Journal of Cardiovascular Magnetic Resonance最新文献

{"title":"AutOmatic floW planning for fetaL MRI (OWL).","authors":"Sara Neves Silva, Tomas Woodgate, Sarah McElroy, Michela Cleri, Kamilah St Clair, Jordina Aviles Verdera, Kelly Payette, Alena Uus, Lisa Story, David Lloyd, Mary A Rutherford, Joseph V Hajnal, Kuberan Pushparajah, Jana Hutter","doi":"10.1016/j.jocmr.2025.101888","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101888","url":null,"abstract":"<p><strong>Purpose: </strong>Widening access to fetal flow imaging by automating real-time planning of 2D phase-contrast flow imaging (OWL).</p><p><strong>Methods: </strong>Two subsequent deep learning networks for fetal body localization and cardiac landmark detection on a coronal whole-uterus scan were trained on 167 and 71 fetal datasets, respectively, and implemented for real-time automatic planning of phase-contrast sequences. OWL was evaluated retrospectively in 10 datasets and prospectively in 7 fetal subjects (36+3-39+3 gestational weeks), with qualitative and quantitative comparisons to manual planning.</p><p><strong>Results: </strong>OWL was successfully implemented in 6/7 prospective cases. Fetal body localization achieved a Dice score of 0.94  ±  0.05, and cardiac landmark detection accuracies were 5.77  ±  2.91 mm (descending aorta), 4.32  ±  2.44 mm (spine), and 4.94  ±  3.82 mm (umbilical vein). Planning quality was 2.73/4 (automatic) and 3.0/4 (manual). Indexed flow measurements differed by  - 1.8% (range  - 14.2% to 14.9%) between OWL and manual planning.</p><p><strong>Conclusions: </strong>OWL achieved real-time automated planning of 2D phase-contrast MRI for 2 major vessels, demonstrating feasibility at 0.55T with potential generalisation across field strengths, extending access to this modality beyond specialised centres.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101888"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780023","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":"Synthetic Extracellular Volume Fraction As an Imaging Biomarker of the Myocardial Interstitium without Blood Sampling: A Systematic Review and Meta-analysis.","authors":"Naofumi Yasuda, Shingo Kato, Nobuyuki Horita, Ryusuke Sekii, Shungo Sawamura, Hiroaki Nagase, Daisuke Utsunomiya","doi":"10.1016/j.jocmr.2025.101889","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101889","url":null,"abstract":"<p><strong>Background: </strong>The calculation of conventional extracellular volume fraction (ECV) requires blood hematocrit (Hct) measurement. Based on the relationship between Hct and blood T1 relaxivity for cardiac magnetic resonance (CMR), a synthetic ECV could be estimated without a blood sampling. The aim of this study was to evaluate the correlation and agreement in the quantification of synthetic ECV and laboratory ECV from conventional Hct measurements.</p><p><strong>Methods: </strong>Electronic database searches of PubMed, Web of Science Core Collection, Cochrane advanced search, and EMBASE were performed. The authors employed a meta-analysis using the generic inverse variance method with a random-effects model to estimate the summary correlation coefficient and mean absolute difference between synthetic and laboratory ECV.</p><p><strong>Results: </strong>Of 38 papers, 10 studies comprising 4,492 patients were identified. Overall, there was an excellent correlation between synthetic ECV and laboratory ECV (0.95 [95% confidence interval (CI): 0.92 to 0.97]) at 1.5T CMR and (0.91 [95% CI: 0.86 to 0.94]) at 3.0T CMR. The pooled mean difference between synthetic ECV and laboratory ECV was 0.61% (95% CI: 0.23 to 0.98%, I² = 0%, p for heterogeneity = 0.67) at 1.5T CMR and 0.24% (95% CI: -0.13 to 0.61%, I² = 19%, p for heterogeneity = 0.25) at 3.0T CMR.</p><p><strong>Conclusions: </strong>This study is the first comprehensive systematic review and meta-analysis of Synthetic ECV evaluation at CMR. Synthetic ECV demonstrated an excellent correlation with laboratory ECV, with a mean difference of less than 1%, and offers non-invasive and instantaneous quantification of the myocardial extracellular space without the need for blood sampling.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101889"},"PeriodicalIF":4.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730262","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":"Rapid Slice-to-Volume 4D Flow in Pediatric Patients with Congenital Heart Disease: A Feasibility Study.","authors":"Valérie Béland, Datta Singh Goolaub, Sharon Portnoy, Shi-Joon Yoo, Christopher Z Lam, Christopher K Macgowan","doi":"10.1016/j.jocmr.2025.101887","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101887","url":null,"abstract":"<p><strong>Background: </strong>Magnetic resonance imaging (MRI) allows cardiac hemodynamic assessment in patients with congenital heart disease. However, conventional techniques are time-consuming and may require blood contrast agents. Slice-to-volume reconstruction (SVR) 4D flow is an innovative imaging technique that may overcome those limitations. This study aimed to assess the feasibility of SVR 4D flow in pediatric congenital heart disease.</p><p><strong>Methods: </strong>Patients with congenital heart disease (n=7, age=12.9±2.8 years) underwent cardiovascular magnetic resonance imaging with conventional 2D phase-contrast MRI (2D PCMRI) and SVR 4D flow. SVR 4D flow datasets were reconstructed from multi-slice 2D spiral PCMRI acquisitions, which were combined via slice-to-volume reconstruction. Mean flow in major thoracic vessels were measured and compared between the two techniques. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated in each participant and compared between imaging techniques.</p><p><strong>Results: </strong>Linear regression for SVR 4D flow against 2D PCMRI showed good agreement in mean flows (slope=1.03, intercept=-5.31ml/s, r²=0.95). The SNR and CNR did not differ significantly between 2D PCMRI and SVR 4D flow data (SNR: p=0.85, CNR: p=0.90).</p><p><strong>Conclusion: </strong>Our results suggest that SVR 4D flow MRI is a feasible 5-minute scan (relative to multiple 2D PCMRI prescriptions and scans) in pediatric patients with congenital heart disease. SVR 4D flow showed good agreement with 2D PCMRI for mean flow measurements. The advantages of SVR 4D flow MRI support further research such as its comparison with conventional 4D flow.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101887"},"PeriodicalIF":4.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730259","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":"Age-, BSA-, and sex-specific reference values for cardiac magnetic resonance imaging derived ventricular and atrial size and function for Chinese healthy children.","authors":"Ke Xu, Wei Bai, Zhi Yang, Rong Xu, Lin-Jun Xie, Ling-Yi Wen, Chuan Fu, Jie-Qian Zheng, Xin-Mao Ma, Hang Fu, Zhong-Qin Zhou, Cheng-Cheng Zhu, Xiao-Yue Zhou, Hua-Yan Xu, Ying-Kun Guo","doi":"10.1016/j.jocmr.2025.101885","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101885","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular magnetic resonance (CMR) is crucial for the diagnosis and prognosis of heart disease. However, normal reference values for CMR-derived morphology parameters have not been established for Chinese children. We sought to establish reference values for ventricular and atrial size and function parameters using CMR in healthy Chinese children across a broad age range.</p><p><strong>Methods: </strong>3-T CMR scans were performed in 191 healthy children, aged 4-18 years. We used balanced steady-state free precession sequence for analyzing chamber size and function. Reference percentile curves and tables were generated using the generalized additive model for location scale and shape. A meta-analysis was conducted to compare our results with those of relevant previously published studies.</p><p><strong>Results: </strong>Boys generally had greater ventricular volumes and masses after normalization for body surface area (BSA) compared with girls. However, in the youngest age group (4-8 years), differences in volumes or masses between sexes were not found. Additionally, differences were not observed in left ventricular and right ventricular ejection fractions between sexes upon stratifying subjects based on age groups. However, after normalizing for BSA, only the maximal right atrial volume (RAV_max) remained significantly greater in boys than that in girls. Age-specific and BSA-specific reference curves revealed non-linear relationships between age/BSA and cardiac parameters. Asian children exhibited significantly smaller chamber sizes compared to those seen in Caucasian children.</p><p><strong>Conclusion: </strong>We report normative CMR ventricular and atrial volume and function in Chinese children based on BSA, age, and sex, which can serve as a reference for future studies and clinical practice.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101885"},"PeriodicalIF":4.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692284","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":"Characteristics of Left Ventricular Dysfunction in Repaired Tetralogy of Fallot: A Multi-Institutional Deep Learning Analysis of Regional Strain and Dyssynchrony.","authors":"Brendan T Crabb, Rahul S Chandrupatla, Evan M Masutani, Sophie Y Wong, Sachin Govil, Silvia Montserrat, Susana Prat-González, Julián Vega-Adauy, Melany Atkins, Daniel Lorenzatti, Chiara Zocchi, Elena Panaioli, Nathalie Boddaert, Laith Alshawabkeh, Lewis Hahn, Sanjeet Hegde, Andrew D McCulloch, Francesca Raimondi, Albert Hsiao","doi":"10.1016/j.jocmr.2025.101886","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101886","url":null,"abstract":"<p><strong>Background: </strong>Patients with repaired tetralogy of Fallot (rTOF) are commonly followed with MRI and frequently develop right ventricular (RV) dysfunction, which can be severe enough to impact left ventricular (LV) function in some patients. In this study, we sought to characterize patterns of LV dysfunction in this patient population using Deep Learning Synthetic Strain (DLSS), a fully automated deep learning algorithm capable of measuring regional LV strain and dyssynchrony.</p><p><strong>Methods: </strong>We retrospectively collected cine SSFP MRI images from a multi-institutional cohort of 198 patients with rTOF and 21 healthy controls. Using DLSS, we measured LV strain and strain rate across 16 AHA segments from short-axis cine SSFP images and compared these values to controls. We then performed a clustering analysis to identify unique patterns of LV contraction, using segmental peak strain and several measures of dyssynchrony. We further characterized these patterns by assessing their relationship to traditional MRI metrics of volume and function. Lastly, we assessed their impact on subsequent progression to pulmonary valve replacement (PVR) through a multivariate analysis.</p><p><strong>Results: </strong>Overall, patients with rTOF had decreased septal radial strain, increased lateral wall radial strain, and increased dyssynchrony relative to healthy controls. Clustering of rTOF patients identified four unique patterns of LV contraction. Most notably, patients in cluster 1 (n=39) demonstrated an LV contraction pattern with paradoxical septal wall motion and severely reduced septal strain. These patients had significantly elevated RV end-diastolic volume relative to clusters 3 and 4 (153±34 vs. 127±34 and 126±31mL/m², ANOVA p<0.01). In the multivariate analysis, this contraction pattern was the only LV metric associated with future progression to pulmonary valve replacement (HR = 2.69, p<0.005). A smaller subset of patients (cluster 2, n=29) showed reduced septal strain and LV ejection fraction despite synchronous ventricular contraction.</p><p><strong>Conclusions: </strong>Patients with rTOF demonstrate four unique patterns of LV dysfunction. Most commonly, but not exclusively, LV dysfunction is characterized by septal wall motion abnormalities and severely reduced septal strain. Patients with this pattern of LV dysfunction had concomitant RV dysfunction and rapid progression to PVR.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101886"},"PeriodicalIF":4.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692285","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":"Characterizing Extravascular Lung Water - A Dual Contrast Agent Extracellular Volume Approach by Cardiovascular Magnetic Resonance.","authors":"Felicia Seemann, Rim Halaby, Andrea Jaimes, Kendall O'Brien, Peter Kellman, Daniel A Herzka, Robert J Lederman, Adrienne E Campbell-Washburn","doi":"10.1016/j.jocmr.2025.101883","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101883","url":null,"abstract":"<p><strong>Introduction: </strong>Pathological extravascular lung water is a facet of decompensated congestive heart failure that current cardiovascular magnetic resonance (CMR) methods fail to quantify. CMR can measure total lung water density, but cannot distinguish between intravascular and extravascular fluid, and thus is not diagnostic. Therefore, we develop and evaluate a novel method to measure extravascular lung water by distinguishing intravascular from extracellular fluid compartments using two different contrast agents, extracellular gadolinium-chelates and iron-based intravascular ferumoxytol.</p><p><strong>Materials and methods: </strong>We created two porcine models of pulmonary edema: reversible catheter-induced mitral regurgitation to induce extravascular lung water (n=5); intravascular volume overload using rapid colloid infusion (n=5); and compared to normal controls (n=8). We sequentially acquired lung T1-maps and lung water density maps at 0.55T with native, gadolinium-based, and ferumoxytol contrast, from which we calculated the extracellular volume (ECV) and blood plasma volume fraction in the pulmonary tissue, respectively. We computed extravascular ECV as the difference in ECV and plasma volume fractions. Extravascular lung water volumes were estimated.</p><p><strong>Results: </strong>In the mitral regurgitation model, baseline vs mitral regurgitation ECV_{extravascular} increased from 27±4.1% to 32±1.9% (p=0.006), and extravascular lung water volume increased from 105±19ml to 143±15ml (p=0.048). Plasma volume fraction was similar at baseline vs mitral regurgitation (43±4.2% vs 46±5.4%, p=0.26). Compared to naïve pigs, we measured higher plasma volume fractions in the intravascular volume loaded model (42±4.7% vs 51±2.7%, p=0.0054), but no differences in ECV_{extravascular} (21±4.6% vs 21±3.6%, p=0.99) or extravascular lung water volume (67±13ml vs 89±24ml, p=0.11). Assessing the regional distribution, the plasma volume was higher posteriorly, indicating gravitational dependency, whereas, the extravascular lung water was higher anteriorly.</p><p><strong>Conclusion: </strong>Extravascular lung ECV measurements and derived lung water volumes corresponded well with predicted increases in extravascular and intravascular pulmonary fluid in animal models. This method may enable mechanistic studies of lung water in patients with dyspnea.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101883"},"PeriodicalIF":4.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692286","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":"Impact of transapical beating-heart septal myectomy on left atrial remodeling and atrioventricular coupling in hypertrophic obstructive cardiomyopathy.","authors":"Yun Zhao, Jin-Yi Xiang, Ziyi Pan, Chenhe Li, Lu Huang, Dazhong Tang, Yi Luo, Chunlin Xiang, Xiaoyue Zhou, Xiang Wei, Liming Xia, Lianming Wu","doi":"10.1016/j.jocmr.2025.101884","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101884","url":null,"abstract":"<p><strong>Background: </strong>Assessment of left atrial (LA) functional strain and atrioventricular coupling is increasingly recognized as critical in patients with hypertrophic obstructive cardiomyopathy (HOCM), associated with adverse atrial remodeling and malignant arrhythmia. However, the effect of transapical beating-heart septal myectomy (TA-BSM) on the improvement of LA function and atrioventricular coupling remains uncertain.</p><p><strong>Purpose: </strong>This study, for the first time, aimed to evaluate the LA reverse remodeling and atrioventricular coupling in HOCM after TA-BSM using cardiovascular magnetic resonance (CMR) feature-tracking technique.</p><p><strong>Materials and methods: </strong>The patients with HOCM who underwent TA-BSM in Tongji Hospital between April 2022 and October 2023 were prospectively investigated. The LA structure parameters (diameters and volumes), functional parameters [total LA emptying fraction (LAEF), total strain (εs), peak positive strain rate (SRs), passive LAEF, passive strain (εe), peak early negative strain rate (SRe), active LAEF, active strain (εa), and late peak negative strain rate (SRa)], and the left atrioventricular coupling index (LACI) obtained using CMR before and after TA-BSM were compared. The Pearson or Spearman correlation analysis was used to investigate the relationships between LA parameters and LACI. The univariate and multivariate linear regression analyses were used to identify variables associated with the rate of change in strains.</p><p><strong>Results: </strong>A total of 133 patients [median (Q1, Q3), 48(35.0, 57.5) years; 92 males] were evaluated. Further, 133 healthy participants matched for age and sex were included as controls. The LA size, reservoir function (total LAEF, εs, and SRs), conduit function (passive LAEF, εe, and SRe), and booster function (active LAEF, εa, and SRa) were worse than control group but improved to various degrees after TA-BSM (all P <.05). The subgroup with poor atrioventricular coupling had greater rate of change of εs, εa, and SRa postoperatively (all P <.001). LACI was highly correlated with strain and strain rate before TA-BSM, which decreased slightly postoperatively. In multivariable regression analysis, preoperative LACI was highly correlated with the rate of change of εs (adjusted β = -0.449, P <.001), εe (adjusted β =-0.285, P <.001), and εa (adjusted β = -0.286, P =.001).</p><p><strong>Conclusions: </strong>LA reverse remodeling was confirmed by CMR in patients with HOCM after TA-BSM and LACI may be a potential factor affecting LA strain improvement and expected to be an effective indicator for long-term monitoring of postoperative left heart function.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101884"},"PeriodicalIF":4.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692287","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":"CMR Radiologic-Pathologic Correlation in Radiomic Analysis of Myocardium in Non-Ischemic Dilated Cardiomyopathy.","authors":"Amine Amyar, Shiro Nakamori, Long Ngo, Masaki Ishida, Satoshi Nakamura, Taku Omori, Keishi Moriwaki, Naoki Fujimoto, Kyoko Imanaka-Yoshida, Hajime Sakuma, Kaoru Dohi, Warren J Manning, Reza Nezafat","doi":"10.1016/j.jocmr.2025.101881","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101881","url":null,"abstract":"<p><strong>Background: </strong>There is a growing interest in CMR radiomic signatures as novel imaging biomarkers of cardiac disease. However, very little is known about pathological correlates of the radiomics signature of myocardium on CMR sequences.</p><p><strong>Purpose: </strong>To investigate the association between CMR myocardial radiomic signatures and histological features in patients with non-ischemic dilated cardiomyopathy (DCM).</p><p><strong>Materials and methods: </strong>CMR images from DCM patients who underwent CMR followed by endomyocardial biopsy within 6 [2-15] days were used to investigate the association between myocardial radiomic signatures measured from native T₁, extra-cellular volume (ECV), late gadolinium enhancement (LGE) and histological features. Radiomic first-order and textural features were computed for each sequence from the mid-septal myocardium near the biopsy region. Hierarchical clustering was then applied to identify distinct radiomic clusters. A representative feature known as the \"medoid\" was identified within each cluster based on its minimal dissimilarity from other features. Logistic regression models were built using one medoid per model to evaluate the association between each medoid and histological feature. Association was determined using odds ratio (OR) with a 95% confidence interval.</p><p><strong>Results: </strong>132 DCM patients (71% male; 54±15 years) were included in the study. Clustering analysis unveiled two radiomic clusters for each sequence. For native T₁, the medoids were textural features. The first medoid was associated with fibrosis, inflammation, myocyte hypertrophy, vacuolization, and fat replacement (OR=2.84[1.62-5.46]; OR=2.05[1.15-4.03]; OR=2.39[1.01-6.62]; OR=2.03[1.22-3.60]; OR=0.35[0.12-0.86]; respectively). The second medoid was associated with nuclear generation (OR=0.55[0.31-0.91]). ECV medoids included first-order and textural features. The first-order medoid was associated with fibrosis (OR=2.97[1.75-5.46]), myocyte hypertrophy (OR=3.20[1.17-10.37]), and nuclear degeneration (OR=1.66[1.02-2.89]), while medoid 2 (texture) was associated with fibrosis (OR=4.44[2.26-10.00]). LGE medoid 1 (texture) was associated with myocyte hypertrophy (OR=0.31[0.10-0.77]), while medoid 2 (texture) was associated with fibrosis (OR=2.40[1.38-4.66]) and vacuolization (OR=2.00[1.16-3.72]).</p><p><strong>Conclusions: </strong>In DCM patients, CMR radiomic signatures were associated with myocardial tissue composition, as assessed by invasive biopsy.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101881"},"PeriodicalIF":4.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673910","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":"Feasibility and Safety of Regadenoson Stress Perfusion Protocol in Pediatric Transplant Patients under General Anesthesia.","authors":"Nikkan Das, Eric L Vu, Andrada Popescu, Defne Magnetta, Cynthia K Rigsby, Joshua D Robinson, Simon Lee, Nazia Husain","doi":"10.1016/j.jocmr.2025.101880","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101880","url":null,"abstract":"<p><strong>Background: </strong>Cardiac magnetic resonance with myocardial stress perfusion (stress CMR) is a non-invasive technique that offers assessment of myocardial function, perfusion, and viability. Regadenoson is a selective cardiac adenosine A2 receptor agonist with fewer side effects than adenosine and a favorable safety profile in older pediatric heart transplant recipients (PHTR). There are limited studies evaluating the hemodynamic response of regadenoson in pediatric patients under general anesthesia (GA).</p><p><strong>Methods: </strong>We reviewed our experience with regadenoson stress CMR in PHTR under GA from 2020-2024 and compared to a non-GA group of PHTR who underwent regadenoson stress CMR from 2015-2022. Demographic and clinical data were recorded. Hemodynamic response and adverse events were reviewed. CMRs were reviewed for perfusion abnormalities and semi-quantitative analysis was performed using myocardial perfusion reserve index (MPRI).</p><p><strong>Results: </strong>Forty-six PHTR underwent 53 stress CMRs under GA over the study period (mean age 7.8 years; range 3-19 years). All patients received endotracheal intubation and sevoflurane and were monitored during and after regadenoson administration per institutional protocol. Heart rate (HR) prior to regadenoson administration was 84±12 beats/min with a peak of 109±14 beats/min and average mean blood pressure (BP) was 63±12mmHg with a nadir of 45±8mmHg. Transient hypotension was observed in 33 (77%) scans, which resolved with phenylephrine. There were no other adverse events. Phenylephrine was used in 48 CMRs (91%) for blood pressure support at the discretion of anesthesia. Thirty-eight PHTR underwent 48 stress CMRs without sedation. CMRs were matched by time-since-transplant. The non-GA group was significantly older (mean age 15.8 years; p<0.001). GA patients had a larger percent decrease in mean BP compared to non-GA patients (27±17% vs 15±17%; p <0.001) with no difference in HR change. There were no significant differences in rates of qualitative perfusion defects, (11% vs 4%, p=0.18), late gadolinium enhancement or MPRI values between the two groups.</p><p><strong>Conclusion: </strong>Regadenoson stress CMR is safe and feasible in PHTR under GA. While hypotension was frequently seen, it improved in all cases with phenylephrine. Semi-quantitative myocardial perfusion analysis by MPRI is feasible in these young patients, however further studies are needed to assess its clinical utility in this population.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101880"},"PeriodicalIF":4.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633962","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":"Age and Sex-Related Outcomes in CMR Versus CT-Guided TAVR: A Secondary Analysis of a Randomized Clinical Trial.","authors":"Ivan Lechner, Fritz Oberhollenzer, Christina Tiller, Magdalena Holzknecht, Alex Kaser, Ronald K Binder, Can Gollmann-Tepeköylü, Gert Klug, Agnes Mayr, Axel Bauer, Bernhard Metzler, Martin Reindl, Sebastian J Reinstadler","doi":"10.1016/j.jocmr.2025.101882","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101882","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter aortic valve replacement (TAVR) is the preferred treatment for older patients with severe aortic stenosis with outcomes influenced by age and sex. Computed tomography (CT) is the reference imaging modality for TAVR planning, while cardiac magnetic resonance (CMR) is an emerging alternative for this indication. The aim of this study was to evaluate the impact of age and sex on implantation success in patients undergoing CT- or CMR-guided TAVR.</p><p><strong>Methods: </strong>This was a secondary analysis of the randomized TAVR-CMR trial comparing TAVR planning by CT or CMR (NCT03831087). Patients were categorized according to the median age (82 years) and sex. Implantation success, defined using the Valve Academic Research Consortium-2 definition (absence of procedural mortality, correct positioning of a single prosthetic valve, and proper prosthetic valve performance), was compared at hospital discharge between age groups and sex for each imaging strategy. All-cause mortality at 6 months was compared between imaging strategies across age groups and sex.</p><p><strong>Results: </strong>A total of 267 patients (median age 82 [IQR 80-85] years, 50% female) underwent TAVR at two heart centers in Austria between September 2017 and December 2022. Implantation success did not differ significantly between imaging strategies across age and sex subgroups. For patients ≤82 years, success rates were 92.1% (CT) vs. 94.7% (CMR) (p=0.524), and for those >82 years, 89.4% (CT) vs. 91.9% (CMR) (p=0.622). Among female patients, success rates were 84.7% (CT) vs. 93.2% (CMR) (p=0.113), and among male patients, 95.7% (CT) vs. 93.8% (CMR) (p=0.610). All-cause mortality at 6 months did not differ significantly between imaging strategies across age and sex subgroups. Mortality rates for patients ≤82 and >82 years were 4.8% vs. 5.3% (p=0.839) and 9.1% vs. 12.9% (p=0.490) for CT and CMR, respectively. Similarly, female and male patients had comparable mortality rates (10.2% vs. 8.1%, p=0.680; 4.3% vs. 9.4%, p=0.240).</p><p><strong>Conclusions: </strong>In this secondary analysis of the TAVR-CMR trial, CMR-guided TAVR was associated with similar outcomes compared with CT-guided TAVR irrespective of age and sex.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101882"},"PeriodicalIF":4.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633961","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}