Journal of Cardiovascular Magnetic Resonance最新文献

{"title":"Age- and sex-differences and reference values for ventricular strain by cardiovascular magnetic resonance imaging in adults without cardiovascular disease or cardiovascular disease risk factors.","authors":"Rohit Pillai, Lu Zhang, Kevin Peters, Vibhav Jha, Christopher J O'Donnell, Warren J Manning, Connie W Tsao","doi":"10.1016/j.jocmr.2025.101902","DOIUrl":"10.1016/j.jocmr.2025.101902","url":null,"abstract":"<p><strong>Background: </strong>Myocardial deformation measured by myocardial strain is an important marker of cardiovascular disease (CVD). We aimed to establish normal values and examine age- and sex-differences in left and right ventricular (LV, RV) strain using feature tracking cardiovascular resonance (FT-CMR) in adults free of CVD in the community.</p><p><strong>Methods: </strong>Framingham Heart Study Offspring participants without CVD, hypertension, or diabetes completed CMR (1.5T) (n=903, 59% (533/903) women, 36-88 years of age). Global longitudinal, circumferential, and radial strain (GLS, GCS, and GRS, respectively) were measured by semi-automated LV and RV myocardial segmentation of short-axis, 2-chamber, and 4-chamber images with cvi42 (v.5.13, Circle Cardiovascular Imaging, Calgary, Canada).</p><p><strong>Results: </strong>Mean LV GLS, GCS, and GRS were -17.8±2.5%, -19.7±2.4%, and 34.9±6.9%, respectively; RV GLS, GCS, and GRS were -20.4±4.0%, -11.7±3.5%, and 19.1±6.5%, respectively. All strain values were of greater magnitude in women than men (all p<0.005). LV and RV GCS and GRS were of greater magnitude (more negative and more positive, respectively) with increasing age (all p<0.001), but GLS was not associated with age. Stratified analysis by sex showed LV and RV GCS and GRS were greater in magnitude with increasing age in women (all p<0.001), whereas no age associations in men were observed.</p><p><strong>Conclusion: </strong>We provide FT-CMR reference values for LV and RV strain in a large, community-dwelling U.S. adult cohort free of CVD and CVD risk factors. Women demonstrated greater magnitude LV and RV GCS and GRS with increasing age. The clinical implications of sex-differences in ventricular strain and mechanical remodeling with age deserve further study.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":"27 1","pages":"101902"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968015","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":"Cardiac diffusion-weighted and tensor imaging: A consensus statement from the special interest group of the Society for Cardiovascular Magnetic Resonance.","authors":"Erica Dall'Armellina, Daniel B Ennis, Leon Axel, Pierre Croisille, Pedro F Ferreira, Alexander Gotschy, David Lohr, Kevin Moulin, Christopher T Nguyen, Sonja Nielles-Vallespin, William Romero, Andrew D Scott, Christian Stoeck, Irvin Teh, Elizabeth M Tunnicliffe, Magalie Viallon, Victoria Wang, Alistair A Young, Jürgen E Schneider, David E Sosnovik","doi":"10.1016/j.jocmr.2024.101109","DOIUrl":"10.1016/j.jocmr.2024.101109","url":null,"abstract":"<p><p>Thanks to recent developments in cardiovascular magnetic resonance (CMR), cardiac diffusion-weighted magnetic resonance is fast emerging in a range of clinical applications. Cardiac diffusion-weighted imaging (cDWI) and diffusion tensor imaging (cDTI) now enable investigators and clinicians to assess and quantify the tridimensional microstructure of the heart. Free-contrast DWI is uniquely sensitized to the presence and displacement of water molecules within the myocardial tissue, including the intracellular, extracellular, and intravascular spaces. CMR can determine changes in microstructure by quantifying: a) mean diffusivity (MD)-measuring the magnitude of diffusion; b) fractional anisotropy (FA)-specifying the directionality of diffusion; c) helix angle (HA) and transverse angle (TA)-indicating the orientation of the cardiomyocytes; d) absolute sheetlet angle (E2A) and E2A mobility-measuring the alignment and systolic-diastolic mobility of the sheetlets, respectively. This document provides recommendations for both clinical and research cDWI and cDTI, based on published evidence when available and expert consensus when not. It introduces the cardiac microstructure focusing on the cardiomyocytes and their role in cardiac physiology and pathophysiology. It highlights methods, observations, and recommendations in terminology, acquisition schemes, postprocessing pipelines, data analysis, and interpretation of the different biomarkers. Despite the ongoing challenges discussed in the document and the need for ongoing technical improvements, it is clear that cDTI is indeed feasible, can be accurately and reproducibly performed and, most importantly, can provide unique insights into myocardial pathophysiology.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101109"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501114","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":"Late gadolinium enhancement cardiovascular magnetic resonance with generative artificial intelligence.","authors":"Omer Burak Demirel, Fahime Ghanbari, Christopher W Hoeger, Connie W Tsao, Adele Carty, Long H Ngo, Patrick Pierce, Scott Johnson, Kathryn Arcand, Jordan Street, Jennifer Rodriguez, Tess E Wallace, Kelvin Chow, Warren J Manning, Reza Nezafat","doi":"10.1016/j.jocmr.2024.101127","DOIUrl":"10.1016/j.jocmr.2024.101127","url":null,"abstract":"<p><strong>Background: </strong>Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging enables imaging of scar/fibrosis and is a cornerstone of most CMR imaging protocols. CMR imaging can benefit from image acceleration; however, image acceleration in LGE remains challenging due to its limited signal-to-noise ratio. In this study, we sought to evaluate a rapid two-dimensional (2D) LGE imaging protocol using a generative artificial intelligence (AI) algorithm with inline reconstruction.</p><p><strong>Methods: </strong>A generative AI-based image enhancement was used to improve the sharpness of 2D LGE images acquired with low spatial resolution in the phase-encode direction. The generative AI model is an image enhancement technique built on the enhanced super-resolution generative adversarial network. The model was trained using balanced steady-state free-precession cine images, readily used for LGE without additional training. The model was implemented inline, allowing the reconstruction of images on the scanner console. We prospectively enrolled 100 patients (55 ± 14 years, 72 males) referred for clinical CMR at 3T. We collected three sets of LGE images in each subject, with in-plane spatial resolutions of 1.5 × 1.5-3-6 mm². The generative AI model enhanced in-plane resolution to 1.5 × 1.5 mm² from the low-resolution counterparts. Images were compared using a blur metric, quantifying the perceived image sharpness (0 = sharpest, 1 = blurriest). LGE image sharpness (using a 5-point scale) was assessed by three independent readers.</p><p><strong>Results: </strong>The scan times for the three imaging sets were 15 ± 3, 9 ± 2, and 6 ± 1 s, with inline generative AI-based images reconstructed time of ∼37 ms. The generative AI-based model improved visual image sharpness, resulting in lower blur metric compared to low-resolution counterparts (AI-enhanced from 1.5 × 3 mm² resolution: 0.3 ± 0.03 vs 0.35 ± 0.03, P < 0.01). Meanwhile, AI-enhanced images from 1.5 × 3 mm² resolution and original LGE images showed similar blur metric (0.30 ± 0.03 vs 0.31 ± 0.03, P = 1.0) Additionally, there was an overall 18% improvement in image sharpness between AI-enhanced images from 1.5 × 3 mm² resolution and original LGE images in the subjective blurriness score (P < 0.01).</p><p><strong>Conclusion: </strong>The generative AI-based model enhances the image quality of 2D LGE images while reducing the scan time and preserving imaging sharpness. Further evaluation in a large cohort is needed to assess the clinical utility of AI-enhanced LGE images for scar evaluation, as this proof-of-concept study does not provide evidence of an impact on diagnosis.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101127"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769307","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":"Assessing microvascular dysfunction and predicting long-term prognosis in patients with cardiac amyloidosis by cardiovascular magnetic resonance quantitative stress perfusion.","authors":"Leting Tang, Wenjin Zhao, Kang Li, Lin Tian, Xiaoyue Zhou, Hu Guo, Mu Zeng","doi":"10.1016/j.jocmr.2024.101134","DOIUrl":"10.1016/j.jocmr.2024.101134","url":null,"abstract":"<p><strong>Background: </strong>Cardiac involvement in light chain amyloidosis (AL) is the main determinant of prognosis. Amyloid can be deposited in the extracellular space and cause an increase in extracellular volume fraction (ECV). At the same time, amyloid can also be deposited in the wall of small vessels and cause microvascular dysfunction. This study sought to investigate the extent of microvascular dysfunction and its incremental prognostic value in cardiac light-chain amyloidosis (AL-CA) by quantitative stress perfusion.</p><p><strong>Methods: </strong>A total of 126 AL amyloidosis patients (61.13 ± 8.46 years, 81 male) confirmed by pathology were prospectively recruited. All subjects underwent cardiovascular magnetic resonance (CMR) with late gadolinium enhancement (LGE), T1 mapping, and stress perfusion on a 3T scanner. ECV and myocardial perfusion reserve (MPR) were measured semi-automatically using a dedicated CMR software. Clinical, laboratory, and CMR parameters were analyzed for their prognostic value in the assessment of AL-CA patients. Mortality-associated markers were analyzed by univariate and multivariable Cox regression.</p><p><strong>Results: </strong>The median follow-up time was 37 (33.6-40.4) months, and 62 patients died. The ECV of survivors was significantly reduced, but the stress myocardial blood flow and MPR were higher (P < 0.001). The MPR of the transmural LGE group was significantly lower than that of the no LGE and subendocardial LGE groups (P < 0.001). In multivariable analysis, ECV, MPR, and LGE were independently predictive. MPR of >1.5 and ECV of ≤53.6% were associated with improved overall survival, both of which provided predictive incremental value in patients with advanced disease. With equal Mayo staging and degree of ECV, MPR improves assessment of patient survival.</p><p><strong>Conclusion: </strong>ECV and MPR showed additive incremental values and further discriminated prognosis of patients in advanced stages. CMR phenotypes with higher ECV and lower MPR had a worse prognosis.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101134"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828603","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 imaging traits associated with adverse right ventricular remodeling in repaired tetralogy of Fallot: A Single Center Outcomes Using cardiovascular magnetic resonance in Tetralogy of Fallot study.","authors":"Elizabeth W Thompson, Ningiun J Dong, Jin-Seo Kim, Abhijit Bhattaru, Phuong Vu, Fengling Hu, Russell T Shinohara, Sophia Swago, Elizabeth Donnelly, Xuemei Zhang, Annefleur Loth, Lipika Vuthuri, Kristen Lanzilotta, Kevin K Whitehead, Jeffrey Duda, James Gee, Laura Almasy, Elizabeth Goldmuntz, Mark A Fogel, Walter R Witschey","doi":"10.1016/j.jocmr.2025.101855","DOIUrl":"10.1016/j.jocmr.2025.101855","url":null,"abstract":"<p><strong>Background: </strong>Deterioration of right ventricular (RV) function in repaired tetralogy of Fallot (rToF) is poorly understood. Cardiovascular magnetic resonance (CMR) is used for monitoring, but its analysis is user-dependent and time-consuming. We sought to automate the analysis of CMR using machine learning and to identify imaging traits associated with adverse RV remodeling in the natural history of rToF.</p><p><strong>Methods: </strong>A longitudinal cohort of rToF patients underwent CMR at the Children's Hospital of Philadelphia. The nnU-Net method was used to train a machine learning model to segment the left ventricular (LV) blood pool, LV myocardium, and RV blood pool from two-dimensional short-axis CMR images. Conventional and novel measures were calculated and studied in association with remodeling rates using multivariable linear regression. Remodeling rates were calculated as ((Variable_scan2 - Variable_scan1)/years between scans) for the variables end-diastolic volume index (EDVi), end-systolic volume index (ESVi), stroke volume index (SVi), ejection fraction (EF), and peak systolic dV/dt.</p><p><strong>Results: </strong>The cohort was comprised of 758 patients, of whom 152 had 2 analyzable scans. Thirty-six patients underwent pulmonic valve replacement (PVR) between scans. Compared to patients with no intervention (representing the natural history of rToF), patients with PVR had significantly lower remodeling rates for RVEDVi, RVESVi, RVSVi, and absolute peak systolic RV dV/dt, while RVEF and left-sided metrics did not differ between groups. In 116 patients without PVR between scans, RV remodeling rates were negatively associated with baseline LV mass index, LVEDVi, LVSVi, and absolute peak systolic LV dV/dt.</p><p><strong>Conclusion: </strong>We demonstrated that rToF patients with two CMR scans and PVR have significant differences in and opposite directions of RV remodeling rates compared to those with no intervention. We also showed that several left-sided measures of structure and function were associated with RV remodeling rates, indicating the importance of baseline LV measurements in characterizing future risk of adverse RV remodeling.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101855"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414435","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":"The future of cardiovascular magnetic resonance imaging in thoracic aortopathy: blueprint for the paradigm shift to improve management.","authors":"James Nadel, José Rodríguez-Palomares, Alkystis Phinikaridou, Claudia Prieto, Pier-Giorgio Masci, René Botnar","doi":"10.1016/j.jocmr.2025.101865","DOIUrl":"10.1016/j.jocmr.2025.101865","url":null,"abstract":"<p><p>Thoracic aortopathies result in aneurysmal expansion of the aorta that can lead to rapidly fatal aortic dissection or rupture. Despite the availability of abundant non-invasive imaging tools, the greatest contemporary challenge in the management of thoracic aortic aneurysm (TAA) is the lack of reliable metrics for risk stratification, with absolute aortic diameter, growth rate, and syndromic factors remaining the primary determinants by which prophylactic surgical intervention is adjudged. Advanced cardiovascular magnetic resonance (CMR) techniques present a potential key to unlocking insights into TAA that could guide disease surveillance and surgical intervention. CMR has the capacity to encapsulate the aorta as a complex biomechanical structure, permitting the determination of aortic volume, morphology, composition, distensibility, and fluid dynamics in a time-efficient manner. Nevertheless, current standard-of-care imaging protocols do not harness its full capacity. This state-of-the-art review explores the emerging role of CMR in the assessment of TAA and presents a blueprint for the required paradigm shift away from aortic size as the sole metric for risk-stratifying TAA.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101865"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476487","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":"Imaging features of desmoplakin arrhythmogenic cardiomyopathy: A comparative cardiovascular magnetic resonance study.","authors":"Mikael Laredo, Etienne Charpentier, Shannon Soulez, Vincent Nguyen, Annamaria Martino, Leonardo Calò, Flavie Ader, Alexis Hermida, Véronique Fressart, Philippe Charron, Nadjia Kachenoura, Estelle Gandjbakhch, Alban Redheuil","doi":"10.1016/j.jocmr.2025.101867","DOIUrl":"10.1016/j.jocmr.2025.101867","url":null,"abstract":"<p><strong>Background: </strong>Arrhythmogenic cardiomyopathy (ACM) related to Desmoplakin (DSP) mutations is a distinct condition associated with particularly severe outcomes, more frequent left ventricular (LV) involvement, including fibrosis, dysfunction, and inflammatory episodes. Whether DSP-ACM is associated with specific imaging features remains elusive. This study aims to provide a comprehensive description of cardiovascular magnetic resonance (CMR) findings in patients with DSP-ACM and to compare them to RV-dominant ACM with LV involvement (LV+ right-dominant-ACM).</p><p><strong>Methods: </strong>Patients with DSP-ACM matched with patients with ACM related to a non-DSP desmosomal mutation and ≥1 feature of LV involvement underwent CMR in two institutions. Biventricular metrics and segmental wall motion abnormalities (WMA) were assessed. LV late gadolinium enhancement (LGE) was assessed both qualitatively and quantitatively after semi-automated segmentation.</p><p><strong>Results: </strong>Overall, 70 ACM patients were analyzed; 37 with DSP-ACM and 33 in the LV+ right-dominant-ACM group. LVEF was significantly lower in the DSP-ACM group (46 ± 12%) than in the LV+ right-dominant-ACM group (56 ± 10%, P = 0.001). Conversely, RVEF was significantly higher in the DSP-ACM group (45 ± 11% vs. 40 ± 12%, P = 0.04) and both RV end-diastolic (100 ± 24 vs 130 ± 44 mL/m², P = 0.002) and end-systolic (56 ± 21 vs 81 ± 45 mL/m², P = 0.007) indexed volumes were significantly smaller in DSP-ACM as compared to the LV+ right-dominant-ACM group. The LV to RV end-systolic volume ratio (0.96 [interquartile range (IQR)0.70-1.27] vs. 0.59 [IQR 0.48-0.69]) was significantly higher in the DSP-ACM group (P < 0.0001), and had a good performance in differentiating both groups (area under the ROC curve 0.86, optimal threshold 0.8). Patients in the DSP-ACM group had significantly more LV and less RV WMA than those in the LV+ right-dominant-ACM group. The amount of LGE was significantly higher in the DSP group (14% ± 16 vs. 2%±3, P < 0.0001) and present in the majority of LV segments, particularly in the lateral and inferior walls, as compared to LV+ right-dominant-ACM patients. Transmural LGE and the presence of a ring-like pattern corresponding to circumferential subepicardial LGE involving ≥3 contiguous LV basal segments were highly specific of DSP-ACM.</p><p><strong>Conclusion: </strong>The presence of LV to RV end-systolic volume ratio>0.8, global LGE>5%, transmural and/or a ring-like LGE pattern are highly suggestive of DSP-ACM and should prompt careful diagnostic assessment considering the severe associated outcome.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101867"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531528","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":"Late gadolinium-enhanced cardiovascular magnetic resonance for predicting left ventricular reverse remodeling in dilated cardiomyopathy: A comprehensive review and meta-analysis.","authors":"Yaqiong Zhou, Yuanwei Xu, Yangjie Li, Chuang Huang, Yucheng Chen","doi":"10.1016/j.jocmr.2025.101860","DOIUrl":"10.1016/j.jocmr.2025.101860","url":null,"abstract":"<p><strong>Background: </strong>There is currently a lack of evidence regarding the significance of late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) in predicting left ventricular (LV) reverse remodeling (RR) in pooled data. This study aimed to evaluate the predictive value of the presence and extent of LGE for LVRR in patients with dilated cardiomyopathy (DCM).</p><p><strong>Methods: </strong>Systematic searches were conducted in PubMed, Embase, Cochrane Library, and ClinicalTrials.gov from database inception to May 21, 2024. We estimated the overall effect sizes using the Mantel-Haenszel random-effects model. Subgroup analyses, meta-regression, and sensitivity analyses were performed to investigate potential sources of heterogeneity among studies.</p><p><strong>Results: </strong>A total of 1141 patients (LGE prevalence: 49.7% (567/1141)) from 13 studies (5 prospective and 8 retrospective) were included. After a median follow-up period of 15 months, 43.5% of patients achieved LVRR. The presence of LGE predicted LVRR with a pooled odds ratio (OR) of 0.23 (95% confidence interval [CI]: 0.14-0.38, P < 0.01) with significant heterogeneity (I² = 68%). The pooled OR for LVRR per percent increase in the extent of LGE was 0.94 (95% CI: 0.90-0.98, P < 0.01) with low heterogeneity (I² = 19%). Subgroup analysis based on follow-up duration demonstrated that the presence of LGE was more strongly inversely associated with LVRR in <12 months follow-up (OR 0.06, 95% CI: 0.03-0.13, P < 0.01) compared to ≥12 months follow-up (OR 0.36, 95% CI: 0.24-0.54, P < 0.01).</p><p><strong>Conclusion: </strong>The presence and increase extent of LGE on CMR significantly diminish LVRR achievement in DCM patients, particularly in short-term follow-up (<12 months).</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101860"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425413","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":"Impact of transapical beating-heart septal myectomy on left atrial remodeling and atrioventricular coupling in hypertrophic obstructive cardiomyopathy.","authors":"Yun Zhao, Jin-Yi Xiang, Ziyi Pan, Chenhe Li, Lu Huang, Dazhong Tang, Yi Luo, Chunlin Xiang, Xiaoyue Zhou, Xiang Wei, Liming Xia, Lian-Ming Wu","doi":"10.1016/j.jocmr.2025.101884","DOIUrl":"10.1016/j.jocmr.2025.101884","url":null,"abstract":"<p><strong>Background: </strong>Assessment of left atrial (LA) functional strain and atrioventricular coupling is increasingly recognized as critical in patients with hypertrophic obstructive cardiomyopathy (HOCM), associated with adverse atrial remodeling and malignant arrhythmia. The effect of transapical beating-heart septal myectomy (TA-BSM) on the improvement of LA function and atrioventricular coupling remains uncertain.</p><p><strong>Methods: </strong>The patients with HOCM who underwent TA-BSM in Tongji Hospital between April 2022 and October 2023 were prospectively investigated. The LA structure parameters (diameters and volumes), functional parameters (total LA emptying fraction [LAEF], total strain [εs], peak positive strain rate [SRs], passive LAEF, passive strain [εe], peak early negative strain rate [SRe], active LAEF, active strain [εa], and late peak negative strain rate [SRa]), and the left atrioventricular coupling index (LACI) obtained using CMR before and after TA-BSM were compared. The Pearson or Spearman correlation analysis was used to investigate the relationships between LA parameters and LACI. The univariate and multivariate linear regression analyses were used to identify variables associated with the rate of change in strains.</p><p><strong>Results: </strong>A total of 133 patients [median (Q1, Q3), 48 (35.0, 57.5) years; 92 males] were evaluated. Further, 133 healthy participants matched for age and sex were included as controls. The LA size, reservoir function (total LAEF, εs, and SRs), conduit function (passive LAEF, εe, and SRe), and booster function (active LAEF, εa, and SRa) were worse than control group but improved to various degrees after TA-BSM (all P < 0.05). The subgroup with poor atrioventricular coupling had greater rate of change of εs, εa, and SRa postoperatively (all P < 0.001). LACI was highly correlated with strain and strain rate before TA-BSM, which decreased slightly postoperatively. In multivariable regression analysis, preoperative LACI was highly correlated with the rate of change of εs (adjusted β = -0.449, P < 0.001), εe (adjusted β = -0.285, P < 0.001), and εa (adjusted β = -0.286, P = 0.001).</p><p><strong>Conclusion: </strong>LA reverse remodeling was confirmed by CMR in HOCM after TA-BSM and LACI may be a potential factor affecting LA strain improvement and expected to be an effective indicator for long-term monitoring of postoperative left heart function.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101884"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692287","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":"Abnormal coronary vascular response in patients with long COVID syndrome - a case-control study using oxygenation-sensitive cardiovascular magnetic resonance.","authors":"Lukas D Weberling, Elizabeth Hillier, Matthias G Friedrich, Marc Zahlten, Norbert Frey, Florian André, Henning Steen","doi":"10.1016/j.jocmr.2025.101890","DOIUrl":"10.1016/j.jocmr.2025.101890","url":null,"abstract":"<p><strong>Background: </strong>Following the worldwide coronavirus disease 2019 (COVID-19) pandemic, many patients reported ongoing severe cardiovascular symptoms after the acute phase. This multisystemic condition has been named long COVID syndrome. While cardiovascular magnetic resonance (CMR) imaging is the gold standard to diagnose acute myocardial damage, no specific changes have been shown in long COVID patients. However, endothelial dysfunction has been hypothesized to contribute to its pathogenesis. Oxygenation-sensitive CMR during breathing exercise is a simple, non-invasive, and accurate test to objectify vascular function, which has not been applied to long COVID patients yet.</p><p><strong>Methods: </strong>After receiving approval from the local ethics committee, this prospective observational case-control study enrolled (i) patients reporting symptoms for ≥6 weeks following an acute COVID-19 infection or vaccination, and (ii) healthy volunteers with neither symptoms nor history of cardiovascular disease. Participants completed a questionnaire, point-of-care testing of cardiac biomarkers, a standard non-contrast CMR, and an oxygenation-sensitive CMR. Heart rate response and breathing-induced myocardial oxygenation reserve (B-MORE) were assessed during metronome-paced hyperventilation and apnea.</p><p><strong>Results: </strong>Thirty-one patients (17 female; age 39.4 [30.3; 51.6] years) and 27 controls (12 female; age 33.3 [27.3; 46.8] years) were included with comparable demographics and cardiovascular risk factors between groups. Laboratory testing and standard CMR did not reveal any pathologies in either of the groups. Indexed left ventricular stroke volume was significantly lower in patients (44.5 mL [41.2; 46.6] vs 55.9 mL [49.2; 59.2]; p < 0.001), while ejection fraction and longitudinal strain of both ventricles were comparable (p > 0.05 for all). Vasoactive breathing exercises induced a significant increase in heart rate (+35/min [21; 45]) and B-MORE (9.8% [4.3; 17.2]) in controls. In patients, however, heart rate increase was blunted (+15/min [7; 26]; p < 0.001) and B-MORE was significantly lower (7.3% [3.4; 10.4], p = 0.044).</p><p><strong>Conclusion: </strong>This pilot study is the first to show a blunted hemodynamic and myocardial oxygenation response to vasoactive breathing maneuvers during oxygenation-sensitive CMR in long COVID patients. This simple, non-invasive test may be the first to objectify complaints of affected patients and indicates evidence for the crucial role of the endothelium in the pathophysiology of long COVID.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101890"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788502","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}