Journal of Cardiovascular Magnetic Resonance最新文献

{"title":"Right atrial function is impaired in pediatric pulmonary arterial hypertension: a multi-center cardiac MRI study.","authors":"Kimberley G Miles, Hieu T Ta, Kurt R Bjorkman, Zhiqian Gao, Nicholas J Ollberding, Russel Hirsch, D Dunbar Ivy, Sean M Lang, Michelle Cash, Melissa Magness, Meredith O'Neil, Kimberly Luebbe, Benjamin S Frank, Paul J Critser","doi":"10.1016/j.jocmr.2025.101962","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101962","url":null,"abstract":"<p><strong>Background: </strong>Impaired right atrial (RA) function is strongly predictive of adverse outcomes in adults with pulmonary arterial hypertension (PAH) but remains incompletely understood in pediatric PAH. In this pediatric multicenter retrospective cohort study using cardiac magnetic resonance imaging (CMR), we analyzed RA size and phasic function and its associations with PAH severity.</p><p><strong>Methods: </strong>PAH and control pediatric patients from two centers who underwent CMR from 2010-2023 were identified. RA volumes were measured throughout the cardiac cycle using the single-plane, area-length method on a standard 4-chamber cine sequence. Total, conduit phase, and active phase stroke volume (SVi; indexed to BSA) and ejection fraction (EF) were calculated. A novel marker, the A/C ratio, was calculated as active/conduit SVi. RA size and phasic function measurements were correlated with clinical, hemodynamic, and non-RA CMR metrics of PAH severity and were associated with adverse events (Potts shunt, lung transplant listing/surgery, and/or death) using univariate and bivariate Cox proportional hazards regression analyses. Intra- and interrater reliability was analyzed using intra-class correlation coefficients (ICC).</p><p><strong>Results: </strong>Compared to controls (n=36), children with PAH (n=72) had higher RA volumes, lower conduit phasic function, and higher active phasic function. In PAH patients, minimum RA volume, active SVi, and A/C ratio directly correlated with NT-proBNP and right ventricular (RV) size, filling pressures, and afterload, while they were inversely correlated with exercise capacity and RVEF. RA conduit EF (cEF) correlations were reversed. During median follow-up of 3.2 years [IQR 1.0, 5.9], RA cEF and A/C ratio remained independent predictors of adverse events after adjustment for common metrics of PAH severity on bivariate analysis, including RVEF (RA cEF aHR 0.91 [95% CI: 0.83-0.99]; A/C ratio aHR 1.58 [95% CI: 1.09-2.29]) and indexed pulmonary vascular resistance (RA cEF aHR 0.83 [95% CI: 0.74-0.93]; A/C ratio aHR 1.79 [95% CI: 1.34-2.41]). RA volume measurements had excellent reliability (ICC >0.97).</p><p><strong>Conclusion: </strong>Correlating with disease severity, impaired RA physiology in pediatric PAH is characterized by RA dilation, reduced conduit phasic function and compensatory augmentation of active phasic function. Assessment of RA size and phasic function is feasible and highly reproducible using standard CMR sequences.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101962"},"PeriodicalIF":6.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113190","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":"Diastolic Dysfunction in Patients with Fontan Palliation is Associated with Death and Heart Transplantation.","authors":"Edward H Hardison, Christopher C Henderson, Rachel K Duncan, Kristen George-Durrett, James C Slaughter, Ryan D Byrne, Joshua D Chew, Benjamin P Frischhertz, David A Parra, Angela J Weingarten, Jonathan H Soslow, Daniel E Clark","doi":"10.1016/j.jocmr.2025.101961","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101961","url":null,"abstract":"<p><strong>Background: </strong>Adults with Fontan failure (FF) have variable presentations and are often diagnosed late. Reliable predictors of FF are unknown. Diastolic dysfunction may be associated with adverse outcomes late after Fontan palliation.</p><p><strong>Methods: </strong>Fontan patients were compared to healthy controls. FF was defined as death, transplant, diagnosis of protein losing enteropathy, peak VO2 < 50% predicted, or new diuretic requirement. All phases in the short axis plane were contoured to calculate filling and ejection curves. The following variables were measured by cardiac magnetic resonance (CMR): peak filling rate (PFR), peak ejection rate (PER), PFR and PER indexed to end diastolic volume (EDV), time to PFR (tPFR), and time to PER (tPER).</p><p><strong>Results: </strong>Compared to healthy controls (N=96), the Fontan group (N=98) had worse diastolic function as evidenced by decreased PFR and PFR/EDV and increased tPFR. Patients with FF (N=39) had similar ventricular systolic function and volumetrics to the Fontan subjects without failure (NF; N=59). PFR/EDV was significantly reduced and indexed common ventricular mass was significantly higher among FF patients with the most severe adverse outcomes of death or heart transplantation. The prevalence of late gadolinium enhancement was higher in the FF cohort than the NF cohort.</p><p><strong>Conclusions: </strong>CMR can identify diastolic dysfunction in the Fontan population. Patients with Fontan circulation who died or had a combined outcome of death or transplant had worse diastolic function by CMR compared to Fontan patients without death or transplant.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101961"},"PeriodicalIF":6.1,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091772","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":"Diagnostic and prognostic comparison of stress ECG, CMR and SPECT, alone and sequentially, in stable chest pain.","authors":"Giandomenico Bisaccia, Peter P Swoboda, John F Younger, Neil Maredia, Catherine J Dickinson, Julia M Brown, Chiara Bucciarelli-Ducci, Sven Plein, John P Greenwood","doi":"10.1016/j.jocmr.2025.101960","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101960","url":null,"abstract":"<p><strong>Background: </strong>Exercise ECG remains widely performed in the assessment of patients with suspected cardiac chest pain. We aimed to assess the comparative diagnostic and prognostic yield of exercise ECG, single photon emission computed tomography (SPECT) and cardiovascular magnetic resonance (CMR), in a large prospective patient population.</p><p><strong>Methods: </strong>Patients recruited to CE-MARC who had exercise ECG were included and followed up to a median(IQR) of 6.3(0.1,6.8) years. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values, and area under the curve (AUC) for diagnostic accuracy were derived and hazard ratios of MACE for prognostic significance calculated.</p><p><strong>Results: </strong>Of 752 patients in the CE-MARC trial, 580 had exercise ECG and invasive coronary angiography, of which 503 also had SPECT and CMR. At follow-up, a total of 91(15.7%) patients experienced MACE. Using invasive angiography as the reference test, the sensitivity, specificity, PPV and NPV(95%CI) of exercise ECG were 68.3(61.9,74.0), 72.5(67.6,76.9), 61.0(54.8,66.8), 78.4(73.7,82.5). Exercise ECG was significantly less sensitive than CMR and less specific than both CMR and SPECT. A positive exercise ECG result was not predictive of MACE at follow-up (HR 1.14[0.75,1.72], p=0.53). CMR had both a greater diagnostic and prognostic yield than exercise ECG, SPECT and their combination. Sequential CMR following inconclusive exercise ECG was comparable to CMR alone as the first-line test.</p><p><strong>Conclusions: </strong>In patients with suspected angina, CMR alone as the first-line test was more sensitive and prognostically accurate than exercise ECG, SPECT, or sequential combination of both tests.</p><p><strong>Condensed abstract: </strong>In a real-world head-to-head comparison study for diagnostic accuracy and prognostic yield, a strategy of CMR alone outperformed SPECT and exercise ECG, as well as their combination, in patients with stable chest pain. Use of CMR following an inconclusive exercise ECG was superior to use of SPECT, and comparable to a strategy of CMR alone.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101960"},"PeriodicalIF":6.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080595","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":"Cardiac Magnetic Resonance versus Echocardiography: An analysis examining risk reclassification by left ventricular ejection fraction and cost burden analysis.","authors":"Annie J Tsay, Kinpritma Sangha, Linda Lee, Shuo Wang, Seban Liu, Arslan Zahid, Maria Poonawalla, Roberto M Lang, Christopher M Kramer, Amit R Patel","doi":"10.1016/j.jocmr.2025.101959","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101959","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is a leading cause of morbidity and mortality in the United States and is projected to increase in the next decade. Left ventricular ejection fraction (LVEF) is used to guide optimal medical therapy and is typically quantified using 2D-transthoracic echocardiography (TTE) due to ease of accessibility and cost. However, LVEF measurements by cardiac magnetic resonance (CMR) are considered the gold standard due to their accuracy and precision. Despite this, CMR is not the first imaging modality selected for LVEF evaluation due to perceptions of long study time, high cost, and inaccessibility. Our study aims to determine the cost of imaging studies (eg, CMR, TTE) relative to the overall HF-related healthcare costs and associated outcomes.</p><p><strong>Methods: </strong>A retrospective single-center cohort study of 420 participants with same day TTE and CMR from 2009-2019 including participants >18 years of age with good image quality with or at risk for cardiovascular disease. Primary outcome was a composite outcome defined as HF admission, left ventricular assist device (LVAD), cardiovascular disease-related death, heart transplantation, and implantable cardioverter defibrillator (ICD) implantation. HF risk groups were determined based on clinically relevant LVEF cutoffs. All costs were calculated and adjusted to 2022 US$.</p><p><strong>Results: </strong>Participants were 49±17 years old, 52% female, 50% White, and 41% Black. Median follow-up was 4 years. HF was the most common co-morbidity (31%). LVEF measured by CMR predicted HF outcomes better than TTE (p=0.005). Continuous net reclassification index of CMR LVEF was 0.36, (95% CI: 0.16-0.56); p=0.001 due to predominant reclassification to lower risk groups. On an individual level, HF healthcare cost increased from low to high-risk groups irrespective of modality. High-risk individuals classified by CMR had lower average per person HF healthcare costs compared to TTE counterparts. Cost of CMR and TTE was < 1% of the total HF healthcare cost.</p><p><strong>Conclusions: </strong>The cost of non-invasive imaging studies accounted for <1% of the cost compared to other components of HF care. Downstream cost prediction based on LVEF classification using CMR has the potential to better predict cost burden compared to TTE in patients with HF.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101959"},"PeriodicalIF":6.1,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064731","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":"Cardiac Magnetic Resonance Imaging in the German National Cohort (NAKO): Automated Segmentation of Short-Axis Cine Images and Post-Processing Quality Control.","authors":"Peter M Full, Robin T Schirrmeister, Manuel Hein, Maximilian F Russe, Marco Reisert, Clemens Ammann, Karin Halina Greiser, Thoralf Niendorf, Tobias Pischon, Jeanette Schulz-Menger, Klaus H Maier-Hein, Fabian Bamberg, Susanne Rospleszcz, Christopher L Schlett, Christopher Schuppert","doi":"10.1016/j.jocmr.2025.101958","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101958","url":null,"abstract":"<p><strong>Background: </strong>The prospective, multicenter German National Cohort (NAKO) provides a unique dataset of cardiac magnetic resonance (CMR) cine images. Effective processing of these images requires a robust segmentation and quality control pipeline.</p><p><strong>Methods: </strong>A deep learning model for semantic segmentation, based on the nnU-Net architecture, was applied to full-cycle short-axis cine images from 29,908 baseline participants. The primary objective was to determine data on structure and function for both ventricles (LV, RV), including end-diastolic volumes (EDV), end-systolic volumes (ESV), and LV myocardial mass. Quality control measures included a visual assessment of outliers in morphofunctional parameters, inter- and intra-ventricular phase differences, and time-volume curves (TVC). These were adjudicated using a five-point rating scale, ranging from five (excellent) to one (non-diagnostic), with ratings of three or lower subject to exclusion. The predictive value of outlier criteria for inclusion and exclusion was evaluated using receiver operating characteristics analysis.</p><p><strong>Results: </strong>The segmentation model generated complete data for 29,609 participants (incomplete in 1.0%), of which 5,082 cases (17.0%) underwent visual assessment. Quality assurance yielded a sample of 26,899 (90.8%) participants with excellent or good quality, excluding 1,875 participants due to image quality issues and 835 participants due to segmentation quality issues. TVC was the strongest single discriminator between included and excluded participants (AUC: 0.684). Of the two-category combinations, the pairing of TVC and phases provided the greatest improvement over TVC alone (AUC difference: 0.044; p<0.001). The best performance was observed when all three categories were combined (AUC: 0.748). By extending the quality-controlled sample to include mid-level 'acceptable' quality ratings, a total of 28,413 (96.0%) participants could be included.</p><p><strong>Conclusion: </strong>The implemented pipeline facilitated the automated segmentation of an extensive CMR dataset, integrating quality control measures. This methodology ensures that ensuing quantitative analyses are conducted with a diminished risk of bias.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101958"},"PeriodicalIF":6.1,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064723","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":"A Radiomic Model Based on 7T Intracranial Vessel Wall Imaging for Identification of Culprit Middle Cerebral Artery Plaque Associated with Subcortical Infarctions.","authors":"Tong Chen, Wenhui Zhu, Xiaoyan Bai, Mahmud Mossa-Basha, Yuanbin Zhao, Xun Pei, Xue Zhang, Gaifen Liu, Xingquan Zhao, Zixiao Li, Jie Xu, Shengjun Sun, Duanduan Chen, Shuaitong Zhang, Binbin Sui","doi":"10.1016/j.jocmr.2025.101956","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101956","url":null,"abstract":"<p><strong>Background: </strong>Radiomics has been proven to be an important method for the quantitative assessment atherosclerotic plaques. Therefore, we aimed to evaluate a radiomics approach based on 7.0T high-resolution vessel wall imaging (HR-VWI) to identify culprit middle cerebral artery (MCA) plaques associated with subcortical infarctions.</p><p><strong>Methods: </strong>One hundred patients with MCA plaques were prospectively enrolled. Among these patients, 145 plaques (74 culprit plaques and 71 non-culprit plaques) were included. A traditional model was constructed by recording the conventional radiological plaque characteristics of HR-VWI. Radiomics features from HR-VWI images were utilized to construct a radiomics model. A combined model was built using both conventional radiological and radiomics features. Receiver operating characteristic (ROC) curves and area under curve (AUC) were used to compare the performance of these models.</p><p><strong>Results: </strong>Plaque surface irregularity and superior wall location of MCA plaques were independently associated with subcortical infarctions. The traditional model had AUCs of 0.744 and 0.700 in the training and test sets, respectively. The radiomics and the combined model showed improved AUCs: 0.860 and 0.896 in the training sets and 0.795 and 0.833 in the test sets, respectively. The radiomics model was superior to the traditional model (p=0.042) in the training set. The combined model outperformed the traditional model (training p<0.001, test p=0.048).</p><p><strong>Conclusions: </strong>The radiomics approach based on 7.0T HR-VWI can accurately identify culprit plaques associated with subcortical infarctions, potentially better than conventional HR-VWI features.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101956"},"PeriodicalIF":6.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145053671","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":"Prospective electrocardiographic and cardiovascular magnetic resonance alterations in the UK Biobank COVID-19 repeat imaging study.","authors":"Sucharitha Chadalavada, Ahmed Salih, Hafiz Naderi, Elisa Rauseo, Jackie Cooper, Stefan van Duijvenboden, Anwar A Chahal, Gaith S Dabbagh, Liliana Szabo, Mohammed Y Khanji, Jose D Vargas, Mihir Sanghvi, Kenneth Fung, Jose Paiva, Stefan K Piechnik, Betty Raman, Patricia B Munroe, Aaron Mark Lee, Alborz Amir-Khalili, Luca Biasiolli, John P Greenwood, Paul M Matthews, Wenjia Bai, Stefan Neubauer, Nay Aung, Nicholas C Harvey, Zahra Raisi-Estabragh, Steffen E Petersen","doi":"10.1016/j.jocmr.2025.101957","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101957","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular magnetic resonance (CMR) and electrocardiographic (ECG) abnormalities after COVID-19 are widely reported. However, the absence of pre-infection assessments limits causal inference from these studies. This study aims to compare interval change in CMR and ECG measures in participants with incident COVID-19 and matched uninfected controls in UK Biobank.</p><p><strong>Methods: </strong>UK Biobank participants with documented COVID-19 who had CMR and ECG performed prior to the pandemic were invited for repeat assessment, along with uninfected participants matched on age, sex, ethnicity, location, and date of baseline imaging. Automated pipelines were used to extract ECG phenotypes and CMR measures of cardiac structure and function, aortic distensibility, aortic flow, and myocardial native T1. Logistic regression was used to examine associations of baseline metrics with incident COVID-19. Standardized residual approach was used to compare the degree of interval change in CMR and ECG metrics between cases and controls.</p><p><strong>Results: </strong>We analyzed 2,092 participants (1,079 cases, 1,013 controls) with average age of 60±7 years. 47% were male. There was 3.2±1.5 years between pre- and post-infection assessments. 4% of cases were hospitalized. Lower baseline left ventricular ejection fraction and worse longitudinal, circumferential, and radial strain were associated with higher risk of incident COVID-19. There were no significant differences in interval change of any CMR or ECG metric between cases and controls.</p><p><strong>Conclusions: </strong>While pre-existing cardiovascular abnormalities are linked to higher risk of COVID-19, exposure to infection does not alter interval change of highly sensitive CMR and ECG indicators of cardiovascular health.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101957"},"PeriodicalIF":6.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145053626","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":"Mitral annular disjunction distance is associated with adverse outcomes in children and young adults with connective tissue disorders.","authors":"Daniel A Castellanos, Spencer B Barfuss, Noah DiBiasio-Hudson, Grace Lee, Elizabeth DeWitt, Edward T O'Leary, Lynn A Sleeper, Chrystalle Katte Carreon, Stephen P Sanders, Daniel Quiat, Michael N Singh, Sunil J Ghelani, Ronald V Lacro","doi":"10.1016/j.jocmr.2025.101954","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101954","url":null,"abstract":"<p><strong>Introduction: </strong>Mitral annular disjunction (MAD) is a pathologic fibrous separation of the mitral valve hinge point from the ventricular myocardium. The aims of this study were to describe the range of MAD distance by cardiac magnetic resonance (CMR) in children and young adults with connective tissue disorders (CTDs) versus a healthy control sample, and to assess the MAD distance as a predictor of adverse cardiovascular outcomes.</p><p><strong>Methods: </strong>This was a retrospective, single-center study of healthy subjects and patients with Marfan syndrome, Loeys-Dietz syndrome, Ehlers-Danlos syndrome, or nonspecific CTD who underwent CMR between 01/01/2000 and 01/01/2020. The MAD distance was measured from the 2-chamber, 4-chamber, and left ventricular outflow tract views in systole and diastole and analyzed as absolute values as well as indexed to BSA and height. The primary outcome was a composite defined as the presence of significant ventricular arrhythmias, cardiac arrest, and/or death. Age-adjusted odds ratios with 95% confidence intervals and c-statistic are reported. Classification and Regression Tree analysis was performed to identify the most discriminating binary threshold to predict occurrence of the composite outcome.</p><p><strong>Results: </strong>30 healthy control subjects and 254 patients with CTD met inclusion criteria. The mean ± SD age at initial CMR was 17±6 years for patients with CTD and 14±3 years for controls. The mean MAD distance was larger in patients with CTD compared to the control sample, and the maximum MAD distance in the control sample was 3.6mm. Median follow-up in the CTD group was 5 years (IQR 3-11 years). Thirty-four (15%) patients met the composite outcome. Systolic MAD distance was positively associated with the composite outcome. The optimal binary threshold for height-indexed maximum systolic MAD distance was 0.033mm/cm with an event rate of 18.6% at/above threshold versus 2.6% below threshold (AUC 0.74). The association was independent of other important clinical predictors.</p><p><strong>Conclusions: </strong>A small MAD distance can be measured in healthy children and young adults. Children and young adults with CTD have a longer MAD distance than healthy control subjects, and a longer MAD distance is associated with adverse outcomes.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101954"},"PeriodicalIF":6.1,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023365","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":"Full Free-Breathing Cardiac MRI: Enhancing Efficiency and Image Quality in Clinical Practice.","authors":"Kai Yang, Chen Cui, Fei Teng, Gang Yin, Jing An, Xinling Yang, Jinghui Li, Xiaoming Bi, Jianing Pang, Kelvin Chow, Shihua Zhao, Minjie Lu","doi":"10.1016/j.jocmr.2025.101955","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101955","url":null,"abstract":"<p><strong>Background: </strong>Conventional cardiac magnetic resonance (CMR) examinations require patients to repeatedly hold their breath, which can reduce examination efficiency and pose challenges for patients unable to do so. This study aimed to demonstrate the feasibility and effectiveness of a full free-breathing CMR protocol in clinical practice.</p><p><strong>Methods: </strong>Patients prospectively enrolled in this study underwent a full free-breathing CMR exam on a 3T scanner between June 1 and June 30, 2024. Acquisition time and image quality were assessed. Cine and flow imaging were compared with those acquired with the conventional breath-holding CMR protocol. Other sequences, including T1/T2 mapping and late gadolinium enhancement (LGE), were evaluated quantitatively and qualitatively, respectively. Group comparisons were performed using the Wilcoxon signed-rank test or paired t-test. Consistency was assessed using Kappa statistics, Bland-Altman statistics, intraclass correlation coefficient (ICC) and linear regression.</p><p><strong>Results: </strong>A total of 211 patients were evaluated (median age: 53 years [IQR: 38-63]; range: 10-82 years; 145 men). The mean acquisition time for full free-breathing CMR was 22.6±3.7min. The median image quality scores for cine and LGE images acquired with free-breathing CMR were 4 (IQR: 4-4) and 5 (IQR: 4-5), respectively. Compared with conventional breath-holding CMR, the end-diastolic volume (EDV), end-systolic volume (ESV), EDV index and ESV index measured by free-breathing CMR were slightly higher (all P＜0.05), whereas the left ventricular ejection fraction (LVEF) and left ventricular mass (LVM) were slightly lower (both P＜0.05). Nonetheless, the two methods demonstrated good agreement and correlation (r values: 0.85-0.99). Native T1 and T2 values in healthy subjects from free-breathing CMR were 1214.9±16.7ms and 38.4±3.2ms, respectively. Among the 211 patients, 147 were LGE positive. Except for five patients with image quality scores below 3, all others had scores of 3 or higher.</p><p><strong>Conclusion: </strong>Full free-breathing CMR examinations are feasible and effective in clinical practice, significantly reduce scan time while maintaining high image quality.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101955"},"PeriodicalIF":6.1,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023385","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":"Visually assessed ischaemia on cardiac magnetic resonance, but not quantitative perfusion metrics, predicts symptomatic improvement in coronary artery bypass.","authors":"Tamim Akbari, Lukas Mach, Daniel J Hammersley, Suzan Hatipoglu, Ruth Owen, Dylan Taylor, Joyce Wong, Shahzad G Raja, Sunil K Bhudia, Dudley J Pennell, Brian P Halliday, Richard E Jones, Sanjay K Prasad","doi":"10.1016/j.jocmr.2025.101953","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101953","url":null,"abstract":"<p><strong>Background: </strong>Serial perfusion cardiovascular magnetic resonance (CMR) in symptomatic patients undergoing coronary artery bypass grafting (CABG) may provide mechanistic insight into dynamic abnormalities of the myocardium.</p><p><strong>Objectives: </strong>To assess how changes in cardiac reperfusion and remodelling associate with symptom improvement in patients undergoing CABG METHODS: Patients awaiting elective CABG completed serial quality of life questionnaires and detailed CMR at baseline and at 6-12 months post CABG as per protocol. Automated fully quantitative stress and rest myocardial blood flow was calculated, alongside assessment of the visual ischaemic burden. Findings were correlated with changes in symptomatology.</p><p><strong>Results: </strong>Of 40 patients who underwent serial evaluation with CMR (mean age 62.1±9.3, median LVEF 68% [IQR: 62-73%]), there was improvement in the median visual ischaemic burden (42% [IQR: 27-51] vs 18% [IQR: 11-21], P<0.001), mean global stress myocardial blood flow (1.34±0.5ml/min/g vs 1.59±0.5ml/min/g, P=0.002) and median global myocardial perfusion reserve (1.85±0.6 vs 2.4±0.9, P<0.001) following CABG. Greater improvement in the SAQ-7 summary score was associated with a greater decrease in the visual ischaemic burden following CABG (ρ=-0.38, P=0.02). Quantitative MBF metrics did not associate with baseline or change in SAQ-7 summary score.</p><p><strong>Conclusion: </strong>Serial perfusion CMR identifies dynamic changes in markers of myocardial perfusion in patients following CABG. Greater reduction of visually assessed ischaemia associated with improvement in SAQ-7 score. Quantitative perfusion indices were not associated with symptom improvement in this study. The results also suggest residual inducible ischaemia post CABG requiring further studies to elucidate its clinical relevance.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101953"},"PeriodicalIF":6.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008207","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}