Journal of Cardiovascular Magnetic Resonance最新文献

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

{"title":"Cardiovascular magnetic resonance worldwide: A global commitment to cardiovascular care.","authors":"Carlos E Rochitte","doi":"10.1016/j.jocmr.2025.101842","DOIUrl":"10.1016/j.jocmr.2025.101842","url":null,"abstract":"","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101842"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Three-dimensional aortic geometry mapping via registration of non-gated contrast-enhanced or gated and respiratory-navigated MR angiographies\" [Journal of Cardiovascular Magnetic Resonance 26 (2024) 100992].","authors":"Lydia Dux-Santoy, Jose F Rodríguez-Palomares, Gisela Teixidó-Turà, Juan Garrido-Oliver, Alejandro Carrasco-Poves, Alberto Morales-Galán, Aroa Ruiz-Muñoz, Guillem Casas, Filipa Valente, Laura Galian-Gay, Rubén Fernández-Galera, Ruperto Oliveró, Hug Cuéllar-Calabria, Albert Roque, Gemma Burcet, José A Barrabés, Ignacio Ferreira-González, Andrea Guala","doi":"10.1016/j.jocmr.2025.101904","DOIUrl":"10.1016/j.jocmr.2025.101904","url":null,"abstract":"","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":"27 1","pages":"101904"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ex-vivo validation of nine algorithms for quantifying infarcts with late gadolinium enhancement cardiovascular magnetic resonance.","authors":"Sascha Kopic, Einar Heiberg, Henrik Engblom, Marcus Carlsson, David Nordlund, Robert Jablonowski, Mikael Kanski, Christos Xanthis, Sebastian Bidhult, Anthony H Aletras, Håkan Arheden","doi":"10.1016/j.jocmr.2025.101915","DOIUrl":"10.1016/j.jocmr.2025.101915","url":null,"abstract":"<p><strong>Background: </strong>In cardiovascular magnetic resonance, late gadolinium enhancement (LGE) is the standard method to visualize myocardial infarction (MI). Many algorithms quantifying infarct size in LGE images exist. However, only few algorithms have been validated, i.e., benchmarked against an ex-vivo measurement. Furthermore, the reported algorithm performance varies considerably between studies.</p><p><strong>Objectives: </strong>The aim of this study was to compare the performance of all infarct measurement algorithms against an ex-vivo measurement and to promote a discourse regarding advantages and disadvantages of individual measurement methods.</p><p><strong>Methods: </strong>MI was induced in 22 pigs. In-vivo LGE imaging was conducted on d0, d3 or d7 post-MI. For ex-vivo validation infarct was measured using high-resolution T1-weighted images. In-vivo infarct size was measured using the full-width at half-maximum (FWHM), n-SD from remote (2,3,5, and 6 SD), feature analysis and combined thresholding (FACT), expectation maximization-weighted A priori information (EWA), Heiberg-08 and Otsu algorithms and manual delineation. No manual adjustments were made to algorithm delineations.</p><p><strong>Results: </strong>Clear differences in variance and bias were observed between algorithm-based methods, and no method performed optimally in this heterogeneous dataset where the best had a bias of -0.48±3.1, -0.3±4.4%, 2.3±4.2% left ventricle for EWA, FWHM, and FACT, respectively. Manual delineation by experienced observers performed well with a bias of 1.9±5.4%.</p><p><strong>Conclusion: </strong>EWA, Heiberg-08, FWHM, and FACT all perform on par with manual delineation, however, Heiberg-08, and FWHM are not suitable for phase sensitive inversion recovery images. The technique used to measure infarct size should be disclosed in clinical trials and in original research. Caution should be applied when comparing datasets employing different infarct quantification methods. Manual infarct delineation by experienced readers remains a reliable technique to measure infarct size.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101915"},"PeriodicalIF":4.2,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191782","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":"Highlights of the Society for Cardiovascular Magnetic Resonance 2025 conference: Leading the way to accessible, efficient, and sustainable cardiovascular magnetic resonance.","authors":"Claudia Prieto, Bradley D Allen, Clerio F Azevedo, Bruno Bezerra Lima, Christopher Z Lam, Rebecca Mills, Merel Huisman, Ricardo A Gonzales, Sebastian Weingärtner, Anthony G Christodoulou, Carlos Rochitte, Michael Markl","doi":"10.1016/j.jocmr.2025.101914","DOIUrl":"10.1016/j.jocmr.2025.101914","url":null,"abstract":"<p><p>The 28th Annual Scientific Sessions of the Society for Cardiovascular Magnetic Resonance (SCMR) took place from January 29 to February 1, 2025, in Washington, D.C. SCMR 2025 brought together a diverse group of 1714 cardiologists, radiologists, scientists, and technologists from more than 80 countries to discuss emerging trends and the latest developments in cardiovascular magnetic resonance (CMR). The conference centered on the theme \"Leading the Way to Accessible, Sustainable, and Efficient CMR,\" highlighting innovations aimed at making CMR more clinically efficient, widely accessible, and environmentally sustainable. The program featured 728 abstracts and case presentations with an acceptance rate of 86% (728/849), including early career award abstracts, oral abstracts, oral cases and rapid-fire sessions, covering a broad range of CMR topics. It also offered engaging invited lectures across eight main parallel tracks and included four plenary sessions, two gold medalists, and one keynote speaker, with a total of 826 faculty participating. Focused sessions on accessibility, efficiency, and sustainability provided a platform for discussing current challenges and exploring future directions, while the newly introduced CMR Innovations Track showcased innovative session formats and fostered greater collaboration between researchers, clinicians, and industry. For the first time, SCMR 2025 also offered the opportunity for attendees to obtain CMR Level 1 Training Verification, integrated into the program. Additionally, expert case reading sessions and hands-on interactive workshops allowed participants to engage with real-world clinical scenarios and deepen their understanding through practical experience. Key highlights included plenary sessions on a variety of important topics, such as expanding boundaries, health equity, women's cardiovascular disease and a patient-clinician testimonial that emphasized the profound value of patient-centered research and collaboration. The scientific sessions covered a wide range of topics, from clinical applications in cardiomyopathies, congenital heart disease, and vascular imaging to women's heart health and environmental sustainability. Technical topics included novel reconstruction, motion correction, quantitative CMR, contrast agents, novel field strengths, and artificial intelligence applications, among many others. This paper summarizes the key themes and discussions from SCMR 2025, highlighting the collaborative efforts that are driving the future of CMR and underscoring the Society's unwavering commitment to research, education, and clinical excellence.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101914"},"PeriodicalIF":6.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FlowMRI-Net: A generalizable self-supervised 4D flow MRI reconstruction network.","authors":"Luuk Jacobs, Marco Piccirelli, Valery Vishnevskiy, Sebastian Kozerke","doi":"10.1016/j.jocmr.2025.101913","DOIUrl":"10.1016/j.jocmr.2025.101913","url":null,"abstract":"<p><strong>Background: </strong>Image reconstruction from highly undersampled four-dimensional (4D) flow magnetic resonance imaging (MRI) data can be very time-consuming and may result in significant underestimation of velocities depending on regularization, thereby limiting the applicability of the method. The objective of the present work was to develop a generalizable self-supervised deep learning-based framework for fast and accurate reconstruction of highly undersampled 4D flow MRI and to demonstrate the utility of the framework for aortic and cerebrovascular applications.</p><p><strong>Methods: </strong>The proposed deep-learning-based framework, called FlowMRI-Net, employs physics-driven unrolled optimization using a complex-valued convolutional recurrent neural network and is trained in a self-supervised manner. The generalizability of the framework is evaluated using aortic and cerebrovascular 4D flow MRI acquisitions acquired on systems from two different vendors for various undersampling factors (R = 8, 16, 24) and compared to compressed sensing locally low rank (CS-LLR) reconstructions. Evaluation includes an ablation study and a qualitative and quantitative analysis of image and velocity magnitudes.</p><p><strong>Results: </strong>FlowMRI-Net outperforms CS-LLR for aortic 4D flow MRI reconstruction, resulting in significantly lower vectorial normalized root mean square error and mean directional errors for velocities in the thoracic aorta. Furthermore, the feasibility of FlowMRI-Net's generalizability is demonstrated for cerebrovascular 4D flow MRI reconstruction. Reconstruction times ranged from 3 to 7 min on commodity central processing unit/graphical processing unit hardware.</p><p><strong>Conclusion: </strong>FlowMRI-Net enables fast and accurate reconstruction of highly undersampled aortic and cerebrovascular 4D flow MRI, with possible applications to other vascular territories.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101913"},"PeriodicalIF":4.2,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward understanding the balanced steady-state free precession signal intensity changes in cine cardiac magnetic resonance imaging: A preliminary evaluation in healthy subjects pre- and postcontrast.","authors":"Tom Dresselaers, Frederik De Keyzer, Alexandru Cernicanu, Jan Bogaert, Peter Gatehouse","doi":"10.1016/j.jocmr.2025.101908","DOIUrl":"10.1016/j.jocmr.2025.101908","url":null,"abstract":"<p><strong>Background: </strong>Although balanced steady-state free-precession (bSSFP) cines provide excellent contrast for morpho-functional cardiac evaluation, the fluctuating myocardial cine signal intensity (mcSI) is rarely used diagnostically. These mcSI fluctuations were related to through-plane motion but the impact of this motion remains unclear. We aim to characterize the mid-ventricular pre- and postcontrast bSSFP cyclic mcSI fluctuations in healthy subjects and compare these to Bloch simulations incorporating through-plane motion.</p><p><strong>Methods: </strong>Retrospectively-gated mid-ventricular short-axis cine bSSFP images from healthy subjects (n = 49) acquired at 1.5T pre- and early postcontrast were analyzed. First, the mcSI fluctuations during the heart cycle were determined and their timing compared to the radial myocardial motion. Next, pre- vs postcontrast differences were determined during systole, early-diastole, and late-diastole. Finally, Bloch simulations and acquisitions in a moving T1 phantom were performed to analyze the through-plane motion effect on the bSSFP and spoiled gradient echo (SGRE) mcSI.</p><p><strong>Results: </strong>The bSSFP mcSI showed a three-peak pattern both pre- and postcontrast, corresponding to the contraction and relaxation phases. However, the mcSI peaks showed a time lag vs the times of maximum radial velocity that was larger for the systolic contraction than for the early or late-diastolic relaxation phases. In addition, the shape and amplitude of the systolic and early diastolic mcSI peaks changed significantly post- vs precontrast. Bloch simulations showed an in-vivo-like (regional) three-peak signal profile and similar changes for post- vs precontrast T1 levels. Finally, results in the moving phantom and accompanying simulations confirmed a slice-thickness-dependent time lag between the motion and mcSI profile in both bSSFP and SGRE.</p><p><strong>Conclusion: </strong>In healthy subjects before and after contrast, the bSSFP mcSI variation during the heart cycle is characterized by a three-peak pattern associated with the contraction and relaxation phases. However, the delays in timing of these peaks vs the myocardial motion, as well as the differences between pre- and postcontrast, vary with the stage of the heart cycle. Bloch simulations suggest that these mcSI fluctuations are largely determined by the regional through-slice motion. A better understanding of these motion-induced contrast mechanisms may be beneficial to methods exploiting bSSFP mcSI.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101908"},"PeriodicalIF":4.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left ventricular flow kinetics and myocardial deformation following acute infarction: Additional predictive value of cardiac magnetic resonance four-dimensional flow for left ventricular remodeling post-ST-elevation myocardial infarction.","authors":"Christel H Kamani, May Lwin, Ioannis Botis, Mehak Asad, Noor Sharrack, Hadar Schapira, Arka Das, Peter P Swoboda, Sven Plein, Rob J Van der Geest, Erica Dall'Armellina","doi":"10.1016/j.jocmr.2025.101905","DOIUrl":"10.1016/j.jocmr.2025.101905","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The exact mechanism underlying myocardial maladaptive changes post ST-elevation myocardial infarction (STEMI) remains unclear. We sought to assess the impact of the tissue=flow interaction on the development of adverse cardiac remodeling 12 months(M) after acute STEMI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;Forty-nine first-STEMI patients (M:F = 26:13; mean age = 58 ± 10) prospectively underwent 3T cardiovascular magnetic resonance (CMR) acutely, at 3 months (3M) and 12M post-STEMI. The CMR protocol included left ventricular (LV) cine-images for LV end-diastolic (LVEDV) and end-systolic volumes, stroke volume (SV), and ejection fraction (LVEF); four-dimensional (4D)-flow and late gadolinium enhancement imaging. The 3M outcome measures included 4D-flow derived LV flow kinetic energy indexed to EDV (KE&lt;sub&gt;iEDV&lt;/sub&gt;) and functional flow components [LV-KE&lt;sub&gt;iEDV&lt;/sub&gt;, minimal- KE&lt;sub&gt;iEDV&lt;/sub&gt;, diastolic- KE&lt;sub&gt;iEDV&lt;/sub&gt;, and residual volume (RV), retained inflow, delayed ejection, direct flow (DF)]; global radial, circumferential, and longitudinal strain (GRS, GCS, GLS) by feature tracking (FT); infarct size (IS). Adverse LV remodeling (LV&lt;sub&gt;remod&lt;/sub&gt;) was defined by a ≥20% increase in LVEDVi at 12M from baseline, in opposition to the non-remodeling group (LV&lt;sub&gt;non-remod&lt;/sub&gt;). Association between SV, FT-strain, KE, and 4D flow parameters was assessed, as well as predictors of adverse remodeling at 12M post-STEMI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There were 23 LV&lt;sub&gt;remod&lt;/sub&gt; patients. At 3M post-STEMI, LV&lt;sub&gt;remod&lt;/sub&gt; patients had significantly reduced LVEF, increased IS, abnormal FT-strain, systolic KE&lt;sub&gt;iEDV&lt;/sub&gt;, DF, and RV compared to LV&lt;sub&gt;non-remod&lt;/sub&gt; patients. There was no significant difference in SV between the two groups. FT-strain parameters significantly correlated with DF (GRS: r = 0.62; GCS: r = -0.67; GLS: r = -0.58, all p &lt; 0.001); RV (GRS: r = -0.56; GCS: r = 0.51; GLS: r = 0.53, all p &lt; 0.001); peak-A-wave KE&lt;sub&gt;iEDV&lt;/sub&gt; (GRS: r = 0.38, p = 0.008; GCS: r = -0.30, p = 0.038; GLS: r = -0.29, p = 0.04); systolic KE&lt;sub&gt;iEDV&lt;/sub&gt; (GRS: r = 0.31, p = 0.033, GLS: r = -0.35, p = 0.012). DF outperformed conventional LV function parameters (SV and LVEF) in the LV&lt;sub&gt;remod&lt;/sub&gt; prediction. DF and IS were the only independent predictors of 12M adverse remodeling after adjustment for LVEF, SV, FT-strain, and KE&lt;sub&gt;iEDV&lt;/sub&gt; parameters.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our study suggests a potential early interaction between FT-strain and 4D-flow parameters post-STEMI leading to the development of adverse remodeling. Within the limitations of our sample size, DF and IS were independent predictors of LV remodeling after adjustment for LVEF, SV, FT-strain, and KE parameters. These findings suggest that these parameters may contribute to further risk stratification at 3M for the development of adverse remodeling at 12M post-STEMI, above conventional LV function parameter","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101905"},"PeriodicalIF":4.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic resonance quantification of regional blood flow and oxygen delivery to the brain, gut, kidneys, and lower extremities in adolescents with a Fontan circulation compared to biventricular controls.","authors":"Jennifer Romanowicz, Sungho Park, Jenifer Bunn, Roni M Jacobsen, Brian Fonseca, Jenny E Zablah, Erin K Englund, Alex J Barker, Jesse A Davidson","doi":"10.1016/j.jocmr.2025.101907","DOIUrl":"10.1016/j.jocmr.2025.101907","url":null,"abstract":"<p><strong>Background: </strong>Accumulation of progressive extracardiac disease is nearly universal for patients with single ventricle heart disease palliated to a Fontan circulation; however, etiologies are poorly understood. Limited flow reserve in the Fontan circulation may underlie extracardiac disease found in Fontan physiology through reduced oxygen and nutrient delivery to the tissues. This study aimed to determine regional flow volumes and oxygen delivery to key organ systems in children and adolescents with a Fontan circulation.</p><p><strong>Methods: </strong>In 17 Fontan subjects and 14 biventricular controls, regional arterial flow volumes to the carotid, celiac, superior mesenteric, renal, and iliac arteries were quantified with magnetic resonance imaging. Arterial oxygen content was calculated using subject hemoglobin level and pulse oximetry, and regional oxygen delivery was calculated using regional flow volume and oxygen content for the above-listed arteries. Cardiac output was measured from ascending aorta flow, systemic blood flow from the caval veins, and aorto-pulmonary collateral flow was calculated as the difference between the two. Flows were compared between groups (t-test) and associations were analyzed between flows and with maximal exercise performance on clinical cardiopulmonary exercise testing (Pearson correlation).</p><p><strong>Results: </strong>On average, renal and iliac arterial flows were lower in the Fontan group, compared to controls. Carotid, celiac, and superior mesenteric arterial flows were preserved in the Fontan group. Arterial oxygen content was equivalent between groups, and thus, regional oxygen delivery followed the same pattern as regional flows. Cardiac output was no different between groups, but systemic blood flow was lower in Fontans due to loss of flow to aorto-pulmonary collaterals. Systemic blood flow correlated with iliac flow such that those with the lowest systemic flow had the least amount of iliac flow. Celiac arterial flow correlated with percent-predicted peak oxygen consumption on exercise testing.</p><p><strong>Conclusion: </strong>Our results are consistent with a limited flow reserve in the Fontan circulation with sacrifice of iliac arterial flow as global systemic blood flow decreases. Importantly, these data were measured with subjects supine and at rest. Future work requires the addition of exercise to determine how flow to specific organs is affected by increasing metabolic demand from the extremities.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101907"},"PeriodicalIF":4.2,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012734","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":"Advanced cardiac magnetic resonance imaging for assessment of obstructive coronary artery disease-ADVOCATE-CMR study rationale and design.","authors":"Sonia Borodzicz-Jazdzyk, Geoffrey W de Mooij, Alexander W den Hartog, Mark B M Hofman, Marco J W Götte","doi":"10.1016/j.jocmr.2025.101900","DOIUrl":"10.1016/j.jocmr.2025.101900","url":null,"abstract":"<p><strong>Background: </strong>First-pass stress-perfusion cardiovascular magnetic resonance (CMR) imaging is the guidelines-recommended non-invasive test for the detection of obstructive coronary artery disease (CAD). Recently developed quantitative perfusion CMR (QP CMR) allows quantification of myocardial blood flow. Moreover, the latest developments established several methods of CAD assessment without the need for a contrast agent, including stress T1 mapping reactivity (∆T1) and oxygenation-sensitive CMR (OS-CMR). These methods might eliminate the need for contrast administration in clinical practice, reducing time, invasiveness, and costs, thereby simplifying the evaluation of patients with suspected obstructive CAD. The ADVOCATE-CMR study aims to validate QP CMR, ∆T1, and OS-CMR imaging against invasive fractional flow reserve (FFR) for the detection of obstructive CAD. The study also aims to head-to-head compare the diagnostic accuracy of these CMR techniques with the conventional visual assessment of stress-perfusion CMR and to correlate them to short- and long-term clinical outcomes.</p><p><strong>Study design and methodology: </strong>ADVOCATE-CMR is a single-center, observational, prospective, cross-sectional cohort study. The study will enroll 182 symptomatic patients with suspected obstructive CAD scheduled for invasive coronary angiography (ICA). Before ICA, all participants will undergo CMR imaging, including OS-CMR with breathing maneuvers, rest, and adenosine stress T1 mapping and rest and adenosine stress first-pass perfusion. Subsequently, ICA will be performed, including FFR, instantaneous wave-free ratio, resting Pd/Pa, coronary flow reserve, and index of microvascular resistance measurements in all main coronary arteries. A follow-up CMR scan with the same protocol will be performed at 3 months after ICA. Clinical follow-up will be performed at 3, 6 months, 1 and 3 years after ICA.</p><p><strong>Conclusion: </strong>The ADVOCATE-CMR will be the first study comprehensively evaluating and comparing head-to-head the diagnostic performance of a range of contrast- and non-contrast agent-based CMR imaging methods (including QP CMR, ∆T1, and OS-CMR) for the detection of FFR-defined obstructive CAD. We expect to establish a validated and time-efficient diagnostic workflow available to a wide range of general CMR services. Finally, these improvements may enable CMR to become an effective non-invasive, radiation-free gatekeeper for ICA in patients with suspected obstructive CAD, potentially without the need for a contrast agent.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101900"},"PeriodicalIF":4.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}