Katerina Eyre, Kenan Kaya, Thomas Coudert, Christopher W Roy, Jérôme Yerly, Dinghui Wang, Isabel Monton Quesada, Augustin C Ogier, Ruud B van Heeswijk, Marco Müller, Jouke Smink, Omer Burak Demirel, Robert J Holtackers, Kim-Lien Nguyen, Tim Leiner, Matthias Stuber
{"title":"Assessment and validation of the established free-running framework for cardiac function by magnetic resonance imaging at 1.5T (FAST-CMR): an international multi-center, multi-vendor study.","authors":"Katerina Eyre, Kenan Kaya, Thomas Coudert, Christopher W Roy, Jérôme Yerly, Dinghui Wang, Isabel Monton Quesada, Augustin C Ogier, Ruud B van Heeswijk, Marco Müller, Jouke Smink, Omer Burak Demirel, Robert J Holtackers, Kim-Lien Nguyen, Tim Leiner, Matthias Stuber","doi":"10.1016/j.jocmr.2026.102784","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102784","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular magnetic resonance (CMR) is the reference standard for assessing cardiac function, yet its widespread clinical use remains challenged by time-intensive workflows requiring ECG gating, repetitive breath-holding, and expert planning. The free-running framework (FRF) addresses these barriers by enabling respiratory and cardiac motion resolved (5D) whole-heart imaging without ECG, breath-holds, or expert scan plane planning. Its fast interrupted steady-state (FISS) variant further enables high quality clinical imaging with gadolinium-based or ferumoxytol contrast agents by providing balanced steady-state free precession (bSSFP)-like contrast with intrinsic fat suppression. The combined 5D FISS-FRF approach, therefore, enables 3D, motion-resolved, free-breathing whole-heart imaging with efficient fat suppression. Early single-center studies have demonstrated feasibility and high concordance with conventional 2D cine imaging, but its generalizability and clinical utility in a multi-center, multi-vendor setting is not yet established.</p><p><strong>Methods/design: </strong>FAST-CMR (Assessment and validation of the established free-running framework for cardiac function by magnetic resonance imaging) is a prospective, observational, intra-individually controlled, pragmatic multi-center study enrolling 300 patients with cardiac disease across 21 international sites from 6 continents using 1.5T MR systems of both Siemens Healthineers and Philips Healthcare. Patients will undergo conventional 2D cine bSSFP CMR in both short-axis and long-axis orientations and a post-contrast 5D FISS-FRF acquisition of six minutes in length. Stratification will include equal representation across three disease cohorts: patients with congenital heart disease (CHD), patients unable to breath-hold, and patients who are able to breath-hold. 5D FISS-FRF raw image acquisition data will undergo centralized reconstruction at the coordinating center (CHUV) before blinded analysis at the core laboratory (Mayo Clinic). The primary endpoint is the precision of the mean paired difference in left ventricular ejection fraction (LVEF) between 5D FISS-FRF and conventional 2D cine CMR, assessed on a within-subject basis. Agreement will be further characterized using confidence intervals for the mean difference and Bland-Altman analysis. Secondary endpoints include detection of regional wall-motion abnormalities, image quality, scan efficiency, patient comfort, LV mass, left and right atrial volumes, and feasibility of automated post-processing and artificial intelligence (AI)-based reconstruction.</p><p><strong>Discussion/conclusion: </strong>FAST-CMR will provide the first prospective international multi-center, multi-vendor evaluation of 5D FISS-FRF. By combining standardized acquisition, centralized reconstruction, and harmonized analysis across 21 international sites and two vendor systems, the study will assess the generalizability and robu","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102784"},"PeriodicalIF":5.0,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684581","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}
Camilla Torlasco, Raffaello Ditaranto, Maria A Schiavo, Irene Ruotolo, Claudio Bergami, Serena Serratore, Luigi P Badano, Giuseppe Limongelli, Luigi Lovato, Elena Biagini
{"title":"Myocardial inflammation and scar expansion in patients with Anderson-Fabry disease.","authors":"Camilla Torlasco, Raffaello Ditaranto, Maria A Schiavo, Irene Ruotolo, Claudio Bergami, Serena Serratore, Luigi P Badano, Giuseppe Limongelli, Luigi Lovato, Elena Biagini","doi":"10.1016/j.jocmr.2026.102782","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102782","url":null,"abstract":"<p><strong>Background: </strong>Anderson-Fabry Disease (AFD) is a lysosomal storage disorder characterized by glycosphingolipid accumulation, leading to multi-organ failure. Cardiac involvement, marked by left ventricular (LV) hypertrophy and fibrosis, is a major cause of mortality. Myocardial inflammation is a frequent finding in these patients, but its role across disease stages remains unclear. This pilot study investigates the association between myocardial inflammation, assessed via cardiac magnetic resonance (CMR) T2 mapping (T2m), and cardiac damage progression, measured by late gadolinium enhancement (LGE) expansion.</p><p><strong>Methods: </strong>This retrospective, single-center study, includes 131 paired CMR scans (1.5T, Philips Ingenia) collected between June 2018 and December 2023 from 41 AFD patients. Cine imaging, T2m, and LGE sequences were acquired in all. Scans were categorised based on quantitative LGE changes into three groups: LGE- (no LGE), LGE= (stable LGE compared to the previous scan), and LGE+ (new/increased LGE compared to the previous scan). T2m was measured globally, in the basal slice (B T2m), infero-lateral basal segment (ILB T2m), and in LGE-matching regions.</p><p><strong>Results: </strong>The sample consisted of 61% women (average of 3±1 scans/patient); at baseline, mean age was 44±18 years, the LV mass was 58±24g/m2. The average time between CMR scans was 14±4 months. In LGE-matching regions, T2m was significantly higher in LGE+ scans compared to LGE= (62ms vs 56ms, p=0.03), and ILB T2m was higher in LGE+ than LGE- (56ms vs 50ms, p=0.007). No other significant differences were observed.</p><p><strong>Conclusion: </strong>In AFD patients, we demonstrated an association between myocardial inflammation and LGE expansion, with T2m potentially serving as an early marker of disease activity. Region-specific T2m measurement is particularly useful in this disease Further research is needed to understand whether T2m changes precedes structural myocardial damage and assess T2m's prognostic value in AFD.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102782"},"PeriodicalIF":5.0,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663984","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":"Integrating Multimodal Data and Genomics for a Comprehensive Assessment of Cardiovascular Aging and Its Impact.","authors":"Adila Abula, Yuxin Yuan, Xiaoyu Li, Yunfeng Zhao, Yushu Huang, Shengkui Zhang, Zilin Li, Jian'an Wang, Xifeng Wu, Wenyuan Li","doi":"10.1016/j.jocmr.2026.102783","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102783","url":null,"abstract":"<p><strong>Background: </strong>Age-related structural and functional remodeling of the heart and vessels increases cardiovascular disease (CVD) risk, yet comprehensive assessments using multimodal imaging and genetic characterization remains limited. We aimed to quantify cardiovascular aging using multimodal biomarkers and evaluate its genetic architecture, lifestyle determinants, and prognostic relevance.</p><p><strong>Methods: </strong>From the UK biobank, cardiovascular magnetic resonance (CMR), electrocardiogram, arterial stiffness, and carotid ultrasound biomarkers were integrated to establish a cardiovascular aging measure using machine learning (ML) models. Seven ML models were evaluated to predict cardiovascular age, and cardiovascular age gap (CardioAG) was calculated using the best-performing model. Associations between CardioAG and incident CVD outcomes were assessed, alongside modality-specific analyses to evaluate the incremental value of multimodal integration. Whole-genome sequencing (WGS) analyses were conducted to identify genetic variants associated with CardioAG, and linear regression models were applied to examine relationships between CardioAG and key lifestyle factors.</p><p><strong>Results: </strong>Among 22,452 participants with complete multimodal data, 13,694 individuals free of baseline CVDs (median age 62.6 years [IQR 56.5-68.3], median follow-up 4.8 years [IQR 3.7-6.3]) were selected for model development. With 57 cardiovascular aging biomarkers, the CatBoost model performed best on the test dataset (Pearson r = 0.75; mean absolute error = 3.88 years). CardioAG was independently associated with hypertension, stroke, atrial fibrillation, coronary artery disease, and composite major adverse cardiovascular event (MACE, hazard ratio = 1.08, 95% CI, 1.06-1.10). Incremental and ablation analyses demonstrated complementary contributions across imaging and functional modalities, with multimodal integration enhancing predictive accuracy and providing independent prognostic value for MACE. WGS analysis identified novel common genetic variants associated with interindividual variability in CardioAG, including RN7SKP155, SVIL, and CBFA2T3, highlighting genetic contributions to vascular remodeling, electrophysiological and hemodynamic regulation, and cardiovascular functional reserve. Dietary factors, sleep duration, physical activity level, smoking, and alcohol intake were found to be significantly associated with CardioAG.</p><p><strong>Conclusions: </strong>This study developed a unified multimodal cardiovascular aging metric that integrates cardiac structure and function, vascular remodeling and stiffness, and electrophysiological features into a single biologically grounded, cumulative aging signal, providing incremental prognostic utility for CVD, and broadening the biological and genetic landscape underlying cardiovascular aging.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102783"},"PeriodicalIF":5.0,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630583","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}
Mark Wrobel, Tina Yao, Ruaraidh Campbell, Rebecca Baker, Elena Milano, Catherine Beattie, Michael Quail, Francesca Raimondi, Yue-Hin Loke, Rajesh Puranik, Mehdi Moghari, Jennifer Steeden, Vivek Muthurangu
{"title":"High Resolution Isotropic 'Pseudo' 3D Cine imaging with Automated Segmentation using Concatenated 2D Real-time Imaging and Deep Learning.","authors":"Mark Wrobel, Tina Yao, Ruaraidh Campbell, Rebecca Baker, Elena Milano, Catherine Beattie, Michael Quail, Francesca Raimondi, Yue-Hin Loke, Rajesh Puranik, Mehdi Moghari, Jennifer Steeden, Vivek Muthurangu","doi":"10.1016/j.jocmr.2026.102780","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102780","url":null,"abstract":"<p><strong>Background: </strong>Conventional cardiovascular magnetic resonance (CMR) in pediatric and congenital heart disease uses 2D, breath-hold (BH), balanced steady state free precession (bSSFP) cine imaging for assessment of function, in addition to cardiac-gated, respiratory-navigated, static 3D bSSFP whole-heart imaging for anatomical assessment. Our aim is to concatenate a stack of 2D free-breathing real-time cines and use Deep Learning (DL) to create an isotropic fully segmented 'pseudo' 3D-cine dataset from these images.</p><p><strong>Methods: </strong>Four DL models were trained on open-source data that performed: a) Interslice signal-correction; b) Interslice respiratory-correction; c) Super-resolution in the slice direction; and d) Segmentation of right and left atria and ventricles (RA, LA, RV, and LV), thoracic aorta (Ao) and pulmonary arteries (PA). Our method was validated in 20 patients undergoing routine cardiovascular examination, by converting prospectively acquired sagittal stacks of real-time cine images to segmented, isotropic pseudo 3D-cine data. Quantitative metrics (ventricular volumes and vessel diameters) and image quality of the DL pseudo-3D-cines were compared to reference-standard breath-hold cine and whole-heart imaging.</p><p><strong>Results: </strong>All real-time data were successfully transformed into pseudo 3D-cines with a total offline reconstruction and post-processing time of <1min in all cases. There were no significant biases in any left ventricular (LV) or right ventricular (RV) metrics (bias ± standard deviation in ml, LV end diastolic volume (EDV): 0.7 ± 8.8, LV end systolic volume (ESV): -1.7 ± 7.1, RV EDV: 1.9 ± 12.4, RV ESV: -1.5 ± 10.7) with reasonable limits of agreement and correlation. There is also reasonable agreement for all vessel diameters, although there was a small but significant overestimation (p<0.05) of right PA (RPA) and main PA (MPA) diameter (RPA: bias = -1.0mm. MPA: bias = -1.1mm). The DL pseudo-3D-cine data were assessed to be of adequate diagnostic quality unlike the unprocessed 2D real-time data.</p><p><strong>Conclusion: </strong>We have demonstrated the potential of creating a pseudo 3D-cine data from concatenated 2D real-time cine images using a series of DL models. Our method has short acquisition and reconstruction times with fully segmented data being available in less than one minute. Our models are trained from fully open-source datasets, allowing our technique to be easily shared with other clinical centers. The agreement with reference-standard imaging suggests that our method could help to significantly speed up CMR in clinical practice.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102780"},"PeriodicalIF":5.0,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148603375","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}
Clemens Ammann, Jan Gröschel, Hadil Saad, Susanne Rospleszcz, Christopher Schuppert, Thomas Hadler, Richard Hickstein, Thoralf Niendorf, Janis M Nolde, Matthias B Schulze, Karin H Greiser, Hermann Brenner, Ute Mons, Josua A Decker, Thomas Kröncke, Thomas Küstner, Konstantin Nikolaou, Stefan N Willich, Thomas Keil, Marcus Dörr, Robin Bülow, Fabian Bamberg, Tobias Pischon, Christopher L Schlett, Jeanette Schulz-Menger
{"title":"Myocardial Native T1 Mapping in the German National Cohort (NAKO): Associations with Age, Sex, and Cardiometabolic Risk Factors.","authors":"Clemens Ammann, Jan Gröschel, Hadil Saad, Susanne Rospleszcz, Christopher Schuppert, Thomas Hadler, Richard Hickstein, Thoralf Niendorf, Janis M Nolde, Matthias B Schulze, Karin H Greiser, Hermann Brenner, Ute Mons, Josua A Decker, Thomas Kröncke, Thomas Küstner, Konstantin Nikolaou, Stefan N Willich, Thomas Keil, Marcus Dörr, Robin Bülow, Fabian Bamberg, Tobias Pischon, Christopher L Schlett, Jeanette Schulz-Menger","doi":"10.1016/j.jocmr.2026.102781","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102781","url":null,"abstract":"<p><strong>Background: </strong>In cardiovascular magnetic resonance (CMR), myocardial native T<sub>1</sub> mapping enables quantitative, non-invasive tissue characterization and is sensitive to subclinical changes in myocardial structure and composition. However, data on the association between cardiometabolic risk and myocardial alterations are still limited. We therefore investigated how age, sex, and cardiometabolic risk factors are associated with myocardial T<sub>1</sub> as a potential imaging marker of myocardial target-organ involvement in a population-based analysis within the German National Cohort (NAKO).</p><p><strong>Methods: </strong>This cross-sectional study included 29,573 prospectively enrolled participants who underwent midventricular T<sub>1</sub> mapping using 3.0T CMR along with deep clinical phenotyping. After artificial intelligence-assisted myocardial segmentation, a subset of 9,162 outlier cases was subjected to manual quality control according to clinical evaluation standards. Cardiometabolic risk factors were identified through self-reported, physician-diagnosed medical history, clinical chemistry, and blood pressure measurements. Associations with myocardial T<sub>1</sub> were evaluated using multiple linear regression models adjusted for age, sex, heart rate, imaging site, and comorbidities.</p><p><strong>Results: </strong>After quality control, 27,794 participants (12,401 [44.6%] women; 20-75 years) were included. Mean T<sub>1</sub> was overall higher in women (1,231 ± 33 ms) than in men (1,209 ± 34 ms), with differences progressively declining with age. The sex difference was confirmed in a healthy subcohort (n = 3,910), whilst age interaction was less pronounced. In adjusted analyses, T<sub>1</sub> was significantly higher in individuals with diabetes, kidney disease, and current smoking. Conversely, hyperlipidaemia was significantly associated with lower T<sub>1</sub>. Associations with hypertension showed strongly sex-specific patterns: women had lower T<sub>1</sub> values, while T<sub>1</sub> increased with hypertension severity in men.</p><p><strong>Conclusions: </strong>Myocardial native T<sub>1</sub> varies by sex and age and shows distinct sex-specific associations with major cardiometabolic risk factors, supporting its role as a sensitive imaging marker of subtle myocardial alterations. Unexpectedly lower T<sub>1</sub> times in participants with hyperlipidaemia suggest a potential direct effect of blood lipids on the heart, which warrants further investigation.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102781"},"PeriodicalIF":5.0,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578728","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}
Sujatha Buddhe, Brian D Soriano, Hunter C Wilson, Adam L Dorfman, Tobias Rutz, Priya Chudgar, Franz Gerald Greil, Carlos-Eduardo Guerrero-Chalela, Nazia Husain, Michael Cheung, Yu-Min Zhong, Andrew J Powell
{"title":"SCMR Survey of Centers Performing CMR in Pediatric/Congenital Heart Disease: 2024 Update.","authors":"Sujatha Buddhe, Brian D Soriano, Hunter C Wilson, Adam L Dorfman, Tobias Rutz, Priya Chudgar, Franz Gerald Greil, Carlos-Eduardo Guerrero-Chalela, Nazia Husain, Michael Cheung, Yu-Min Zhong, Andrew J Powell","doi":"10.1016/j.jocmr.2026.102779","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102779","url":null,"abstract":"<p><strong>Background: </strong>Few data exist on practice trends for cardiovascular magnetic resonance (CMR) in pediatric and congenital heart disease (CHD). The Society for Cardiovascular Magnetic Resonance addressed this gap by conducting an international survey of CMR sites in 2014 and 2018. We now report the most recent survey results from 2024.</p><p><strong>Methods: </strong>Surveys with 31 (2014), 33 (2018), and 41 (2024) items were sent to all SCMR members. One response per center was collected.</p><p><strong>Results: </strong>There were 93 centers that responded in 2014, 83 in 2018, and 124 in 2024. The following results are per center and data from 2014, 2018, and 2024 are separated by dashes. The median annual number of pediatric/CHD CMR cases was 183-209-250. The median number of CMR scanners was 2-2-2 (range, 1-8) with 58-63-53% using only 1.5T scanners and 4-4-3% using only 3T. CMR examinations were performed in infants (<1 year old) in 74%-76%-90% and sedation and/or anesthesia was used in 84%-86%-94% of the centers. The mean number of attendings/staff reading CMRs was 3.7-2.6-2.9. Combining attending/staff physicians from all centers, 52-61-62% were pediatric or adult cardiologists, and 47-38-37% were pediatric or adult radiologists. The median annual case volume per physician per center was 54-86-76. The median number of technologists was 4-5-4. The median scanner time allocated for a non-sedated examination was 75-75-75minutes (range, 30-120minutes). Among the 14 centers responding to all 3 surveys, the mean annual case volume was 380-500-588, with 82% of centers experiencing a sequential increase in volume with each survey. All of these 14 centers were in the United States and for them, the mean time for an attending/staff physician to perform a typical CMR examination, including supervision and reporting, was 150-153-154minutes, and the median scanner time allocated per ex per year was 92 in the amination for non-sedation cases remained unchanged at 90-90-90minutes.</p><p><strong>Conclusion: </strong>These survey data provide a unique and comprehensive view of CMR practice in pediatric and CHD across centers worldwide. This information is useful for internal benchmarking, resource allocation, addressing practice variation, quality improvement initiatives, and identifying unmet needs.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102779"},"PeriodicalIF":5.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562213","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}
Chiara Trenti, Deneb Boito, Filip Hammaréus, Jennifer Suhil Habib, Marcus Lindenberger, Eva Swahn, Lena Jonasson, Bertil Wegmann, Petter Dyverfeldt
{"title":"Identifying abnormal patterns of wall shear stress in mild-to-moderate aortic dilation and tricuspid valves using permutation tests.","authors":"Chiara Trenti, Deneb Boito, Filip Hammaréus, Jennifer Suhil Habib, Marcus Lindenberger, Eva Swahn, Lena Jonasson, Bertil Wegmann, Petter Dyverfeldt","doi":"10.1016/j.jocmr.2026.102778","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102778","url":null,"abstract":"<p><strong>Background: </strong>Aortic wall shear stress (WSS) maps allow three-dimensional visualization and quantification of WSS patterns in the aorta and can be used to identify patch-wise differences between cohorts. However, a method addressing the multiplicity of the testing should be considered when investigating patch-wise differences. In this study, we sought to explore the capability of permutation tests in addressing the regional statistical differences in WSS values between patients with mild-to-moderate aortic dilation with tricuspid valves and age- and sex- matched controls.</p><p><strong>Methods: </strong>4D Flow MRI-derived WSS parameters were computed in a cohort of 46 patients with mild-to-moderate ascending aortic dilation (\"cases\") and a cohort of 51 age- and sex-matched individuals without dilation (\"controls\"). The 3D WSS maps were mapped to a shared geometry where the ascending aorta was divided into 40×40 surface patches. Synthetic data were created and used to assess the false positive and false negative rates for permutation tests with threshold-free cluster enhancement (TFCE) and, for comparison, for statistical tests common in cardiovascular studies, namely the Student's t-test (with and without Bonferroni correction and Benjamin-Hochberg procedure), and the Wilcoxon rank sum test.</p><p><strong>Results: </strong>Significance maps obtained from synthetic data showed that permutation tests had lower false positive rates compared to the uncorrected Student's t-test and the Wilcoxon rank sum test, lower false negative rates compared to the Student's t-test with Bonferroni correction, but higher false negative rates compared to the Student's t-test with the Benjamin-Hochberg procedure. However, the false negatives were concentrated near the boundary of regions of no difference between the groups. On the real data, several regions, indicated as significant by the non-corrected Student's t-test, were not significant when statistical testing was corrected for multiple comparisons. Significance maps created with TFCE-based permutation tests reveal that individuals with mild-to-moderate aortic dilation and tricuspid valves have lower peak WSS, higher OSI, and higher WSS in diastole.</p><p><strong>Conclusion: </strong>Permutation tests applied to 4D Flow-derived WSS parameters are suitable for the local analysis of WSS differences between cohorts, correcting for the family-wise error rate while accounting for spatial relationships between WSS values.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102778"},"PeriodicalIF":5.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536006","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}
Yichen Zhao, Haiyang Chen, Yiwen Gong, Zhuo Chen, Juan Gao, Fan Yang, Zhihao Xue, Zeping Qiu, Ji Zhao, Qing Li, Chengyan Wang, Yucheng Chen, Liang Zhong, Wei Jin, Sha Hua, Chenxi Hu
{"title":"Fully Automatic Left Atrial Strain Quantification via Multi-task Learning on Cardiac Cine MRI.","authors":"Yichen Zhao, Haiyang Chen, Yiwen Gong, Zhuo Chen, Juan Gao, Fan Yang, Zhihao Xue, Zeping Qiu, Ji Zhao, Qing Li, Chengyan Wang, Yucheng Chen, Liang Zhong, Wei Jin, Sha Hua, Chenxi Hu","doi":"10.1016/j.jocmr.2026.102777","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102777","url":null,"abstract":"<p><strong>Background: </strong>Cardiac magnetic resonance feature tracking (CMR-FT) of left atrial (LA) strain is hindered by thin-wall contouring errors, motion heterogeneity, and temporal drift, while manual or landmark-based methods lack reproducibility and scalability.</p><p><strong>Methods: </strong>We retrospectively collected a multi-center, two-vendor cine MRI dataset. A multi-task learning model was developed to quantify LA strain directly from two-chamber and four-chamber cine images, by coupling a groupwise registration network with a segmentation network through a spatiotemporal cross-attention module and synergistic losses. Performance was benchmarked against common feature tracking algorithms, including optical flow, pairwise registration, and VoxelMorph, via various metrics such as mean-squared error, contour distance, mitral annular tracking accuracy, and drift error. Diagnostic performance to distinguish healthy from diseased subjects was assessed by ROC analysis.</p><p><strong>Results: </strong>546 subjects (142 healthy; age 49±18 years; 343 male) were included for method development and internal/external testing. The proposed method outperformed all other methods in tracking accuracy and reduced the drift effect commonly observed in optical flow and pairwise registration to a level comparable to fixed-reference learning-based registration. Inference required half a second. Automatic strains agreed closely with manual-segmentation-derived values (reservoir r=0.95, conduit r=0.96, booster r=0.92; all p<0.001). In the external dataset, all three strain components were lower in diseased subjects than normal controls (reservoir 24.4±13.2% vs 45.7±12.6%, conduit 14.1±8.8% vs 31.1±10.2%, and booster 10.3±6.4% vs 14.6±5.1%, all p<0.001). Compared with alternative methods, the automatic reservoir strain achieved the highest discriminative power across multiple diseased groups (AUC: 0.81-0.97).</p><p><strong>Conclusion: </strong>A fully automatic, multi-task learning framework for LA strain quantification, validated in multi-center two-vendor data, enhances tracking accuracy and speed over prior methods, enabling rapid, scalable atrial function assessment in routine care. Source code is available at SJTU-CMRLab/Dual_Task_LA_Strain_Quantification.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102777"},"PeriodicalIF":5.0,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470847","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}
Ahmed M Salih, Elisa Rauseo, Ilaria Boscolo Galazzo, Esmeralda Ruiz Pujadas, Víctor M Campello, Karim Lekadir, Nay Aung, Gregory G Slabaugh, Ghaith Sharaf Dabbagh, Anwar A Chahal, Gloria Menegaz, Steffen E Petersen
{"title":"Advancing Heart Ageing in Ischemic Heart Disease: Insights from CMR and ECG Analysis.","authors":"Ahmed M Salih, Elisa Rauseo, Ilaria Boscolo Galazzo, Esmeralda Ruiz Pujadas, Víctor M Campello, Karim Lekadir, Nay Aung, Gregory G Slabaugh, Ghaith Sharaf Dabbagh, Anwar A Chahal, Gloria Menegaz, Steffen E Petersen","doi":"10.1016/j.jocmr.2026.102776","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102776","url":null,"abstract":"<p><strong>Aims: </strong>Ischemic heart disease (IHD) patients undergo cardiovascular alterations that can accelerate heart ageing. Estimating biological heart age using advanced cardiac magnetic resonance (CMR) and electrocardiogram (ECG)-derived phenotypes provides a biomarker for heart ageing. We investigated the relationship of IHD and heart ageing using biological age estimation biomarkers, and the contribution of conventional cardiac imaging indices and vascular risk factors (VRFs).</p><p><strong>Methods and results: </strong>Heart age was estimated in prevalent IHD cases (n = 2,142) incorporating CMR radiomics and ECG features. Heart age gap (HAG), representing the disparity between predicted and actual heart age, was calculated. IHD subjects had significantly higher heart age compared to those without the disease (HAG: 1.55 years ± 5.66; p <0.001). The main radiomics and ECG features linked to heart ageing in IHD delineated a phenotype of structural and electrical remodelling not typically seen in the ageing heart. Conventional CMR indices accounted for only a negligible fraction of the association between IHD and HAG. Among the VRFs, adiposity and hypertension were significantly associated with increasing HAG in IHD.</p><p><strong>Conclusion: </strong>Individuals with IHD showed higher estimated heart ageing than controls, consistent with greater deviation from normal heart ageing, and this was associated with selected VRFs. This relationship was only minimally explained by conventional CMR indices, suggesting that the heart age model captures additional imaging and electrical features beyond standard CMR measures. HAG may offer an exploratory framework for characterising phenotypic heterogeneity in IHD and contextualising cardiovascular risk; however, prospective validation is required prior to clinical application.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102776"},"PeriodicalIF":5.0,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470904","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}
Koji Yamasaki, Satonori Tsuneta, Motoma Kanaya, So Sasaki, Takeshi Hamaya, Suguru Ishizaka, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai, Kohsuke Kudo
{"title":"Impact of transcatheter aortic valve replacement on blood flow in the ascending aorta and brachiocephalic artery.","authors":"Koji Yamasaki, Satonori Tsuneta, Motoma Kanaya, So Sasaki, Takeshi Hamaya, Suguru Ishizaka, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai, Kohsuke Kudo","doi":"10.1016/j.jocmr.2026.102775","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102775","url":null,"abstract":"<p><strong>Background: </strong>Although transcatheter aortic valve replacement (TAVR) can improve cerebral blood flow (CBF) in patients with aortic stenosis (AS), the effect of pre-TAVR flow rate on post-TAVR flow rate increase is unclear. We aimed to evaluate blood flow changes before and after TAVR in the ascending aorta (AAo) and brachiocephalic artery (BCA) using four-dimensional flow cardiovascular magnetic resonance (4D flow CMR) and assess whether the post-TAVR flow response depends on the pre-TAVR flow rate.</p><p><strong>Methods: </strong>This prospective study included patients who underwent TAVR for AS at our institution between January 2022 and December 2023 and who underwent 4D flow CMR before and after TAVR. Patients were divided into two groups, normal-flow (NF) and low-flow (LF) groups, using a cutoff value of 35mL/beat/m<sup>2</sup> for the ratio of pre-TAVR AAo flow rate per beat to body surface area. Flow rates in the AAo and BCA were analyzed.</p><p><strong>Results: </strong>Sixty-one patients were enrolled. The median age was 84 (82-87) years, and twenty-three patients (38%) were men. The net flow rates in the AAo and BCA increased after TAVR, but the changes were not statistically significant (AAo, 3206 (2499-3975) mL/min vs. 3591 (2880-4419) mL/min, p = 0.23; BCA, 435 (302-560) mL/min vs. 512 (377-666) mL/min, p = 0.06). In the analysis of the NF and LF groups, the LF group demonstrated significant increases in net flow after TAVR (AAo, 2598 (1972-3079) vs. 3468 (2900-4131) mL/min, p < 0.001; BCA, 365 (230-529) vs. 522 (377-659) mL/min, p = 0.006).</p><p><strong>Conclusion: </strong>4D flow CMR revealed that TAVR significantly increased the AAo and BCA flow rates in patients with LF AS. (274 words / 350 limit).</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102775"},"PeriodicalIF":5.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470911","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}