Journal of Cardiovascular Magnetic Resonance最新文献

{"title":"Myocardial Blood Flow Quantification in Patients with an Implanted Cardiodefibrillator during Stress and at Rest using a Wideband Perfusion Pulse Sequence: An Initial Feasibility Study.","authors":"Lexiaozi Fan, Maria Davo Jimenez, Dima Bishara, Jacqueline Urban, Kyungpyo Hong, Austin E Culver, Jeremy D Collins, Li-Yueh Hsu, Shuo Wang, Amit R Patel, Oluyemi B Aboyewa, Cagdas Topel, Daniel C Lee, Daniel Kim","doi":"10.1016/j.jocmr.2025.101952","DOIUrl":"10.1016/j.jocmr.2025.101952","url":null,"abstract":"<p><strong>Background: </strong>Although a recently developed wideband perfusion sequence has shown diagnostically acceptable image quality and accurate myocardial blood flow (MBF) quantification at rest in patients with cardiac implanted electronic devices (CIEDs), its performance during vasodilator stress remains unproven. This study aims to determine whether the sequence produces diagnostically acceptable image quality during stress and is capable of quantitatively detecting abnormal stress MBF and myocardial perfusion reserve (MPR) in patients with implanted cardiodefibrillators (ICDs).</p><p><strong>Methods: </strong>We enrolled 29 patients with an ICD (mean age = 63 ± 15 years, 17 males, 12 females) and 11 control patients (mean age = 50 ± 17 years, 6 males, 5 females; negative coronary artery disease; negative stress perfusion CMR; and no cardiac event one year post CMR) with an ICD taped below the left clavicle to mimic image artifacts. Both groups underwent imaging using a six-fold accelerated wideband perfusion sequence during adenosine stress and at rest. Images were reconstructed using a compressed sensing framework. Two clinical readers independently graded the following three categories on a 5-point Likert scale (1: worst, 3: clinically acceptable, 5: best): conspicuity of wall enhancement, noise, and artifact. Pixel-wise stress-rest MBF maps were quantified for both global and segmental analysis. MPR was calculated as the ratio of mean stress to rest MBFs.</p><p><strong>Results: </strong>The median summed visual score was above the acceptable cut-point (>9.0) and not significantly different between the two groups. Both mean global and segmental stress MBF and MPR were significantly lower (p < 0.05) in the ICD patient group (global MBF=1.79±0.50ml/g/min; global MPR=2.11±0.53) compared to the control group (global MBF=2.92±0.52ml/g/min; global MPR=3.28±0.57), while rest MBF showed no significant difference (global MBF=0.88±0.18ml/g/min in the patient group vs. 0.92±0.13ml/g/min in the control group).</p><p><strong>Conclusions: </strong>This study demonstrates the feasibility of using a six-fold accelerated wideband perfusion pulse sequence, which provides diagnostically acceptable image quality during stress and is sensitive for detecting abnormal stress MBF and MPR in patients with ICDs.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101952"},"PeriodicalIF":6.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008222","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":"Optimising Cardiac Diffusion Tensor Imaging In Vivo: More Directions or Repetitions?","authors":"Sam Coveney, David Shelley, Richard Foster, Maryam Afzali, Ana-Maria Poenar, Noor Sharrack, Sven Plein, Erica Dall'Armellina, Jürgen E Schneider, Christopher Nguyen, Irvin Teh","doi":"10.1016/j.jocmr.2025.101951","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101951","url":null,"abstract":"<p><strong>Background: </strong>Cardiac diffusion tensor imaging (cDTI) is sensitive to imaging parameters including the number of unique diffusion encoding directions (ND) and number of repetitions (NR; analogous to number of signal averages or NSA). However, there is no clear guidance for optimising these parameters in the clinical setting.</p><p><strong>Methods: </strong>Spin echo cDTI data with 2^nd order motion compensated diffusion encoding gradients were acquired in ten healthy volunteers on a 3T MRI scanner with different diffusion encoding schemes in pseudo-randomised order. The data were subsampled to yield 96 acquisition schemes with 6 ≤ ND ≤ 30 and 33 ≤ total number of acquisitions (NA_all) ≤ 180. Stratified bootstrapping with robust fitting was performed to assess the accuracy and precision of each acquisition scheme. This was quantified across a mid-ventricular short-axis slice in terms of root mean squared difference (RMSD) with respect to the full reference dataset, and standard deviation (SD) across bootstrap samples respectively.</p><p><strong>Results: </strong>For the same acquisition time, the ND = 30 schemes had on average 48%, 40%, 34% and 34% lower RMSD and 6.2%, 7.4%, 10% and 5.6% lower SD in MD, FA, HA and |E2A| compared to the ND = 6 schemes. Given a fixed number of high b-value acquisitions, there was a trend towards lower RMSD and SD of MD and FA with increasing numbers of low b-value acquisitions. Higher NA_all with longer acquisition times led to improved accuracy in all metrics whereby quadrupling NA_all from 40 to 160 volumes led to a 20%, 39%, 11% and 5.4% reduction in RMSD of MD, FA, HA and |E2A| respectively, averaged across six diffusion encoding schemes. Precision was also improved with a corresponding 53%, 50%, 53% and 36% reduction in SD.</p><p><strong>Conclusions: </strong>We observed that accuracy and precision were enhanced by (i) prioritising number of diffusion encoding directions over number of repetitions given a fixed acquisition time, (ii) acquiring sufficient low b-value data, (iii) using longer protocols where feasible. For clinically relevant protocols, our findings support the use of ND = 30 and NA_b50:NA_b500 ≥ 1/3 for better accuracy and precision in cDTI parameters. These findings are intended to help guide protocol optimisation for harmonisation of cDTI.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101951"},"PeriodicalIF":6.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000672","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":"Regional 4D Cardiac Magnetic Resonance Strain Predicts Cardiomyopathy Progression in Duchenne Muscular Dystrophy.","authors":"Conner C Earl, Alexa M Jauregui, Marco A Prado, Guang Lin, Kan N Hor, Larry W Markham, Jonathan H Soslow, Craig J Goergen","doi":"10.1016/j.jocmr.2025.101950","DOIUrl":"10.1016/j.jocmr.2025.101950","url":null,"abstract":"<p><strong>Background: </strong>Cardiomyopathy (CMP) is the leading cause of death in Duchenne muscular dystrophy (DMD). Characterization of disease trajectory can be challenging, especially in early stages of CMP where onset and progression may vary. Traditional metrics from cardiovascular magnetic resonance (CMR) imaging such as LVEF (left ventricular ejection fraction) and LGE (late gadolinium enhancement) are often insufficient for assessing the pace of disease progression. We hypothesized that strain patterns from a novel 4D (3D+time) CMR regional strain analysis method can be used to predict DMD CMP progression.</p><p><strong>Methods: </strong>We compiled 190 short-axis cine CMR image stacks for n=66 pediatric DMD patients (13.3 [10.8-16.5] years; median [interquartile range]) imaged for 3 consecutive years and computed regional strain metrics using custom-built feature tracking software. We measured regional strain parameters from the generated 4D endocardial surface mesh.</p><p><strong>Results: </strong>Using LVEF decrease, measured two years following the initial scan, we classified patients into slow (ΔLVEF%<5; n=35) or fast (ΔLVEF%≥5; n=30) progressing groups. There was no statistical difference between the slow and fast-progressing groups in terms of standard metrics such as age, LVEF, or LGE status. However, peak basal circumferential strain (E_cc) and surface area strain (E_a) magnitudes were decreased in fast progressors (p<0.01 for all). Basal E_cc late diastolic strain rate and basal E_a late diastolic strain rate magnitude were also significantly decreased in fast progressors (p<0.01 for all).</p><p><strong>Conclusion: </strong>Regional strain metrics from 4D CMR can be used to differentiate between slow or fast CMP progression in a longitudinal DMD cohort.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101950"},"PeriodicalIF":6.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955667","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":"Atorvastatin and Left Atrial Function During Anthracycline-based Chemotherapy.","authors":"Vencel Juhasz, Zsofia D Drobni, Thiago Quinaglia, Hannah K Gilman, Giselle Alexandra Suero-Abreu, Azin Ghamari, Julius C Heemelaar, Donna S Neuberg, Yuchi Han, Bonnie Ky, Raymond Y Kwong, James L Januzzi, Aarti Asnani, Negareh Mousavi, Robert A Redd, Michael Jerosch-Herold, Marielle Scherrer-Crosbie, Tomas G Neilan","doi":"10.1016/j.jocmr.2025.101946","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101946","url":null,"abstract":"<p><strong>Background: </strong>Structural and functional abnormalities of the left atrium (LA) predict adverse outcomes such as heart failure and mortality in many patients with heart disease. However, the effect of anthracyclines on LA structural and functional abnormalities remains incompletely characterized. Further, atorvastatin prevented the anthracycline-associated decline in the left ventricular ejection fraction; however, whether atorvastatin protects against anthracycline-associated impairment of LA structure and function is currently unknown.</p><p><strong>Methods: </strong>In the STOP-CA randomized clinical trial, participants with lymphoma treated with anthracyclines were randomized to placebo (n=150) or atorvastatin (n=150) for 12 months. In post-hoc analyses, CMR-derived LA volumetric and functional measurements (reservoir [GLS], conduit, and booster strain) were measured at baseline and 12 months using feature tracking (FT). The primary endpoint was the difference in the proportion of participants with a ≥1SD decrease in LA GLS between the atorvastatin and placebo groups. The secondary endpoint was a ≥20% relative decrease in LA GLS. Other exploratory endpoints included volume indices and emptying fractions.</p><p><strong>Results: </strong>Of 300 participants, 158 (mean age 51±16 years, 48% female, 83 with atorvastatin) had paired CMR-derived LA strain and volumetric data at baseline and follow-up. Both groups had similar baseline characteristics and cancer treatment. All LA strain and volumetric measures were similar between the two groups at baseline. Among the placebo group, LA GLS decreased from baseline to follow-up (35.5±8.8 vs. 32.4±8.2%, p=0.007). A ≥1SD absolute decrease in LA GLS (8.8% units) was observed among 24% with atorvastatin and 28% with placebo (p=0.59). Similarly, a ≥20% relative decrease in GLS was observed in 25% vs. 31% (p=0.48). Participants over 50 had an almost 10% (9.9%, 95% confidence interval: -18.75, -1.12) greater relative decrease in LA GLS with anthracyclines. There were no differences between cardiac hospitalization rates with a ≥1SD absolute decrease (5% vs. 8%, p=0.72) in LA GLS at 24 months. Among other indices of LA structure and function, the LA total emptying fraction also decreased from baseline to follow-up, with no differences between groups at follow-up.</p><p><strong>Conclusion: </strong>Atorvastatin did not attenuate the decline in CMR-derived LA GLS among lymphoma patients undergoing anthracycline-based chemotherapy.</p><p><strong>Clinical trial registration: </strong>NCT02943590; https://clinicaltrials.gov/study/NCT02943590.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101946"},"PeriodicalIF":6.1,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955655","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":"Validation of normal reference ranges in cardiac magnetic resonance imaging: The Multi-Ethnic Study of Atherosclerosis.","authors":"Nadine Kawel-Boehm, Spencer L Hansen, Bharath Ambale-Venkatesh, J Jeffrey Carr, J Paul Finn, Michael Jerosch-Herold, Steven M Kawut, Robyn L McClelland, Wendy Post, Martin R Prince, Steven Shea, João A C Lima, David A Bluemke","doi":"10.1016/j.jocmr.2025.101949","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101949","url":null,"abstract":"<p><strong>Background: </strong>Normal reference ranges in cardiovascular imaging studies are typically established as the mean value plus and minus twice the standard deviation (SD) of a healthy reference cohort (\"2 SD-method\"). Although widely used for cardiac magnetic resonance (CMR), this approach has not been previously validated. The purpose of this study was to use longitudinal cohort data to assess the clinical predictive validity of normal reference values for cardiac CMR.</p><p><strong>Methods: </strong>Normal reference ranges for left- and right ventricular (LV and RV) CMR parameters were derived from baseline exam data of 1518 participants (age 45-84 years) in the Multi-Ethnic Study of Atherosclerosis (MESA) study without known CV disease and without established CV risk factors. Cut-off values at 1 and 2 SDs were obtained for the following LV and RV parameters indexed to body surface area: end-diastolic volume (LVEDVi, RVEDVi), end-systolic volume (LVESVi, RVESVi), mass (LVMi, RVMi), as well as for LVED diameter (LVEDD), LVED wall thickness and ejection fraction (LVEF, RVEF). The relationship of reference values to CV events was then evaluated in the entire MESA cohort with CMR data (n=4915), including individuals with CV risk factors at the baseline exam. Cox proportional hazard models were calculated for major adverse and all CV events (MACE and ACE, respectively) at 5 and 10 years of follow-up.</p><p><strong>Results: </strong>At 5 years of follow-up, LVEDVi, LVESVi and LVEF beyond the 2SD-threshold of the mean reference values were predictors of MACE and ACE in men and women (HR 2.1-4.3; P <.001-.029). In men, LVMi and LVED wall thickness above the 1 SD-threshold were associated with CV events (HR 1.6-2.1; P <.001-.002). For women, LVED wall thickness above the 1 SD-threshold significantly increased risk of adverse events (HR 1.6-2.3; P.034-.002) while LVMi was associated with events only for values above the 2SD-threshold (HR 2.7-4.1; P <.001). Notably, LVEDD, RVMi, RVESVi and RVEF were not associated with CV events in men or women. CV events over 10 years showed similar trends.</p><p><strong>Conclusions: </strong>Our results support the clinical relevance of CMR normal reference ranges for LV parameters. Most LV CMR parameters beyond the normal reference range (2SD-threshold) were associated with elevated CV risk at 5 and 10 years. Elevated LVEDDi, RVMi, RVESVi and RVEF however were not associated with CV events.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101949"},"PeriodicalIF":6.1,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955649","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":"Multi-centre Investigation of Cardiac Diffusion Tensor Imaging in Healthy Volunteers by SCMR Cardiac Diffusion Special Interest Group NETwork (SIGNET).","authors":"Irvin Teh, Kévin Moulin, Pedro F Ferreira, Julie Absil, Maryam Afzali, Peter Agger, Behnaz Akbari, Anthony H Aletras, Satoru Aono, Charles Benton, Suryava Bhattacharya, Pierre Croisille, Yves De Bruecker, Erica Dall'Armellina, Daniel B Ennis, Carl Glessgen, Anna Glinska, Sandra Haltmeier, Ariel Hannum, Erik Hedström, Tawfik Hussein, Sarah Jones, George Joy, Karen Kettless, Won Yong Kim, Sebastian Kozerke, Julie Magat, Raja Muthupillai, Reza Nezafat, Sonia Nielles-Vallespin, John Oshinski, Valéry Ozenne, Dudley J Pennell, Roderick Pettigrew, Iain Pierce, Betty Raman, Agnieszka Sabisz, Jürgen E Schneider, Janet H Sherman, Abhishek Shetye, Rolf Symons, Philippe Thoma, Thomas Treibel, Satonori Tsuneta, Jean-Paul Vallee, Niels Vejlstrup, Magalie Viallon, Christopher Nguyen, Andrew D Scott, Christian T Stoeck","doi":"10.1016/j.jocmr.2025.101948","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101948","url":null,"abstract":"<p><strong>Background: </strong>Cardiac diffusion tensor imaging (cDTI) is an emerging technique for microstructural characterization of the heart and has shown clinical potential in a range of cardiomyopathies. However, there is substantial variation reported for in vivo cDTI results across the literature, and sensitivity of cDTI to differences in imaging sites, scanners, acquisition protocols and post-processing methods remains incompletely understood.</p><p><strong>Methods: </strong>SIGNET is a prospective multi-centre, observational study in travelling and non-travelling healthy volunteers. The study was initiated by the executive board of the SCMR Cardiac Diffusion Special Interest Group (SIG) as a follow up to a previous multi-centre study on phantom validation of cardiac DTI and a recently published SCMR consensus statement on cardiac diffusion MRI. The study has been developed by the Project Management Committee in consultation with the SCMR Cardiac Diffusion SIG, which includes international experts in cardiac diffusion MRI. To date, more than 20 international institutions have engaged with the study, including sites that are new to cardiac DTI, making this the largest collaborative effort in the field.</p><p><strong>Discussion: </strong>SIGNET will provide important information about the key sources of variation in cardiac DTI. This will help rationalise strategies for addressing and minimising such variation. Harmonisation of protocols in this and future studies will underpin efforts to translate cardiac DTI for clinical application.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101948"},"PeriodicalIF":6.1,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955664","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 Trajectories of Left Ventricular Myocardial Remodelling: Associations with Cardiovascular Risk Factors in the Multi-Ethnic Study of Atherosclerosis.","authors":"Charlène A Mauger, Bharath Ambale-Venkatesh, Avan Suinesiaputra, David A Bluemke, Colin O Wu, Joao A C Lima, Alistair A Young","doi":"10.1016/j.jocmr.2025.101943","DOIUrl":"https://doi.org/10.1016/j.jocmr.2025.101943","url":null,"abstract":"<p><strong>Background: </strong>Understanding the influence of cardiovascular risk factors on longitudinal cardiac remodelling requires three-dimensional analysis of longitudinal shape changes beyond scalar indicators such as mass and volumes. The aim of this study is to determine trajectories of cardiovascular risk factor-related remodelling in a large cohort imaging study.</p><p><strong>Methods: </strong>We examined 2,521 participants (54% female, aged 60±9y) of the Multi-Ethnic Study of Atherosclerosis (MESA) at baseline and after 10 years. Myocardial remodelling was assessed by longitudinal left ventricular shape trajectories derived from cardiac magnetic resonance imaging using a statistical shape atlas. Penalized logistic regression was used to examine the associations between trajectory scores and cardiovascular risk factors, after adjustment for sex and age at baseline. Multivariate regression was used to determine independent shape changes associated with each risk factor.</p><p><strong>Results: </strong>Between baseline and follow-up, there was a higher prevalence of hypertension (18.4%), antihypertensive medication usage (21.6%), statin usage, and treated diabetes mellitus (8.9%); all p < 0.05. Longitudinal shape trajectory scores had stronger associations with obesity, high blood pressure, hypertension medication and diabetes mellitus, than mass and volume changes (p<0.05). Multivariate regression showed independent longitudinal changes in wall thickening with obesity (13% increase), smoking (11% decrease), and high systolic blood pressure (5.6% increase), with distinct regional variations.</p><p><strong>Conclusions: </strong>Trajectories of cardiovascular risk factor-related longitudinal remodelling can be examined using shape atlases. In addition to global changes, each risk factor is associated with a distinct regional remodelling of the myocardium.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101943"},"PeriodicalIF":6.1,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955639","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":"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}