title":"Diffuse elevations of T1 and T2 are common in newly transplanted pediatric cardiac grafts without rejection and decrease over time.","authors":"Ravi V Vegulla, Sarah Blackwell, Nicolle M Ceneri, Joshua Kanter, John T Berger, Tacy Downing, Nicholas Mouzakis, Yue-Hin Loke, Russell Cross, Steven Staffa, Laura Olivieri","doi":"10.1016/j.jocmr.2026.102815","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102815","url":null,"abstract":"<p><strong>Background: </strong>Pediatric heart transplantation carries a high risk of subclinical myocardial injury and rejection. While cardiovascular magnetic resonance (CMR) parametric map elevations detect subtle myocardial changes with rejection, the typical temporal evolution of T1 and T2 values and their correlation with diastolic function in new grafts remains poorly defined.</p><p><strong>Methods: </strong>This prospective study evaluated 14 pediatric heart transplant recipients without acute rejection who underwent 22 non-contrast 1.5T CMR with their routine catheterization. New grafts (≤6 months; n=7) were compared to age-, sex- and body surface area-matched controls with established, established grafts (≥12 months; n=15). Comprehensive T1 and T2 mapping was performed and systolic/diastolic function were quantified with left atrial (LA) strain, volumes, and ejection fraction. Data were analyzed using linear mixed-effects models (LMM) and Hedge's g effect sizes.</p><p><strong>Results: </strong>Compared to established grafts, new grafts demonstrated significantly elevated Mean T1 (Δ 27 ms; p=0.005, g=1.25), Peak T1 (Δ 43 ms; p=0.02, g=1.03), and Mean T2 (Δ 2.6 ms; p=0.05, g=1.18). Longitudinal follow-up in three new grafts revealed temporal normalization of T1. Peak T2 (Δ2.5 ms; p=0.2, g=0.62) did not reach statistical significance. Functionally, new grafts exhibited trends of early diastolic impairment, including lower LA strain and higher indexed LA volumes. While these functional differences did not reach statistical significance, they demonstrated large, standardized effect sizes (g ≥ 0.8), suggesting directional trends that warrant larger investigation.</p><p><strong>Conclusions: </strong>During the first 6 months post-transplant, pediatric grafts exhibit diffuse and focal T1 and T2 elevations accompanied by transient diastolic impairment. In this pilot study, these directional trends likely reflect expected ischemia-reperfusion injury, edema, and new graft remodelling rather than acute rejection. Utilizing graft-age-specific normative values is essential to avoid false-positive rejection diagnoses during early post-transplant CMR surveillance.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102815"},"PeriodicalIF":5.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193943","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}

{"title":"Accelerated 3D Late Gadolinium Enhancement Pulse Sequence with Isotropic Spatial Resolution, Self-Navigation of Respiratory Motion, and Arrhythmia Rejection for Quantification of Left Atrial Fibrosis in Patients with Atrial Fibrillation.","authors":"Jonathan Louis, KyungPyo Hong, Rupsa Paul, Mohammed S M Elbaz, Onural Ozturk, Roberta Catania, Daniel C Lee, Eugene Kholmovski, Anna Pfenniger, Kenneth C Bilchick, Harold I Litt, Rod S Passman, Saman Nazarian, Daniel Kim","doi":"10.1016/j.jocmr.2026.102813","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102813","url":null,"abstract":"<p><strong>Background: </strong>The left atrium (LA) is a thin structure (1.5-2.5mm). Conventional 3D late gadolinium enhancement (LGE) pulse sequences for imaging the LA typically have limited through-plane resolution (2.5-5mm) or prolonged scan times (10-15min), resulting in poor image quality and limited clinical translatability. We sought to develop and test whether a 3D LGE pulse sequence featuring 1.5mm³ isotropic spatial resolution and a predictable scan time of 600 heartbeats can produce diagnostically acceptable image quality at 1.5T for quantification of LA structural remodeling in patients with atrial fibrillation (AF).</p><p><strong>Methods: </strong>A 3D LGE pulse sequence was developed using gradient-recalled echo (GRE) readout, stack-of-stars k-space sampling with variable density along the partition direction, retrospective arrhythmia rejection, and XD-GRASP reconstruction with self-navigation of respiratory motion. Thirty patients with AF (twenty imaged prior to first-time ablation, ten prior to repeat ablation) and twenty healthy controls were scanned using this pulse sequence. The upper limit of normal image intensity ratio (IIR) was derived from the control group; specifically, 2 standard deviations (SDs) above the mean. Suspected LA fibrosis was quantified by one rater. Two cardiothoracic radiologists independently graded the image quality across three categories (conspicuity, artifacts, noise) using a 5-point Likert scale per category, with a score of 3 considered clinically acceptable.</p><p><strong>Results: </strong>The proposed pulse sequence produced diagnostically acceptable image quality scores in all three categories for AF and control cohorts. Retrospective rejection of data acquired during ectopic heartbeats significantly (p<0.05) improved contrast-to-noise ratio (+3.7%) and sharpness (blur metric -3.2%) metrics, albeit at the expense of a significantly reduced signal-to-noise ratio (-4.4%). The upper limit of normal IIR was 1.43. Using this cutoff value to identify suspected LA fibrosis, compared with the control group (2.47 ± 2.24%), the first-time ablation group (7.45 ± 7.38%) was not significantly different (p = 0.14), whereas the repeat ablation group (14.94 ± 13.83%) was significantly different (p < 0.05).</p><p><strong>Conclusion: </strong>The proposed pulse sequence produces diagnostically acceptable image quality at 1.5T and provides evidence of LA structural remodeling in AF patients, including greater suspected LA fibrosis burden, relative to control subjects.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102813"},"PeriodicalIF":5.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193930","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}

{"title":"4D Flow Acquisition Parameters as Technical Correlates of Hemodynamic Measurements: An Analysis of the multicenter Tetralogy of Fallot Registry of 4D flow Energetics and Kinetics (TREK).","authors":"Yue-Hin Loke, Marc Lee, Ryan O'Hara, Wiebke Muegge, Katharina Drews, Bryan Gonzalez, Roland Axt-Fliedner, Jared Klein, Richard Friesen, Matthew Dove, Hieu Ta, Jonathan Kochav, Anmol Goyal, Laura Schoeneberg, Adam Christopher, Laura Olivieri, Rajesh Krishnamurthy, Elias Balaras, Yves d'Udekem, Julio Sotelo, Michael Taylor, Stanley Fricke, Ilias Bilionis, Brett A Meyers, Francesco Capuano","doi":"10.1016/j.jocmr.2026.102809","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102809","url":null,"abstract":"<p><strong>Background: </strong>Advanced 4D flow cardiovascular magnetic resonance (CMR) biomarkers such as kinetic energy (KE), vorticity (ω), and viscous energy loss (VEL) are increasingly used to characterize abnormal flow in repaired tetralogy of Fallot (rTOF), but their sensitivity to acquisition parameters including magnet vendor, sequence and signal quality has not been defined. We sought to evaluate the real-world variability in 4D flow sequences and technical correlates to 4D flow measurements of the aorta (Ao) and right ventricle, leveraging the multicenter Tetralogy of Fallot 4D flow Registry of Energetics and Kinetics (TREK).</p><p><strong>Methods: </strong>This was a multicenter observational analysis of clinically acquired 4D flow CMR processed at a core laboratory. The technical analysis focused on systolic Ao and diastolic RV hemodynamic measurements of KE, ω and VEL. Time-resolved hemodynamic curves were summarized and compared across sequence/reconstruction type, contrast agents and sequence parameters. Interobserver variability was assessed with Bland-Altman analysis and intraclass correlation coefficients. Apparent signal-to-noise ratio (aSNR), apparent velocity-to-noise ratio (aVNR) and presence of velocity aliasing were also measured. Multivariable linear/logistic regression was used to identify acquisition parameters associated with aSNR, aVNR and aliasing. Multivariable linear regression models were constructed to evaluate associations of aSNR, aVNR, and aliasing with KE, ω, and VEL after adjustment for clinical covariates.</p><p><strong>Results: </strong>The cohort included 345 datasets (295 rTOF studies and 50 controls). Sequence/reconstruction type, field strength, voxel volume, temporal resolution, and VENC were associated with aSNR and aVNR in multivariable models. Aliasing was associated with lower VENC. ω and VEL varied substantially across sequence/reconstruction type and contrast groups, whereas KE was comparatively more stable. In multivariable models, lower aSNR was associated with higher measured hemodynamic values after adjustment for clinical covariates, with stronger associations for ω and VEL rather than KE.</p><p><strong>Conclusions: </strong>In a real-world multicenter 4D flow CMR registry, measured advanced hemodynamic biomarkers were associated with acquisition/reconstruction characteristics, apparent image quality, and residual aliasing. 4D Flow harmonization efforts should therefore extend beyond vendor types alone and explicitly account for aSNR, aVNR, and aliasing when interpreting derivative-based 4D flow measurements.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102809"},"PeriodicalIF":5.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181847","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}

{"title":"The Prognostic Value of Entropy from T1 Mapping in Pulmonary Arterial Hypertension.","authors":"Ji Zhao, Jiajun Guo, Juan He, Chen Chen, Xuhan Liu, Lidan Yin, Shoufang Pu, Yangjie Li, Yuanwei Xu, Jie Wang, Ke Wan, Yuchi Han, Yucheng Chen","doi":"10.1016/j.jocmr.2026.102810","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102810","url":null,"abstract":"<p><strong>Background: </strong>The prognostic value of left ventricular (LV) entropy from T1 mapping in pulmonary arterial hypertension (PAH) remains unexplored.</p><p><strong>Study design and methods: </strong>This prospective study enrolled patients with PAH who underwent cardiovascular magnetic resonance (CMR) within 72h of right heart catheterization (RHC). Myocardial native T1, extracellular volume fraction (ECV) and entropy were calculated in mid-ventricular short-axis slice. The primary endpoint was defined as all-cause mortality or lung transplantation. Outcomes were further analyzed across groups stratified by survival status using Cox proportional hazards regression and Kaplan-Meier survival analysis.</p><p><strong>Results: </strong>A total of 312 patients were analyzed over a median follow-up of 36.10 months, with 59 deaths. Elevated LV entropy was positively correlated with log-transformed NT-proBNP, right ventricular (RV) end-systolic, end-diastolic volume indices, LV native T1 and ECV, and inversely correlated with RV ejection fraction (all P < 0.01). LV entropy did not differ significantly across etiological subgroups, whereas LV entropy without IPs was higher in congenital heart disease-associated PAH. Both LV entropy ≥8.60 and LV entropy without IPs ≥8.30 independently predicted all-cause mortality (HR, 2.207; 95% CI, 1.324-3.678; P = 0.002; and HR, 2.357; 95% CI, 1.405-3.955; P = 0.001, respectively) and were associated with reduced survival (both log-rank P < 0.005). Adding LV entropy improved ESC models (χ²: 55.79 to 60.61, C-statistic: 0.782 to 0.801) and ESC-CMR models (χ²: 35.31 to 41.77, C-statistic: 0.805 to 0.813).</p><p><strong>Conclusions: </strong>Elevated LV entropy was related to disease severity, RV dysfunction, and adverse clinical outcomes, and served as an independent predictor of all-cause mortality in patients with PAH.</p><p><strong>Registration: </strong>URL: https://www.</p><p><strong>Clinicaltrials: </strong>gov; Unique identifier: ChiCTR1800019314 and ChiCTR1900025518.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102810"},"PeriodicalIF":5.0,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167303","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}

{"title":"Automatic 3D TOF-MRA Intracranial Aneurysm Segmentation using SAM-Guided Multi-View Decoding Network.","authors":"Xiaorong Chen, Jiangfeng Pan, Jiaqi Xu, Yi Hu, Yanping Dong, Suping Wang, Shoujun Huang, Jianfeng Zhang, Dexing Kong, Hongjie Hu, Wei Lou","doi":"10.1016/j.jocmr.2026.102811","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102811","url":null,"abstract":"<p><strong>Background: </strong>Deep learning-based aneurysm segmentation using 3D time-of-flight magnetic resonance angiography (TOF-MRA) offers promising non-invasive screening, but its accuracy and generalizability remain limited.</p><p><strong>Purpose: </strong>To develop a deep learning model for intracranial aneurysm detection and segmentation on MRA, and evaluate its multicenter performance against the digital subtraction angiography (DSA) gold standard and radiologists of varying experience.</p><p><strong>Materials and methods: </strong>MRA images from patients suspected of harboring unruptured intracranial aneurysms were retrospectively collected from Jinhua Municipal Central Hospital for model development. An external test set, with DSA as the reference standard, was gathered from Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. Manual segmentation of cerebral arteries and aneurysms was performed using 3D-Slicer software. Performance was evaluated via Dice Similarity Coefficient (DSC), sensitivity, and F1-score, and compared against independent clinical evaluations from radiologists with different experience levels.</p><p><strong>Results: </strong>The internal dataset comprised 1,560 patients (1,554 aneurysms), including 421 patients (522 aneurysms) for testing. The external test set included 208 patients (224 aneurysms). On the internal test set, the model achieved a lesion-level sensitivity of 86.0% (95% CI: 82.8 - 88.7), a precision of 87.4% (95% CI: 84.2, 90.0), and a DSC of 0.88 (95% CI: 0.84, 0.90). On the independent external test set, the model demonstrated robust generalizability with a sensitivity of 83.4% (95% CI: 75.9, 88.0) and a DSC of 0.84 (95% CI: 0.79, 0.87). The model achieved an overall detection F1-score of 86.7, significantly outperforming junior radiologists (P <.001) and was comparable to mid-level radiologists (P >.05), with an average processing time of approximately 72seconds per exam.</p><p><strong>Conclusion: </strong>The proposed deep learning model demonstrated robust multicenter performance for intracranial aneurysm detection and segmentation. Achieving diagnostic accuracy comparable to mid-level radiologists, it holds potential as an efficient assistive tool for MRA interpretation in clinical workflows.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102811"},"PeriodicalIF":5.0,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167905","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}

{"title":"Simultaneous Cardiopulmonary Exercise Testing and Cardiac Magnetic Resonance Imaging in Patients with Conduction System Pacemakers.","authors":"Ajay Pillai, Elisa Palladino, Justin M Canada, W Gregory Hundley, Kenneth A Ellenbogen, Cory R Trankle","doi":"10.1016/j.jocmr.2026.102796","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102796","url":null,"abstract":"","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102796"},"PeriodicalIF":5.0,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166300","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}