Journal of Cardiovascular Magnetic Resonance最新文献

{"title":"4D flow cardiac magnetic resonance postprocessing in congenital heart disease: SCMR FLIICR workgroup recommendations.","authors":"Julio Garcia, Julia Geiger, Adam Christopher, Christian Meierhofer, Shiraz Maskatia, Francesca Raimondi, Lynette Teo, Sergio Uribe, Julio Sotelo, Kwannapas Saengsin, Kenichiro Suwa, Liang Zhong, Animesh Tandon, Tobias Rutz","doi":"10.1016/j.jocmr.2026.102789","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102789","url":null,"abstract":"<p><p>The large majority of patients with congenital heart disease (CHD) survive into adulthood in the modern era of surgical advancements. However, patients require life-long follow-up and non-invasive imaging is crucial for diagnostic and therapeutic purposes. Cardiovascular magnetic resonance (CMR) plays a major role in patients with CHD as it is a non-invasive and ionizing radiation free imaging tool which overcomes the technical limitations of echocardiography. 4D flow is an evolving technique for flow quantification allowing improved CMR exam quality and reduced scan time. However, comprehensive postprocessing of hemodynamics in CHD may be demanding. This document addresses the needs for an \"ideal\" post-processing software for 4D flow in patients with CHD. It provides information on general requirements, velocity encoding, offset and aliasing correction, visualization, segmentation and reconstruction as well as output data. This document aims to support stakeholders in the field to develop solutions for improved 4D flow post-processing and visualization in CHD patients and thus improve the accuracy and efficiency of patient care.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102789"},"PeriodicalIF":5.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793577","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":"Assessment of Coronary Plaque Burden using Non-Contrast T1-weighted Cardiovascular MR: Comparison with Coronary CT Angiography.","authors":"Alexandra Amalie Uglebjerg Pedersen, Gregory Wood, Andreas Kabel, Damini Dey, Erik Thorlund Parner, Jesper Møller Jensen, Martin Bødtker Mortensen, Karl P Kunze, Claudia Prieto, René M Botnar, Bjarne Linde Nørgaard, Won Yong Kim","doi":"10.1016/j.jocmr.2026.102788","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102788","url":null,"abstract":"<p><strong>Background: </strong>Non-contrast T1-weighted cardiovascular MR (CMR) enables assessment of coronary atherosclerotic plaques by exploiting elevated signal intensity within high-risk plaque components. The novel iT2prep-BOOST sequence provides co-registered coronary lumen and vessel wall whole-heart imaging, potentially facilitating plaque assessment. However, direct comparison of quantitative plaque measures between iT2prep-BOOST and coronary computed tomography angiography (CCTA), the non-invasive standard for plaque assessment, remains limited. This study aimed to compare coronary plaque burden and plaque signal intensity measured by iT2prep-BOOST with plaque burden and plaque attenuation characteristics derived from CCTA.</p><p><strong>Methods: </strong>In this prospective, observational study, patients with stable coronary artery disease confirmed by diagnostic CCTA were recruited and subsequently underwent CMR using the iT2prep-BOOST sequence. Using semi-automated software, per-lesion cross-sectional areas of total, calcified, non-calcified, and low-density non-calcified plaque (≤30 Hounsfield unit) together with measures of plaque burden (percentage vessel atheroma) were quantified on CCTA. The corresponding coronary atherosclerotic lesion was analysed on T1-weighted black-blood iT2prep-BOOST CMR to assess cross-sectional plaque area, burden, and plaque-to-myocardial signal intensity ratio (PMR).</p><p><strong>Results: </strong>A total of 188 lesions in 85 patients were analysed and compared between iT2prep-BOOST and CCTA. Plaque burden estimates derived from iT2prep-BOOST demonstrated moderate correlation with CCTA-derived total plaque burden (r = 0.58) and non-calcified plaque burden (r = 0.54). However, agreement between modalities was limited. For total plaque burden, the mean difference was -4% (95% CI: -7% to -2%) with limits of agreement ranging from -38% to 29%. For non-calcified plaque burden, the mean difference was 3% (95% CI: 0% to 5%) with limits of agreement from -34% to 39%. In univariate regression analyses, PMR was associated with increasing total, non-calcified, and low-density non-calcified plaque areas and decreasing CT attenuation values.</p><p><strong>Conclusion: </strong>Coronary plaque burden assessed by iT2prep-BOOST demonstrated modest correlation and limited agreement with CCTA-derived plaque burden, indicating that the two modalities are not directly interchangeable for plaque burden quantification. Nevertheless, the observed associations between PMR and adverse CCTA plaque characteristics support the potential role of T1-weighted CMR as a complementary, non-invasive tool for coronary plaque characterization.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102788"},"PeriodicalIF":5.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793547","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 Myocardial Changes in MIS-C: Admission Clinical Features and Longitudinal Findings.","authors":"Sudeep D Sunthankar, Stephen E Hudson, Nicholas Joy, Joshua D Chew, William A McEachern, Kristen M George-Durrett, Gary W Coburn, Sophie E Katz, Anna E Patrick, Matthew L Dove, Olga Toro-Salazar, David A Parra, Jonathan H Soslow","doi":"10.1016/j.jocmr.2026.102791","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102791","url":null,"abstract":"<p><strong>Background: </strong>Multisystem inflammatory syndrome in children (MIS-C) is a sequela of SARS-CoV-2 infection; however, longitudinal cardiac outcomes are unclear. Herein, we test the association between MIS-C biomarkers, inpatient echocardiographic features, and outcomes of interest: presence of myocarditis and myocardial delayed enhancement (MDE) on cardiac magnetic resonance (CMR). Furthermore, we describe the evolution of CMR features in MIS-C.</p><p><strong>Methods: </strong>Patients diagnosed with MIS-C from 2020-2021 with CMR were included. Admission and serial biomarkers and echocardiographic features were collected. Primary outcomes measured were diagnosis of myocarditis (using modified Lake Louise criteria) and myocardial delayed enhancement (quantified by full width at half maximum method) on CMR. Secondary outcomes included abnormal LVEF on admission echocardiogram and changes in parametric mapping with serial CMR.</p><p><strong>Results: </strong>A total of 66 patients were included (median age 9.7 IQR [7.2-14.7] years). Admission BNP (P=0.016), CRP (P=0.027), and ESR (P=0.002) associated with LV dysfunction on inpatient echocardiogram. CMR1 was obtained a median of 38 [26-61] days after hospital presentation. Myocarditis was present in 44% and MDE in 52% on CMR1, with median MDE burden of 10.8 [8.5-16.8]% in those affected. Inpatient echocardiographic features were not associated with presence of myocarditis or MDE. Admission ESR (P=0.031) associated with MDE. Admission platelets associated with myocarditis (P=0.040) and MDE (P=0.004). CMR2 (n=19), occurring a median of 11 [7-14] months after baseline CMR, demonstrated lower global T2 z-scores (P=0.035) without significant change in global T1 z-scores or ECV. Myocarditis (16% [3/19]) and MDE (28% [5/18]) were less frequent on CMR2.</p><p><strong>Conclusions: </strong>For MIS-C patients, initial echocardiographic indices do not associate with myocarditis or MDE by CMR one month later; admission ESR and platelet levels may portend myocarditis or MDE on initial CMR. Reduced T2 z-score over serial CMR suggests resolving edema.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102791"},"PeriodicalIF":5.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial T1 and T2 Mapping at 5.0T: Feasibility and Comparison with 3.0-T MRI.","authors":"Qinfang Miao, Hongzhang Huang, Zhenfeng Lyu, Wenjian Liu, Tianyi Wu, Peng Hu, Haikun Qi","doi":"10.1016/j.jocmr.2026.102787","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102787","url":null,"abstract":"<p><strong>Background: </strong>Myocardial T1 and T2 mapping provide a non-invasive quantitative assessment of cardiac tissue. While established at 1.5-T and 3.0-T MRI, the mapping performance and reference values at 5.0-T MRI remain to be investigated. This study aims to evaluate the feasibility and establish reference values for cardiac T1 and T2 mapping at 5.0-T MRI in healthy subjects.</p><p><strong>Methods: </strong>In this prospective study, 50 healthy volunteers underwent cardiovascular magnetic resonance at both 3.0-T and 5.0-T systems from February to April 2025. Mapping protocols included MOdified Look Locker Inversion recovery (MOLLI, T1), T2-prepared gradient-echo (T2-prep-GRE, T2), and a simultaneous multi-parametric mapping technique (Multimap, T1 and T2). At 3.0-T MRI, both balanced steady-state free precession (bSSFP) and fast low-angle shot (FLASH) readouts were employed, while only the FLASH readout was used at 5.0-T MRI. Segment exclusion rates were analyzed at the subject-level using nonparametric tests with Holm correction for multiple comparisons. Measurement repeatability (intra-observer, scan-rescan) and reproducibility (inter-observer) were assessed by coefficient of variation (CoV), repeatability coefficient (RC), and intraclass correlation coefficient (ICC). Systematic difference and agreement between repeated measurements were evaluated using Bland-Altman analysis. Group-level variability was described by mean ± SD across subjects. Group comparisons were performed with repeated measures ANOVA.</p><p><strong>Results: </strong>All techniques at 5.0-T MRI yielded high-quality images that were predominantly free of visible artifacts with the FLASH readout. After quality control, segment acceptance rates ranged from 87.8% to 94.0%, and matched FLASH-readout comparisons showed higher exclusion rates at 5.0T than at 3.0T (all P < 0.001). Native T1 values were significantly higher at 5.0T than at 3.0-T MRI (MOLLI: 1452.9 ± 33.2 ms vs. 1305.9 ± 38.3 ms, P < 0.0001), while T2 values were significantly lower (T2-prep-GRE: 37.53 ± 1.74 ms vs. 43.97 ± 2.95 ms, P < 0.0001). Scan-rescan repeatability at 5.0-T (ICC: 0.87-0.92; CoV: 1.25%-2.17%; RC: 3.45%-6.01%) was comparable to 3.0-T MRI. Measurement precision, as assessed by CoV, RC, and ICC, was higher for 5.0-T than 3.0-T with FLASH, and lower than bSSFP-based techniques. Multimap enabled efficient, simultaneous T1 and T2 quantification with acceptable reproducibility at 5.0-T.</p><p><strong>Conclusion: </strong>Myocardial T1 and T2 mapping at 5.0-T MRI are reliable and reproducible in healthy individuals, offering reference values for normal myocardium at this field strength. The good measurement reproducibility and precision of 5.0-T cardiac mapping support its clinical potential for myocardial tissue characterization.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102787"},"PeriodicalIF":5.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793606","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 Ventricular Mass is Associated with Biopsy-Assessed Renal Fibrosis in Chronic Kidney Disease.","authors":"Carl G Glessgen, Aurélie Huber, Lindsey A Crowe, Sophie de Seigneux, Grégoire Arnoux, Jean-Paul Vallée, Lena Berchtold","doi":"10.1016/j.jocmr.2026.102790","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102790","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular remodeling predicts cardiovascular mortality in chronic kidney disease (CKD). Prior studies have linked renal functional markers to cardiac structural changes, but the direct relationship between cardiac MRI parameters and renal interstitial fibrosis remains uncharacterized. We aimed to investigate the association between cardiac remodeling and biopsy-assessed renal interstitial fibrosis in patients with CKD.</p><p><strong>Materials & methods: </strong>This prospective single-center cohort included CKD patients with native kidneys who underwent same-week cardiac MRI and renal biopsy. Renal interstitial fibrosis was quantified as a percentage of the affected cortex area. Five cardiac parameters were selected: LVMi, LVEDVi, GLS, GCS, and myocardial T1. Associations with renal fibrosis were assessed using Spearman correlations, and multivariable linear regression adjusted for age and estimated glomerular filtration rate (eGFR). Sensitivity analyses were performed after excluding outliers.</p><p><strong>Results: </strong>Forty-seven patients were included (median age, 49 years; 55% male). LVMi correlated with renal fibrosis (ρ = 0.49; p < 0.001). GLS (ρ = 0.33; p = 0.03) and GCS (ρ = 0.30; p = 0.04) showed consistent trends that did not survive statistical correction. Renal fibrosis remained associated with LVMi after adjustment for age and eGFR (β = 0.33; p < 0.001). Adding LVEDVi attenuated the fibrosis coefficient by 22% (β = 0.26; p < 0.001). The renal fibrosis - left ventricular mass association persisted after excluding patients with high LVMi or high fibrosis grades (ρ = 0.45, p = 0.002; ρ = 0.35, p = 0.026, respectively).</p><p><strong>Conclusion: </strong>In CKD patients, LV mass was associated with biopsy-assessed renal fibrosis, independently of eGFR, suggesting that structural renal injury provides information beyond kidney function alone. This association was only partially attenuated after adjustment for LV volume, indicating that volume-related hemodynamic factors may not fully account for the link between renal fibrosis and LV remodeling.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102790"},"PeriodicalIF":5.0,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758732","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 Cardiovascular Magnetic Resonance Work-Volume Loop Model in Heart Failure with Preserved Ejection Fraction.","authors":"Fahime Ghanbari, Jennifer Rodriguez, Deepa M Gopal, Manuel A Morales, Aaron B Waxman, Warren J Manning, Reza Nezafat","doi":"10.1016/j.jocmr.2026.102785","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102785","url":null,"abstract":"<p><strong>Background: </strong>Heart failure with preserved ejection fraction (HFpEF) is a hemodynamically heterogeneous syndrome including stage C HFpEF (overt) and exercise-induced HFpEF. While impaired compliance reserve is well recognized, contractile reserve remains underexplored. In addition, distinguishing exercise-induced HFpEF from non-cardiac dyspnea (NCD) remains challenging. Exercise cardiovascular magnetic resonance (Ex-CMR) enables quantification of reserve metrics, yet standardizing exercise protocol in dyspneic patients with limited capacity is challenging. This study aimed to establish an analytic framework for deriving non-invasive compliance and contractile reserve metrics independent of fixed exercise thresholds using Ex-CMR, and to evaluate their utility for pathophysiological differentiation among NCD, exercise-induced HFpEF, and stage C HFpEF.</p><p><strong>Methods: </strong>We proposed a non-invasive work-volume (W-V) loop model from Ex-CMR using left ventricular end-diastolic (LVEDV) and end-systolic volumes (LVESV) at rest and stress, along with maximum workload during supine cycle ergometer exercise, to construct a trapezoidal loop. The loop's base angles θ₁ and θ₂ represent effort-adjusted compliance and contractile reserve, respectively. In a retrospective analysis of a prospective multi-center Ex-CMR study, these markers were calculated in healthy controls, NCD, exercise-induced HFpEF, and stage C HFpEF groups. Patient cohorts were defined based on invasive hemodynamic exercise-testing thresholds and non-invasive data. ANOVA and post hoc testing were performed. Reproducibility was assessed.</p><p><strong>Results: </strong>Among 120 participants (40 healthy controls, 27 NCD, 20 exercise-induced HFpEF, 33 stage C HFpEF), effort-adjusted compliance reserve was impaired in both HFpEF subgroups compared with healthy controls and NCD (p<0.0001). Effort-adjusted contractile reserve was significantly higher in exercise-induced HFpEF than in healthy controls, NCD, and stage C HFpEF (p=0.018, 0.006, and <0.0001, respectively), despite comparable absolute ΔLVESV to NCD and lower ΔLVESV than healthy controls. In contrast, stage C HFpEF demonstrated depressed contractile reserve compared with other groups (p<0.0001). Reproducibility of reserve markers was good to excellent.</p><p><strong>Conclusions: </strong>Ex-CMR-derived W-V loop geometry reveals distinctive features across HFpEF subgroups and provides pathophysiological insight from an imaging perspective, demonstrating universal impairment of compliance reserve in HFpEF and a newly identified hypercontractile profile characteristic of exercise-induced HFpEF. Elevated θ₂ in exercise-induced HFpEF may identify a window for intervention before contractile reserve becomes compromised.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102785"},"PeriodicalIF":5.0,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765183","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":"Whole heart non-contrast 4D Flow MRI at 3.0T for clinical follow-up of congenital heart disease in children and adolescents.","authors":"J van Schuppen, A E van der Hulst, R A P Takx, M Groenink, S D Haas, J Oosterlaan, N A Blom, J J Splinter, I M Kuipers, J L Nelissen, J M den Harder, E M Schrauben, R N Planken, P van Ooij","doi":"10.1016/j.jocmr.2026.102786","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102786","url":null,"abstract":"<p><strong>Aims: </strong>Cardiac MRI is central to evaluating ventricular function and hemodynamics in pediatric congenital heart disease (CHD). Conventional two-dimensional phase-contrast (2D-PC) imaging is challenged by fixed planes, operator dependence, and multiple breath-holds, where four-dimensional flow (4DF) MRI overcomes these challenges. This study compares accelerated whole heart 4D Flow (WH-4DF) MRI with 2D-PC and volumetric measurements in routine clinical follow up of pediatric CHD and highlights its applicability.</p><p><strong>Methods and results: </strong>For this prospective study seventy-one consecutive pediatric patients (median age 14 ± 2.4 years; 49 male) with surgically corrected CHD underwent both 2D-PC and accelerated WH-4DF MRI. Planning and acquisition times and overall success rate were recorded. Flow, velocity and volumetric measurements were compared using Bland-Altman analysis, orthogonal regression, and intraclass correlation coefficients. WH-4DF showed excellent agreement with 2D-PC and short-axis volumetry for aortic, pulmonary, and ventricular stroke volumes (mean differences <5%). Mean planning and acquisition time for WH-4DF was 10.3minutes (SD 1.1), where planning and acquisition time of 2D-PC was 11.2minutes (SD 6.25). Aliasing was observed in 11% of the WH-4DF acquisitions but did not compromise interpretability.</p><p><strong>Conclusions: </strong>Accelerated WH-4DF MRI is clinically robust and broadly applicable across CHD, including complex postoperative anatomies. It provides comparable numbers to 2D-PC, reproducible, and time-efficient flow quantification with superior coverage and reduced operator dependence. A single WH-4DF scan can replace multiple 2D-PC acquisitions with comparable results and may enhance assessment of regurgitant flow. These features underscore its potential role in routine clinical practice and in advancing our understanding of disease processes.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102786"},"PeriodicalIF":5.0,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759986","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":"Assessment and validation of the established free-running framework for cardiac function by magnetic resonance imaging at 1.5T (FAST-CMR): an international multi-center, multi-vendor study.","authors":"Katerina Eyre, Kenan Kaya, Thomas Coudert, Christopher W Roy, Jérôme Yerly, Dinghui Wang, Isabel Monton Quesada, Augustin C Ogier, Ruud B van Heeswijk, Marco Müller, Jouke Smink, Omer Burak Demirel, Robert J Holtackers, Kim-Lien Nguyen, Tim Leiner, Matthias Stuber","doi":"10.1016/j.jocmr.2026.102784","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102784","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cardiovascular magnetic resonance (CMR) is the reference standard for assessing cardiac function, yet its widespread clinical use remains challenged by time-intensive workflows requiring ECG gating, repetitive breath-holding, and expert planning. The free-running framework (FRF) addresses these barriers by enabling respiratory and cardiac motion resolved (5D) whole-heart imaging without ECG, breath-holds, or expert scan plane planning. Its fast interrupted steady-state (FISS) variant further enables high quality clinical imaging with gadolinium-based or ferumoxytol contrast agents by providing balanced steady-state free precession (bSSFP)-like contrast with intrinsic fat suppression. The combined 5D FISS-FRF approach, therefore, enables 3D, motion-resolved, free-breathing whole-heart imaging with efficient fat suppression. Early single-center studies have demonstrated feasibility and high concordance with conventional 2D cine imaging, but its generalizability and clinical utility in a multi-center, multi-vendor setting is not yet established.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods/design: &lt;/strong&gt;FAST-CMR (Assessment and validation of the established free-running framework for cardiac function by magnetic resonance imaging) is a prospective, observational, intra-individually controlled, pragmatic multi-center study enrolling 300 patients with cardiac disease across 21 international sites from 6 continents using 1.5T MR systems of both Siemens Healthineers and Philips Healthcare. Patients will undergo conventional 2D cine bSSFP CMR in both short-axis and long-axis orientations and a post-contrast 5D FISS-FRF acquisition of six minutes in length. Stratification will include equal representation across three disease cohorts: patients with congenital heart disease (CHD), patients unable to breath-hold, and patients who are able to breath-hold. 5D FISS-FRF raw image acquisition data will undergo centralized reconstruction at the coordinating center (CHUV) before blinded analysis at the core laboratory (Mayo Clinic). The primary endpoint is the precision of the mean paired difference in left ventricular ejection fraction (LVEF) between 5D FISS-FRF and conventional 2D cine CMR, assessed on a within-subject basis. Agreement will be further characterized using confidence intervals for the mean difference and Bland-Altman analysis. Secondary endpoints include detection of regional wall-motion abnormalities, image quality, scan efficiency, patient comfort, LV mass, left and right atrial volumes, and feasibility of automated post-processing and artificial intelligence (AI)-based reconstruction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion/conclusion: &lt;/strong&gt;FAST-CMR will provide the first prospective international multi-center, multi-vendor evaluation of 5D FISS-FRF. By combining standardized acquisition, centralized reconstruction, and harmonized analysis across 21 international sites and two vendor systems, the study will assess the generalizability and robu","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102784"},"PeriodicalIF":5.0,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial inflammation and scar expansion in patients with Anderson-Fabry disease.","authors":"Camilla Torlasco, Raffaello Ditaranto, Maria A Schiavo, Irene Ruotolo, Claudio Bergami, Serena Serratore, Luigi P Badano, Giuseppe Limongelli, Luigi Lovato, Elena Biagini","doi":"10.1016/j.jocmr.2026.102782","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102782","url":null,"abstract":"<p><strong>Background: </strong>Anderson-Fabry Disease (AFD) is a lysosomal storage disorder characterized by glycosphingolipid accumulation, leading to multi-organ failure. Cardiac involvement, marked by left ventricular (LV) hypertrophy and fibrosis, is a major cause of mortality. Myocardial inflammation is a frequent finding in these patients, but its role across disease stages remains unclear. This pilot study investigates the association between myocardial inflammation, assessed via cardiac magnetic resonance (CMR) T2 mapping (T2m), and cardiac damage progression, measured by late gadolinium enhancement (LGE) expansion.</p><p><strong>Methods: </strong>This retrospective, single-center study, includes 131 paired CMR scans (1.5T, Philips Ingenia) collected between June 2018 and December 2023 from 41 AFD patients. Cine imaging, T2m, and LGE sequences were acquired in all. Scans were categorised based on quantitative LGE changes into three groups: LGE- (no LGE), LGE= (stable LGE compared to the previous scan), and LGE+ (new/increased LGE compared to the previous scan). T2m was measured globally, in the basal slice (B T2m), infero-lateral basal segment (ILB T2m), and in LGE-matching regions.</p><p><strong>Results: </strong>The sample consisted of 61% women (average of 3±1 scans/patient); at baseline, mean age was 44±18 years, the LV mass was 58±24g/m2. The average time between CMR scans was 14±4 months. In LGE-matching regions, T2m was significantly higher in LGE+ scans compared to LGE= (62ms vs 56ms, p=0.03), and ILB T2m was higher in LGE+ than LGE- (56ms vs 50ms, p=0.007). No other significant differences were observed.</p><p><strong>Conclusion: </strong>In AFD patients, we demonstrated an association between myocardial inflammation and LGE expansion, with T2m potentially serving as an early marker of disease activity. Region-specific T2m measurement is particularly useful in this disease Further research is needed to understand whether T2m changes precedes structural myocardial damage and assess T2m's prognostic value in AFD.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102782"},"PeriodicalIF":5.0,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663984","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":"Integrating Multimodal Data and Genomics for a Comprehensive Assessment of Cardiovascular Aging and Its Impact.","authors":"Adila Abula, Yuxin Yuan, Xiaoyu Li, Yunfeng Zhao, Yushu Huang, Shengkui Zhang, Zilin Li, Jian'an Wang, Xifeng Wu, Wenyuan Li","doi":"10.1016/j.jocmr.2026.102783","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102783","url":null,"abstract":"<p><strong>Background: </strong>Age-related structural and functional remodeling of the heart and vessels increases cardiovascular disease (CVD) risk, yet comprehensive assessments using multimodal imaging and genetic characterization remains limited. We aimed to quantify cardiovascular aging using multimodal biomarkers and evaluate its genetic architecture, lifestyle determinants, and prognostic relevance.</p><p><strong>Methods: </strong>From the UK biobank, cardiovascular magnetic resonance (CMR), electrocardiogram, arterial stiffness, and carotid ultrasound biomarkers were integrated to establish a cardiovascular aging measure using machine learning (ML) models. Seven ML models were evaluated to predict cardiovascular age, and cardiovascular age gap (CardioAG) was calculated using the best-performing model. Associations between CardioAG and incident CVD outcomes were assessed, alongside modality-specific analyses to evaluate the incremental value of multimodal integration. Whole-genome sequencing (WGS) analyses were conducted to identify genetic variants associated with CardioAG, and linear regression models were applied to examine relationships between CardioAG and key lifestyle factors.</p><p><strong>Results: </strong>Among 22,452 participants with complete multimodal data, 13,694 individuals free of baseline CVDs (median age 62.6 years [IQR 56.5-68.3], median follow-up 4.8 years [IQR 3.7-6.3]) were selected for model development. With 57 cardiovascular aging biomarkers, the CatBoost model performed best on the test dataset (Pearson r = 0.75; mean absolute error = 3.88 years). CardioAG was independently associated with hypertension, stroke, atrial fibrillation, coronary artery disease, and composite major adverse cardiovascular event (MACE, hazard ratio = 1.08, 95% CI, 1.06-1.10). Incremental and ablation analyses demonstrated complementary contributions across imaging and functional modalities, with multimodal integration enhancing predictive accuracy and providing independent prognostic value for MACE. WGS analysis identified novel common genetic variants associated with interindividual variability in CardioAG, including RN7SKP155, SVIL, and CBFA2T3, highlighting genetic contributions to vascular remodeling, electrophysiological and hemodynamic regulation, and cardiovascular functional reserve. Dietary factors, sleep duration, physical activity level, smoking, and alcohol intake were found to be significantly associated with CardioAG.</p><p><strong>Conclusions: </strong>This study developed a unified multimodal cardiovascular aging metric that integrates cardiac structure and function, vascular remodeling and stiffness, and electrophysiological features into a single biologically grounded, cumulative aging signal, providing incremental prognostic utility for CVD, and broadening the biological and genetic landscape underlying cardiovascular aging.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102783"},"PeriodicalIF":5.0,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630583","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}