Xavier Sieber, Katherine Binzel, Juliet Varghese, Yingmin Liu, Jerome Yerly, Christopher W Roy, Panagiotis Antiochos, Milan Prsa, Ruud B van Heeswijk, Orlando P Simonetti, Matthias Stuber
{"title":"Measuring biventricular function and left atrial volume in a single five-dimensional whole-heart cardiovascular magnetic resonance scan at 0.55T.","authors":"Xavier Sieber, Katherine Binzel, Juliet Varghese, Yingmin Liu, Jerome Yerly, Christopher W Roy, Panagiotis Antiochos, Milan Prsa, Ruud B van Heeswijk, Orlando P Simonetti, Matthias Stuber","doi":"10.1016/j.jocmr.2025.101906","DOIUrl":"10.1016/j.jocmr.2025.101906","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular magnetic resonance (CMR) has not seen widespread adoption beyond large urban academic centers. The reasons for this limited uptake include the cost, time-intensive nature, and special expertise of CMR. Self-navigated five-dimensional (5D), x-y-z-cardiac-respiratory, free-funning whole-heart CMR using self-navigation (5D CMR) implemented on a low-field clinical scanner may help bridge this gap for biventricular function assessment and left atrium volume index measurement.</p><p><strong>Methods: </strong>Whole-heart three-dimensional radial phyllotaxis balanced steady-state free precession data were collected in ten healthy adult subjects. Self-navigation was used to extract respiratory and cardiac motion signals and to generate motion-resolved 5D CMR datasets. The right- and left-ventricular ejection fraction (RVEF and LVEF), left atrial volume index, contrast ratio, sharpness, perceived image quality, and total scan durations were ascertained and compared to those obtained with the reference 2D cine images.</p><p><strong>Results: </strong>5D CMR allowed for time-efficient and concordant measurements when compared to the 2D reference method. The 5D CMR images resulted in lower CR on 5D CMR images (3.3±2.9) than on 2D cines (4.7±1.2), and similarly lower perceived image quality (1.8±0.8 for 5D CMR and 3.6±0.9 for the 2D cines). However, the LVEF measurements were similar with no statistically significant differences (Mean: 58±5% for 5D CMR and 59±5% for 2D cine, p=0.49) and the LoA were low (-2.81% to 3.81%). For the RVEF, the measurements were also in good agreement when RVEF was measured on the axial views (60±3% for 5D CMR and 60±4% for 2D cine, p=0.85) and the LoA were also low (-2.87% to 3.07%).</p><p><strong>Conclusion: </strong>5D CMR without the need for electrocardiogram, breath-holding, navigators, or complex scan planning enables a highly simplified and time-efficient assessment of biventricular cardiac function on a 0.55T clinical system in 7:50 min.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101906"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12166699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ida Marie Hauge-Iversen, Einar S Nordén, Arne Olav Melleby, Linn Espeland, Lili Zhang, Ivar Sjaastad, Emil Knut Stenersen Espe
{"title":"Non-invasive estimation of left ventricular chamber stiffness using cardiovascular magnetic resonance and echocardiography.","authors":"Ida Marie Hauge-Iversen, Einar S Nordén, Arne Olav Melleby, Linn Espeland, Lili Zhang, Ivar Sjaastad, Emil Knut Stenersen Espe","doi":"10.1016/j.jocmr.2025.101849","DOIUrl":"10.1016/j.jocmr.2025.101849","url":null,"abstract":"<p><strong>Background: </strong>Preclinical studies exploring the underlying mechanisms of elevated left ventricular (LV) chamber stiffness play a crucial role in developing new therapeutic strategies. However, there is a lack of systematic evaluation of imaging biomarkers of diastolic function against gold standard assessment of LV chamber stiffness in rodents. Therefore, we aimed to evaluate imaging biomarkers of diastolic function from cardiovascular magnetic resonance (CMR) and echocardiography in predicting the slope of the end-diastolic pressure-volume relationship (EDPVR) in rats.</p><p><strong>Methods: </strong>Sprague Dawley rats with varying degrees of myocardial stiffness induced by aortic constriction (n=38) and healthy controls (n=9) underwent echocardiography and CMR at approximately 13 weeks post-operation. Imaging biomarkers of diastolic function were evaluated for their ability to predict the EDPVR slope from pressure-volume recordings using regression analysis and receiver operating characteristics analysis.</p><p><strong>Results: </strong>Both CMR and echocardiographic imaging biomarkers, in particular those related to the left atrium and mitral flow, were able to predict the EDPVR slope in a rat model with varying stiffness. From CMR, native T1 values, peak early diastolic longitudinal strain rate (SRe(long)) and E/SRe(long), left atrial (LA) ejection fraction, isovolumetric relaxation time (IVRT), E/A and peak LA strain, correlated best with the EDPVR slope (|r|=0.54-0.72). From echocardiography, E/A, E, LA diameter, e'/a', E/SRe(long) and IVRT correlated with the EDPVR slope (|r|=0.49-0.67), while E/e', e' and E-wave deceleration time demonstrated poor correlation (|r|=0.17-0.27). Receiver operating characteristics analysis indicated better performance of CMR imaging biomarkers than echocardiography in predicting increased EDPVR slope.</p><p><strong>Conclusions: </strong>Several diastolic imaging biomarkers commonly employed in preclinical studies have poor ability to predict cardiac chamber stiffness. Our study identifies several imaging biomarkers obtained from both echocardiography and CMR that are able to estimate LV chamber stiffness non-invasively, providing an important tool for future mechanistic research on myocardial stiffness.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101849"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sebastian Kelle, Anna Clara Nolden, Maximilian Leo Müller, Rebecca Elisabeth Beyer, Henning Steen, Bjoern Andrew Remppis, Johannes Wieditz, Hannah Kentenich, Alex Tuit, Mina Cvetkovic, Undine Ella Witt, Florian André, Sein Schmidt, Alexander Huppertz, Dusan Simic, Dirk Müller, Arim Shukri, Matthias Issing, Andre Glardon, Katrin Christiane Reber, Ulf Landmesser, Norbert Frey, Burkert Pieske, Stephanie Stock, Volkmar Falk, Tim Friede, Gisela Thiede
{"title":"Rationale and design of the HERZCHECK trial: Detection of early heart failure using telemedicine and cardiovascular magnetic resonance in structurally weak regions (NCT05122793).","authors":"Sebastian Kelle, Anna Clara Nolden, Maximilian Leo Müller, Rebecca Elisabeth Beyer, Henning Steen, Bjoern Andrew Remppis, Johannes Wieditz, Hannah Kentenich, Alex Tuit, Mina Cvetkovic, Undine Ella Witt, Florian André, Sein Schmidt, Alexander Huppertz, Dusan Simic, Dirk Müller, Arim Shukri, Matthias Issing, Andre Glardon, Katrin Christiane Reber, Ulf Landmesser, Norbert Frey, Burkert Pieske, Stephanie Stock, Volkmar Falk, Tim Friede, Gisela Thiede","doi":"10.1016/j.jocmr.2025.101841","DOIUrl":"10.1016/j.jocmr.2025.101841","url":null,"abstract":"<p><strong>Background and aims: </strong>Heart failure (HF) is an imminent global health problem. Yet established screening algorithms for asymptomatic pre-HF, allowing for early and effective preventive interventions, are largely lacking. The HERZCHECK trial, conducted in structurally underserved rural regions of North-Eastern Germany, aims to close this gap by evaluating the feasibility, diagnostic efficacy, and cost-effectiveness of a fully mobile, telemedically-supervised screening approach, combining cardiovascular magnetic resonance (CMR) imaging and laboratory testing as central elements.</p><p><strong>Study design and methodology: </strong>The HERZCHECK trial is a prospective, randomized controlled trial employing a prospective randomized open blinded endpoint design. The study targets asymptomatic adults aged 40-69 years without a history of HF, but with at least one of the following cardiovascular risk factors: hypertension, hypercholesterolemia, obesity, smoking/tobacco consumption, chronic diabetes mellitus, or chronic kidney disease. Participants undergo a comprehensive screening examination including a questionnaire-based medical history, laboratory testing, and CMR at baseline. Based on CMR-derived global longitudinal strain (GLS), participants are classified as stratum A (GLS < -15%), B (GLS ≥ -15% to < -11%), or C (GLS ≥ -11%), with strata B and C being defined as asymptomatic pre-HF. Ten percent of participants in stratum A and all of stratum B and C are subsequently randomized into two groups, receiving either conventional or innovative medical reports, the latter including information on GLS, guideline-based recommendations, and access to a lifestyle intervention app for cardiovascular prevention. Additionally, treating physicians of participants in the innovative group are granted access to an expert center for telemedical inquiries. Follow-up assessments are performed over 12 months to evaluate changes in GLS, as well as adverse cardiac events and quality of life.</p><p><strong>Conclusion: </strong>HERZCHECK aims to provide a blueprint for a comprehensive, contemporary screening approach tailored to the needs of the targeted structurally underserved population. By implementing this approach in a representative at-risk cohort, HERZCHECK will provide important new information about (a) the prevalence of asymptomatic pre-HF in at-risk patients and (b) the feasibility, added diagnostic value and health economic aspects of CMR exams as part of future screening mechanisms for HF in clinical routine care (NCT05122793).</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101841"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11870244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kate Hanneman, Eugenio Picano, Adrienne E Campbell-Washburn, Qiang Zhang, Lorna Browne, Rebecca Kozor, Thomas Battey, Reed Omary, Paulo Saldiva, Ming Ng, Andrea Rockall, Meng Law, Helen Kim, Yoo Jin Lee, Rebecca Mills, Ntobeko Ntusi, Chiara Bucciarelli-Ducci, Michael Markl
{"title":"Society for Cardiovascular Magnetic Resonance recommendations toward environmentally sustainable cardiovascular magnetic resonance.","authors":"Kate Hanneman, Eugenio Picano, Adrienne E Campbell-Washburn, Qiang Zhang, Lorna Browne, Rebecca Kozor, Thomas Battey, Reed Omary, Paulo Saldiva, Ming Ng, Andrea Rockall, Meng Law, Helen Kim, Yoo Jin Lee, Rebecca Mills, Ntobeko Ntusi, Chiara Bucciarelli-Ducci, Michael Markl","doi":"10.1016/j.jocmr.2025.101840","DOIUrl":"10.1016/j.jocmr.2025.101840","url":null,"abstract":"<p><p>Delivery of health care, including medical imaging, generates substantial global greenhouse gas emissions. The cardiovascular magnetic resonance (CMR) community has an opportunity to decrease our carbon footprint, mitigate the effects of the climate crisis, and develop resiliency to current and future impacts of climate change. The goal of this document is to review and recommend actions and strategies to allow for CMR operation with improved sustainability, including efficient CMR protocols and CMR imaging workflow strategies for reducing greenhouse gas emissions, energy, and waste, and to decrease reliance on finite resources, including helium and waterbody contamination by gadolinium-based contrast agents. The article also highlights the potential of artificial intelligence and new hardware concepts, such as low-helium and low-field CMR, in achieving these aims. Specific actions include powering down magnetic resonance imaging scanners overnight and when not in use, reducing low-value CMR, and implementing efficient, non-contrast, and abbreviated CMR protocols when feasible. Data on estimated energy and greenhouse gas savings are provided where it is available, and areas of future research are highlighted.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101840"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sascha Kopic, Einar Heiberg, Henrik Engblom, Marcus Carlsson, David Nordlund, Robert Jablonowski, Mikael Kanski, Christos Xanthis, Sebastian Bidhult, Anthony H Aletras, Håkan Arheden
{"title":"Ex-vivo validation of nine algorithms for quantifying infarcts with late gadolinium enhancement cardiovascular magnetic resonance.","authors":"Sascha Kopic, Einar Heiberg, Henrik Engblom, Marcus Carlsson, David Nordlund, Robert Jablonowski, Mikael Kanski, Christos Xanthis, Sebastian Bidhult, Anthony H Aletras, Håkan Arheden","doi":"10.1016/j.jocmr.2025.101915","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101915","url":null,"abstract":"<p><strong>Background: </strong>In cardiovascular magnetic resonance, late gadolinium enhancement (LGE) is the standard method to visualize myocardial infarction (MI). Many algorithms quantifying infarct size in LGE images exist. However, only few algorithms have been validated, i.e. benchmarked against an ex-vivo measurement. Furthermore, the reported algorithm performance varies considerably between studies.</p><p><strong>Objectives: </strong>The aim of this study was to compare the performance of all infarct measurement algorithms against an ex-vivo measurement and to promote a discourse regarding advantages and disadvantages of individual measurement methods.</p><p><strong>Methods: </strong>MI was induced in 22 pigs. In-vivo LGE imaging was conducted on d0, d3 or d7 post-MI. For ex-vivo validation infarct was measured using high-resolution T1-weighted images. In-vivo infarct size was measured using the Full-Width at Half-Maximum (FWHM), n-SD from remote (2,3,5 and 6SD), Feature Analysis and Combined Thresholding (FACT), Expectation maximization Weighted A priori information (EWA), Heiberg-08 and Otsu algorithms and manual delineation. No manual adjustments were made to algorithm delineations.</p><p><strong>Results: </strong>Clear differences in variance and bias were observed between algorithm-based methods, and no method performed optimally in this heterogeneous dataset where the best had a bias of -0.48±3.1, -0.3±4.4%, 2.3±4.2%LV for EWA, FWHM, and FACT, respectively. Manual delineation by experienced observers performed well with a bias of 1.9±5.4%.</p><p><strong>Conclusions: </strong>EWA, Heiberg-08, FWHM, and FACT all perform on par with manual delineation, however Heiberg-08, and FWHM are not suitable for PSIR images. The technique used to measure infarct size should be disclosed in clinical trials and in original research. Caution should be applied when comparing datasets employing different infarct quantification methods. Manual infarct delineation by experienced readers remains a reliable technique to measure infarct size.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101915"},"PeriodicalIF":4.2,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191782","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}
Claudia Prieto, Bradley D Allen, Clerio F Azevedo, Bruno Bezerra Lima, Christopher Z Lam, Rebecca Mills, Merel Huisman, Ricardo A Gonzales, Sebastian Weingärtner, Anthony G Christodoulou, Carlos Rochitte, Michael Markl
{"title":"Highlights of the Society for Cardiovascular Magnetic Resonance (SCMR) 2025 Conference: leading the way to accessible, efficient and sustainable CMR.","authors":"Claudia Prieto, Bradley D Allen, Clerio F Azevedo, Bruno Bezerra Lima, Christopher Z Lam, Rebecca Mills, Merel Huisman, Ricardo A Gonzales, Sebastian Weingärtner, Anthony G Christodoulou, Carlos Rochitte, Michael Markl","doi":"10.1016/j.jocmr.2025.101914","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101914","url":null,"abstract":"<p><p>The 28th Annual Scientific Sessions of the Society for Cardiovascular Magnetic Resonance (SCMR) took place from January 29 to February 1, 2025, in Washington, D.C. SCMR 2025 brought together a diverse group of 1714 cardiologists, radiologists, scientists, and technologists from more than 80 countries to discuss emerging trends and the latest developments in cardiovascular magnetic resonance (CMR). The conference centered on the theme \"Leading the Way to Accessible, Sustainable, and Efficient CMR,\" highlighting innovations aimed at making CMR more clinically efficient, widely accessible, and environmentally sustainable. The program featured 728 abstracts and case presentations with an acceptance rate of 86% (728/849), including Early Career Award abstracts, oral abstracts, oral cases and rapid-fire sessions, covering a broad range of CMR topics. It also offered engaging invited lectures across eight main parallel tracks and included four plenary sessions, two gold medalists, and one keynote speaker, with a total of 826 faculty participating. Focused sessions on accessibility, efficiency, and sustainability provided a platform for discussing current challenges and exploring future directions, while the newly introduced CMR Innovations Track showcased innovative session formats and fostered greater collaboration between researchers, clinicians, and industry. For the first time, SCMR 2025 also offered the opportunity for attendees to obtain CMR Level 1 Training Verification, integrated into the program. Additionally, expert case reading sessions and hands-on interactive workshops allowed participants to engage with real-world clinical scenarios and deepen their understanding through practical experience. Key highlights included plenary sessions on a variety of important topics, such as expanding boundaries, health equity, women's cardiovascular disease and a patient-clinician testimonial that emphasized the profound value of patient-centered research and collaboration. The scientific sessions covered a wide range of topics, from clinical applications in cardiomyopathies, congenital heart disease, and vascular imaging to women's heart health and environmental sustainability. Technical topics included novel reconstruction, motion correction, quantitative CMR, contrast agents, novel field strengths, and artificial intelligence applications, among many others. This paper summarizes the key themes and discussions from SCMR 2025, highlighting the collaborative efforts that are driving the future of CMR and underscoring the Society's unwavering commitment to research, education, and clinical excellence.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101914"},"PeriodicalIF":4.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142775","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}
Luuk Jacobs, Marco Piccirelli, Valery Vishnevskiy, Sebastian Kozerke
{"title":"FlowMRI-Net: A Generalizable Self-Supervised 4D Flow MRI Reconstruction Network.","authors":"Luuk Jacobs, Marco Piccirelli, Valery Vishnevskiy, Sebastian Kozerke","doi":"10.1016/j.jocmr.2025.101913","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101913","url":null,"abstract":"<p><strong>Background: </strong>Image reconstruction from highly undersampled 4D flow MRI data can be very time consuming and may result in significant underestimation of velocities depending on regularization, thereby limiting the applicability of the method. The objective of the present work was to develop a generalizable self-supervised deep learning-based framework for fast and accurate reconstruction of highly undersampled 4D flow MRI and to demonstrate the utility of the framework for aortic and cerebrovascular applications.</p><p><strong>Methods: </strong>The proposed deep-learning-based framework, called FlowMRI-Net, employs physics-driven unrolled optimization using a complex-valued convolutional recurrent neural network and is trained in a self-supervised manner. The generalizability of the framework is evaluated using aortic and cerebrovascular 4D flow MRI acquisitions acquired on systems from two different vendors for various undersampling factors (R=8,16,24) and compared to compressed sensing (CS-LLR) reconstructions. Evaluation includes an ablation study and a qualitative and quantitative analysis of image and velocity magnitudes.</p><p><strong>Results: </strong>FlowMRI-Net outperforms CS-LLR for aortic 4D flow MRI reconstruction, resulting in significantly lower vectorial normalized root mean square error and mean directional errors for velocities in the thoracic aorta. Furthermore, the feasibility of FlowMRI-Net's generalizability is demonstrated for cerebrovascular 4D flow MRI reconstruction. Reconstruction times ranged from 3 to 7minutes on commodity CPU/GPU hardware.</p><p><strong>Conclusion: </strong>FlowMRI-Net enables fast and accurate reconstruction of highly undersampled aortic and cerebrovascular 4D flow MRI, with possible applications to other vascular territories.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101913"},"PeriodicalIF":4.2,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093727","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}
Tom Dresselaers, Frederik De Keyzer, Alexandru Cernicanu, Jan Bogaert, Peter Gatehouse
{"title":"Toward understanding the balanced steady-state free precession signal intensity changes in cine cardiac magnetic resonance imaging: A preliminary evaluation in healthy subjects pre- and postcontrast.","authors":"Tom Dresselaers, Frederik De Keyzer, Alexandru Cernicanu, Jan Bogaert, Peter Gatehouse","doi":"10.1016/j.jocmr.2025.101908","DOIUrl":"10.1016/j.jocmr.2025.101908","url":null,"abstract":"<p><strong>Background: </strong>Although balanced steady-state free-precession (bSSFP) cines provide excellent contrast for morpho-functional cardiac evaluation, the fluctuating myocardial cine signal intensity (mcSI) is rarely used diagnostically. These mcSI fluctuations were related to through-plane motion but the impact of this motion remains unclear. We aim to characterize the mid-ventricular pre- and postcontrast bSSFP cyclic mcSI fluctuations in healthy subjects and compare these to Bloch simulations incorporating through-plane motion.</p><p><strong>Methods: </strong>Retrospectively-gated mid-ventricular short-axis cine bSSFP images from healthy subjects (n = 49) acquired at 1.5T pre- and early postcontrast were analyzed. First, the mcSI fluctuations during the heart cycle were determined and their timing compared to the radial myocardial motion. Next, pre- vs postcontrast differences were determined during systole, early-diastole, and late-diastole. Finally, Bloch simulations and acquisitions in a moving T1 phantom were performed to analyze the through-plane motion effect on the bSSFP and spoiled gradient echo (SGRE) mcSI.</p><p><strong>Results: </strong>The bSSFP mcSI showed a three-peak pattern both pre- and postcontrast, corresponding to the contraction and relaxation phases. However, the mcSI peaks showed a time lag vs the times of maximum radial velocity that was larger for the systolic contraction than for the early or late-diastolic relaxation phases. In addition, the shape and amplitude of the systolic and early diastolic mcSI peaks changed significantly post- vs precontrast. Bloch simulations showed an in-vivo-like (regional) three-peak signal profile and similar changes for post- vs precontrast T1 levels. Finally, results in the moving phantom and accompanying simulations confirmed a slice-thickness-dependent time lag between the motion and mcSI profile in both bSSFP and SGRE.</p><p><strong>Conclusion: </strong>In healthy subjects before and after contrast, the bSSFP mcSI variation during the heart cycle is characterized by a three-peak pattern associated with the contraction and relaxation phases. However, the delays in timing of these peaks vs the myocardial motion, as well as the differences between pre- and postcontrast, vary with the stage of the heart cycle. Bloch simulations suggest that these mcSI fluctuations are largely determined by the regional through-slice motion. A better understanding of these motion-induced contrast mechanisms may be beneficial to methods exploiting bSSFP mcSI.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101908"},"PeriodicalIF":4.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christel H Kamani, May Lwin, Ioannis Botis, Mehak Asad, Noor Sharrack, Hadar Schapira, Arka Das, Peter P Swoboda, Sven Plein, Rob J Van der Geest, Erica Dall'Armellina
{"title":"Left ventricular flow kinetics and myocardial deformation following acute infarction: Additional predictive value of cardiac magnetic resonance four-dimensional flow for left ventricular remodeling post-ST-elevation myocardial infarction.","authors":"Christel H Kamani, May Lwin, Ioannis Botis, Mehak Asad, Noor Sharrack, Hadar Schapira, Arka Das, Peter P Swoboda, Sven Plein, Rob J Van der Geest, Erica Dall'Armellina","doi":"10.1016/j.jocmr.2025.101905","DOIUrl":"10.1016/j.jocmr.2025.101905","url":null,"abstract":"<p><strong>Background: </strong>The exact mechanism underlying myocardial maladaptive changes post ST-elevation myocardial infarction (STEMI) remains unclear. We sought to assess the impact of the tissue=flow interaction on the development of adverse cardiac remodeling 12 months(M) after acute STEMI.</p><p><strong>Materials and methods: </strong>Forty-nine first-STEMI patients (M:F = 26:13; mean age = 58 ± 10) prospectively underwent 3T cardiovascular magnetic resonance (CMR) acutely, at 3 months (3M) and 12M post-STEMI. The CMR protocol included left ventricular (LV) cine-images for LV end-diastolic (LVEDV) and end-systolic volumes, stroke volume (SV), and ejection fraction (LVEF); four-dimensional (4D)-flow and late gadolinium enhancement imaging. The 3M outcome measures included 4D-flow derived LV flow kinetic energy indexed to EDV (KE<sub>iEDV</sub>) and functional flow components [LV-KE<sub>iEDV</sub>, minimal- KE<sub>iEDV</sub>, diastolic- KE<sub>iEDV</sub>, and residual volume (RV), retained inflow, delayed ejection, direct flow (DF)]; global radial, circumferential, and longitudinal strain (GRS, GCS, GLS) by feature tracking (FT); infarct size (IS). Adverse LV remodeling (LV<sub>remod</sub>) was defined by a ≥20% increase in LVEDVi at 12M from baseline, in opposition to the non-remodeling group (LV<sub>non-remod</sub>). Association between SV, FT-strain, KE, and 4D flow parameters was assessed, as well as predictors of adverse remodeling at 12M post-STEMI.</p><p><strong>Results: </strong>There were 23 LV<sub>remod</sub> patients. At 3M post-STEMI, LV<sub>remod</sub> patients had significantly reduced LVEF, increased IS, abnormal FT-strain, systolic KE<sub>iEDV</sub>, DF, and RV compared to LV<sub>non-remod</sub> patients. There was no significant difference in SV between the two groups. FT-strain parameters significantly correlated with DF (GRS: r = 0.62; GCS: r = -0.67; GLS: r = -0.58, all p < 0.001); RV (GRS: r = -0.56; GCS: r = 0.51; GLS: r = 0.53, all p < 0.001); peak-A-wave KE<sub>iEDV</sub> (GRS: r = 0.38, p = 0.008; GCS: r = -0.30, p = 0.038; GLS: r = -0.29, p = 0.04); systolic KE<sub>iEDV</sub> (GRS: r = 0.31, p = 0.033, GLS: r = -0.35, p = 0.012). DF outperformed conventional LV function parameters (SV and LVEF) in the LV<sub>remod</sub> prediction. DF and IS were the only independent predictors of 12M adverse remodeling after adjustment for LVEF, SV, FT-strain, and KE<sub>iEDV</sub> parameters.</p><p><strong>Conclusions: </strong>Our study suggests a potential early interaction between FT-strain and 4D-flow parameters post-STEMI leading to the development of adverse remodeling. Within the limitations of our sample size, DF and IS were independent predictors of LV remodeling after adjustment for LVEF, SV, FT-strain, and KE parameters. These findings suggest that these parameters may contribute to further risk stratification at 3M for the development of adverse remodeling at 12M post-STEMI, above conventional LV function parameter","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101905"},"PeriodicalIF":4.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennifer Romanowicz, Sungho Park, Jenifer Bunn, Roni M Jacobsen, Brian Fonseca, Jenny E Zablah, Erin K Englund, Alex J Barker, Jesse A Davidson
{"title":"Magnetic Resonance Quantification of Regional Blood Flow and Oxygen Delivery to the Brain, Gut, Kidneys, and Lower Extremities in Adolescents with a Fontan Circulation Compared to Biventricular Controls.","authors":"Jennifer Romanowicz, Sungho Park, Jenifer Bunn, Roni M Jacobsen, Brian Fonseca, Jenny E Zablah, Erin K Englund, Alex J Barker, Jesse A Davidson","doi":"10.1016/j.jocmr.2025.101907","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101907","url":null,"abstract":"<p><strong>Background: </strong>Accumulation of progressive extracardiac disease is nearly universal for patients with single ventricle heart disease palliated to a Fontan circulation; however, etiologies are poorly understood. Limited flow reserve in the Fontan circulation may underlie extracardiac disease found in Fontan physiology through reduced oxygen and nutrient delivery to the tissues. This study aimed to determine regional flow volumes and oxygen delivery to key organ systems in children and adolescents with a Fontan circulation.</p><p><strong>Methods: </strong>In 17 Fontan subjects and 14 biventricular controls, regional arterial flow volumes to the carotid, celiac, superior mesenteric, renal, and iliac arteries were quantified with MRI. Arterial oxygen content was calculated using subject hemoglobin level and pulse oximetry, and regional oxygen delivery was calculated using regional flow volume and oxygen content for the above listed arteries. Cardiac output was measured from ascending aorta flow, systemic blood flow from the caval veins, and aorto-pulmonary collateral flow was calculated as the difference between the two. Flows were compared between groups (t-test) and associations were analyzed between flows and with maximal exercise performance on clinical cardiopulmonary exercise testing (Pearson correlation).</p><p><strong>Results: </strong>On average, renal and iliac arterial flows were lower in the Fontan group, compared to controls. Carotid, celiac, and superior mesenteric arterial flows were preserved in the Fontan group. Arterial oxygen content was equivalent between groups, and thus, regional oxygen delivery followed the same pattern as regional flows. Cardiac output was no different between groups, but systemic blood flow was lower in Fontans due to loss of flow to aorto-pulmonary collaterals. Systemic blood flow correlated with iliac flow such that those with the lowest systemic flow had the least amount of iliac flow. Celiac arterial flow correlated with percent-predicted peak oxygen consumption (VO2) on exercise testing.</p><p><strong>Conclusions: </strong>Our results are consistent with a limited flow reserve in the Fontan circulation with sacrifice of iliac arterial flow as global systemic blood flow decreases. Importantly, these data were measured with subjects supine and at rest. Future work requires the addition of exercise to determine how flow to specific organs is affected by increasing metabolic demand from the extremities.</p><p><strong>Data availability: </strong>The data that support the findings of this study are available from the corresponding author, JR, upon reasonable request.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101907"},"PeriodicalIF":4.2,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012734","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}