Journal of Cardiovascular Magnetic Resonance最新文献

{"title":"Cardiac MRI Diastolic Function Assessment in Preserved Ejection Fraction and Absence of Late Gadolinium Enhancement.","authors":"Jonathan A Pan, Shuo Wang, Alper Turgot, Cristiane De Carvalho Singulane, Deyu Sun, Yu Wang, Sivam Bhatt, Roberto M Lang, Christopher M Kramer, Amit R Patel","doi":"10.1016/j.jocmr.2026.102737","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102737","url":null,"abstract":"<p><strong>Background: </strong>Cardiac magnetic resonance (CMR) accurately measures left ventricular (LV) ejection fraction (EF) and late gadolinium enhancement (LGE), but is not commonly used for diastolic function. This study combined unsupervised machine learning and diastolic function with cine imaging to identify prognostic groups.</p><p><strong>Methods: </strong>CMR studies from 391 patients with LVEF≥50%, and no LGE were included. Using LV cine diastolic time-volume curves, early peak filling rate (E-PFR) indexed to stroke volume index (SVI), E/A ratio, and deceleration time (Decel_t) were measured, along with left atrial volume index (LAVI) and LV mass index (LVMI). K-means clustering grouped individuals using only these parameters. Primary outcome was a composite of heart failure or ventricular arrhythmia admission, heart transplant, mechanical support, and cardiac death.</p><p><strong>Results: </strong>Median follow-up was 5 years with 30 events. Three clusters were identified with event rates of 2.6% (group 1), 8.5% (group 2), and 17.2% (group 3). Time-volume curves demonstrated a triphasic pattern with group 2 having lower E-PFR (6.5 vs 9.7 and 8.4SVI/s for group 1 and 3 respectively, p<0.001), lower E/A (1.2 vs 2.4 and 1.9 for group 1 and 3 respectively, p<0.001), and longer Decel_t (223 vs 79 and 105ms for group 1 and 3 respectively, p<0.001). Group 3 had increased remodeling based on higher LAVI (51.4 vs 26.6 and 27.5ml/m² for group 1 and 2 respectively, p<0.001) and LVMI (78.7 vs 48.7 and 50.6g/m² for group 1 and 2 respectively, p<0.001). Compared to group 1, group 2 and 3 had hazard ratios (HR) of 3.21 (95% confidence interval [CI] 1.06-9.68, p=0.038) and 2.52 (95% CI 1.06-4.47, p=0.002) for events respectively. Adjusting for comorbidities, only group 3 had a significant HR of 2.55 [95% CI 1.42-4.57], p=0.002) compared to group 1.</p><p><strong>Conclusion: </strong>CMR cine-derived diastolic parameters can add prognostic value despite normal EF and absence of LGE.</p><p><strong>Summary: </strong>Diastolic Function Methods and Results from Cine Time-Volume Measurements. CMR, cardiac magnetic resonance; LA, left atrial; LV, left ventricular; MACE, major adverse cardiovascular events.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102737"},"PeriodicalIF":6.1,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729041","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":"Clinical implications of Vessel wall imaging - State of the Art Review.","authors":"Niranjan Balu, Gador Canton, Mahmud Mossa-Basha, Luca Saba, Scott McNally, Thomas Hatsukami, Chun Yuan","doi":"10.1016/j.jocmr.2026.102733","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102733","url":null,"abstract":"<p><p>Diseases of the arterial wall are best diagnosed using vessel wall MRI since luminal imaging does not show the extent of wall pathology. Intracranial and extracranial carotid artery pathology such as atherosclerosis, dissections, vasculitis and occlusions can lead to clinically significant events such as stroke. Direct visualization of the arterial wall pathology using vessel wall MRI can direct clinical diagnosis and management. This review highlights the importance of carotid and intracranial vessel wall MRI and their clinical applications in neurovascular pathologies. Recent developments such as carotid Plaque-RADS risk scoring and intracranial vasculopathy differentiation using vessel wall MRI are reviewed. Technical requirements of vessel wall MRI sequences for clinical diagnosis and future diagnostic approaches such as stroke etiology reclassification are also discussed.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102733"},"PeriodicalIF":6.1,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722754","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":"Assessing changes in aortic motion and hemodynamics after valve-sparing aortic root surgery in Marfan syndrome using 4D bSSFP and 4D flow CMR.","authors":"D Bosshardt, R Merton, E M Schrauben, A J Nederveen, M G P J Cox, D Robbers-Visser, D R Koolbergen, M Groenink, P van Ooij","doi":"10.1016/j.jocmr.2026.102728","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102728","url":null,"abstract":"<p><strong>Background: </strong>Aortic root surgery in patients with Marfan syndrome (MFS) has significantly improved survival, allowing time for distal aortic complications such as type B aortic dissection (TBAD) to emerge. The implantation of a non-compliant synthetic graft may alter aortic biomechanics and hemodynamics, potentially contributing to these late complications. This proof-of-concept study aimed to assess changes in aortic motion and flow characteristics following aortic root surgery using advanced cardiovascular magnetic resonance (CMR) techniques.</p><p><strong>Methods: </strong>Three MFS patients (aged 26-37 years), 2 males, one female, undergoing valve-sparing aortic root surgery, were prospectively studied before and six months after surgery. All participants underwent non-contrast-enhanced 4D balanced steady-state free precession and 4D flow CMR at 3T. A deep learning-based segmentation pipeline (nnU-Net) provided segmentations utilized for calculation of aortic displacement, distensibility, regional wall shear stress (WSS) and velocity, and global pulse wave velocity (PWV).</p><p><strong>Results: </strong>Postoperatively, all patients exhibited markedly decreased ascending aortic (AAo) volume. 3D distensibility (10⁻³ mmHg⁻¹) also decreased: patient 1, from 4.1 to 1.7; patient 2, from 3.4 to 1.2; and patient 3, from 2.9 to 1.5. Displacement in the AAo, especially at the sinotubular junction, was substantially reduced, consistent with the rigidity of the implanted graft. In the descending aorta (DAo), distensibility and displacement showed increases in two patients and a decrease in one. Peak systolic velocity and WSS increased in the AAo for all patients, whereas DAo values remained largely unchanged. PWV change varied between patients: decreasing slightly in patient 1, from 8.4 to 7.9m/s, but increased in patients 2 and 3 (8.0 to 8.9m/s and 6.2 to 9.8m/s, respectively.</p><p><strong>Conclusions: </strong>This study demonstrated that AAo biomechanics and hemodynamics change predictably following valve-sparing aortic root surgery in MFS, while changes in the DAo were not consistent between patients. Further research with larger sample sizes is required to identify which of these changes are linked to specific disease profiles and whether parameter combinations can indicate a predisposition to TBAD.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102728"},"PeriodicalIF":6.1,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722725","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":"Contrast-free postoperative imaging of the pulmonary arteries: Intraindividual comparison of Relaxation-Enhanced Angiography without Contrast and Triggering (REACT) and time-resolved contrast-enhanced MRA.","authors":"Vanessa Schmidt, Lukas Goertz, Juliana Tristram, Robert Terzis, Kenan Kaya, Thorsten Gietzen, Kilian Weiss, David Maintz, Carsten Gietzen, Lenhard Pennig, Jan Paul Janssen","doi":"10.1016/j.jocmr.2026.102732","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102732","url":null,"abstract":"<p><strong>Purpose: </strong>To compare a flow-independent, 3D isotropic non-contrast MRA (REACT), with time-resolved contrast-enhanced MRA (4D CE-MRA) for postoperative assessment of the pulmonary arteries in patients with congenital heart disease (CHD), with emphasis on different implant types.</p><p><strong>Methods: </strong>In this retrospective single-center study, 53 patients with CHD underwent clinically indicated cardiovascular magnetic resonance (CMR) including both 4D CE-MRA and REACT at 1.5T. Three radiologists independently scored image quality (IQ) as well as motion and susceptibility artifacts on 5-point Likert scales and measured the diameters of the pulmonary arteries (PAs) [main (MPA), left (LPA) and right pulmonary artery (RPA)]. Subgroup analysis was performed for stents, conduit/patch/valve (CPV), and no implant.</p><p><strong>Results: </strong>Pooled across readers and PA segments, REACT achieved higher overall IQ than 4D CE-MRA (median 3.67 [3.00-4.17] vs. 3.00 [2.33-3.33]; p < 0.001) and provided significantly better motion scores (p < 0.001), whereas susceptibility scores were comparable between techniques. The proportion of fully diagnostic studies (3/3 segments) was similar (REACT 77.4%, 41/53; 4D CE-MRA 83.0%, 44/53; McNemar, p = 0.38). Diameter measurements showed excellent inter-reader agreement (ICC ≈ 0.89-0.95) and minimal bias between techniques; only the RPA yielded slightly smaller diameters in REACT (mean difference -0.85 ± 1.51mm, p < 0.001). In subgroup analysis, stented segments showed no IQ advantage of REACT (p > 0.99) with IQ being limited due to susceptibility artifacts in both 4D CE-MRA and REACT. In the CPV and the no implant group, REACT yielded a one point higher median IQ score (both p = 0.002) and one point less impaired by motion artifacts (CPV: p < 0.001; no implant: p = 0.002), while both techniques provided very high shares of diagnostic image quality (defined as IQ ≥ 2; both > 90%; p > 0.99).</p><p><strong>Conclusions: </strong>REACT enables robust, contrast-free postoperative imaging of the pulmonary arteries in patients with CHD with superior IQ and reduced motion artifacts compared to 4D CE-MRA, while maintaining highly reproducible diameter measurements. Stented segments remain a shared limitation.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102732"},"PeriodicalIF":6.1,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722690","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":"Spatiotemporal Deep Learning for Scar Screening in CMR: Toward Selective Use of Gadolinium.","authors":"Amine Amyar, Shiro Nakamori, Jiwon Kim, Martin S Maron, Ethan J Rowin, Karishma Pareek, Alexander Schulz, Robert M Judd, Warren J Manning, Raymond Y Kwong, Frederick L Ruberg, Jonathan W Weinsaft, Reza Nezafat","doi":"10.1016/j.jocmr.2026.102730","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102730","url":null,"abstract":"<p><strong>Background: </strong>Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) is the gold standard for assessing myocardial scar. However, a substantial proportion of patients referred for CMR scar assessment are ultimately found to have no evidence of myocardial scarring.</p><p><strong>Purpose: </strong>To develop and evaluate a deep learning (DL) model capable of identifying patients without myocardial scar using cine imaging alone, thereby obviating the need for contrast administration and LGE imaging in these individuals.</p><p><strong>Materials and methods: </strong>We developed a novel spatiotemporal DL architecture to identify patients unlikely to have myocardial scar using contrast-free cine images. The model was trained on short-axis cine images from a consecutive cohort of 3,000 patients (1,753 males; mean age 54 ± 18 years) undergoing CMR for evaluation of known or suspected cardiovascular disease, using 1.5 and 3T scanners from Siemens and GE. External validation was performed in an independent multicenter cohort of 1,792 patients where images were acquired on 1.5T and 3T scanners from Siemens and Philips. The architecture utilizes factorized convolutions to extract spatial and temporal features and incorporates residual attention mechanisms to emphasize features most predictive of scar presence on LGE imaging. To evaluate the incremental value of incorporating temporal information, a second model was developed that excluded the temporal kernel from the DL architecture. Both models were trained and optimized using the same training dataset and were evaluated based on similar internal and external testing cohorts. Model performance in identifying patients without myocardial scar was evaluated using the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity.</p><p><strong>Results: </strong>The spatiotemporal model had a higher AUC compared to the spatial model in the internal (0.79±0.02 vs. 0.70±0.05, p<0.05, n=500) and external cohort (0.78 vs. 0.64, p<0.001, n=1792). The spatiotemporal model correctly identified 64% and 52% of patients without scar in the internal and external test sets, while maintaining a high sensitivity (86% and 82%).</p><p><strong>Conclusions: </strong>Incorporating temporal information from cine images using an end-to-end spatiotemporal DL architecture enables non-contrast screening for myocardial scar.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102730"},"PeriodicalIF":6.1,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716843","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":"Native T1 is independently associated with aerobic exercise capacity in long-term follow-up after mild initial COVID-19 disease (Impression COVID&Heart Study).","authors":"Monika Rozewicz-Juraszek, Stephan Mueller, Midjisuren Ganbat, Carlos Rodriguez Bolanos, Anna Klement, Sonia Antoñana Ugalde, Martin Halle, Eike Nagel, Valentina Puntmann","doi":"10.1016/j.jocmr.2026.102725","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102725","url":null,"abstract":"<p><strong>Background: </strong>Exercise intolerance is a common and incapacitating long-term consequence of COVID-19, even after mild acute illness. Cardiovascular magnetic resonance (CMR) studies have demonstrated persistent perimyocardial inflammatory abnormalities; however, their relationship with long-term aerobic capacity remains unclear.</p><p><strong>Methods: </strong>In this prospective observational study, individuals without prior structural heart disease underwent standardised CMR, echocardiography, and cardiopulmonary exercise testing (CPET) at least 3 years after the initial COVID-19. The primary endpoint was the association between %-predicted VO₂peak (age-sex-body mass index (BMI) adjusted, Study of Health in Pomerania (SHIP) reference) and imaging parameters. Secondary analyses included lactate measurements and sex-stratified models.</p><p><strong>Results: </strong>A total of 132 participants (mean age 49 ± 12 years; 68/132 (52%) male) were evaluated 48 months [interquartile range (IQR) 42-53] post-infection. Non-ischaemic perimyocardial enhancement was present in 34/132 (26%), whereas two participants had an unrecognised ischaemic scar. Male sex, higher BMI, lower age, and higher native T1 were associated with lower %-predicted VO₂peak in univariate models. In multivariate analysis, male sex, lower age, and higher native T1 (β = -0.25 per ms, 95% CI -0.40 to -0.10; p < 0.001) remained independent predictors of lower %-predicted VO₂peak. In total, 63/132 (48%) participants demonstrated %-predicted VO₂peak below predicted values. Sex-stratified multivariate analyses showed that higher native T1 (p<0.001) independently associated with lower %-predicted VO₂peak in both men and women, with lower age additionally retained in men. In a lactate-measured subgroup (n=73), higher resting lactate, higher native T1, male sex, and lower left atrial area were associated with lower %-predicted VO₂peak.</p><p><strong>Conclusions: </strong>In long-term follow-up of individuals with mild initial COVID-19 and no prior structural heart disease, aerobic capacity relative to predicted values was reduced in 48% of participants, particularly in men, and was independently associated with higher myocardial native T1. Native T1 and resting lactate, but not conventional structural measures or peak exercise.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102725"},"PeriodicalIF":6.1,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Reconstruction Type on Late Gadolinium Enhancement Scar Quantification at 3-Tesla: Magnitude vs. Phase-Sensitive Inversion Recovery.","authors":"Aida Moafi, Simran Shergill, David Adlam, Nilesh J Samani, Gerry P McCann, J Ranjit Arnold","doi":"10.1016/j.jocmr.2026.102727","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102727","url":null,"abstract":"<p><strong>Background: </strong>The identification of myocardial scar using late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) is well established, providing diagnostic and prognostic value in both ischemic and non-ischemic cardiomyopathies. Phase-sensitive inversion recovery (PSIR) provides more consistent image contrast compared with magnitude (MAG) reconstructions. However, the impact of reconstruction method on scar quantification remains uncertain.</p><p><strong>Methods: </strong>One-hundred and thirty-six patients from three prospectively enrolled cohorts with chronic myocardial infarction (>3 months post-infarction), representing distinct infarct phenotypes, underwent contrast-enhanced research CMR. LGE images were acquired using either a breath-hold, segmented spoiled gradient-echo or free-breathing, motion-corrected, balanced steady-state free precession sequence. Infarction was quantified on matched, short-axis MAG and PSIR reconstructions using the full-width at half-maximum method, with total infarct size expressed in grams (g) and as percentage of left ventricular mass. The primary analysis compared scar quantification between the two reconstruction methods.</p><p><strong>Results: </strong>Compared with MAG, PSIR demonstrated significantly higher median scar mass (13.7g [6.0-25.7] vs. 8.9g [4.4-16.6], p<0.001) and percentage of left ventricular mass (14.2% [7.5-21.9] vs. 10.6% [5.4-14.2], p<0.001). Inter-method agreement was moderate for both absolute and relative scar mass (intraclass correlation coefficients: 0.76 [95% CI: 0.33, 0.89] and 0.74 [95% CI: 0.20, 0.89], respectively), with a systematic, proportional difference on Bland-Altman analysis, with consistently higher scar mass by PSIR (mean bias: +5.01 ± 5.87g; limits of agreement: -6.50 to +16.51g and +4.54 ± 4.62%; limits of agreement: -4.51 to +13.60%).</p><p><strong>Conclusion: </strong>Quantification using PSIR yields higher infarct sizes compared with MAG LGE reconstructions. This emphasizes the importance of using a consistent reconstruction method when quantifying scar burden.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102727"},"PeriodicalIF":6.1,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716851","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":"Customizing Native T1 Mapping: the effects of compressed sensing, deep learning-based denoising and high-resolution on measurement of native myocardial T1.","authors":"Alessio Perazzolo, Camilla V Vita, Vincenzo Scialò, Mohamed Gamal, Elisa Bruno, Tzu Cheng Chao, Jacinta Browne, Burak Demirel, Spencer Waddle, Tim Leiner","doi":"10.1016/j.jocmr.2026.102726","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102726","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Quantitative native T1 mapping is a key component in Cardiovascular magnetic resonance (CMR) for myocardial tissue characterization; however, further improvements in acquisition efficiency and robustness are needed to optimize clinical applicability. Undersampling techniques in k-space, such as compressed sensing (CS), and deep learning-based (DL) denoising reconstructions, have improved morphological and cine-imaging, but their impact on quantitative relaxation times remains underexplored. This study evaluated image quality and native T1 quantification across ten combinations with varying CS acceleration levels, spatial resolutions, and application of DL-denoising reconstruction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this prospective single-center study, 48 healthy volunteers underwent native T1 mapping. After quality review, 41 subjects were included. Blurring, aliasing, susceptibility artifacts, and overall image quality (IQ), were rated by three blinded readers using a 4-point Likert scale. Quantitative analysis was performed on a per-segment basis using custom software, yielding mean native T1 values for each AHA segment. Nine cases were reanalyzed by three additional readers to assess interobserver variability. Test-retest and phantom experiments were performed to assess reproducibility and to cover pathological T1 ranges, respectively. The reference T1-mapping protocol was obtained with CS3, with spatial resolution of 2.0×2.0×10mm&lt;sup&gt;3&lt;/sup&gt;. Additional acquisitions were obtained with CS3, 4, 5 and spatial resolutions of 2.0×2.0×10mm&lt;sup&gt;3&lt;/sup&gt;, 1.8×1.8×10mm&lt;sup&gt;3&lt;/sup&gt;, and 1.6×1.6×10mm&lt;sup&gt;3&lt;/sup&gt; for CS3 and 2.0×2.0×10mm&lt;sup&gt;3&lt;/sup&gt; for CS4 and 5.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Significant differences in IQ, blurring, and aliasing were observed among acquisition protocols (p&lt;0.05), but not in susceptibility artifacts (p=0.66). Higher CS levels slightly reduced IQ and increased aliasing and blurring. DL-denoising and higher spatial resolution methods improved sharpness without changing overall scores. Segment-wise T1 quantitative analysis revealed only minor differences, even in the presence of high acceleration factors or increased spatial resolution. In most segments, two one-sided testing confirmed equivalence with low bias (-21 to +22 ms). Scan-rescan experiments confirmed repeatability in healthy volunteers, while phantom experiments extended repeatability and inter-method stability to pathological T1 ranges.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Native T1 values remained stable across various CS acceleration factors, changes in spatial resolution, and application of denoising, with clinically negligible bias for tissue characterization. These findings, within a framework where total acquisition time is primarily determined by the number of inversion time (TI) images, support the use of CS to improve temporal resolution within each TI image, benefiting patients with arrhythmias or elevated heart rates, a","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102726"},"PeriodicalIF":6.1,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716867","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":"Direct Assessment of Total Cavopulmonary Connection Power Loss with Interventional CMR in Fontan Circulation.","authors":"Hamza Dahshi, Tarique Hussain, Surendranath Veeram Reddy, Yousef Arar, Maria Gusseva","doi":"10.1016/j.jocmr.2026.102724","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102724","url":null,"abstract":"<p><strong>Background: </strong>Fontan physiology, reliant on a single ventricle and a passive total cavopulmonary connection (TCPC) flow, is vulnerable to inefficiency. Linking TCPC power loss to cardiac function can provide valuable insights into Fontan hemodynamics. This study quantifies direct TCPC power loss from invasive cardiac magnetic resonance (iCMR) data and its relationship to conduit geometry, fenestration flow, and myocardial contractility pre- and post-Fontan fenestration test occlusion (FFTO).</p><p><strong>Methods: </strong>Twenty post-Fontan patients underwent iCMR, with 9 also having a FFTO. iCMR catheter-based pressures were combined with phase-contrast CMR flow in the vena cavae and pulmonary arteries. 3D whole-heart imaging provided conduit cross-sectional areas (CSA). A patient-specific biomechanical model estimated myocardial contractility from iCMR data. In-vivo TCPC blood flow indexed power loss (iPL) was calculated at baseline in 20 patients, and post- FFTO in 9.</p><p><strong>Results: </strong>Mean (±SD) at baseline was 0.24±0.15 and decreased significantly from 0.27±0.14 to 0.13±0.10 in 9 patients post-FFTO (p=0.010). Fenestration flow explained 46.5% of variation in iPL at baseline. Higher iPL was associated with higher myocardial contractility (R²=0.216, p=0.004) pre-FFTO, and with lower myocardial contractility (R²=0.43, p=0.054) post-FFTO. Higher iPL correlated with smaller conduit CSA (R²=0.26, p=0.030) at baseline.</p><p><strong>Conclusion: </strong>Increased iPL was related to increased fenestration flow, increased contractility and decreased conduit narrowing at baseline. Post-FFTO, increased iPL was associated with decreased contractility suggesting that acute fenestration closure might cause preload suppression in the ventricle. This study offers a clinically relevant framework to obtain mechanistic insights into Fontan physiology and guide personalized strategies fenestration management.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102724"},"PeriodicalIF":6.1,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147673757","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":"Combined CMR and Catheterization for Pre-Fontan Evaluation: Comparing Metrics and Clinical Correlations.","authors":"Ashish Shrivastava, Russel Hirsch, Shabana Shahanavaz, Cara E Morin, Todd Jenkins, Zhiqian Gao, Sean M Lang","doi":"10.1016/j.jocmr.2026.102723","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102723","url":null,"abstract":"<p><strong>Background: </strong>Cardiac magnetic resonance imaging (CMR) is increasingly used in combination with cardiac catheterization (Cath) for the pre-Fontan evaluation of children with single ventricle (SV) physiology. The aim of this study was to describe our institutional experience of this combined assessment.</p><p><strong>Methods: </strong>We conducted a retrospective, single-center study of 57 single-ventricle patients who underwent CMR and Cath under the same anesthesia prior to Fontan completion. CMR and Cath-based pulmonary and systemic blood flow ratio (Qp/Qs) and aortopulmonary collateral (APC) assessments were compared. In addition, we analyzed the association between significant APC burden (>30% of aortic flow) and preoperative hemodynamics, as well as postoperative outcomes, including chest tube duration and hospital length of stay.</p><p><strong>Results: </strong>CMR consistently yielded higher Qp/Qs values compared to Cath, with a mean underestimation of 0.41 by the latter. This difference was strongly correlated with CMR-derived APC burden (p<0.0001). In comparison, Cath-based qualitative assessment of the APC had a poor correlation with the CMR APC burden and Qp/Qs. The CMR APC burden was also associated with increased indexed ventricular volumes and lower ejection fraction (EF).</p><p><strong>Conclusions: </strong>Combined CMR and Cath provide a comprehensive pre-Fontan assessment, with CMR offering superior quantification of aortopulmonary collateral burden and demonstrating larger Qp/Qs than calculated by Cath methods. These findings support the continued use of integrated imaging modalities for individualized care.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102723"},"PeriodicalIF":6.1,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638937","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}