Journal of Cardiovascular Magnetic Resonance最新文献

{"title":"Elevated septal native T1 time in cardiac magnetic resonance imaging suggesting myocardial fibrosis in young kidney transplant recipients.","authors":"Tim Alexander Ubenauf, Jeannine von der Born, Rizky I Sugianto, Carl Grabitz, Elena Lehmann, Nima Memaran, Nele Kanzelmeyer, Jan Falk, Nigar Babazade, Samir Sarikouch, Diane Miriam Renz, Bernhard Magnus Wilhelm Schmidt, Anette Melk","doi":"10.1016/j.jocmr.2025.101839","DOIUrl":"10.1016/j.jocmr.2025.101839","url":null,"abstract":"<p><strong>Background: </strong>Patients after kidney transplantation (KTx) in childhood show a high prevalence of cardiac complications, but the underlying mechanism is still poorly understood. In adults, myocardial fibrosis detected in cardiovascular magnetic resonance (CMR) imaging is already an established risk factor. Data for children after KTx are not available. This study aimed to explore cardiac function and structure with focus on myocardial fibrosis and associated risk factors in KTx recipients.</p><p><strong>Methods: </strong>Forty-six KTx recipients (mean age 16.0 ± 3.5 years) and 46 age- and sex-matched healthy controls were examined with non-contrast CMR imaging. Native T1 time (nT1), a marker for myocardial fibrosis, was measured at the interventricular septum. Other parameters comprised left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF), and global longitudinal strain (GLS). Multivariable linear regression analyses were used to explore associations with nT1.</p><p><strong>Results: </strong>Mean nT1 was significantly higher in KTx recipients compared to controls (1198.1 ± 48.8 vs 1154.4 ± 23.4 ms, p < 0.0001). 46% (21/46) had a nT1 above the upper limit of the normal range (mean + 2 standard deviations of controls). KTx recipients showed higher LVMI z-scores (0.1 ± 1.1 vs -0.3 ± 0.7, p = 0.026), higher LVEF (67.3 ± 3.8% vs 65.3 ± 3.6%, p = 0.012), and lower GLS (-19.0 ± 2.1% vs -20.3 ± 2.7%, p = 0.010). Higher systolic blood pressure (ß = 1.284, p = 0.001), LVMI (ß = 1.542, p < 0.001), and LVEF (ß = 3.535, p = 0.026) were associated with longer nT1 only in KTx recipients, but not in controls. Only 2 KTx recipients exhibited left ventricular hypertrophy; however, a total of 18 displayed elevated nT1 with LVMI z-score within the normal range.</p><p><strong>Conclusion: </strong>Our data suggest the presence of cardiac remodeling with myocardial fibrosis in a significant proportion of young KTx recipients. Non-contrast CMR imaging has the potential to visualize early structural cardiac changes and could become an important diagnostic adjunct in the follow-up of KTx recipients. Longitudinal studies are needed to further evaluate the importance of nT1 in early identification of those at high risk for sudden cardiac death allowing to integrate preventive strategies.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101839"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11870264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of magnetic resonance imaging-guided cardiac catheterization, angioplasty, and stenting in a commercial wide-bore 0.55T scanner.","authors":"Aimee K Armstrong, Yixuan Liu, John M Kelly, Ramkumar Krishnamurthy, Jason Swinning, Yingmin Liu, Matthew Joseph, Ning Jin, Jianing Pang, Florian Maier, Axel J Krafft, Orville Bramwell, Nathan Ooms, Jesse Roll, Joshua Krieger, David C Gross, Lucien de Mos, Paul Borm, Orlando P Simonetti","doi":"10.1016/j.jocmr.2025.101858","DOIUrl":"10.1016/j.jocmr.2025.101858","url":null,"abstract":"<p><strong>Background: </strong>Low-field (0.55T) magnetic resonance imaging (MRI) may allow MRI-guided interventions using available catheterization equipment, as radiofrequency-induced heating of interventional devices is reduced at low field. The purpose of this study was to test the feasibility of real-time MRI-guided right and left heart catheterization (R&LHC) as well as angioplasty and stenting of the inferior vena cava using a commercially available 0.55T MRI system (MAGNETOM Free.Max, Siemens Healthineers AG, Erlangen, Germany) with 80 cm patient bore and maximum gradient amplitude and slew rate of 26 mT/m and 45 mT/m/ms, respectively. A secondary aim was to evaluate three different sizes of magnetic resonance (MR)-visible markers.</p><p><strong>Methods: </strong>Sheaths were placed in the femoral vein and artery of juvenile Yorkshire pigs under general anesthesia. Air-filled balloon wedge catheters and Judkins right catheters were used for R&LHC, respectively, aided by an MR-compatible guidewire. Ferumoxytol was administered as a T1-shortening contrast agent and real-time visualization was carried out with a research interactive sequence using different spatiotemporal resolution settings. IVC angioplasty was performed using balloons filled with 1% gadolinium, and IVC stenting was performed with stainless-steel stents and one platinum-iridium-covered sten.</p><p><strong>Results: </strong>RHC was successful in all eight attempts with balloon tip visibility in all real-time protocols. One pig expired with ferumoxytol infusion, but the catheterization was completed post-mortem. LHC and IVC angioplasty were attempted and successful in two and four pigs, respectively. For stenting, higher resolution, lower frame rate imaging was used. All six attempted stent implantations were successful. The MR markers on the angioplasty balloon with widths of 0.5 and 1 mm were more visible than the 0.25 mm markers. Marker placement affected distinguishability from the crimped stent. Stainless-steel stents created only minimal signal voids pre- and post-deployment; however, the platinum-iridium stent caused significant artifact obscuring wall apposition assessment.</p><p><strong>Conclusion: </strong>This study is the first to demonstrate the technical feasibility of R&LHC, IVC angioplasty, and IVC stenting using real-time MRI on a commercially available low-field scanner.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101858"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved quantification of aortic regurgitation with direct regurgitant jet measurement by four-dimensional flow cardiovascular magnetic resonance in complex congenital heart disease.","authors":"Brynn Connor, Makoto Takei, Daniel E Clark, Shiraz A Maskatia","doi":"10.1016/j.jocmr.2025.101876","DOIUrl":"10.1016/j.jocmr.2025.101876","url":null,"abstract":"<p><strong>Background: </strong>Due to the presence of complex flow states and significant jet eccentricity in patients with congenital heart disease (CHD), accurate quantification of aortic regurgitation (AR) using standard echocardiographic or conventional cardiovascular magnetic resonance (CMR) imaging measures remains challenging. Four-dimensional flow (4DF) CMR permits transvalvular flow quantification under non-laminar flow states, although it has not been well validated for AR quantification in CHD.</p><p><strong>Methods: </strong>In 186 patients with moderate or complex CHD, we evaluated the agreement between different methods of AR quantification by 4DF CMR when compared to volumetry. Regurgitant flow volumes were measured (1) conventionally on time-resolved, velocity-encoded 4DF sequences at the aortic annulus, sinotubular junction (STJ), and ascending aorta (AAo), and via (2) direct regurgitant jet quantification 5 mm proximal to the vena contracta.</p><p><strong>Results: </strong>Moderate overall agreement in AR quantification was observed between study methods (ρ=0.58-0.73). Compared with conventional flow quantification at the annulus, STJ, and AAo, direct regurgitant jet measurements showed improved correlation with volumetry (ρ=0.76), especially in patients with significant aortic dilation (r=0.95-0.97). In this latter group, regurgitant flow quantification at all other aortic levels resulted in AR severity classifications that were nearly a full grade lower (mean aortic regurgitant fraction difference: 7-12% ± 10-12%; p<0.001).</p><p><strong>Conclusion: </strong>4DF CMR permits AR quantification in complex CHD with comparable accuracy to volumetry. Under non-laminar or complex flow states, as observed with significant aortic dilation, direct regurgitant jet measurements may be preferable to regurgitant flow quantification at all other aortic levels.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101876"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypothermia as an adjunctive therapy to percutaneous intervention after ST-elevation myocardial infarction-Effects on regional myocardial contractility.","authors":"Lucas de Mello Queiroz, Rafael Almeida Fonseca, Luis Augusto Palma Dallan, Thatiane Facholi Polastri, Ludhmila Abrahao Hajjar, Jose Carlos Nicolau, Roberto Kalil Filho, Karl B Kern, Sergio Timerman, Carlos E Rochitte","doi":"10.1016/j.jocmr.2025.101850","DOIUrl":"10.1016/j.jocmr.2025.101850","url":null,"abstract":"<p><strong>Background: </strong>The effects of endovascular therapeutic hypothermia (ETH) in ST-elevation myocardial infarction (STEMI) regional contractility are unknown, and its impact on segmental contractility has still not been evaluated. We sought to evaluate segmental myocardial strain after ETH adjuvant to percutaneous coronary intervention (PCI) in STEMI.</p><p><strong>Methods: </strong>We included patients who underwent 1.5T cardiovascular magnetic resonance exams 5 and 30 days after acute anterior or inferior STEMI in a previous randomized trial. Left ventricle (LV) strain was evaluated on infarcted, adjacent, and remote myocardium. Segmental circumferential (CS) and radial strains (RS) were measured using feature-tracking imaging. Repeated measures of analysis of variance were used for comparisons within time and treatment.</p><p><strong>Results: </strong>Forty patients were divided into hypothermia (ETH, n = 29) and control (n = 11) groups, with 5210 LV segments. In ETH infarcted areas, RS (11.2 ± 16 vs 14.8 ± 15.2, p = 0.001) and CS (-5.4 ± 11.1 vs -8 ± 11.1, p = 0.001) showed recovery from 5-30 days compared to controls (11.4 ± 14 vs 13.1 ± 1 6.8, p = 0.09; -6.5 ± 10.6 vs -6.4 ± 12.5, p = 0.94). In control remote areas, RS (28 ± 18 vs 31.7 ± 18.5, p = 0.001) and CS (-15.5 ± 10.7 vs -17.1 ± 9, p = 0.001) improved from 5-30 days compared to ETH (28.6 ± 18.6 vs 29 ± 20, p = 0.44; -15.2 ± 10.4 vs -15.3 ± 10.6, p = 0.82). Transmural infarcted areas in ETH improved RS (11.8 ± 13.2 vs 8.17 ± 14.7, p = 0.001) and CS (-6.1 ± 10.9 vs.-3.1 ± 11.3, p = 0.001) compared to controls, with better contractility at 30 days.</p><p><strong>Conclusion: </strong>In anterior or inferior STEMI patients, ETH adjuvant to PCI is associated with significant improvement in RS and CS of infarcted areas, including transmural segments, but not in remote area. This might further increase our pathophysiological knowledge on early LV remodeling and ultimately suggest potential clinical value.</p><p><strong>Availability of data and materials: </strong>The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101850"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerated real-time cine and flow under in-magnet staged exercise.","authors":"Preethi S Chandrasekaran, Chong Chen, Yingmin Liu, Syed Murtaza Arshad, Christopher Crabtree, Matthew Tong, Yuchi Han, Rizwan Ahmad","doi":"10.1016/j.jocmr.2025.101894","DOIUrl":"10.1016/j.jocmr.2025.101894","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular magnetic resonance (CMR) imaging is a well-established imaging tool for diagnosing and managing cardiac conditions. The integration of exercise stress with CMR (ExCMR) can enhance its diagnostic capacity. Despite recent advances in CMR technology, quantitative ExCMR during exercise remains technically challenging due to motion artifacts and limited spatial and temporal resolution.</p><p><strong>Methods: </strong>This study investigated the feasibility of biventricular functional and hemodynamic assessment using real-time (RT) ExCMR during a staged exercise protocol in 24 healthy volunteers. We employed high acceleration rates and applied a coil-reweighting technique to minimize motion blurring and artifacts. We further applied a beat-selection technique that identified beats from the end-expiratory phase to minimize the impact of respiration-induced through-plane motion on cardiac function quantification. Additionally, results from six patients were presented to demonstrate clinical feasibility.</p><p><strong>Results: </strong>Our findings indicated a consistent decrease in end-systolic volume and stable end-diastolic volume across exercise intensities, leading to increased stroke volume and ejection fraction. The selection of end-expiratory beats modestly enhanced the repeatability of cardiac function parameters, as shown by scan-rescan tests in nine volunteers. High scores from a blinded image quality assessment indicated that coil reweighting effectively minimized motion artifacts.</p><p><strong>Conclusion: </strong>This study demonstrated the feasibility of RT ExCMR with in-magnet exercise in healthy subjects and patients. Our results indicate that high acceleration rates, coil reweighting, and selection of respiratory phase-specific heartbeats enhance image quality and repeatability of quantitative RT ExCMR.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101894"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of bone scintigraphy versus cardiovascular magnetic resonance in cardiac amyloidosis.","authors":"Josefin Obergassel, Michael Bietenbeck, Nuriye Akyol, Volker Vehof, Claudia Meier, Maria Theofanidou, Philipp Stalling, Ali Yilmaz","doi":"10.1016/j.jocmr.2025.101859","DOIUrl":"10.1016/j.jocmr.2025.101859","url":null,"abstract":"<p><strong>Background: </strong>Accurate diagnosis of transthyretin amyloidosis cardiomyopathy (ATTR-CM) and its differentiation from light-chain (AL) cardiac amyloidosis (CA) cases (AL-CM) are of paramount importance. Surprisingly, comparative imaging data based on concurrent cardiovascular magnetic resonance (CMR) and bone scintigraphy in the same patients with biopsy-proven diagnosis of CA are still rare.</p><p><strong>Methods: </strong>This was a real-world retrospective single-center study based on a local clinical care pipeline and we carefully analyzed clinical, laboratory, CMR, and bone scintigraphy data (and if necessary additional endomyocardial biopsy [EMB] data) in patients with suspected CA. As a major inclusion criterion, we only looked at those patients who underwent both a CMR study and a bone scintigraphy-with a clear-cut imaging finding detected by at least one imaging method.</p><p><strong>Results: </strong>One hundred twenty three patients in whom the final diagnosis was obtained either non-invasively based on combined findings from bone scintigraphy and monoclonal protein studies or invasively based on additional EMB findings were included. A positive CMR result indicating the presence of CA was found in 121 patients-suggesting a CMR sensitivity of 98.4% for the diagnosis of any CA. Bone scintigraphy identified 18 patients with low to moderate uptake (Perugini score = 0-1) and 105 patients with high uptake (Perugini score ≥2)-resulting in a sensitivity for bone scintigraphy of 85.4% for the diagnosis of any CA. There was an agreement (\"diagnostic match\") between CMR and bone scintigraphy results in 103 patients (84%) of the total study cohort, while a discrepancy (\"diagnostic mismatch\") was observed in 20 patients (16%). In 18 out of these 20 diagnostic mismatch cases, CMR correctly diagnosed the presence of CA despite a negative or inconclusive result on bone scintigraphy (8 with AL-CM, 8 with ATTR-CM, and 2 with EMB-proven but unspecified CA).</p><p><strong>Conclusion: </strong>CMR shows a substantially higher diagnostic yield for the diagnosis of CA compared to bone scintigraphy, if a real-world cohort of patients comprising different subtypes of CA is looked at, since CMR does not only detect ATTR-CM but also depicts other CA subtypes such as AL. In case of a clear-cut positive CMR result unequivocally indicative of CA, there is no incremental diagnostic value of an additionally performed bone scintigraphy.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101859"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11979466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction techniques for accelerating dynamic cardiovascular magnetic resonance imaging.","authors":"Andrew Phair, René M Botnar, Claudia Prieto","doi":"10.1016/j.jocmr.2025.101873","DOIUrl":"10.1016/j.jocmr.2025.101873","url":null,"abstract":"<p><p>Achieving sufficient spatial and temporal resolution for dynamic applications in cardiovascular magnetic resonance (CMR) imaging is a challenging task due to the inherently slow nature of CMR. In order to accelerate scans and allow improved resolution, much research over the past three decades has been aimed at developing innovative reconstruction methods that can yield high-quality images from reduced amounts of k-space data. In this review, we describe the evolution of these reconstruction techniques, with a particular focus on those advances that have shifted the dynamic reconstruction paradigm as it relates to CMR. This review discusses and explains the fundamental ideas behind the success of modern reconstruction algorithms, including parallel imaging, spatio-temporal redundancies, compressed sensing, low-rank methods and machine learning.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101873"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of obesity on myocardial tissue characteristics in patients with hypertrophic cardiomyopathy: a cardiovascular magnetic resonance-based study.","authors":"Jie Wang, Lutong Pu, Jinquan Zhang, Ruihao Xu, Yang Li, Mengdi Yu, Yangjie Li, Jiajun Guo, Yuanwei Xu, Yu Kang, Yuchi Han, Yucheng Chen","doi":"10.1016/j.jocmr.2025.101903","DOIUrl":"10.1016/j.jocmr.2025.101903","url":null,"abstract":"<p><strong>Background: </strong>Obesity is associated with cardiac steatosis in healthy adults and is independently associated with increased left ventricular (LV) mass and could contribute to the progression of heart failure-related composite events in patients with hypertrophic cardiomyopathy (HCM). However, it is unclear whether the increased LV mass is accompanied by increased fibrosis. We aimed to assess the impact of increased body mass index (BMI) on myocardial tissue characteristics in patients with HCM.</p><p><strong>Methods: </strong>A total of 737 patients with HCM (99 obese, 298 overweight, and 340 normal-weight patients) who underwent cardiovascular magnetic resonance (CMR) imaging were prospectively included. We assessed the relationship between BMI and LV mass, global native T1, extracellular volume, and late gadolinium enhancement (LGE) using CMR. Myocardial tissues from one patient each with obstructive HCM who underwent septal myectomy of the obese, overweight, and normal-weight groups were obtained and stained with red oil O, hematoxylin, and Masson's trichrome.</p><p><strong>Results: </strong>LV mass index (87.2, interquartile range [IQR]: 71.3 to 113.8, 89.4, IQR:75.5 to 111.5, and 104.7, IQR: 86.4 to 123.4 g/m², P < 0.001) was higher in obese and overweight patients with HCM than those with normal weight, but the native T1 was decreased in obese patients with HCM (1324±67 ms, 1308±63 ms, and 1298±67 ms, P < 0.001). In addition, there was no significant difference in LGE extent among the three subgroups (normal weight: 3.7%, IQR: 0 to 9.5%, overweight: 2.7%, IQR: 0 to 7.7%, obese: 3.8%, IQR: 0 to 7.2%, P = 0.194). Multivariable linear regression analyses found that BMI was independently associated with global native T1 (β = -1.918, P = 0.005). Furthermore, myocardial tissues stained with oil red O from three patients showed an increasing extent of fat deposits with BMI, whereas collagen volume fractions were similar.</p><p><strong>Conclusion: </strong>In HCM patients, obesity is associated with increased myocardial mass and decreased native T1, likely reflecting cardiac steatosis in addition to fibrosis. This distinction underscores the potential reversibility of obesity-related myocardial changes through targeted weight management.</p><p><strong>Trial registration: </strong>This prospective cohort study was registered in the Chinese Clinical Trial Registry (URL: http://www.chictr.org.cn; Registry number: ChiCTR1900024094).</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101903"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stress cardiovascular magnetic resonance imaging in intermediate-risk emergency department patients with abnormal high-sensitivity troponin.","authors":"Joanna S Cavalier, John D Ike, Céleste Chevalier, Anissa Cervantes, Maham F Karatela, Katha Desai, Jerishma S Patel, Edward A Graviss, Duc T Nguyen, Clerio De Azevedo Filho, Han W Kim, Alexander T Limkakeng, Charles J Gerardo, Joseph B Borawski, Igor Klem","doi":"10.1016/j.jocmr.2025.101851","DOIUrl":"10.1016/j.jocmr.2025.101851","url":null,"abstract":"<p><strong>Background: </strong>Patients presenting to the emergency department (ED) with chest pain often have abnormal high-sensitivity troponin (hsTn). However, only about 5% have an acute coronary syndrome. We aimed to assess the safety, feasibility, and utility of a clinical disposition protocol, including outpatient observation with stress cardiovascular magnetic resonance (CMR) in intermediate-risk patients with abnormal hsTn of unclear etiology.</p><p><strong>Methods: </strong>Patients with abnormal hsTn and modified HEART-score ≤6 underwent CMR to inform diagnosis, risk stratification, and ED disposition. Patients were followed at 30 and 90 days for all-cause mortality, readmission for myocardial infarction, and unplanned coronary revascularization.</p><p><strong>Results: </strong>CMR was completed in 50 patients (64 years, 56% male) at a median of 23.2 h after presentation to the ED. CMR findings of coronary artery disease (CAD) were present in 19 (38%, 19/50) of patients, of which 13 had known CAD and 6 received a new diagnosis of CAD. In 12 (24%, 12/50) patients, cardiac noncoronary artery disease was diagnosed [cardiomyopathy (8), valvular disease (3), and myocarditis/pericarditis (1)], of which the majority (83%) (10/12) were new diagnoses. CMR was normal in 19 (38%, 19/50) patients. After CMR results were reported, the decision to admit was made in 10 (20%, 10/50) patients, while 40 (80%, 40/50) were discharged from the ED without further cardiac testing. Follow-up was completed in 96% (48/50) of patients, of which no patients experienced an adverse event.</p><p><strong>Conclusion: </strong>A disposition protocol with outpatient observation and stress CMR is feasible and useful for determining the etiology of myocardial injury and risk stratification in patients presenting to the ED with chest pain, abnormal hsTn, and intermediate risk.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101851"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical use of cardiovascular magnetic resonance-defined synthetic extracellular volume fraction.","authors":"David A Bluemke, Prashant Nagpal","doi":"10.1016/j.jocmr.2025.101891","DOIUrl":"10.1016/j.jocmr.2025.101891","url":null,"abstract":"","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":"27 1","pages":"101891"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}