Journal of Cardiovascular Magnetic Resonance最新文献

{"title":"Fat-Induced Signal-oscillation Analysis Enhances Myocardial Iron Deposition Detection in Myocardial Infarction on Cardiac T2* Mapping.","authors":"Rui Chen, Yuelong Yang, Xinyi Wu, Zhigang Wu, Yongzhou Xu, Wei Luo, Caiying Mo, Xinyi Luo, Liqi Cao, Hui Liu, Jiajun Xie","doi":"10.1016/j.jocmr.2026.102771","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102771","url":null,"abstract":"<p><strong>Background: </strong>Accurate detection of myocardial iron deposition is essential for diagnosis, risk stratification and therapeutic decision-making. The black-blood cardiac T2* mapping is the guideline-recommended technique for detecting myocardial iron deposition. However, mixtures of fat (MF) can confound the results, because MF also reduces T2* values. The present study proposes a method that reduces MF-related overestimation of iron deposition in cardiac T2* mapping.</p><p><strong>Method: </strong>This secondary analysis of a prospective trial (clinicaltrials.gov, NCT04863677) included myocardial infarction participants from April 2022 to June 2025. The guideline method defines iron deposition based on reduced T2* values. The proposed method introduced fat-induced signal-oscillation analysis of T2* decay curves using Reduced Chi-squared (χ_ν²). The χ_ν² is a metric that enabled to quantify the signal-oscillation characteristic of signal curves. Predictive performance for detecting iron deposition without MF was evaluated by area under the receiver operating characteristic curves (AUC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy using DeLong's test or Z-test.</p><p><strong>Results: </strong>Totally 73 regions of interest (ROI) from 15 ex-vivo hearts (mean age, 56±6.6 years [SD], 15 males) and 115 ROIs from 35 in-vivo hearts (mean age, 52±11 years [SD], 33 males) were included. The χ_ν² elevated in MF relative to iron depositions, both ex-vivo (MF, 39±51, iron deposition, 0.20±0.12, P=.001) and in-vivo (MF, 10±9.8, iron deposition, 0.54±0.55, P<.001) hearts. The proposed method adding fat-induced signal-oscillation analysis to the guideline method achieved higher AUC than guideline method for identifying iron deposition without MF in ex-vivo [proposed method, 0.99 (95% CI, 0.97, 1.00), guideline method, 0.78 (95% CI, 0.71, 0.85), P<.001] and in-vivo hearts [proposed method, 0.94 (95% CI, 0.90, 0.99), guideline method, 0.79 (95% CI, 0.73, 0.84), P<.001]. Specificity, PPV and accuracy of proposed method also improved in both datasets (all P <.001).</p><p><strong>Conclusion: </strong>The proposed method effectively mitigated MF-related overestimation of myocardial iron deposition on cardiac T2* mapping, positioning it as a strong candidate for inclusion in future cardiac T2* mapping guidelines.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102771"},"PeriodicalIF":5.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352058","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":"Feasibility of real-time in-magnet exercise cardiovascular MRI with an individualized exercise protocol: Quantitative assessment at low, intermediate, and high exercise intensities.","authors":"Christopher D Crabtree, Justen Stoner, Preethi S Chandrasekaran, Yingmin Liu, Syed M Arshad, Alyssa Marie Castillo, Chong Chen, Matt S Tong, Orlando P Simonetti, Rizwan Ahmad, Yuchi Han","doi":"10.1016/j.jocmr.2026.102770","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102770","url":null,"abstract":"<p><strong>Background: </strong>Exercise cardiovascular MRI (ExCMR) offers unique diagnostic potential, combining quantitative cardiac imaging with physiological provocation. Clinical adoption is limited by difficulty achieving high exercise workloads while maintaining diagnostic image quality.</p><p><strong>Purpose: </strong>To develop an individualized in-bore supine exercise protocol capable of achieving high levels of exercise with the goal of reaching symptom- or fatigue-limited peak exercise. Age-predicted maximal heart rate (APMHR%) and Borg rating of perceived exertion (RPE) were used for peak effort while acquiring images suitable for quantitative analysis.</p><p><strong>Methods: </strong>Healthy and patient volunteers with dyspnea on exertion (DOE) underwent in-bore, supine ergometer ExCMR with simultaneous imaging using a highly accelerated real-time (RT) cine pulse sequence (temporal resolution 22.1-23.7 ms and spatial resolution 2mm). After rest imaging, subjects underwent continuously increased ramped resistance to achieve staged targets based on %APMHR (65%, 75%, > 85%) with corresponding RPE (10-13, 14-16, 17-20). During each stage, resistance was held steady while RT cine images were acquired. Two expert reviewers evaluated image quality using a 1-4 Likert scale. Biventricular functions were quantified at rest and all exercise stages.</p><p><strong>Results: </strong>Twelve healthy subjects (5 males, 7 females) completed peak exercise imaging with an average of 86% APMHR (Range77%-96%). Peak exercise was rated \"extremely hard\" (Average RPE 19, range 17-20). Cardiac output increased from rest (4.9±1.2L/min) to peak exercise (14.3±2.2L/min; p<.001). Image quality was rated \"good\" at each stage of exercise. All eight patient subjects completed the exercise protocol, achieving an average 75% APMHR (range 45-97%) and RPE 19 (range 18-20) at peak exercise.</p><p><strong>Conclusion: </strong>We developed a ramped and staged supine in-bore ExCMR protocol targeting graded APMHR% and RPE enabling individualized testing to achieve a high level of exercise. Highly accelerated, high resolutionRT cine images were successfully acquired for quantification of volumes and cardiac output.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102770"},"PeriodicalIF":5.0,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338669","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":"Evaluation of the systemic right ventricle in transposition of the great arteries using fast strain encoded cardiovascular magnetic resonance.","authors":"Ailís Ceara Haney, Andreas Ochs, Jeanna Darino, Janek Salatzki, Lukas D Weberling, Norbert Frey, Henning Steen, Matthias Gorenflo, Alexander Kovacevic, Florian André, Dirk Loßnitzer","doi":"10.1016/j.jocmr.2026.102769","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102769","url":null,"abstract":"<p><strong>Background and aims: </strong>Patients with a systemic right ventricle (SRV) experience increased morbidity and mortality, highlighting the need for precise assessment of systolic function. Fast Strain-ENCoded imaging (fSENC) is a novel strain measurement method that allows early detection of cardiac impairment and has demonstrated significant diagnostic and prognostic value. This study aimed to evaluate global and regional cardiac function using fSENC in patients with SRV due to transposition of the great arteries following Senning/Mustard repair (TGA) or congenitally corrected TGA (ccTGA).</p><p><strong>Methods: </strong>In this prospective, single-center study, patients with SRV underwent conventional cardiovascular magnetic resonance (CMR), including feature tracking (FT) strain and fSENC imaging between October 2022 and November 2023. Age- and sex-matched healthy controls were recruited. fSENC was acquired in a single heartbeat per slice to assess global longitudinal and circumferential strain (GLS, GCS) and segmental strains. Laboratory values, including N-terminal pro-hormone brain natriuretic peptide (NT-pro BNP), and a 6-minute walk test (6MWT) were obtained in SRV patients.</p><p><strong>Results: </strong>A total of 26 patients (19 males (73.1%), median age 40 (34 - 49)years) and 26 controls were included. SRV patients had a median NT-pro BNP of 380 (215-667) ng/L and reduced SRV ejection fraction (EF 42.8 ± 8.8%) with chamber dilation. Segmental fSENC strain analysis revealed significantly lower strain values in SRV patients compared with controls, particularly in septal and anterior segments (strain ≥ -17%). Correlation of fSENC-derived GLS and GCS with FT metrics and NT-pro BNP levels was moderate (r = 0.4 for both), whereas EF and 6MWT showed no significant correlation with FT metrics or NT-pro BNP levels.</p><p><strong>Conclusion: </strong>This is the first study to comprehensively assess both regional and global strains using fSENC in SRV patients. fSENC enables reproducible assessment of myocardial deformation and shows moderately strong agreement with established strain methods. Its association with NT-pro BNP suggests potential clinical relevance, warranting further studies to evaluate its role in longitudinal monitoring and prognostic assessment.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102769"},"PeriodicalIF":5.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329724","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":"Native T1 and Exercise Capacity After COVID-19: A Question of Causality.","authors":"James P Howard, Alexander Stevenson","doi":"10.1016/j.jocmr.2026.102768","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102768","url":null,"abstract":"","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102768"},"PeriodicalIF":5.0,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283965","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":"Incremental Prognostic Impact of Quantitative Perfusion CMR and T1 Mapping in Patients with Heart Failure.","authors":"Masafumi Takafuji, Ching-Hui Sia, Thomas Anderton, Bradley Chambers, Maryum Farooq, Erica Dall'Armellina, John P Greenwood, Peter Kellman, Pankaj Garg, Sven Plein, Peter P Swoboda","doi":"10.1016/j.jocmr.2026.102767","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102767","url":null,"abstract":"<p><strong>Background: </strong>Alterations in myocardial perfusion and fibrosis are key components in the pathophysiology of heart failure (HF). However, the incremental prognostic value of combining myocardial perfusion and fibrosis remains unclear. The purpose of this study was to evaluate the incremental prognostic value of myocardial perfusion and diffuse fibrosis as defined by cardiovascular magnetic resonance (CMR) in patients with HF.</p><p><strong>Materials and methods: </strong>We collected data from prospectively recruited patients who were clinically diagnosed with HF and referred for CMR assessment between November 2017 to April 2024. Stress/rest myocardial blood flow (MBF) and perfusion reserve (MPR) were calculated from QP-CMR. Extracellular volume fraction (ECV) was calculated using T1 mapping. The primary endpoint was defined as a composite of HF hospitalization (HFH) and all-cause mortality, based on the timing of the first event. Univariate and multivariate Cox regression analysis, and global chi-square analysis were used to assess prognostic performance.</p><p><strong>Results: </strong>A total of 677 patients with HF (median (interquartile range) 63.2 (55.2-72.3) years; 436 male.) were enrolled. During a median 3.5 year follow-up, 109 patients (16.1%) reached the primary endpoints (59 deaths and 50 HFHs). Lower tertile of MPR [adjusted hazard ratio (aHR) 1.74 (95% confidence interval 1.18-2.56), p=0.005) and higher tertiles of native T1 [aHR 1.74 (1.16-2.59), p=0.007] and ECV [aHR 2.35 (1.58-3.49), p<0.001] were associated with the occurrence of the primary endpoint, whereas stress and rest MBF were not significantly associated. Patients exhibiting both high-risk MPR and high-risk ECV had the poorest prognosis [aHR 4.01 (2.28-7.03), p<0.001] whereas patients with only isolated high-risk MPR (aHR 1.74 (1.06-2.86), p=0.027), or high-risk ECV [aHR 2.36(1.36-4.09), p=0.002] demonstrated significantly worse prognoses than patients with both parameters within the low-risk range. Adding ECV to age, sex, and conventional parameters increased the global chi-square values from 33.79 to 50.34 (p<0.001), and further addition of MPR to 57.78 (p=0.006).</p><p><strong>Conclusions: </strong>QP-CMR and T1 mapping provide incremental, complementary prognostic information for predicting adverse outcomes in HF patients. Impaired myocardial perfusion may be an important marker for risk stratification in addition to myocardial fibrosis in HF patients.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102767"},"PeriodicalIF":5.0,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277617","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":"Detection of coronary artery aneurysm in children with Kawasaki disease: a prospective study using contrast-enhanced coronary MRA with combined diastolic and systolic phases imaging at 3T.","authors":"Haitang Jiang, Quanli Shen, Qiong Yao, Guanke Cai, Yan Zheng, Lan He, Chenxi Hu, Haikun Qi, Xihong Hu","doi":"10.1016/j.jocmr.2026.102766","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102766","url":null,"abstract":"<p><strong>Background: </strong>Contrast-enhanced coronary magnetic resonance angiography (MRA) images can be obtained during two comparatively quiescent phases in the cardiac cycle (mid-diastole and end-systole) to evaluate coronary artery aneurysms (CAA) in children with Kawasaki disease (KD), but each phase of coronary MRA has its own advantages and disadvantages. Integrating the diastolic and systolic phases images may improve the clinical utility of coronary MRA.</p><p><strong>Methods: </strong>101 participants with KD were prospectively enrolled. Coronary MRA images were acquired twice in the diastole and systole acquired within the late gadolinium enhancement (LGE) delay window (10-15min), eliminating the need for extended scan time. Scan-relevant parameters and image quality were assessed. The diagnostic efficacy of CAA was compared among three groups (systole, diastole and dual-phase). The detection performance of CAA with thrombosis was also calculated. Myocardial injury is detected on LGE images. The association between myocardial injury and baseline or CAA with thrombosis were identified with logistic regression analyses.</p><p><strong>Results: </strong>101 participants (aged 7.4 ± 3.4, 35.6% female) were evaluated. The mean MRA acquisition times were 241.5 ± 51.9s and 251 ± 79s in systole and diastole, and the average total scan time of two-phase coronary MRA image was 492.6 ± 112.4s, which are integrated into the LGE delay period. The subjective overall image quality in systole were better than that during the diastole. When comparing with the diastolic-phase MRA on a per-segment basis, dual-phase coronary MRA showed greater sensitivity (85.92% [244/284] vs. 79.58% [226/284], p < 0.001) and accuracy (91.97% [828/909] vs. 90.54% [823/909], p < 0.001) in detecting CAA, also the area under the receiver operating characteristic curve (AUC-ROC) of dual-phase MRA was improved (0.903 vs.0.875, p < 0.001). Consistent improvements were observed on per-vessel basis (sensitivity: 88.55% [201/227] vs. 84.58% [192/227]; accuracy: 87.62% [354/404] vs. 86.14% [348/404]; both p < 0.05). Dual-phase coronary MRA also demonstrated excellent diagnostic performance in detecting CAA with thrombosis, achieving an AUC-ROC of 0.863 in per-patient analysis. Intracoronary aneurysmal thrombus was independently associated with myocardial injury (OR: 4.5, [95% CI: 1.8-11.1], p < 0.001; adjusted OR: 3.7, [95% CI: 1.4-9.7], p < 0.05).</p><p><strong>Conclusion: </strong>Dual-phase 3T contrast-enhanced coronary MRA has satisfactory diagnostic performance in detecting CAA. It is a feasible option for the clinical application of CMRA in patients with Kawasaki disease.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102766"},"PeriodicalIF":5.0,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277571","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":"Filling the Gaps: Generating 4D Dense Cardiac Anatomy from Sparse CMR for Enhanced Tetralogy of Fallot Assessment.","authors":"Charlène Mauger, Yu Deng, Yiyang Xu, Michelle C Williams, Steven E Williams, David E Newby, M Jay Campbell, Shaimaa Fadl, Orlando Simonetti, Andrew D McCulloch, Jeffrey Omens, Kuberan Pushparajah, Alistair Young","doi":"10.1016/j.jocmr.2026.102765","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102765","url":null,"abstract":"<p><strong>Background: </strong>Accurate assessment of 3D four chamber cardiac anatomy is essential for managing repaired Tetralogy of Fallot (rToF), yet standard cardiac magnetic resonance (CMR) protocols acquire sparse 2D slices with anisotropic resolution, inter-slice inconsistencies, and motion artifacts from patient movement and incomplete acquisitions. As CT provides isotropic 3D whole-heart segmentations, it can be used to train deep learning models to reconstruct dense 3D anatomies from sparse CMR-like slices simulated from these volumes, bridging the gap between CMR's clinical accessibility and CT's spatial resolution. We aimed to develop and validate such a deep learning pipeline for comprehensive 3D whole-heart reconstruction from routine 2D cine short and long axis CMR images in rToF patients.</p><p><strong>Methods: </strong>A two-stage deep learning pipeline was developed to reconstruct cardiac anatomy from sparse two-dimensional cine (2D+time) CMR images. A UNet segmentation network was trained on 152 and tested on 19 held-out rToF patients from multiple centres. A label completion network reconstructed dense 3D geometries from sparse segmentations using 1,715 CT segmentations augmented with synthetic right ventricle (RV) myocardium and simulated ToF-specific views. The approach was validated using simulated slices from 18 3D non-contrast enhanced magnetic resonance angiography scans and clinical CMR scans. To simulate incomplete acquisitions encountered in paediatric clinical practice - where scans are frequently abandoned prematurely or individual views are missing due to patient motion or non-compliance - reconstruction performance was evaluated by randomly removing 50-70% of short-axis slices prior to 3D geometry reconstruction.</p><p><strong>Results: </strong>With 50-70% of short-axis slices randomly removed, reconstruction achieved 3D Dice similarity coefficient (DSC) of 0.95 (left ventricle (LV)), 0.93 (right ventricle (RV)), 0.89 (LV myocardium), 0.89 (left atrium), 0.79 (right atrium), and 0.74 (RV myocardium). Chamber volumes and masses were accurately recovered: LV volume -0.27±1.60mL, RV volume 3.91±4.98mL, LA volume -2.32±3.33mL, LV mass -1.87±2.08g, RV mass 2.47±5.6g. On test CMR cases (n=19) with motion artifacts, 2D-DSC were 0.95±0.02 (LV cavity), 0.91±0.02 (RV cavity), 0.95±0.06 (LA cavity), 0.91±0.09 (RA cavity), 0.70±0.06 (RV myocardium) and 0.88±0.03 (LV myocardium), meeting or exceeding inter-observer variability. The network accurately reconstructed geometries throughout the cardiac cycle despite training only on diastasis hearts.</p><p><strong>Conclusions: </strong>This pipeline enables anatomically accurate cardiac anatomy from sparse CMR data, potentially reducing scan times while maintaining diagnostic accuracy.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102765"},"PeriodicalIF":5.0,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264714","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":"Cardiovascular magnetic resonance reclassification of aortic regurgitation after transcatheter aortic valve implantation: A COMPARE-TAVI 1 substudy.","authors":"Alexandra Amalie Uglebjerg Pedersen, Anders Lehmann Dahl Pedersen, Nils Sofus Borg Mogensen, Lene Hüche Nielsen, Henrik Nissen, Philip Freeman, Nicolaj Hansson, Julia Ellert-Gregersen, Tomas Zaremba, Bjarne Linde Nørgaard, Troels Thim, Evald Høj Christiansen, Christian Juhl Terkelsen, Won Yong Kim, Jordi Sanchez Dahl","doi":"10.1016/j.jocmr.2026.102763","DOIUrl":"10.1016/j.jocmr.2026.102763","url":null,"abstract":"<p><strong>Background: </strong>Aortic regurgitation (AR) after transcatheter aortic valve implantation (TAVI) is a clinical concern. Echocardiography is routinely used to assess AR but relies on semiquantitative and operator-dependent measures, while cardiovascular magnetic resonance (CMR) allows direct quantification of regurgitant flow. This study compared transthoracic echocardiography (TTE) and CMR in assessing AR after TAVI using standardized Valve Academic Research Consortium-3 (VARC-3) criteria.</p><p><strong>Methods: </strong>In this prespecified substudy of the multicenter COMPARE-TAVI 1 trial, patients were randomized to treatment with Sapien 3/Sapien 3 Ultra or Myval/Myval Octacor transcatheter heart valves. TTE and CMR were performed in 327 participants 4-6 weeks post-TAVI, and AR severity was graded according to VARC-3 criteria. TTE was evaluated by core laboratory consensus, whereas CMR-derived regurgitant fraction was quantified by phase-contrast velocity mapping. Agreement, diagnostic accuracy, and clinical predictors of discordance were evaluated.</p><p><strong>Results: </strong>By TTE, AR was none-trace-mild in 88.4% (289/327), mild-moderate in 10.1% (33/327), moderate in 0.9% (3/327), and moderate-severe in 0.6% (2/327) of patients. Corresponding CMR results were 92.7% (303/327), 7.0% (23/327), 0.3% (1/327), and 0%, with a median [IQR] AR fraction of 5% [3-9]. Overall agreement between modalities was 86% (281/327), with TTE overestimating AR in 9% (31/327) and underestimating in 5% (15/327) as compared with CMR. Using CMR as the reference for detecting moderate or greater AR (AR fraction ≥30%), TTE did not identify the one patient who had moderate AR by CMR. Of five patients graded as moderate or greater by TTE, all were downgraded by CMR to less than moderate AR (sensitivity 0.00, 95% CI 0.00-0.98; specificity 0.99, 95% CI 0.97-1.00). Discordance was more frequent with extensive aortic valve calcification and those receiving Myval/Myval Octacor valves.</p><p><strong>Conclusion: </strong>In this multicenter study, current-generation transcatheter valves exhibit low rates of moderate or greater AR. One patient with moderate AR by CMR was not detected by TTE. CMR reclassified all five patients classified with moderate or greater AR by TTE to lower severity categories, underscoring the complementary value of CMR to TTE, when moderate or severe AR is suspected.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102763"},"PeriodicalIF":5.0,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Importance of All the Characteristics of Late Gadolinium Enhancement from Acquisition to Expert and Artificial Intelligence Analysis: State-of-the-Art.","authors":"Jeremy Florence, Alexandre Unger, Trecy Gonçalves, Gabriela Liberato, Jérôme Garot, Gilles Soulat, François Pontana, Jean-Nicolas Dacher, Yohann Bohbot, Jeanette Schulz-Menger, Solenn Toupin, Joao A C Lima, Théo Pezel","doi":"10.1016/j.jocmr.2026.102764","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102764","url":null,"abstract":"<p><p>Late gadolinium enhancement (LGE) assessed by cardiovascular magnetic resonance is the cornerstone in the assessment of myocardial tissue characterization, providing crucial diagnostic and prognostic information across a wide spectrum of cardiac conditions. While LGE is traditionally evaluated for its presence and extent, a comprehensive assessment of its diverse characteristics, called \"LGE granularity\"-including its location, extent, and pattern-offers deeper insights into myocardial pathophysiology. The clinical significance of LGE is influenced by various factors, ranging from acquisition protocols including choice of contrast-media and post-processing techniques to interpretation by expert readers and, more recently, artificial intelligence (AI)-based analysis. Advances in imaging protocols have refined LGE detection and quantification, improving diagnostic accuracy and reproducibility. Furthermore, AI approaches are revolutionizing LGE assessment by enabling automated segmentation, feature extraction, and risk stratification. Despite the widespread clinical use of LGE, challenges remain in standardizing acquisition parameters and harmonizing interpretation criteria across centers. Additionally, the integration of AI into clinical workflows raises important considerations regarding validation, generalizability, and physician acceptance. However, emerging evidence suggests that AI-based LGE analysis may improve prognostic modeling, facilitate earlier disease detection, and enhance personalized therapeutic decision-making. This review provides a state-of-the-art of LGE's technical, interpretative, and prognostic aspects, highlighting the role of AI in myocardial tissue characterization. By bridging traditional expert analysis with cutting-edge computational techniques, the future of LGE assessment aims to refine cardiac risk stratification and guide precision medicine in cardiology.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102764"},"PeriodicalIF":6.1,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148225416","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 Atrioventricular Coupling Index in Health and Disease: A Longitudinal Multicohort Analysis.","authors":"Roman Roy, Janek Salatzki, Liliana Szabo, Dorina-Gabriela Condurache, Jackie Cooper, Gracia Andriamiadana, Ahmed M Salih, Dominika Suchá, Tim Leiner, Robin Bülow, Marcus Dörr, Giovanni Donato Aquaro, Andrea Barison, Thu-Thao Le, Calvin W L Chin, Matthias G Friedrich, Florian André, Steffen E Petersen, Zahra Raisi-Estabragh","doi":"10.1016/j.jocmr.2026.102761","DOIUrl":"https://doi.org/10.1016/j.jocmr.2026.102761","url":null,"abstract":"<p><strong>Background: </strong>The Left Atrioventricular Coupling Index (LACI), calculated as the ratio of left atrial (LA) to left ventricular (LV) end-diastolic volume (EDV) has emerged as a novel imaging biomarker of LA-LV coupling. However, reference thresholds are undefined and its predictive value beyond established clinical and imaging markers remains uncertain, limiting broader clinical implementation.</p><p><strong>Methods: </strong>Two large datasets were leveraged to 1) investigate demographic variations of LACI in health, 2) establish population-specific reference thresholds, 3) characterise the relationship between LACI and cardiac structure/function, and 4) investigate its incremental predictive value for cardiovascular outcomes. Cardiovascular magnetic resonance (CMR) scans were performed and analysed using standardised protocols. In the Healthy Hearts Consortium (HHC), a large image bank of verified healthy individuals, demographic variations of LACI were examined, and population-specific reference thresholds were calculated using the 95% prediction interval method. Associations between LACI and markers of LA/LV structure and function were assessed using linear regression models. In UK Biobank, associations of LACI with incident outcomes [atrial fibrillation (AF), heart failure (HF), myocardial infarction, cardiovascular death, all-cause death] were examined over a median 5.5 years prospective follow-up, using Cox regression models adjusted for demographic, clinical, and established CMR variables.</p><p><strong>Results: </strong>In the HHC (n=7,111, 54% female, median 61.5 years), a higher LACI was observed in older age, ethnicities other than White, and women (who also had a greater age-related increase in LACI). After adjustment for demographic factors, higher LACI was associated with poorer LA function and higher LV filling pressures. In UK Biobank (n=25,849, 52% female, median 63.0 years), higher LACI was independently predictive of incident AF [HR per 1 standard deviation increase 1.31 (1.19, 1.44)] and HF [HR 1.15 (1.07, 1.24)], in Cox models adjusted for demographic, clinical, and established CMR variables. Applying the newly derived reference thresholds in a population-specific manner to the UKB cohort revealed a significantly higher probability of AF and HF amongst those with a raised LACI.</p><p><strong>Conclusion: </strong>LACI is a robust predictor of AF and HF with incremental value over established clinical and imaging markers. The provided population-specific reference thresholds permit its broader clinical application.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102761"},"PeriodicalIF":6.1,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148211357","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}