Journal of Cardiovascular Magnetic Resonance最新文献

{"title":"Preclinical MRI of proinflammatory epicardial adipose tissue: Accelerated methods for simultaneous fatty acid composition and relaxation parameter mapping with relationships to tissue biomarkers.","authors":"Julia E Bresticker, Caitlin M Pavelec, John T Echols, Amit R Patel, Matthew J Wolf, Frederick H Epstein","doi":"10.1016/j.jocmr.2025.101947","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101947","url":null,"abstract":"<p><strong>Background: </strong>Epicardial adipose tissue (EAT) plays a central role in metabolic heart disease through local inflammatory signaling. In obesity, EAT undergoes pathological remodeling marked by increased adipocyte size, saturated fatty acids (SFAs), macrophage infiltration, and inflammatory cytokine secretion. Proton density fat fraction (PDFF), T₁, and the fatty acid composition (FAC) (the amount of SFAs, monounsaturated fatty acids [MUFAs], and polyunsaturated fatty acids [PUFAs]) are promising metrics of EAT quality, yet their role as biomarkers of proinflammatory EAT has not been established. This study presents an accelerated CMR method for simultaneous EAT FAC and T₁ mapping and evaluates their relationships with histological and cytokine markers of inflammation.</p><p><strong>Methods: </strong>An ECG-gated inversion recovery multi-echo gradient-echo sequence with radial golden-angle sampling was developed for simultaneous FAC and T₁ mapping. A high-dimensionality patch-based low-rank reconstruction was applied to undersampled images. Phantom validation was performed using oil mixture and gadolinium phantoms, followed by in vivo imaging of mice (n=16-20/group) fed a high-fat high-sucrose diet (HFHSD), HFHSD plus the sodium-glucose cotransporter-2 inhibitor (SGLT2i) empagliflozin (HFHSD+EMPA), or a high-fat diet (HFD). PDFF, SFA fraction, MUFA fraction, PUFA fraction, R₂*, and T₁ measurements were made in EAT and subcutaneous adipose tissue (SAT). EAT FAC values were indexed to those of SAT. Ex vivo histology and cytokine assays were used to assess EAT and myocardial inflammation.</p><p><strong>Results: </strong>Phantom validation demonstrated strong agreement between MRI-derived and reference FAC and T₁ values (r > 0.94, p < 0.05). Diet-induced changes in adipose tissue FAC were detected by MRI. HFHSD+EMPA mice had lower EAT SFA index than both HFHSD (p < 0.01) and HFD (p < 0.05) mice, and higher MUFA index (p < 0.01), PUFA index (p < 0.05), and T₁ (p < 0.05) compared HFHSD mice. EAT SFA index positively correlated with macrophage infiltration and proinflammatory cytokines, while MUFA and PUFA indexes were inversely correlated with proinflammatory cytokines. EAT T₁ negatively correlated with adipocyte hypertrophy.</p><p><strong>Conclusion: </strong>This study developed an accelerated EAT FAC and T₁ imaging method and provides evidence that MRI-derived EAT FAC indexes and T₁ may serve as biomarkers of proinflammatory EAT by demonstrating correlations with histological and cytokine markers.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101947"},"PeriodicalIF":6.1,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955680","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":"ScarNet: A Novel Foundation Model for Automated Myocardial Scar Quantification from Late Gadolinium-Enhancement Images.","authors":"Neda Tavakoli, Amir Ali Rahsepar, Brandon C Benefield, Daming Shen, Santiago López-Tapia, Florian Schiffers, Jeffrey J Goldberger, Christine M Albert, Edwin Wu, Aggelos K Katsaggelos, Daniel C Lee, Daniel Kim","doi":"10.1016/j.jocmr.2025.101945","DOIUrl":"10.1016/j.jocmr.2025.101945","url":null,"abstract":"<p><strong>Background: </strong>Late Gadolinium Enhancement (LGE) imaging remains the gold standard for assessing myocardial fibrosis and scarring, with left ventricular (LV) LGE presence and extent serving as a predictor of major adverse cardiac events (MACE). Despite its clinical significance, LGE-based LV scar quantification is not used routinely due to the labor-intensive manual segmentation and substantial inter-observer variability.</p><p><strong>Methods: </strong>We developed ScarNet that synergistically combines a transformer-based encoder in Medical Segment Anything Model (MedSAM), which we fine-tuned with our dataset, and a convolution-based decoder in U-Net with tailored attention blocks to automatically segment myocardial scar boundaries while maintaining anatomical context. This network was trained and fine-tuned on an existing database of 401 ischemic cardiomyopathy patients (4,137 2D LGE images) with expert segmentation of myocardial and scar boundaries in LGE images, validated on 100 patients (1,034 2D LGE images) during training, and tested on unseen set of 184 patients (1,895 2D LGE images). Ablation studies were conducted to validate each architectural component's contribution.</p><p><strong>Results: </strong>In 184 independent testing patients, ScarNet achieved accurate scar boundary segmentation (median DICE=0.912 [interquartile range (IQR): 0.863-0.944], concordance correlation coefficient [CCC]=0.963), significantly outperforming both MedSAM (median DICE=0.046 [IQR: 0.043-0.047], CCC=0.018) and nnU-Net (median DICE=0.638 [IQR: 0.604-0.661], CCC=0.734). For scar volume quantification, ScarNet demonstrated excellent agreement with manual analysis (CCC=0.995, percent bias=-0.63%, CoV=4.3%) compared to MedSAM (CCC=0.002, percent bias=-13.31%, CoV=130.3%) and nnU-Net (CCC=0.910, percent bias=-2.46%, CoV=20.3%). Similar trends were observed in the Monte Carlo simulations with noise perturbations. The overall accuracy was highest for SCARNet (sensitivity=95.3%; specificity=92.3%), followed by nnU-Net (sensitivity=74.9%; specificity=69.2%) and MedSAM (sensitivity=15.2%; specificity=92.3%).</p><p><strong>Conclusion: </strong>ScarNet outperformed MedSAM and nnU-Net for predicting myocardial and scar boundaries in LGE images of patients with ischemic cardiomyopathy. The Monte Carlo simulations demonstrated that ScarNet is less sensitive to noise perturbations than other tested networks.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101945"},"PeriodicalIF":6.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955604","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":"Exercise Stress Cardiac MRI is Feasible in Adolescents and Young Adults with Anomalous Coronary Arteries.","authors":"Elizabeth Carter, Rebecca L Moore, Kevin K Whitehead, Sara L Partington, David M Biko, Danish Vaiyani, Mark A Fogel, Matthew A Harris, Julie A Brothers","doi":"10.1016/j.jocmr.2025.101944","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101944","url":null,"abstract":"<p><strong>Aims: </strong>Anomalous aortic origin of a coronary artery (AAOCA) can result in sudden cardiac death in the young and risk stratification is challenging. Though dobutamine stress cardiac magnetic resonance (DS-CMR) is feasible in pediatric patients, exercise stress CMR (ES-CMR) may have lower rates of adverse events, higher diagnostic accuracy, and the ability to better reflect the physiologic changes occurring with exercise. We aimed to describe our institution's experience with ES-CMR using supine bicycle ergometry in pediatric and young adult patients with AAOCA.</p><p><strong>Methods and results: </strong>We retrospectively reviewed the medical records of AAOCA patients who underwent ES-CMR at our institution between 2011 and 2024 for demographic, clinical presentation, cardiopulmonary exercise test (CPET) and ESCMR data. The exercise-based portion of the CMR consisted of supine cycle ergometry utilizing a ramp protocol, immediately after which ES perfusion imaging was performed. Fifteen minutes after stress imaging, rest perfusion imaging was acquired.Of 38 patients who underwent ES-CMR, the median age was 16 years (range 13-24) and 68% were male. Diagnoses included anomalous right coronary artery (n=28),anomalous left coronary artery (n=8), and single coronary artery (n=1 single right, n=1single left). Median maximal heart rate (HR) during ES-CMR was 160 bpm (range 130-190, median 80% predicted) compared to a median maximal HR during patients' most recent CPET of 187 bpm (range 160-203, median 97% predicted). No patients had perfusion defects at rest or with exercise stress, or evidence of myocardial scarring.</p><p><strong>Conclusions: </strong>We demonstrate for the first time the use of ES-CMR in a cohort of pediatric and young adult patients with AAOCA. ES-CMR is a unique modality to assess for ischemia at rest and stress to assist with risk stratification by simulating physiologic changes with exercise stress. Although maximum heart rates during supine cycle ergometry are lower than those reached during CPET, they are similar to those reached during DS-CMR. ES-CMR is a valuable diagnostic tool and may be useful in the risk stratification of patients with AAOCA.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101944"},"PeriodicalIF":6.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955674","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 of Epicardial Adipose Tissue and Biventricular Strain in Heart Failure with Preserved and Reduced Ejection Fraction.","authors":"Yu-Jiao Song, Ting Ning, Ming-Tian Chen, Xiao-Ying Zhao, Wan-Qiu Zhang, Lu-Jing Wang, Xin-Xiang Zhao","doi":"10.1016/j.jocmr.2025.101935","DOIUrl":"10.1016/j.jocmr.2025.101935","url":null,"abstract":"<p><strong>Background and purpose: </strong>Epicardial adipose tissue (EAT) plays a crucial role in the progression of heart failure (HF). This study employs cardiac magnetic resonance (CMR) imaging to investigate potential differences in EAT between patients with heart failure with reduced ejection fraction (HFrEF) and those with heart failure with preserved ejection fraction (HFpEF), as well as the correlation between EAT and biventricular function (myocardial strain).</p><p><strong>Methods: </strong>We collected data from patients diagnosed with HF at the Second Affiliated Hospital of Kunming Medical University between January 2021 and December 2023. All patients underwent CMR imaging and were categorized into two groups based on left ventricular ejection fraction (LVEF): the HFrEF group and the HFpEF group. Patients without heart failure served as the control group. We gathered clinical baseline data and utilized the CVI-42 post-processing software to obtain parameters related to cardiac structure and function, including LVEF, global radial strain (GRS), global longitudinal strain (GLS), EAT, pericardial adipose tissue (PeAT), paracardial adipose tissue (PaAT), and wall stress. We compared the differences in parameters among the three groups and conducted pairwise comparisons. Additionally, we performed correlation analyses of EAT and PeAT with GLS and body mass index (BMI) within the HFrEF and HFpEF cohorts.</p><p><strong>Results: </strong>A total of 104 patients with HFrEF, 226 patients with HFpEF, and 172 patients without heart failure were ultimately included in the study. Significant statistical differences were observed among the three groups regarding age, smoking status, diabetes, brain natriuretic peptide (BNP) levels, BMI, EAT, PeAT, PaAT, wall stress, GLS and GRS of both ventricles (P < 0.05). The EAT volume in HFrEF patients (32 ± 14ml) was lower than that in HFpEF patients (51 ± 21ml) and the control group (33 ± 19ml). Additionally, PeAT and PaAT levels were higher in HFpEF patients compared to those in HFrEF and the control group. Correlation analysis revealed that in HFrEF patients, EAT accumulation was associated with better left ventricular (LV) function (LVGLS, r = 0.85, p < 0.01) and right ventricular (RV) function (RVGLS, r = 0.73, p < 0.01). Conversely, in HFpEF patients, EAT accumulation correlated with poorer LV (LVGLS, r = -0.67, p < 0.01) and RV (RVGLS, r = 0.55, p < 0.01) function.</p><p><strong>Conclusion: </strong>EAT was greater in patients with HFpEF compared to HFrEF. In the HFpEF group, increased EAT was correlated with worsening biventricular function, while the opposite trend was observed in the HFrEF group.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101935"},"PeriodicalIF":6.1,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873366","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":"CMR versus CCTA with fractional flow reserve for diagnosing obstructive coronary artery disease in higher risk patients: rationale and design of CONCORD - a prospective, single-centre diagnostic accuracy study.","authors":"Simran Shergill, Mohamed Elshibly, Kelly S Parke, Rachel England, Joanne V Wormleighton, Indrajeet Das, Gaurav S Gulsin, Sandeep S Hothi, Robert Heggie, Olivia Wu, Peter Kellman, Alasdair McIntosh, Alex McConnachie, Andrew Ladwiniec, Gerry P McCann, J Ranjit Arnold","doi":"10.1016/j.jocmr.2025.101939","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101939","url":null,"abstract":"<p><strong>Background: </strong>In patients with suspected coronary artery disease (CAD), the optimal diagnostic algorithm remains uncertain. Non-invasive imaging plays a central role as a \"gatekeeper\" to invasive coronary angiography, with both cardiovascular magnetic resonance (CMR) and coronary computed tomography angiography (CCTA) with fractional flow reserve (FFR_CT) proving effective in reducing unnecessary invasive procedures. However, direct comparisons between the two modalities are limited.</p><p><strong>Trial design: </strong>CONCORD is a prospective, single-centre study comparing the diagnostic accuracy of CMR and CCTA/FFR_CT to detect obstructive CAD in 300 patients with suspected angina referred for clinically indicated invasive coronary angiography. The primary outcome is the diagnostic accuracy of each imaging protocol against the reference standard of invasive fractional flow reserve. Key secondary outcomes include whether quantitative CMR is more accurate than qualitative CMR and/or CCTA/FFR_CT, and whether hybrid imaging models may outperform single modality strategies (NCT04761991).</p><p><strong>Summary: </strong>CONCORD will comprehensively evaluate two frontline non-invasive functional imaging modalities in patients with suspected angina and determine the comparative accuracy of CCTA/FFR_CT and CMR in patients with a moderate-high risk of CAD. Evaluation of these strategies has the potential to inform both the quality and cost-effectiveness of imaging services.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101939"},"PeriodicalIF":6.1,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862266","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":"High variability in reporting of right ventricle contouring technique and body surface area methodology in cardiac magnetic resonance studies of patients with repaired Tetralogy of Fallot: A systematic review.","authors":"Abbey J Grbac, Phillip S Naimo, Jeremy J Russo, Samuel J Fogarty, William M Wilson, Dominica Zentner, Katherine M English, Leeanne E Grigg, Andrew J Taylor, Elaine H Lui, Subodh B Joshi, Melissa G Y Lee","doi":"10.1016/j.jocmr.2025.101942","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101942","url":null,"abstract":"<p><strong>Background: </strong>Timing of pulmonary valve intervention (PVI) for pulmonary regurgitation in patients with repaired Tetralogy of Fallot (TOF) is guided by right ventricle (RV) volumetric/function assessment on cardiac magnetic resonance (CMR) indexed to actual body surface area (BSA). However, different RV contouring techniques and BSA formulae exist with significant variability in reported measurements. We aimed to review the protocols reported in CMR studies of PVI in TOF.</p><p><strong>Methods: </strong>A search of electronic databases (Embase and MEDLINE) was performed to identify studies published between 28/2/10-28/2/25 which assessed adults with repaired TOF before and after PVI using CMR. RV contouring methods and BSA formulae were reviewed.</p><p><strong>Results: </strong>After screening 610 references, a total of 27 studies met criteria and were included. All studies were of only level III or level IV (lowest) levels of evidence. Most studies (81%, 22/27) did not specify the RV contouring technique used and none defined the RV basal slice. Of the 5 studies describing the RV contouring technique, 4 excluded trabeculations/papillary muscles from the RV volume and 1 included these structures. No studies reported the formula used to calculate actual BSA.</p><p><strong>Conclusion: </strong>RV contouring technique and BSA methodology utilised in CMR studies of PVI in TOF is poorly reported. Given the importance of severity thresholds for RV volumes in triggering intervention in clinical practice, clear reporting and standardisation of RV contouring and BSA methodology should be mandatory. Further research into the optimal RV thresholds for PVI based on clear contouring methods is required.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101942"},"PeriodicalIF":6.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859247","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 in Marfan Syndrome: A Multicenter Cardiovascular Magnetic Resonance Study.","authors":"Kenan Kaya, Jonathan Kottlors, Thorsten W Gietzen, Leon Bischoff, Jan M Brendel, Reza Dehdab, Moritz C Halfmann, Lukas Müller, Philipp V Stein, Lukas Goertz, Jan Paul Janßen, Roman Johannes Gertz, Robert Terzis, Vanessa Schmidt, Kilian Weiss, Christopher Hohmann, David Maintz, Tilman Emrich, Patrick Krumm, Julian A Luetkens, Carsten H Gietzen, Lenhard Pennig","doi":"10.1016/j.jocmr.2025.101938","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101938","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Data on the prevalence of mitral annular disjunction (MAD) in Marfan syndrome (MFS) based on cardiovascular magnetic resonance (CMR) is sparse. The purpose of this study was to assess prevalence, extent, and distribution of MAD in MFS using CMR and to examine its association with left heart parameters, aortic dimensions, and cardiovascular events.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective multicenter study included CMR studies of patients treated for MFS at four tertiary care medical centers with a (likely) pathogenic fibrillin-1 gene variant. Two radiologists (five and eight years of experience in CMR) evaluated datasets for MAD (at four points around the annulus, including measurement of extent) and mitral valve prolapse (MVP). Further assessment comprised volumetric and functional analysis of the left ventricle (LV), left atrial size, and aortic root diameters. Cardiovascular events included aortic (aortic surgery or aortic dissection), arrhythmic (sustained ventricular tachycardia or sudden cardiac death), and mitral events (mitral valve surgery, MVS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 91 patients (28.9±14.0 years, 47.3% female), 81.3% had MAD (extent: 6.1±2.6mm). MAD was mostly found at the inferior insertion (72.5% of patients) and usually affected all sites (39.6% of patients). Left heart parameters and aortic dimensions did not differ between MAD and no MAD groups (P&gt;0.05). MAD extent and localizations showed significant correlations with LV dilatation (e.g., inferior MAD: r=0.62 for end-diastolic volume index), decreased LV ejection fraction (e.g., anterolateral MAD: r=-0.46), and MVP (e.g., MAD distance: r=0.83), which was found in 44.6% of patients with MAD while only affecting 11.8% without MAD (P=0.017). Based on receiver operating characteristic analysis for the prediction of MVP prevalence, a threshold of 7.1mm MAD extent was identified as the optimal cut-off value (sensitivity: 77.1%, specificity: 89.3%). Additionally, subgroup analysis applying different thresholds of MAD extent revealed a significantly larger displacement of MVP and LV volumes as well as higher aortic root z scores for a threshold of ≥ 8mm. After a mean follow-up of 4.0±3.0 years, cardiovascular events [aortic: n=13 (14.3%), arrhythmic: n=2 (2.2%), and mitral: n=2 (2.2%) of patients] did not differ significantly (all P&gt;0.05) between no MAD and MAD groups regardless of applied thresholds although MVS was observed exclusively in patients with MAD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The high prevalence, large extent, and predominantly pan-annular distribution of MAD suggest a systemic annular pathology in MFS. Overall presence of MAD was not associated with changes to left heart parameters, aortic dimensions, and cardiovascular events. However, MAD, taking into account its extent and affected insertion sites, could serve as a potential marker of disease progression given the shown association of localizations and distanc","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101938"},"PeriodicalIF":6.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859248","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":"SCMR Expert Consensus Statement on Quantitative Myocardial Perfusion Cardiovascular Magnetic Resonance Imaging.","authors":"Amedeo Chiribiri, Andrew E Arai, Edward DiBella, Li-Yueh Hsu, Masaki Ishida, Michael Jerosch-Herold, Sebastian Kozerke, Xenios Milidonis, Reza Nezafat, Sven Plein, Cian M Scannell, Michael Salerno","doi":"10.1016/j.jocmr.2025.101940","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101940","url":null,"abstract":"<p><p>Myocardial perfusion imaging plays a central role in the management of patients with known or suspected coronary artery disease (CAD) and increasingly in patients with suspected ischemia with normal coronary arteries (INOCA) as well as anomalous origins of the coronary arteries and Kawasaki disease. Stress perfusion cardiovascular magnetic resonance (CMR) is recognized by international guidelines, with several Class 1 indications for the detection of abnormal myocardial blood flow in these clinical scenarios and offers excellent diagnostic accuracy and independent prognostic value. While visual interpretation of the perfusion data is the prevailing analysis method in clinical practice, quantitative perfusion CMR is at least as accurate for the detection of significant obstructive CAD and provides a more accurate estimation of the total ischemic burden in patients with CAD. Moreover, quantitative myocardial perfusion analysis provides unique insights into the pathophysiology of myocardial ischemia, including microvascular disease in INOCA. Quantitative perfusion CMR can be fully automated, is user-independent, and may facilitate more widespread use of the modality. The aim of this Society for Cardiovascular Magnetic Resonance (SCMR) expert consensus document is to provide recommendations for the acquisition and analysis of quantitative myocardial perfusion CMR to facilitate standardization of methodology. This paper also discusses research and development goals to address current limitations, to ensure data reliability and validity, to create the basis for future multi-vendor and multi-center research, and to broaden the clinical use of quantitative perfusion CMR.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101940"},"PeriodicalIF":6.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816749","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":"Increased extracellular volume after aortic valve replacement: a footprint of reverse ventricular remodeling that does not affect conduction velocity.","authors":"Vladimír Sobota, Christoph M Augustin, Gernot Plank, Edward J Vigmond, Sarah Nordmeyer, Jason D Bayer","doi":"10.1016/j.jocmr.2025.101936","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101936","url":null,"abstract":"<p><strong>Background: </strong>Extracellular volume (ECV) determined by cardiovascular magnetic resonance (CMR) is considered a marker of diffuse myocardial fibrosis and a predictor of mortality. Using personalized computational models, we investigated the relationship between ECV, conduction velocity (CV), and cell radius in aortic stenosis (AS) patients.</p><p><strong>Methods: </strong>CMR was performed on 12 AS patients (6 males, 6 females) before and 3 months after surgical aortic valve replacement (AVR). All patients had a QRS≤110 ms, and no scar on late gadolinium enhanced (LGE) CMR. Computational biventricular models were developed from each CMR dataset. Using patient-specific ECV and the relative change in cell radius between the time points as inputs, tissue conductivity was adjusted in each model to match the patient's QRS duration. A physiological pattern of ventricular depolarization was mimicked by simultaneously pacing each model from 5 activation sites. CV was measured during a simulation of apical pacing, using two points positioned at the right ventricular septum of the model.</p><p><strong>Results: </strong>Left ventricular mass decreased after AVR (62 [58-79] vs. 51 [41-60] g/m², p=0.0005) while ECV increased (24.2 [20.6-24.8] vs. 28.0 [25.1-29.5] %, p=0.0008). No changes in the patient's QRS duration (89.0 [80.5-99.0] vs. 88 [78.5-99.5] ms, p=0.2148) were observed. No changes in the CV obtained from the models (64.3 [61.9-72.8] vs. 66.0 [60.0-74.5] cm/s, p=0.5186) were found between the time points, suggesting there was no substantial increase in diffuse fibrosis. ECV was negatively correlated with cell radius (r=-0.5267, p=0.0082), but not correlated with CV obtained from the models (r=-0.2036, p=0.3399).</p><p><strong>Conclusion: </strong>Increased ECV 3 months after AVR in patients with no LGE scar and with normal ventricular conduction appears to be a footprint of reverse ventricular remodeling that does not necessarily translate into changes in myocardial CV.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101936"},"PeriodicalIF":6.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804187","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":"Left Atrial Volumetric and Functional Remodeling Post-Pulmonary Vein Isolation: Insights from Cardiac Magnetic Resonance Imaging.","authors":"Nikki van Pouderoijen, Luuk H G A Hopman, Leontine E Wentrup, Joris R de Groot, Michiel J B Kemme, Cornelis P Allaart, Marco J W Götte","doi":"10.1016/j.jocmr.2025.101937","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101937","url":null,"abstract":"<p><strong>Aim: </strong>To assess left atrial (LA) volumetric and functional remodeling parameters using cardiac magnetic resonance (CMR) imaging early and late after pulmonary vein isolation (PVI) in atrial fibrillation (AF) patients.</p><p><strong>Methods and results: </strong>This study involved 61 AF patients undergoing radiofrequency (RF) PVI. CMR scans were performed pre-PVI, within 72hours and 3 months post-PVI. LA volumes and strain were assessed using two- and four-chamber cine images. Early AF recurrence was monitored during 3 months follow-up.LAVImin significantly increased early post-PVI (22.5±8.7mL/m² to 25.8±9.9mL/m²,p<0.01). At 3 months, both LAVImin and LAVImax significantly reduced compared to early post-PVI (25.4±8.87mL/m² to 19.4±7.7mL/m²,p<0.001;48.2±12.7mL/m² to 38.7±10.6mL/m²,p<0.001, respectively), as well as compared to baseline (22.5±8.7mL/m² to 20.1±8.5mL/m²,p=0.04;45.6±11.8mL/m² to 39.3±11.2mL/m²,p<0.001, respectively). Early post-PVI, LA emptying fraction (LA EF), LA reservoir, and contractile strain significantly reduced compared to baseline (from 51.6±10.8% to 47.1±8.9%,p<0.01;18.3±4.4% to 15.4±2.9%,p<0.001;8.3±3.1% to 5.4±1.8%,p<0.001, respectively). At 3 months, LA EF, LA reservoir, and contractile strain significantly increased as compared to early post-PVI (from 47.1±8.9% to 50.5±8.6%,p<0.01;15.4±2.9% to 16.8±3.1%,p<0.01;5.4±1.8% to 6.9±2.3%,p<0.001, respectively). However, LA reservoir and contractile strain remained significantly lower compared to baseline (18.3±4.4% to 16.8±3.1%,p=0.02;8.3±3.1% to 6.9±2.3%,p<0.01, respectively). In patients with early AF recurrence (27.9%), LA volume reduction and partial functional recovery was not observed during 3 months post-PVI.</p><p><strong>Conclusion: </strong>LA volumes significantly reduced 3 months post-PVI. While LA function initially declined, it showed partial recovery at 3 months. However, LA reservoir and contractile strain remained reduced compared to pre-PVI. LA reverse remodeling and partial LA functional recovery only occurred in patients without early AF recurrence.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101937"},"PeriodicalIF":6.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804188","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}