Journal of Cardiovascular Magnetic Resonance最新文献

{"title":"Vasodilator stress perfusion CMR for outcome prediction in patients under 45 years with suspected CAD.","authors":"Elsa Richard de Vesvrotte, Jérôme Garot, Suzanne Duhamel, Mariama Akodad, Thomas Hovasse, Francesca Sanguineti, Stéphane Champagne, Thierry Unterseeh, Antoinette Neylon, Riccardo Mager, Neyla Sayah, Alexandre Unger, Trecy Gonçalves, Aicha Kante, Emmanuel Gall, Alexandre Pfeffer, Raphael Mirailles, Julien Hudelo, Valérie Bousson, Jean Guillaume Dillinger, Solenn Toupin, Philippe Garot, Théo Pezel","doi":"10.1016/j.jocmr.2026.102794","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102794","url":null,"abstract":"<p><strong>Background: </strong>Although the prognostic value of vasodilator stress cardiovascular magnetic resonance (CMR) is established, it has never been assessed in patients <45 years with suspected coronary artery disease. The aim was to assess the long-term prognostic value of stress CMR to predict mortality in a multicenter cohort of patients <45 years-old.</p><p><strong>Methods: </strong>Between December 2008 and December 2024, a prospective multicenter registry enrolled all consecutive patients undergoing vasodilator stress CMR at three French centers. For the present retrospective analysis, all patients aged <45 years were included. The primary endpoint was all-cause mortality, assessed through the French National Death Registry. Cox regression analyses were performed to determine the prognostic value of inducible ischemia and late gadolinium enhancement (LGE).</p><p><strong>Results: </strong>Of the 3,671 patients (mean age 38±6 years, 65% males), 102 (2.8%) died after a median follow-up of 6.8 years (interquartile range: 3-11 years). Annualized mortality rates increased gradually with the number of segments of ischemia and LGE (both p-trend<0.001). The extent of ischemia (hazard ratio [HR]: 1.45; 95% confidence interval [CI]: 1.24-1.70) and LGE (HR: 1.56; 95% CI: 1.39-1.75) were both associated with mortality (both p<0.001). After adjustment for traditional prognostic factors, both the extent of ischemia (adjusted HR: 1.26, per 1-segment increase; 95% CI: 1.06-1.51, p=0.011) and LGE (adjusted HR: 1.50, per 1-segment increase; 95% CI: 1.25-1.80, p<0.001) remained independent predictors of mortality.</p><p><strong>Conclusions: </strong>In patients <45 years undergoing stress CMR, the extent of both inducible ischemia and LGE provide strong and independent prognostic value for predicting all-cause mortality.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102794"},"PeriodicalIF":5.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887667","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 Cardiac MRI Using Deep Learning Cine Imaging: Validation in Pediatric Patients both with and without Congenital Heart Disease.","authors":"Jonathan Kochav, Junjie Ma, Sachin Jambawalikar, Maggie Fung, Patrick Quarterman, Amee Shah, Kanwal Farooqi, Amara Majeed, Simone Jhaveri, Alexandra Channing, Sophia Hsien, Martin Janich, Michael P DiLorenzo","doi":"10.1016/j.jocmr.2026.102793","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102793","url":null,"abstract":"<p><strong>Background: </strong>Conventional breath-held 2D bSSFP cine CMR requires multiple breath holds and prolonged acquisition time, posing challenges for children and patients with congenital heart disease (CHD). Deep-learning (DL)-based reconstruction enables undersampled data acquisition with rapid image completion, offering the potential for substantial time savings while preserving diagnostic accuracy.</p><p><strong>Methods: </strong>Fifty pediatric patients (median age 16.1 years [14.7, 17.5], 56% CHD) with two-ventricle physiology were prospectively recruited, and underwent conventional breath-held bSSFP cine imaging and DL-accelerated cine imaging at three acceleration levels: with breath-held acquisitions over 3-RR intervals, 1-RR interval, and 1-RR interval with free-breathing. Acquisition time, image quality, and quantitative ventricular measurements were compared across sequences.</p><p><strong>Results: </strong>Median short-axis cine stack acquisition time was reduced by 66%, 83%, and 89% for the 3-RR, 1-RR, and 1-RR free-breathing sequences, respectively, compared with conventional cine (all p<0.001). Image quality remained diagnostic in 96%, 88%, and 88% of cases, respectively with no statistical difference in image quality score between conventional cine and 3-RR acquisition. Quantitative assessment of myocardial thickening via radial strain demonstrated excellent agreement (ICC = 0.92, 95% CI 0.82-0.96, p < 0.001) between conventional cine and 3-RR acquisition, with only slightly higher measurements. on 3-RR sequences (29.7 ± 6.5% vs. 28.5 ± 6.1%, p<0.001). LV and RV volumes differed by <5 and <10mL/m² across all acceleration levels, LV mass by <3g/m², and LVEF/RVEF by ≤2%. Among CHD patients, a 2% overestimation of RVEF was observed.</p><p><strong>Conclusions: </strong>DL Cine enables rapid and diagnostically robust quantification of biventricular size and function in pediatric patients, including those with CHD. Image acceleration with 3-RR acquisitions optimally balances efficiency and image quality, supporting integration of DL cine imaging into routine pediatric and congenital CMR workflows.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102793"},"PeriodicalIF":5.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865213","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":"Volumetric real-time MRI for the guidance of cardiac catheterization at 0.55T.","authors":"Prakash Kumar, Rajiv Ramasawmy, Ahsan Javed, Duc Le, Pierre Daudé, Kendall J O'Brien, Andrea E Jaimes, Dominique Franson, Kelvin Chow, Fang Dong, Florian Maier, Robert J Lederman, Krishna S Nayak, Adrienne E Campbell-Washburn","doi":"10.1016/j.jocmr.2026.102792","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102792","url":null,"abstract":"<p><strong>Background: </strong>Interventional cardiovascular MRI (iCMR) uses rapid high-contrast images to guide invasive procedures, such as right-heart catheterization (RHC), an important diagnostic tool for characterizing pulmonary hypertension and heart failure. Current iCMR uses interleaved multi-planar 2D acquisitions (1-3 planes) with balanced steady-state free precession (bSSFP) contrast. A common challenge is tracking devices as they move out of plane and the operational burden of updating views in real-time. We propose a volumetric method that images the heart and great vessels in their entirety, and offers flexible real-time re-slicing, volumetric 3D visualization, and the potential for improved device monitoring.</p><p><strong>Methods: </strong>Volumetric real-time MRI (3DRT) was implemented at 0.55T using a stack-of-spirals bSSFP acquisition paired with a low-latency online spatiotemporally constrained image reconstruction, to achieve 3.5 mm³ isotropic spatial resolution and ~500 ms/volume temporal resolution. Numerical simulations were performed to evaluate tracking capability of gadolinium balloons as a function of device speed, and to verify image quality. Six healthy volunteers were imaged without catheterization to test performance on human subjects. Six naïve pigs were imaged during RHC, with gadolinium-filled polymer balloon wedge end-hole catheters.</p><p><strong>Results: </strong>Simulation experiments demonstrated that 3DRT imaging with low-latency spatiotemporally constrained reconstruction can resolve moving catheters at ~2.0cm/s. 3DRT with bSSFP contrast was successfully demonstrated for right-heart catheterization procedures in porcine models, providing adequate blood-myocardium contrast, and balloon-blood contrast to track the catheter tip. 3DRT images provided adequate image quality and resolved respiratory motion in healthy volunteers. Volumes were re-sliced live and re-sliced planes could be flexibly manipulated during the scan in real-time before the next volume was acquired.</p><p><strong>Conclusion: </strong>Volumetric real-time MRI is feasible for the guidance of invasive procedures such as right-heart catheterization at 0.55T. 3DRT imaging has been demonstrated in model pig experiments with ~500 ms temporal resolution and 3.5 mm³ isotropic spatial resolution, providing improved balloon tracking.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102792"},"PeriodicalIF":5.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813018","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 cardiac magnetic resonance postprocessing in congenital heart disease: SCMR FLIICR workgroup recommendations.","authors":"Julio Garcia, Julia Geiger, Adam Christopher, Christian Meierhofer, Shiraz Maskatia, Francesca Raimondi, Lynette Teo, Sergio Uribe, Julio Sotelo, Kwannapas Saengsin, Kenichiro Suwa, Liang Zhong, Animesh Tandon, Tobias Rutz","doi":"10.1016/j.jocmr.2026.102789","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102789","url":null,"abstract":"<p><p>The large majority of patients with congenital heart disease (CHD) survive into adulthood in the modern era of surgical advancements. However, patients require life-long follow-up and non-invasive imaging is crucial for diagnostic and therapeutic purposes. Cardiovascular magnetic resonance (CMR) plays a major role in patients with CHD as it is a non-invasive and ionizing radiation free imaging tool which overcomes the technical limitations of echocardiography. 4D flow is an evolving technique for flow quantification allowing improved CMR exam quality and reduced scan time. However, comprehensive postprocessing of hemodynamics in CHD may be demanding. This document addresses the needs for an \"ideal\" post-processing software for 4D flow in patients with CHD. It provides information on general requirements, velocity encoding, offset and aliasing correction, visualization, segmentation and reconstruction as well as output data. This document aims to support stakeholders in the field to develop solutions for improved 4D flow post-processing and visualization in CHD patients and thus improve the accuracy and efficiency of patient care.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102789"},"PeriodicalIF":5.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793577","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":"Assessment of Coronary Plaque Burden using Non-Contrast T1-weighted Cardiovascular MR: Comparison with Coronary CT Angiography.","authors":"Alexandra Amalie Uglebjerg Pedersen, Gregory Wood, Andreas Kabel, Damini Dey, Erik Thorlund Parner, Jesper Møller Jensen, Martin Bødtker Mortensen, Karl P Kunze, Claudia Prieto, René M Botnar, Bjarne Linde Nørgaard, Won Yong Kim","doi":"10.1016/j.jocmr.2026.102788","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102788","url":null,"abstract":"<p><strong>Background: </strong>Non-contrast T1-weighted cardiovascular MR (CMR) enables assessment of coronary atherosclerotic plaques by exploiting elevated signal intensity within high-risk plaque components. The novel iT2prep-BOOST sequence provides co-registered coronary lumen and vessel wall whole-heart imaging, potentially facilitating plaque assessment. However, direct comparison of quantitative plaque measures between iT2prep-BOOST and coronary computed tomography angiography (CCTA), the non-invasive standard for plaque assessment, remains limited. This study aimed to compare coronary plaque burden and plaque signal intensity measured by iT2prep-BOOST with plaque burden and plaque attenuation characteristics derived from CCTA.</p><p><strong>Methods: </strong>In this prospective, observational study, patients with stable coronary artery disease confirmed by diagnostic CCTA were recruited and subsequently underwent CMR using the iT2prep-BOOST sequence. Using semi-automated software, per-lesion cross-sectional areas of total, calcified, non-calcified, and low-density non-calcified plaque (≤30 Hounsfield unit) together with measures of plaque burden (percentage vessel atheroma) were quantified on CCTA. The corresponding coronary atherosclerotic lesion was analysed on T1-weighted black-blood iT2prep-BOOST CMR to assess cross-sectional plaque area, burden, and plaque-to-myocardial signal intensity ratio (PMR).</p><p><strong>Results: </strong>A total of 188 lesions in 85 patients were analysed and compared between iT2prep-BOOST and CCTA. Plaque burden estimates derived from iT2prep-BOOST demonstrated moderate correlation with CCTA-derived total plaque burden (r = 0.58) and non-calcified plaque burden (r = 0.54). However, agreement between modalities was limited. For total plaque burden, the mean difference was -4% (95% CI: -7% to -2%) with limits of agreement ranging from -38% to 29%. For non-calcified plaque burden, the mean difference was 3% (95% CI: 0% to 5%) with limits of agreement from -34% to 39%. In univariate regression analyses, PMR was associated with increasing total, non-calcified, and low-density non-calcified plaque areas and decreasing CT attenuation values.</p><p><strong>Conclusion: </strong>Coronary plaque burden assessed by iT2prep-BOOST demonstrated modest correlation and limited agreement with CCTA-derived plaque burden, indicating that the two modalities are not directly interchangeable for plaque burden quantification. Nevertheless, the observed associations between PMR and adverse CCTA plaque characteristics support the potential role of T1-weighted CMR as a complementary, non-invasive tool for coronary plaque characterization.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102788"},"PeriodicalIF":5.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793547","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 Myocardial Changes in MIS-C: Admission Clinical Features and Longitudinal Findings.","authors":"Sudeep D Sunthankar, Stephen E Hudson, Nicholas Joy, Joshua D Chew, William A McEachern, Kristen M George-Durrett, Gary W Coburn, Sophie E Katz, Anna E Patrick, Matthew L Dove, Olga Toro-Salazar, David A Parra, Jonathan H Soslow","doi":"10.1016/j.jocmr.2026.102791","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102791","url":null,"abstract":"<p><strong>Background: </strong>Multisystem inflammatory syndrome in children (MIS-C) is a sequela of SARS-CoV-2 infection; however, longitudinal cardiac outcomes are unclear. Herein, we test the association between MIS-C biomarkers, inpatient echocardiographic features, and outcomes of interest: presence of myocarditis and myocardial delayed enhancement (MDE) on cardiac magnetic resonance (CMR). Furthermore, we describe the evolution of CMR features in MIS-C.</p><p><strong>Methods: </strong>Patients diagnosed with MIS-C from 2020-2021 with CMR were included. Admission and serial biomarkers and echocardiographic features were collected. Primary outcomes measured were diagnosis of myocarditis (using modified Lake Louise criteria) and myocardial delayed enhancement (quantified by full width at half maximum method) on CMR. Secondary outcomes included abnormal LVEF on admission echocardiogram and changes in parametric mapping with serial CMR.</p><p><strong>Results: </strong>A total of 66 patients were included (median age 9.7 IQR [7.2-14.7] years). Admission BNP (P=0.016), CRP (P=0.027), and ESR (P=0.002) associated with LV dysfunction on inpatient echocardiogram. CMR1 was obtained a median of 38 [26-61] days after hospital presentation. Myocarditis was present in 44% and MDE in 52% on CMR1, with median MDE burden of 10.8 [8.5-16.8]% in those affected. Inpatient echocardiographic features were not associated with presence of myocarditis or MDE. Admission ESR (P=0.031) associated with MDE. Admission platelets associated with myocarditis (P=0.040) and MDE (P=0.004). CMR2 (n=19), occurring a median of 11 [7-14] months after baseline CMR, demonstrated lower global T2 z-scores (P=0.035) without significant change in global T1 z-scores or ECV. Myocarditis (16% [3/19]) and MDE (28% [5/18]) were less frequent on CMR2.</p><p><strong>Conclusions: </strong>For MIS-C patients, initial echocardiographic indices do not associate with myocarditis or MDE by CMR one month later; admission ESR and platelet levels may portend myocarditis or MDE on initial CMR. Reduced T2 z-score over serial CMR suggests resolving edema.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102791"},"PeriodicalIF":5.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793575","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":"Myocardial T1 and T2 Mapping at 5.0T: Feasibility and Comparison with 3.0-T MRI.","authors":"Qinfang Miao, Hongzhang Huang, Zhenfeng Lyu, Wenjian Liu, Tianyi Wu, Peng Hu, Haikun Qi","doi":"10.1016/j.jocmr.2026.102787","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102787","url":null,"abstract":"<p><strong>Background: </strong>Myocardial T1 and T2 mapping provide a non-invasive quantitative assessment of cardiac tissue. While established at 1.5-T and 3.0-T MRI, the mapping performance and reference values at 5.0-T MRI remain to be investigated. This study aims to evaluate the feasibility and establish reference values for cardiac T1 and T2 mapping at 5.0-T MRI in healthy subjects.</p><p><strong>Methods: </strong>In this prospective study, 50 healthy volunteers underwent cardiovascular magnetic resonance at both 3.0-T and 5.0-T systems from February to April 2025. Mapping protocols included MOdified Look Locker Inversion recovery (MOLLI, T1), T2-prepared gradient-echo (T2-prep-GRE, T2), and a simultaneous multi-parametric mapping technique (Multimap, T1 and T2). At 3.0-T MRI, both balanced steady-state free precession (bSSFP) and fast low-angle shot (FLASH) readouts were employed, while only the FLASH readout was used at 5.0-T MRI. Segment exclusion rates were analyzed at the subject-level using nonparametric tests with Holm correction for multiple comparisons. Measurement repeatability (intra-observer, scan-rescan) and reproducibility (inter-observer) were assessed by coefficient of variation (CoV), repeatability coefficient (RC), and intraclass correlation coefficient (ICC). Systematic difference and agreement between repeated measurements were evaluated using Bland-Altman analysis. Group-level variability was described by mean ± SD across subjects. Group comparisons were performed with repeated measures ANOVA.</p><p><strong>Results: </strong>All techniques at 5.0-T MRI yielded high-quality images that were predominantly free of visible artifacts with the FLASH readout. After quality control, segment acceptance rates ranged from 87.8% to 94.0%, and matched FLASH-readout comparisons showed higher exclusion rates at 5.0T than at 3.0T (all P < 0.001). Native T1 values were significantly higher at 5.0T than at 3.0-T MRI (MOLLI: 1452.9 ± 33.2 ms vs. 1305.9 ± 38.3 ms, P < 0.0001), while T2 values were significantly lower (T2-prep-GRE: 37.53 ± 1.74 ms vs. 43.97 ± 2.95 ms, P < 0.0001). Scan-rescan repeatability at 5.0-T (ICC: 0.87-0.92; CoV: 1.25%-2.17%; RC: 3.45%-6.01%) was comparable to 3.0-T MRI. Measurement precision, as assessed by CoV, RC, and ICC, was higher for 5.0-T than 3.0-T with FLASH, and lower than bSSFP-based techniques. Multimap enabled efficient, simultaneous T1 and T2 quantification with acceptable reproducibility at 5.0-T.</p><p><strong>Conclusion: </strong>Myocardial T1 and T2 mapping at 5.0-T MRI are reliable and reproducible in healthy individuals, offering reference values for normal myocardium at this field strength. The good measurement reproducibility and precision of 5.0-T cardiac mapping support its clinical potential for myocardial tissue characterization.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102787"},"PeriodicalIF":5.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793606","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":"Left Ventricular Mass is Associated with Biopsy-Assessed Renal Fibrosis in Chronic Kidney Disease.","authors":"Carl G Glessgen, Aurélie Huber, Lindsey A Crowe, Sophie de Seigneux, Grégoire Arnoux, Jean-Paul Vallée, Lena Berchtold","doi":"10.1016/j.jocmr.2026.102790","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102790","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular remodeling predicts cardiovascular mortality in chronic kidney disease (CKD). Prior studies have linked renal functional markers to cardiac structural changes, but the direct relationship between cardiac MRI parameters and renal interstitial fibrosis remains uncharacterized. We aimed to investigate the association between cardiac remodeling and biopsy-assessed renal interstitial fibrosis in patients with CKD.</p><p><strong>Materials & methods: </strong>This prospective single-center cohort included CKD patients with native kidneys who underwent same-week cardiac MRI and renal biopsy. Renal interstitial fibrosis was quantified as a percentage of the affected cortex area. Five cardiac parameters were selected: LVMi, LVEDVi, GLS, GCS, and myocardial T1. Associations with renal fibrosis were assessed using Spearman correlations, and multivariable linear regression adjusted for age and estimated glomerular filtration rate (eGFR). Sensitivity analyses were performed after excluding outliers.</p><p><strong>Results: </strong>Forty-seven patients were included (median age, 49 years; 55% male). LVMi correlated with renal fibrosis (ρ = 0.49; p < 0.001). GLS (ρ = 0.33; p = 0.03) and GCS (ρ = 0.30; p = 0.04) showed consistent trends that did not survive statistical correction. Renal fibrosis remained associated with LVMi after adjustment for age and eGFR (β = 0.33; p < 0.001). Adding LVEDVi attenuated the fibrosis coefficient by 22% (β = 0.26; p < 0.001). The renal fibrosis - left ventricular mass association persisted after excluding patients with high LVMi or high fibrosis grades (ρ = 0.45, p = 0.002; ρ = 0.35, p = 0.026, respectively).</p><p><strong>Conclusion: </strong>In CKD patients, LV mass was associated with biopsy-assessed renal fibrosis, independently of eGFR, suggesting that structural renal injury provides information beyond kidney function alone. This association was only partially attenuated after adjustment for LV volume, indicating that volume-related hemodynamic factors may not fully account for the link between renal fibrosis and LV remodeling.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102790"},"PeriodicalIF":5.0,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758732","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":"Exercise Cardiovascular Magnetic Resonance Work-Volume Loop Model in Heart Failure with Preserved Ejection Fraction.","authors":"Fahime Ghanbari, Jennifer Rodriguez, Deepa M Gopal, Manuel A Morales, Aaron B Waxman, Warren J Manning, Reza Nezafat","doi":"10.1016/j.jocmr.2026.102785","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102785","url":null,"abstract":"<p><strong>Background: </strong>Heart failure with preserved ejection fraction (HFpEF) is a hemodynamically heterogeneous syndrome including stage C HFpEF (overt) and exercise-induced HFpEF. While impaired compliance reserve is well recognized, contractile reserve remains underexplored. In addition, distinguishing exercise-induced HFpEF from non-cardiac dyspnea (NCD) remains challenging. Exercise cardiovascular magnetic resonance (Ex-CMR) enables quantification of reserve metrics, yet standardizing exercise protocol in dyspneic patients with limited capacity is challenging. This study aimed to establish an analytic framework for deriving non-invasive compliance and contractile reserve metrics independent of fixed exercise thresholds using Ex-CMR, and to evaluate their utility for pathophysiological differentiation among NCD, exercise-induced HFpEF, and stage C HFpEF.</p><p><strong>Methods: </strong>We proposed a non-invasive work-volume (W-V) loop model from Ex-CMR using left ventricular end-diastolic (LVEDV) and end-systolic volumes (LVESV) at rest and stress, along with maximum workload during supine cycle ergometer exercise, to construct a trapezoidal loop. The loop's base angles θ₁ and θ₂ represent effort-adjusted compliance and contractile reserve, respectively. In a retrospective analysis of a prospective multi-center Ex-CMR study, these markers were calculated in healthy controls, NCD, exercise-induced HFpEF, and stage C HFpEF groups. Patient cohorts were defined based on invasive hemodynamic exercise-testing thresholds and non-invasive data. ANOVA and post hoc testing were performed. Reproducibility was assessed.</p><p><strong>Results: </strong>Among 120 participants (40 healthy controls, 27 NCD, 20 exercise-induced HFpEF, 33 stage C HFpEF), effort-adjusted compliance reserve was impaired in both HFpEF subgroups compared with healthy controls and NCD (p<0.0001). Effort-adjusted contractile reserve was significantly higher in exercise-induced HFpEF than in healthy controls, NCD, and stage C HFpEF (p=0.018, 0.006, and <0.0001, respectively), despite comparable absolute ΔLVESV to NCD and lower ΔLVESV than healthy controls. In contrast, stage C HFpEF demonstrated depressed contractile reserve compared with other groups (p<0.0001). Reproducibility of reserve markers was good to excellent.</p><p><strong>Conclusions: </strong>Ex-CMR-derived W-V loop geometry reveals distinctive features across HFpEF subgroups and provides pathophysiological insight from an imaging perspective, demonstrating universal impairment of compliance reserve in HFpEF and a newly identified hypercontractile profile characteristic of exercise-induced HFpEF. Elevated θ₂ in exercise-induced HFpEF may identify a window for intervention before contractile reserve becomes compromised.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102785"},"PeriodicalIF":5.0,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765183","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":"Whole heart non-contrast 4D Flow MRI at 3.0T for clinical follow-up of congenital heart disease in children and adolescents.","authors":"J van Schuppen, A E van der Hulst, R A P Takx, M Groenink, S D Haas, J Oosterlaan, N A Blom, J J Splinter, I M Kuipers, J L Nelissen, J M den Harder, E M Schrauben, R N Planken, P van Ooij","doi":"10.1016/j.jocmr.2026.102786","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102786","url":null,"abstract":"<p><strong>Aims: </strong>Cardiac MRI is central to evaluating ventricular function and hemodynamics in pediatric congenital heart disease (CHD). Conventional two-dimensional phase-contrast (2D-PC) imaging is challenged by fixed planes, operator dependence, and multiple breath-holds, where four-dimensional flow (4DF) MRI overcomes these challenges. This study compares accelerated whole heart 4D Flow (WH-4DF) MRI with 2D-PC and volumetric measurements in routine clinical follow up of pediatric CHD and highlights its applicability.</p><p><strong>Methods and results: </strong>For this prospective study seventy-one consecutive pediatric patients (median age 14 ± 2.4 years; 49 male) with surgically corrected CHD underwent both 2D-PC and accelerated WH-4DF MRI. Planning and acquisition times and overall success rate were recorded. Flow, velocity and volumetric measurements were compared using Bland-Altman analysis, orthogonal regression, and intraclass correlation coefficients. WH-4DF showed excellent agreement with 2D-PC and short-axis volumetry for aortic, pulmonary, and ventricular stroke volumes (mean differences <5%). Mean planning and acquisition time for WH-4DF was 10.3minutes (SD 1.1), where planning and acquisition time of 2D-PC was 11.2minutes (SD 6.25). Aliasing was observed in 11% of the WH-4DF acquisitions but did not compromise interpretability.</p><p><strong>Conclusions: </strong>Accelerated WH-4DF MRI is clinically robust and broadly applicable across CHD, including complex postoperative anatomies. It provides comparable numbers to 2D-PC, reproducible, and time-efficient flow quantification with superior coverage and reduced operator dependence. A single WH-4DF scan can replace multiple 2D-PC acquisitions with comparable results and may enhance assessment of regurgitant flow. These features underscore its potential role in routine clinical practice and in advancing our understanding of disease processes.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102786"},"PeriodicalIF":5.0,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759986","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}