Journal of Cardiovascular Magnetic Resonance最新文献

{"title":"A Visual LGE Extent Cutoff for Mortality Risk Stratification in Ischemic Cardiomyopathy.","authors":"Alexandre Unger, Jérôme Garot, Suzanne Duhamel, Philippe Garot, Francesca Sanguineti, Myriam Akodad, Antoinette Neylon, Thomas Hovasse, Trecy Gonçalves, Louis Perrard, Jeremy Florence, Aïcha Kante, Julien Hudelo, Jean Guillaume Dillinger, Antoine Bondue, Patrick Henry, Valérie Bousson, Solenn Toupin, Théo Pezel","doi":"10.1016/j.jocmr.2026.102808","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102808","url":null,"abstract":"<p><strong>Background: </strong>Late gadolinium enhancement (LGE) extent has been linked to adverse outcomes in ischemic cardiomyopathy (ICM). While quantitative methods of LGE assessment are widely accepted, semi-quantitative methods remain debated but still hold value. This study aimed to determine an optimal LGE segments cutoff for ICM patients with left ventricular ejection fraction (LVEF) <50% in a large bicentric cohort.</p><p><strong>Methods: </strong>This bicentric retrospective French study included 3,591 patients with ICM (defined by prior myocardial infarction and/or coronary revascularization), LVEF <50%, and ischemic-LGE on cardiovascular magnetic resonance performed between 2008 and 2022. Ischemic LGE extent was assessed semi-quantitatively using the 17-segment model. An optimal cutoff for LGE extent was derived in the derivation cohort (Center 1, N=2,900) using a conditional inference tree and externally validated in an independent cohort (Center 2, N=691). The primary outcome was all-cause mortality. Prognostic performance was compared between a conventional model based on LVEF ≤35% alone and a combined model integrating LVEF ≤35% with the newly identified ischemic-LGE cutoff. Model discrimination and reclassification were assessed using Harrell's C-index, continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI).</p><p><strong>Results: </strong>During a median follow-up of 9 years, 549 patients (15.3%) died. The optimal cutoff of visual LGE extent to predict mortality was 5 segments. Patients with high ischemic LGE extent (>5 segments) had a markedly increased risk of all-cause mortality compared with those with ≤5 segments (adjusted hazard ratio, 3.8; 95% CI: 3.0-4.8; p<0.001). Survival discrimination according to this cutoff was consistent across derivation and validation cohorts. Compared with the conventional LVEF ≤35% model alone, the combined model integrating the >5 ischemic-LGE segment cutoff significantly improved risk discrimination and patient reclassification (ΔC-index: +16%; continuous NRI: +36%; IDI: +4%; all p<0.001).</p><p><strong>Conclusion: </strong>In patients with ICM, reduced LVEF (<50%), and detectable ischemic LGE, a visually assessed segment-based cutoff of >5 ischemic-LGE segments was independently associated with all-cause mortality and validated in an independent second-center cohort. This pragmatic, software-independent assessment may complement conventional risk stratification, although prospective studies are required before integration into clinical decision-making.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102808"},"PeriodicalIF":5.0,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166364","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":"Cardiovascular magnetic resonance derived myocardial strain: applications, acquisition techniques, analysis, and reporting. A Scientific Statement of the Society for Cardiovascular Magnetic Resonance, Radiological Society of North America, and the European Association of Cardiovascular Imaging of the ESC.","authors":"Gaurav S Gulsin, Bharath Ambale-Venkatesh, Leon Axel, David A Bluemke, Gabriella Captur, João L Cavalcante, Daniel B Ennis, Frederick H Epstein, Bernhard Gerber, Kate Hanneman, Nadine Kawel-Boehm, Sebastian Kelle, Christopher M Kramer, Joao A C Lima, Hildo J Lamb, Minjie Lu, Thomas H Marwick, Simone Romano, Alistair A Young, Gerry P McCann","doi":"10.1016/j.jocmr.2026.102758","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102758","url":null,"abstract":"<p><p>Myocardial strain imaging enables quantification of cardiac deformation. Cardiovascular magnetic resonance imaging (CMR) is well suited for strain assessment due to the ability to image in any given plane with high spatial and contrast resolution. CMR strain measures have incremental diagnostic and prognostic utility over conventional clinical imaging parameters across disease states. Routine integration of CMR strain assessment in clinical practice has been hindered by the lack of agreement on imaging protocols and analysis methods, variability due to noise sensitivity, and a paucity of robust normative age-, sex- and ethnicity-specific reference ranges. In recognition of the expanding applications of strain techniques in clinical and research CMR, this joint SCMR/RSNA/EACVI scientific statement integrates data from original research studies, guidelines, and opinions from experts across the field to guide responsible and evidence-based utilization of CMR strain.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102758"},"PeriodicalIF":5.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148274","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":"Robust Approach to Measure Time-Resolved Septal Curvature in Pediatric Pulmonary Hypertension Patients Using Standard Short-Axis Ventricular Volume Contours: A Retrospective, Cross-Sectional Study.","authors":"Takashi Fujiwara, Vivian I Lu, Benjamin S Frank, Charles Simpkin, Dunbar Ivy, Brian Fonseca, Helio V Neves da Silva, Daniel Sassoon, Jochen Gerstner Saucedo, Dale A Burkett, Lorna P Browne, Alex J Barker","doi":"10.1016/j.jocmr.2026.102807","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102807","url":null,"abstract":"<p><strong>Background: </strong>Right heart catheterization is the gold standard for diagnosis and monitoring of pediatric pulmonary hypertension (PH). Noninvasive cardiovascular magnetic resonance (CMR) and echocardiography can additionally provide volumetric and functional assessment of the right ventricle and possibly serve as a non-invasive method for surveillance of PH severity using ventricular septal curvature (SC), interventricular septal (IVS) angle, or eccentricity index (EI). However, these septal wall measurements require manual interaction and can be observer dependent. This study presents the results of a robust, contour-based SC computation and assesses interobserver variability and performance as a candidate marker of RV afterload as compared to manually measured SC, IVS angle and EI.</p><p><strong>Methods: </strong>This cross-sectional, retrospective study enrolled PH patients with mixed etiology (idiopathic/heritable and congenital heart/connective tissue disease-associated PH) and similar-age controls who underwent clinical CMR and catheterization (catheterization only for patients). A standard short-axis CMR stack was processed on commercial image-processing software to semi-automatically extract the relevant contours for the endo- and epicardial ventricular walls. SC was computed based on the contours and the minimum value in the cardiac cycle was obtained (SC_contour). For comparison, SC (SC_manu), IVS angle and EI were manually obtained from the CMR images. The relationship between septal wall measurements and invasive pressure measurements by catheterization was evaluated via Spearman correlation. Association with adverse events (death, lung or heart and lung transplant, and Potts surgery) was evaluated via univariate Cox proportional hazard model. Interobserver agreement was analyzed using intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>Analysis was performed on 24 patients and 14 controls (median age 16.4 [12.3 - 18.9] and 15.9 [14.7 - 17.4] years respectively). SC_contour demonstrated moderate-strong correlations with RVSP (ρ=-0.79), RVSP/SBP (ρ =-0.65), and mPAP (ρ=-0.80) and had the strongest correlation in idiopathic/heritable PH patients (ρ = -0.74 - -0.83). SC_contour demonstrated a higher ICC (0.96 (95% CI 0.93 - 0.98; p<0.001) versus SC_manu (0.89 (95% CI 0.80 - 0.94; p<0.001)). In the exploratory prognostic analysis, significant associations with adverse events were not observed for any septal wall measurements.</p><p><strong>Conclusions: </strong>The contour-based SC approach demonstrated strong correlation with invasive pressure measurements, with less manual interaction and observer dependency than manual measurements.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102807"},"PeriodicalIF":5.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136755","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":"Comparison of Deep Learning-Based Free Breathing with Conventional Breath Holding CMR for Quantifying Degenerative Mitral Regurgitation.","authors":"Salomon Chamay, Stephen J Horgan, Islamiyat Babs Animashaun, Hai Yang Jiang, Seth Uretsky","doi":"10.1016/j.jocmr.2026.102806","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102806","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular magnetic resonance (CMR) imaging acquisition frequently relies on breath-holding, which poses challenges in patients with certain underlying comorbidities. A new technique consisting of deep learning-based accelerated 2D steady-state free precession (SSFP) cine imaging (Sonic DL Cine, GE HealthCare) allows for 1 heart beat free-breathing SSFP acquisition. This study aimed to demonstrate the accuracy of free-breathing acquisition SSFP using Sonic DL Cine and free-breathing phase contrast imaging versus standard breath holding for mitral regurgitation (MR) quantification in patients with degenerative MR.</p><p><strong>Methods: </strong>Patients with degenerative MR were prospectively enrolled and underwent both breath-holding and free-breathing CMR. Short axis SSFP images and phase contrast images in the ascending aorta and proximal pulmonary artery were acquired using breath hold and free-breathing techniques to quantify ventricular volumes and blood flow in the ascending aorta and proximal pulmonary artery. MR volume and fraction were calculated for each patient using both techniques. Pearson's correlation and Bland-Altman plots were utilized to compare the two groups.</p><p><strong>Results: </strong>A total of 27 patients (64 ± 9 years; 67% male) underwent 33 CMR studies. There was no statistically significant difference in left ventricular end-diastolic volume (LVEDV), LV stroke volume (SV), aortic phase contrast, pulmonary artery phase contrast, MR volume or MR fraction between breath-holding and free-breathing CMR. Pearson's correlation and Bland-Altman plots demonstrated excellent correlation and good agreement for LVEDV (r² = 0.96; mean difference 0.7mL; p<0.001), LVESV (r² = 0.93; mean difference 2mL; p<0.001), LVSV (r² = 0.96; mean difference -1 mL; p<0.001), MR volume (r² = 0.96; mean difference -1mL; p<0.001), and MR fraction (r² = 0.93; mean difference -0.4mL; p<0.001).</p><p><strong>Conclusion: </strong>Compared to conventional breath-holding, free-breathing CMR is feasible and comparable in the evaluation of ventricular parameters and MR quantification in patients with degenerative MR. This CMR technique would allow clinicians to accurately quantify MR in patients who are unable to perform conventional breath hold CMR.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102806"},"PeriodicalIF":5.0,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110296","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":"Cardiovascular Magnetic Resonance Reference Values for Left Ventricular Diastolic Function and Left Atrial Sphericity Index in Healthy Adults.","authors":"Yiyuan Gao, Wanzhen Li, Wenqi Liu, Shanshan Zhou, Jingjing Shi, Gengxiao Li, Zhiwei Zhao, Zhenchang Wang, Zhen Zhang, Kuncheng Li, Gerald M Pohost","doi":"10.1016/j.jocmr.2026.102802","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102802","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular magnetic resonance (CMR) is increasingly used to quantify volumetric indices reflecting left ventricular (LV) diastolic function. However, normal reference values for CMR-derived volumetric parameters of LV diastolic function and the left atrial sphericity index (LASI) remain limited. This study aimed to establish age- and sex-specific reference values for CMR-derived LV diastolic volumetric parameters and LASI in a large cohort of healthy Chinese adults.</p><p><strong>Methods: </strong>A total of 503 healthy Chinese adults, rigorously validated by comprehensive health screening, were retrospectively included. A structured literature review was performed to identify candidate CMR-derived volumetric parameters of LV diastolic function, as well as LASI. Based on this review, left atrioventricular coupling index (LACI), left atrial expansion index (LAEI), peak filling rate (PFR), PFR normalized to end-diastolic volume (PFR/EDV), CMR-derived left ventricular filling pressure (LVFP), and LASI were selected and measured from cine CMR images. Reference values were calculated and stratified by sex and age decades. Associations of these CMR-derived parameters with sex and age were evaluated.</p><p><strong>Results: </strong>Men exhibited significantly lower LACI [0.19 (0.15-0.24) vs. 0.20 (0.17-0.25)], LAEI [146.9 (122.5-181.2) % vs. 161.4 (139.6-202.4) %], PFR/EDV [2.61 (2.25-3.09) s^-1 vs. 2.97 (2.51-3.32) s^-1], and LASI [0.52 (0.46-0.62) vs. 0.59 (0.50-0.68)], but higher absolute PFR [385.4 (325.4-442.6) mL/s vs. 341.2 (290.9-394.9) mL/s] and CMR-derived LVFP [13.2 (12.4-14.4) mmHg vs. 12.3 (11.4-13.1) mmHg] than women (all p < 0.05). With advancing age, LACI increased progressively in both sexes (men: r = 0.20; women: r = 0.24; both p < 0.001), whereas LAEI, PFR, PFR/EDV, and LASI exhibited significant declines (men: r = -0.25, -0.33, -0.21, and -0.22; women: r = -0.22, -0.36, -0.26, and -0.32; all p < 0.001).</p><p><strong>Conclusions: </strong>This study provides age- and sex-specific reference values for CMR-derived LV diastolic volumetric parameters and LASI in a large cohort of validated healthy Chinese adults. Both age and sex significantly influence these parameters. These normative data support standardized interpretation of CMR-derived diastolic parameters in clinical and research settings, particularly for the Chinese population.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102802"},"PeriodicalIF":5.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074670","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":"From Guidelines to Ground Reality: The Underutilization of Stress Cardiac MRI in Ischemic Heart Disease - A Narrative State-of-the-Art Review.","authors":"Omar Sami Abdelhai, Wael AlJaroudi, Musa A Sharkawi, Christopher M Kramer, Deya A Alkhatib","doi":"10.1016/j.jocmr.2026.102801","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102801","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Stress cardiovascular magnetic resonance (CMR) imaging offers a radiation-free, high-resolution modality for assessing myocardial perfusion, function, and viability. It is supported by robust evidence and holds a Class I recommendation in the 2021 American College of Cardiology /American Heart Association (ACC/AHA) Chest Pain Guidelines for evaluating both stable chest pain and acute chest pain in patients at intermediate risk, with or without known coronary artery disease (CAD). However, despite its proven diagnostic and prognostic value, stress CMR remains substantially underutilized in clinical practice, accounting for less than 1% of ischemia testing in many healthcare settings. This disconnect between evidence and practice underscores a critical implementation gap in the noninvasive assessment of CAD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This narrative state of the art review synthesizes data from 48 peer-reviewed studies to evaluate the diagnostic performance, real-world utilization patterns, and multifactorial barriers limiting broader adoption of stress CMR. A standardized 18-variable data abstraction framework was developed to support the review, and studies were analyzed using Microsoft Excel and Stata. Thematic and descriptive analyses were performed to identify common challenges and successful implementation strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Common challenges identified included restricted scanner access, reimbursement limitations, workflow inefficiencies, clinician unfamiliarity, and patient-related factors. The review also highlighted successful institutional strategies, such as streamlined protocols and specialized CMR teams, that have enabled more effective implementation in select centers. Thematic and descriptive analyses revealed that even after guideline endorsement, uptake of stress CMR remains stagnant. Several limitations of this review must be acknowledged. First, the search was restricted to English-language studies indexed in PubMed, which may have introduced a language or geographic bias. Second, the included studies exhibit significant heterogeneity in design, ranging from small prospective cohorts to large retrospective registries, which precluded a formal meta-analysis of diagnostic performance or cost-effectiveness. Finally, as a 'State-of-the-Art Review,' this work synthesized existing literature to provide a narrative overview of current barriers; however, regional differences in healthcare infrastructure and reimbursement models, particularly between the United States and Europe, may limit the global generalizability of the identified economic and structural findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Bridging the implementation gap for stress CMR will require coordinated efforts in education, infrastructure investment, policy reform, and targeted dissemination to ensure broader, equitable integration of this clinically valuable tool. Our observations emphasize the need for ","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102801"},"PeriodicalIF":5.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074682","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":"Dual-phase systolic and diastolic cardiac diffusion tensor imaging using higher order motion compensation spin echo sequences at 300 mT/m gradient strength.","authors":"Maryam Afzali, Irvin Teh, Sam Coveney, Lars Mueller, Isaac Watson, May Lwin, Sarah Jones, Fabrizio Fasano, C John Evans, Filip Szczepankiewicz, Derek K Jones, Erica Dall'Armellina, Jürgen E Schneider","doi":"10.1016/j.jocmr.2026.102805","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102805","url":null,"abstract":"<p><strong>Background: </strong>Cardiac diffusion tensor imaging (cDTI) provides unique insights into myocardial microstructure and its dynamic changes during the cardiac cycle. However, motion sensitivity remains a major obstacle for spin echo (SE)-based approaches, restricting most implementations to a relatively narrow low-motion window near peak systole.</p><p><strong>Purpose: </strong>To establish whether higher-order motion-compensated (up to 6th order) diffusion gradients beyond standard second order motion compensation (M₂) on a magnetic resonance imaging (MRI) system with a maximum gradient strength of 300 mT/m improve SE-based cDTI techniques for both systolic and diastolic acquisitions.</p><p><strong>Methods: </strong>Ten healthy volunteers underwent free-breathing, cardiac-gated SE-cDTI acquisitions in systole and in diastole using diffusion gradients with up to second- (M₂), fourth- (M₄), and sixth-order (M₆) motion compensation. Success rate (percentage of left ventricular voxels with (1.1 < MD < 1.9)  × 10^-3mm²∕s) and diffusion measures including mean diffusivity, fractional anisotropy, helix angle, and secondary eigenvector angle were quantified and compared between both cardiac phases.</p><p><strong>Results: </strong>Second-order motion compensation was sufficient for systolic cDTI, whereas fourth-order motion compensation was required for successful diastolic acquisitions in all participants. Mean diffusivity values in systole were (1.53 ± 0.06), (1.60 ± 0.07),   and   (1.62 ± 0.06)  × 10^-3mm²∕s for M₂, M₄,   and   M₆ respectively, and in diastole were (2.26 ± 0.67), (1.73 ± 0.19),   and   (1.71 ± 0.12) × 10^-3mm²∕s. No significant differences in cDTI-derived parameters were observed between M₄ and M₆ for systolic and diastolic acquisitions.</p><p><strong>Conclusion: </strong>This study demonstrates the feasibility of dual-phase SE-based cDTI techniques enabled by 300 mT/m gradients. This method will allow reliable quantification of myocardial microstructural changes between systole and diastole and represents a step towards clinical translation of dynamic cDTI.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102805"},"PeriodicalIF":5.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074743","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":"Current Role and Future Utility of Cardiovascular Magnetic Resonance in the Assessment of Patients prior to and following Cardiac Transplantation - A narrative review.","authors":"Cassandra Li, Eylem Levelt, Jim Pouliopoulos, James Hare, Andrew Jabbour, Andrew Taylor, John P Greenwood, Chris Anthony, Sarah Gutman","doi":"10.1016/j.jocmr.2026.102804","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102804","url":null,"abstract":"","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102804"},"PeriodicalIF":5.0,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061307","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 of Continuous Ventricular Volumetric Quantification in Arrhythmias using Real-Time 3D CMR-MOTUS.","authors":"Thomas Edi Olausson, Maarten Lennart Terpstra, Rizwan Ahmad, Edwin Versteeg, Casper Beijst, Yuchi Han, Marco Guglielmo, Birgitta Katinka Velthuis, Cornelis van den Berg, Alessandro Sbrizzi","doi":"10.1016/j.jocmr.2026.102803","DOIUrl":"10.1016/j.jocmr.2026.102803","url":null,"abstract":"<p><strong>Background: </strong>Conventional cardiovascular magnetic resonance (CMR) cine sequences rely on binning reconstructions that average multiple heartbeats, an assumption that breaks down in arrhythmic patients where beat-to-beat variations lead to motion artifacts and loss of clinically relevant functional information. While two-dimensional (2D) real-time imaging can capture individual heartbeats, a stack of 2D slices is sub-optimal to map the full complexity of incoherent cardiac dynamics during arrhythmia. We investigated the feasibility of three-dimensional (3D) real-time motion field reconstruction for continuous beat-to-beat volumetric quantification in patients with premature ventricular contractions (PVC) using a free-running CMR protocol.</p><p><strong>Methods: </strong>We extended CMR-MOTUS to jointly reconstruct real-time 3D motion fields and a motion-corrected reference image from continuously acquired data without breath-holds or electrocardiogram (ECG) gating. A variable-density Cartesian sampling trajectory (OPRA) was used with a 3D spoiled gradient echo or balanced steady-state free precession sequence. The real-time volumetric beat-to-beat changes were quantified by propagating a single manual segmentation on the reference image, through all time frames using the reconstructed motion fields. The method was evaluated on a cardiac motion phantom with ground-truth static acquisitions and in 10 healthy volunteers and 10 patients with PVC. All in vivo datasets were acquired post contrast enhancement. The ejection fraction (EF) was compared to ground-truth values for the phantom and to standard 2D real-time cine EF measurement techniques for the in vivo subjects.</p><p><strong>Results: </strong>Reconstructed mean EF values of the phantom experiment were close to the ground-truth (Mean EF = 17.86 ± 0.33% versus 17.27%). In healthy volunteers, narrow beat-to-beat EF distributions reflected normal physiological consistency. In PVC patients, the method revealed broader, sometimes bimodal EF distributions. Simultaneously acquired ECG signals supported the temporal correspondence between volume irregularities and PVC episodes.</p><p><strong>Conclusions: </strong>3D real-time joint motion field and image reconstruction from a free-running CMR protocol enables continuous beat-to-beat volumetric quantification in arrhythmic patients, revealing functional heterogeneity that conventional single-beat and averaging measurements (binning and gating) can obscure. Larger studies are needed before claims of clinical validation or replacement of standard 2D cine analysis.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102803"},"PeriodicalIF":5.0,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061344","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":"Impaired myocardial oxygen metabolism and energy efficiency in patients with dilated cardiomyopathy.","authors":"Liya Dai, Jinhan Qiao, Keyan Wang, Ran Li, Yang Yang, Caleb Berberet, Qi Huang, Chenying Lu, Jiansong Ji, Scott M Bugenhagen, Thomas H Schindler, Linda R Peterson, Pamela K Woodard, Yong Zhang, Jie Zheng","doi":"10.1016/j.jocmr.2026.102800","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102800","url":null,"abstract":"<p><strong>Background: </strong>Myocardial oxygen metabolism and mechano-energetic efficiency are key determinants of cardiac function and clinical outcomes, but their status in dilated cardiomyopathy (DCM) remains incompletely understood. This study applied a non-contrast cardiovascular magnetic resonance (CMR) technique to assess myocardial oxygenation, cardiac work, and energy efficiency in DCM.</p><p><strong>Methods: </strong>We enrolled 49 DCM patients and 23 age- and sex- matched controls. All subjects underwent cine CMR imaging for left ventricular ejection fraction (LVEF) and global longitudinal strain (LVGLS), pre- and post-contrast T1 mapping for extracellular volume (ECV), and first-pass perfusion imaging for semi-quantification of myocardial blood flow (MBF). A non-contrast CMR technique was applied to quantify myocardial oxygen extraction fraction (mOEF). Semi-quantitative myocardial oxygen consumption (MVO₂), external work (EW), and myocardial external efficiency (MEE) were derived for analysis.</p><p><strong>Results: </strong>Compared with controls, DCM patients exhibited significantly lower mOEF (50.3 [47.9, 53.9] % vs. 57.6 [56.2, 60.4] %, p < 0.001), MVO₂ per gram tissue (0.07 ± 0.01 vs. 0.08 ± 0.01, p = 0.027), EW (248.38 ± 97.87 vs. 341.88 ± 86.98mmHg×mL/min×10³, p < 0.001), and MEE (22.88 ± 10.62% vs. 45.95 ± 10.53%, p < 0.001), but higher total MVO₂ (7.99 ± 2.58 vs. 5.30 ± 1.48, p < 0.001). Resting mOEF showed no significant association with LVEF and LVGLS, whereas total MVO₂ and MEE correlated significantly with both LVEF and LVGLS. Female DCM patients exhibited higher LVEF (31.30 ± 10.18% vs. 22.47 ± 9.74%, p = 0.006), absolute LVGLS (9.81 ± 3.55% vs. 7.24 ± 2.86%, p = 0.011) and MEE (27.29 ± 11.87% vs. 20.74 ± 9.43%, p = 0.049) compared with males.</p><p><strong>Conclusion: </strong>This feasibility study demonstrates the potential of this non-contrast CMR technique for noninvasive assessment of myocardial oxygen metabolism and mechano-energetic coupling in DCM. Patients with DCM showed impaired resting myocardial oxygen metabolism and reduced energy efficiency.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102800"},"PeriodicalIF":5.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061267","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}