Journal of Cardiovascular Magnetic Resonance最新文献

{"title":"Safety of dobutamine stress cardiovascular magnetic resonance in patients with prior coronary artery bypass grafting.","authors":"Jannick Heins, Janek Salatzki, Anne Köhrer, Andreas Ochs, Lukas D Weberling, Hauke Hund, Evangelos Giannitsis, Norbert Frey, Dirk Loßnitzer, Florian André, Henning Steen","doi":"10.1016/j.jocmr.2024.101119","DOIUrl":"https://doi.org/10.1016/j.jocmr.2024.101119","url":null,"abstract":"<p><strong>Background and purpose: </strong>Patients with coronary artery bypass grafts (CABG) face an elevated risk of major adverse cardiac events (MACE). High-dose dobutamine stress cardiovascular magnetic resonance imaging (DCMR) is a well-established technique to detect hemodynamically significant coronary artery disease (CAD). However, there is a lack of data regarding the safety of DCMR in patients with CABG. This study aims to evaluate the safety of DCMR in patients with CABG.</p><p><strong>Methods: </strong>We retrospectively studied patients after CABG who subsequently underwent DCMR between November 2008 and July 2018. Side effects, defined as adverse events and minor symptoms, during DCMR were analyzed and compared to 200 individuals matched for age, sex and BMI without prior CABG undergoing DCMR.</p><p><strong>Results: </strong>336 patients (70±9 years, 85% men) were identified. Adverse events occurred in 35 CABG patients (10%) and 18 controls (9%, p=0.595). A drop of systolic blood pressure (SBP) >40mmHg (12 patients), non-sustained ventricular tachycardia (6 patients), increase in SBP >200mmHg (5 patients), monomorphic premature ventricular contractions (PVC) (2 patients), bigeminy (2 patients), left bundle-branch block (2 patients), as well as tachycardiac paroxysmal atrial fibrillation, bradycardia, supraventricular tachycardia, couplets/triplets, and sinus arrhythmia in one patient each occurred in the study group. In addition, one patient was hospitalized due to tachycardiac paroxysmal atrial fibrillation and transient ischemic attack. 29 (8.7%) examinations in the study group were aborted because of either chest pain, dyspnea, nausea, dizziness, a drop of SBP, arrhythmias, tachycardiac paroxysmal atrial fibrillation, monomorphic PVCs, or non-sustained ventricular tachycardia. The rate of aborted examination was comparable to the control group (15 (7.5%), p=0.631). Univariable logistic regression analysis revealed that female sex (OR 2.21, 95% CI 1.2 - 4.3, p=0.017) and inducible ischemia (OR 3.50, 95% CI 2.0 - 6.0, p<0.001) were associated with an increased risk of side effects during DCMR.</p><p><strong>Conclusion: </strong>Dobutamine stress CMR did not show a relevant increase of adverse events in patients with prior CABG compared to patients without prior CABG. Female sex and dobutamine-induced myocardial ischemia are associated with side effects during DCMR.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101119"},"PeriodicalIF":4.2,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545663","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":"Easing the Strain of Fetal CMR: Editorial for \"Fetal Cardiovascular Magnetic Resonance Feature Tracking Myocardial Strain Analysis in Congenital Heart Disease\".","authors":"Alex J Barker, Lorna P Browne, Richard M Friesen","doi":"10.1016/j.jocmr.2024.101115","DOIUrl":"https://doi.org/10.1016/j.jocmr.2024.101115","url":null,"abstract":"","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101115"},"PeriodicalIF":4.2,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568732","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":"Phase-contrast Magnetic Resonance Angiography of Foot at Ultra-high field 5T System: Visualization of Distal Small Vessels and Enhancement by Warm Water Immersion.","authors":"Zhang Shi, Hao Li, Xiyin Miao, Bei Wang, Dong Wang, He Wang, Mengsu Zeng","doi":"10.1016/j.jocmr.2024.101114","DOIUrl":"https://doi.org/10.1016/j.jocmr.2024.101114","url":null,"abstract":"<p><strong>Background: </strong>Ultra-high field strength MR system has been proved to offer improved visualization of the distal intracranial vessels and branches, but its effectiveness on peripheral vasculatures was not investigated. We aim to assess the visualization of lower-extremity vessels using three-dimensional phase contrast MR angiography (3D PC-MRA) at 5T field-strength through the feet with warm water immersion (WWI).</p><p><strong>Methods: </strong>Participants were prospectively recruited and underwent 3T, 5T 3D PC-MRA on feet with and without WWI (water temperature between 40 to 45 ℃ for a duration of 10minutes). Patients with suspected lower-extremity vessel diseases underwent CTA for lesion identification. Signal-to-noise ratio (SNR), subjective scoring, quantitative vessel segmentation and flow velocity were performed to assess vessel visualization before and after WWI. Friedman's test was conducted to determine statistical significance.</p><p><strong>Results: </strong>Out of thirty participants (mean age, 46.2±5.9; males, 20; lower-extremity vessel disease, 10), 900 vessel segments were available for evaluation. 5T images showed significantly higher scores of image quality and foot vessel visualization than 3T (all P <.05). WWI further improved the visualizing scores (percentage of score 3: 40.2% vs 66.2%, P =.008), SNR (44.27 vs 67.78, P <.001), total branch count (151.92 ± 29.17 vs 225.63 ± 16.76; P <.001), and the flow velocity (0.72 ± 0.03 vs 0.48 ± 0.11cm/s; P <.001).</p><p><strong>Conclusion: </strong>3D PC-MRA at 5T effectively visualizes foot vessels in patients with lower-extremity disease. Furthermore, WWI can significantly enhance the depiction of distal and small vessels.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101114"},"PeriodicalIF":4.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501118","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":"Delayed 3D IR FLASH for airway imaging in children: more than myocardial fibrosis assessment.","authors":"Laura Acosta Izquierdo, Romina Dsouza, Ankavipar Saprungruang, Afsaneh Amirabadi, Mike Seed, Shi-Joon Yoo, Christopher Z Lam","doi":"10.1016/j.jocmr.2024.101110","DOIUrl":"https://doi.org/10.1016/j.jocmr.2024.101110","url":null,"abstract":"<p><strong>Background: </strong>To investigate the ability of a delayed respiratory-navigated, electrocardiographically-gated three-dimensional inversion recovery-prepared flash low angle shot (3D IR FLASH) sequence to evaluate the lower airways in children undergoing routine cardiovascular magnetic resonance (CMR).</p><p><strong>Methods: </strong>This retrospective study included pediatric patients (0-18 years) who underwent clinical CMR where a delayed 3D IR FLASH sequence was performed between July 2020 and April 2021. The airway image quality and extent of lower airway visibility was graded by two blinded readers using a four-point ordinal scale (0-3). Lower airway anatomical variants and abnormalities were recorded.</p><p><strong>Results: </strong>180 patients were included with a median age of 11.7 (4.6-15.3) years. 51/180 (28%) were under general anesthesia (GA). Overall, the median grading of airway image quality was 3 (2-3) and extent of lower airway visibility was 3 (3-3). Interrater agreement was almost perfect (κ = 0.867 and κ = 0.956, respectively). Image quality correlated with extent of lower airway visibility (r = 0.62, p < 0.01). Delayed 3D IR FLASH was able to characterize the segmental bronchi in 137/180 (76%) and lobar bronchi in 172/180 (96%) of patients. Lower airway abnormalities were identified in 37/180 (21%) of patients and in 33/129 (26%) with congenital heart disease (CHD). Identified abnormalities included tracheobronchial branching anomalies in 6/180 (3%), abnormal tracheobronchial situs in 6/180 (3%), and extrinsic vascular compression in 25/180 (14%).</p><p><strong>Conclusions: </strong>Delayed 3D IR FLASH has excellent performance for evaluation of the lower airway anatomy and can simultaneously assess for myocardial late gadolinium enhancement. Lower airway abnormalities are not infrequently seen in children undergoing routine CMR for CHD.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101110"},"PeriodicalIF":4.2,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501116","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":"Histological Validation of 3D Variable Flip Angle TSE Multi-Contrast Magnetic Resonance Vessel Wall Imaging in Characterizing Carotid Vulnerable Atherosclerotic Plaques.","authors":"Jiachen Liu, Zihan Ning, Chenlin Du, Shuo Chen, Tao Wang, Jingli Cao, Ran Huo, Dongye Li, Dandan Yang, Rui Shen, Shuwan Yu, Chunjiang Hu, Shuhao Wang, Huiyu Qiao, Xihai Zhao","doi":"10.1016/j.jocmr.2024.101112","DOIUrl":"https://doi.org/10.1016/j.jocmr.2024.101112","url":null,"abstract":"<p><strong>Background: </strong>Accurate assessment of the vulnerability of carotid atherosclerotic plaques is crucial for stroke prevention. The three-dimensional (3D) magnetic resonance (MR) vessel wall imaging (VWI) has been increasingly employed to evaluate carotid plaques due to its extensive coverage and isotropic high spatial resolution. However, the accuracy of such technique lacks validation by histology.</p><p><strong>Objective: </strong>This study aims to validate the accuracy of 3D multi-contrast MR VWI used variable-flip-angle (VFA) and turbo spin echo (TSE) readout in identifying vulnerable carotid plaques, using histological analysis as a reference.</p><p><strong>Methods: </strong>Twenty-one male patients (mean age: 64.4 ± 7.2 years) scheduled for carotid endarterectomy (CEA) were recruited for this study. All patients underwent carotid multi-contrast MR VWI, including 3D T1- and T2-weighted variable flip angle-based turbo spin echo (VFA-TSE) sequences, as well as 3D time of flight (TOF) MR angiography (MRA), using a 3.0T MR system. Histological processing was performed for carotid plaque specimens. The presence or absence, along with the area measurements, of lipid-rich necrotic core (LRNC), intraplaque hemorrhage (IPH), and calcifications (CA) were independently evaluated on both MR images and histological sections. Cohen's kappa (κ) analysis was utilized to determine the agreement between 3D multi-contrast MR VWI and histology in identifying carotid plaque compositions before and after excluding compositions bellow certain size threshold. Spearman's correlation analysis was also conducted to assess the agreement in quantifying plaque compositions.</p><p><strong>Results: </strong>A total of 81 slices of MR images were successfully matched with histological sections. Moderate to almost perfect agreements were observed between 3D MR VWI and histology in the identification of LRNC (κ: 0.85 and 0.89), IPH (κ: 0.65 and 0.69), and CA (κ: 0.46 and 0.62) before and after excluding compositions smaller than 0.79 mm². Strong to very strong correlations were found in the quantification of plaque compositions including LRNC (r=0.88), IPH (r=0.80), and CA (r=0.74) between MR imaging and histology.</p><p><strong>Conclusion: </strong>The 3D VFA-TSE multi-contrast MR VWI is capable of accurately characterizing vulnerable carotid atherosclerotic plaques.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101112"},"PeriodicalIF":4.2,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501117","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":"Characterization and Z-score Calculation of Cardiac MRI parameters in patients after the Fontan operation. A Fontan Outcome Registry using CMR Examinations (FORCE) study.","authors":"Tarek Alsaied, Runjia Li, Adam Christopher, Mark Fogel, Timothy C Slesnick, Rajesh Krishnamurthy, Vivek Muthurangu, Adam L Dorfman, Christopher Z Lam, Justin Weigand, Jong-Hyeon Jeong, Joshua D Robinson, Laura J Olivieri, Rahul H Rathod","doi":"10.1016/j.jocmr.2024.101113","DOIUrl":"https://doi.org/10.1016/j.jocmr.2024.101113","url":null,"abstract":"<p><strong>Background: </strong>Cardiac magnetic resonance (CMR) offers valuable hemodynamic insights post-Fontan, but is limited by the absence of normative single ventricle data. The Fontan Outcomes Registry using CMR Examinations (FORCE) is a large international Fontan-specific CMR registry. This study used FORCE registry data to evaluate expected CMR ventricular size/function and create Fontan-specific z-scores adjusting for ventricular morphology (VM) in healthier Fontan patients.</p><p><strong>Methods: </strong>\"Healthier\" Fontan patients were defined as patients free of adverse outcomes, who are New York Heart Association Class I, have mild or less valve disease, and <30% aortopulmonary collateral burden. General linear modeling was performed on 70% of the dataset to create z-scores for volumes and function. Models were tested using the remainder (30%) of the data. The z-scores were compared between children and adults. The z-scores were also compared between \"healthier\" Fontan and patients with adverse outcomes (death, listing for transplantation or multiorgan disease).</p><p><strong>Results: </strong>The \"healthier\" Fontan population included 885 patients (15.0 ± 7.6 years) from 18 institutions with 1,156 CMR examinations. Patients with left ventricle morphology had lower volume, mass and higher ejection fraction (EF) compared to right or mixed (two-ventricles) morphology (p<0.001 for all pairwise comparisons). Gender, BSA and VM were used in z-scores. Of the \"healthier\" Fontan patients, 647 were children <18 years and 238 were adults. Adults had lower ascending aorta flow (2.9 ± 0.7 vs 3.3 ± 0.8L/min/m2, p<0.001) and ascending aorta flow z-scores (-0.16 ± 1.23 vs 0.05 ± 0.95, 0.02) compared to children. Additionally, there were 1595 patients with adverse outcomes who were older (16.1 ± 9.3 vs 15.0 ± 7.6, p<0.001) and less likely to have LV morphology (35 vs 47%, p<0.001). Patients with adverse outcomes had higher z-scores for ventricular volume and mass and lower z-scores for EF and ascending aorta flow compared to the \"healthier\" Fontan cohort.</p><p><strong>Conclusion: </strong>This is the first study to generate CMR z-scores post-Fontan. Importantly the z-scores were generated and tested in \"healthier\" Fontan patients and both pediatric and adult Fontan patients. These equations may improve CMR-based risk stratification after the Fontan operation.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101113"},"PeriodicalIF":4.2,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501115","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 diffusion-weighted and tensor imaging: a Society for Cardiovascular Magnetic Resonance (SCMR) special interest group consensus statement.","authors":"E Dall'Armellina, D B Ennis, L Axel, P Croisille, P F Ferreira, A Gotschy, D Lohr, K Moulin, C Nguyen, S Nielles-Vallespin, W Romero, A D Scott, C Stoeck, I Teh, L Tunnicliffe, M Viallon, Wang, A A Young, J E Schneider, D E Sosnovik","doi":"10.1016/j.jocmr.2024.101109","DOIUrl":"https://doi.org/10.1016/j.jocmr.2024.101109","url":null,"abstract":"<p><p>Thanks to recent developments in Cardiovascular magnetic resonance (CMR), cardiac diffusion-weighted magnetic resonance is fast emerging in a range of clinical applications. Cardiac diffusion-weighted imaging (cDWI) and diffusion tensor imaging (cDTI) now enable investigators and clinicians to assess and quantify the 3D microstructure of the heart. Free-contrast DWI is uniquely sensitized to the presence and displacement of water molecules within the myocardial tissue, including the intra-cellular, extra-cellular and intra-vascular spaces. CMR can determine changes in microstructure by quantifying: a) mean diffusivity (MD) -measuring the magnitude of diffusion; b) fractional anisotropy (FA) - specifying the directionality of diffusion; c) helix angle (HA) and transverse angle (TA) -indicating the orientation of the cardiomyocytes; d) E2A and E2A mobility - measuring the alignment and systolic-diastolic mobility of the sheetlets, respectively. This document provides recommendations for both clinical and research cDWI and cDTI, based on published evidence when available and expert consensus when not. It introduces the cardiac microstructure focusing on the cardiomyocytes and their role in cardiac physiology and pathophysiology. It highlights methods, observations and recommendations in terminology, acquisition schemes, post-processing pipelines, data analysis and interpretation of the different biomarkers. Despite the ongoing challenges discussed in the document and the need for ongoing technical improvements, it is clear that cDTI is indeed feasible, can be accurately and reproducibly performed and, most importantly, can provide unique insights into myocardial pathophysiology.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101109"},"PeriodicalIF":4.2,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501114","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":"Myocardial mechanical function measured by cardiac magnetic resonance in patients with heart failure.","authors":"Yufan Gao, Boxin Li, Yanhe Ma, Shuo Liang, Anhong Yu, Hong Zhang, Zhigang Guo","doi":"10.1016/j.jocmr.2024.101111","DOIUrl":"https://doi.org/10.1016/j.jocmr.2024.101111","url":null,"abstract":"<p><strong>Aim: </strong>Strain analysis offers a valuable tool to assess myocardial mechanics, allowing for the detection of impairments in heart function. This study aims to evaluate the pattern of myocardial strain in patients with heart failure (HF).</p><p><strong>Methods: </strong>In the present study, myocardial strain was measured by cardiac magnetic resonance imaging feature tracking in 35 control subjects without HF and 195 HF patients. The HF patients were further categorized as HF with preserved ejection fraction (HFpEF, n=80), with mid-range ejection fraction (HFmrEF, n=34), and with reduced ejection fraction (HFrEF, n=81). Additionally, quantitative tissue evaluation parameters, including native T1 relaxation time and extracellular volume (ECV), were examined.</p><p><strong>Results: </strong>Compared to controls, patients in all HF groups (HFpEF, HFmrEF, and HFrEF) demonstrated impaired left ventricular (LV) strains and systolic and diastolic strain rates in all three directions (radial, circumferential, and longitudinal) (p < 0.05 for all). LV strains also showed significant correlations with left ventricular ejection fraction and brain natriuretic peptide levels (p < 0.001 for all). Notably, septal contraction was significantly affected in HFpEF compared to controls. While LV torsion was slightly increased in HFpEF, it was decreased in HFrEF. Native T1 relaxation times and ECV fractions were significantly higher in HFrEF compared to HFpEF (p < 0.05). Overall, myocardial strain parameters demonstrated good performance in differentiating HF categories.</p><p><strong>Conclusions: </strong>The myocardial strain impairments exhibit a spectrum of severity in patients with HFpEF, HFmrEF, and HFrEF compared to controls. Assessment of myocardial mechanics using strain analysis may offer a clinically useful tool for monitoring the progression of systolic and diastolic dysfunction in HF patients.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101111"},"PeriodicalIF":4.2,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466382","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":"Association Between Coronary Microvascular Dysfunction and Exercise Capacity in Dilated Cardiomyopathy.","authors":"Abhishek Dattani, Benjamin A Marrow, Gaurav S Gulsin, Jian L Yeo, Amitha Puranik, Emer M Brady, David Adlam, Anvesha Singh, Mohammedimran M Ansari, Jayanth R Arnold, Hui Xue, Peter Kellman, James S Ware, Gerry P McCann","doi":"10.1016/j.jocmr.2024.101108","DOIUrl":"https://doi.org/10.1016/j.jocmr.2024.101108","url":null,"abstract":"<p><strong>Background: </strong>Aerobic exercise capacity is an independent predictor of mortality in dilated cardiomyopathy (DCM), but the central mechanisms contributing to exercise intolerance in DCM are unknown.</p><p><strong>Objectives: </strong>Characterize coronary microvascular function in DCM and determine if cardiovascular magnetic resonance (CMR) measures are associated with aerobic exercise capacity.</p><p><strong>Methods: </strong>Prospective case-control comparison of adults with DCM and matched controls. Adenosine-stress perfusion CMR to assess cardiac structure, function and automated inline myocardial blood flow quantification, and cardiopulmonary exercise testing (CPET) to determine peak VO₂, were performed. Pre-specified multivariable linear regression, including key clinical and cardiac variables, was undertaken to identify independent associations with peak VO₂.</p><p><strong>Results: </strong>Sixty-six patients with DCM (mean age 61 years, 71% male) were propensity-matched to 66 controls (mean age 59 years, 71% male) based on age, sex, body mass index and diabetes. DCM patients had markedly lower peak VO₂ (19.8±5.5 versus 25.2±7.3mL/kg/min; P<0.001). The DCM group had greater left ventricular (LV) volumes, lower systolic function, and had more fibrosis compared to controls. In the DCM group, there was similar rest but lower stress myocardial blood flow (1.53±0.49 versus 2.01±0.60mL/g/min; P<0.001) and lower MPR (2.69±0.84 versus 3.15±0.84; P=0.002). Multivariable linear regression demonstrated that LV ejection fraction, extracellular volume fraction and MPR, were independently associated with percentage predicted peak VO₂ in DCM (R²=0.531, P<0.001).</p><p><strong>Conclusions: </strong>In comparison to controls, DCM patients have lower stress myocardial blood flow and MPR. In DCM, MPR, LV ejection fraction and fibrosis are independently associated with aerobic exercise capacity.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101108"},"PeriodicalIF":4.2,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466381","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":"Longitudinal changes in systemic right ventricular remodeling in adult patients with transposition of the great vessels as assessed by cardiovascular magnetic resonance imaging.","authors":"Jonathan Kochav, Michael P DiLorenzo, Matthew J Lewis, Maarten Groenink, Malou van den Boogaard, Barbara Mulder, Marlon Rosenbaum","doi":"10.1016/j.jocmr.2024.101107","DOIUrl":"https://doi.org/10.1016/j.jocmr.2024.101107","url":null,"abstract":"<p><strong>Background: </strong>Systemic right ventricular (sRV) physiology occurs in patients with congenitally corrected transposition of the great arteries (ccTGA) and D-TGA post atrial switch repair, and the natural history is of progressive sRV dysfunction. No study has assessed longitudinal changes in sRV remodeling by serial CMR.</p><p><strong>Methods: </strong>Patients evaluated at two adult congenital heart disease centers and who underwent ≥2 CMR exams were studied. Indexed sRV end-diastolic volume (sRVEDVi), end-systolic volume (sRVESVi), and ejection fraction (sRVEF) were determined by a core laboratory. Concurrent echocardiograms were assessed for degree of systemic TR (sTR). Tricuspid valve events were defined as ≥moderate sTR, or interval tricuspid replacement (TVR). Generally, the earliest and most recent studies were compared. A subset of patients were followed with ≥moderate sTR, and then subsequently underwent interval TVR. For these patients, two study time-intervals were defined to analyze the impact of each event independently.</p><p><strong>Results: </strong>67 patients were studied (33±11 years, 47% male, 33% ccTGA), with 72 total time intervals studied (median interval 9.0 years [IQR 4.6-13.3]). There was a small increase in sRVEDVi over time (ΔsRVEDVi 5.5±15.8ml/m², p<0.001), but mean change in sRVEF was not significant (ΔsRVEF 0.1±6.9%, p=0.86); notably, confidence intervals were wide for both. ccTGA patients had a trend towards greater decrement in sRVEF (ΔsRVEF -1.7±6.8 vs 1.3±6.7%, p=0.06). For each 25ml/m2 increase in baseline sRVEDVi, there was a 1.8% decrease in sRVEF (95% CI -3.2% to -0.5%, p=0.01). Patients without significant sTR had lesser deterioration in sRVEF compared to those with ≥moderate sTR or with interval TR intervention (ΔsRVEF 1.8±6.9% vs -2.1±6.6% and -2.6±4.5, p<0.05). Interval sRV conduction delay was associated with a trend towards greater decrements in sRVEF (ΔsRVEF -3.9±6.3 vs. 0.9±6.8%, p=0.07). Overall, underlying congenital anatomy, baseline sRVEDVi, advanced sTR or interval TVR, and sRV conduction delay explained only 16% of the variability in ΔsRVEF over time.</p><p><strong>Conclusions: </strong>Longitudinal changes in sRV remodeling were small, with great heterogeneity. Apparent risk factors in our study, namely underlying congenital anatomy, baseline sRVEDVi, TR events, and sRV conduction disease accounted for only 16% of the variability seen in the longitudinal change of sRVEF.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101107"},"PeriodicalIF":4.2,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400327","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}