Journal of Cardiovascular Magnetic Resonance最新文献

{"title":"Stress cardiovascular magnetic resonance imaging in intermediate-risk emergency department patients with abnormal high-sensitivity troponin.","authors":"Joanna S Cavalier, John D Ike, Céleste Chevalier, Anissa Cervantes, Maham F Karatela, Katha Desai, Jerishma S Patel, Edward A Graviss, Duc T Nguyen, Clerio De Azevedo Filho, Han W Kim, Alexander T Limkakeng, Charles J Gerardo, Joseph B Borawski, Igor Klem","doi":"10.1016/j.jocmr.2025.101851","DOIUrl":"10.1016/j.jocmr.2025.101851","url":null,"abstract":"<p><strong>Background: </strong>Patients presenting to the emergency department (ED) with chest pain often have abnormal high-sensitivity troponin (hsTn). However, only about 5% have an acute coronary syndrome. We aimed to assess the safety, feasibility, and utility of a clinical disposition protocol, including outpatient observation with stress cardiovascular magnetic resonance (CMR) in intermediate-risk patients with abnormal hsTn of unclear etiology.</p><p><strong>Methods: </strong>Patients with abnormal hsTn and modified HEART-score ≤6 underwent CMR to inform diagnosis, risk stratification, and ED disposition. Patients were followed at 30 and 90 days for all-cause mortality, readmission for myocardial infarction, and unplanned coronary revascularization.</p><p><strong>Results: </strong>CMR was completed in 50 patients (64 years, 56% male) at a median of 23.2 h after presentation to the ED. CMR findings of coronary artery disease (CAD) were present in 19 (38%, 19/50) of patients, of which 13 had known CAD and 6 received a new diagnosis of CAD. In 12 (24%, 12/50) patients, cardiac noncoronary artery disease was diagnosed [cardiomyopathy (8), valvular disease (3), and myocarditis/pericarditis (1)], of which the majority (83%) (10/12) were new diagnoses. CMR was normal in 19 (38%, 19/50) patients. After CMR results were reported, the decision to admit was made in 10 (20%, 10/50) patients, while 40 (80%, 40/50) were discharged from the ED without further cardiac testing. Follow-up was completed in 96% (48/50) of patients, of which no patients experienced an adverse event.</p><p><strong>Conclusion: </strong>A disposition protocol with outpatient observation and stress CMR is feasible and useful for determining the etiology of myocardial injury and risk stratification in patients presenting to the ED with chest pain, abnormal hsTn, and intermediate risk.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101851"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065963","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":"Diagnostic value of bone scintigraphy versus cardiovascular magnetic resonance in cardiac amyloidosis.","authors":"Josefin Obergassel, Michael Bietenbeck, Nuriye Akyol, Volker Vehof, Claudia Meier, Maria Theofanidou, Philipp Stalling, Ali Yilmaz","doi":"10.1016/j.jocmr.2025.101859","DOIUrl":"10.1016/j.jocmr.2025.101859","url":null,"abstract":"<p><strong>Background: </strong>Accurate diagnosis of transthyretin amyloidosis cardiomyopathy (ATTR-CM) and its differentiation from light-chain (AL) cardiac amyloidosis (CA) cases (AL-CM) are of paramount importance. Surprisingly, comparative imaging data based on concurrent cardiovascular magnetic resonance (CMR) and bone scintigraphy in the same patients with biopsy-proven diagnosis of CA are still rare.</p><p><strong>Methods: </strong>This was a real-world retrospective single-center study based on a local clinical care pipeline and we carefully analyzed clinical, laboratory, CMR, and bone scintigraphy data (and if necessary additional endomyocardial biopsy [EMB] data) in patients with suspected CA. As a major inclusion criterion, we only looked at those patients who underwent both a CMR study and a bone scintigraphy-with a clear-cut imaging finding detected by at least one imaging method.</p><p><strong>Results: </strong>One hundred twenty three patients in whom the final diagnosis was obtained either non-invasively based on combined findings from bone scintigraphy and monoclonal protein studies or invasively based on additional EMB findings were included. A positive CMR result indicating the presence of CA was found in 121 patients-suggesting a CMR sensitivity of 98.4% for the diagnosis of any CA. Bone scintigraphy identified 18 patients with low to moderate uptake (Perugini score = 0-1) and 105 patients with high uptake (Perugini score ≥2)-resulting in a sensitivity for bone scintigraphy of 85.4% for the diagnosis of any CA. There was an agreement (\"diagnostic match\") between CMR and bone scintigraphy results in 103 patients (84%) of the total study cohort, while a discrepancy (\"diagnostic mismatch\") was observed in 20 patients (16%). In 18 out of these 20 diagnostic mismatch cases, CMR correctly diagnosed the presence of CA despite a negative or inconclusive result on bone scintigraphy (8 with AL-CM, 8 with ATTR-CM, and 2 with EMB-proven but unspecified CA).</p><p><strong>Conclusion: </strong>CMR shows a substantially higher diagnostic yield for the diagnosis of CA compared to bone scintigraphy, if a real-world cohort of patients comprising different subtypes of CA is looked at, since CMR does not only detect ATTR-CM but also depicts other CA subtypes such as AL. In case of a clear-cut positive CMR result unequivocally indicative of CA, there is no incremental diagnostic value of an additionally performed bone scintigraphy.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101859"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11979466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425469","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":"Effect of obesity on myocardial tissue characteristics in patients with hypertrophic cardiomyopathy: a cardiovascular magnetic resonance-based study.","authors":"Jie Wang, Lutong Pu, Jinquan Zhang, Ruihao Xu, Yang Li, Mengdi Yu, Yangjie Li, Jiajun Guo, Yuanwei Xu, Yu Kang, Yuchi Han, Yucheng Chen","doi":"10.1016/j.jocmr.2025.101903","DOIUrl":"10.1016/j.jocmr.2025.101903","url":null,"abstract":"<p><strong>Background: </strong>Obesity is associated with cardiac steatosis in healthy adults and is independently associated with increased left ventricular (LV) mass and could contribute to the progression of heart failure-related composite events in patients with hypertrophic cardiomyopathy (HCM). However, it is unclear whether the increased LV mass is accompanied by increased fibrosis. We aimed to assess the impact of increased body mass index (BMI) on myocardial tissue characteristics in patients with HCM.</p><p><strong>Methods: </strong>A total of 737 patients with HCM (99 obese, 298 overweight, and 340 normal-weight patients) who underwent cardiovascular magnetic resonance (CMR) imaging were prospectively included. We assessed the relationship between BMI and LV mass, global native T1, extracellular volume, and late gadolinium enhancement (LGE) using CMR. Myocardial tissues from one patient each with obstructive HCM who underwent septal myectomy of the obese, overweight, and normal-weight groups were obtained and stained with red oil O, hematoxylin, and Masson's trichrome.</p><p><strong>Results: </strong>LV mass index (87.2, interquartile range [IQR]: 71.3 to 113.8, 89.4, IQR:75.5 to 111.5, and 104.7, IQR: 86.4 to 123.4 g/m², P < 0.001) was higher in obese and overweight patients with HCM than those with normal weight, but the native T1 was decreased in obese patients with HCM (1324±67 ms, 1308±63 ms, and 1298±67 ms, P < 0.001). In addition, there was no significant difference in LGE extent among the three subgroups (normal weight: 3.7%, IQR: 0 to 9.5%, overweight: 2.7%, IQR: 0 to 7.7%, obese: 3.8%, IQR: 0 to 7.2%, P = 0.194). Multivariable linear regression analyses found that BMI was independently associated with global native T1 (β = -1.918, P = 0.005). Furthermore, myocardial tissues stained with oil red O from three patients showed an increasing extent of fat deposits with BMI, whereas collagen volume fractions were similar.</p><p><strong>Conclusion: </strong>In HCM patients, obesity is associated with increased myocardial mass and decreased native T1, likely reflecting cardiac steatosis in addition to fibrosis. This distinction underscores the potential reversibility of obesity-related myocardial changes through targeted weight management.</p><p><strong>Trial registration: </strong>This prospective cohort study was registered in the Chinese Clinical Trial Registry (URL: http://www.chictr.org.cn; Registry number: ChiCTR1900024094).</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101903"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007201","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":"Accelerated real-time cine and flow under in-magnet staged exercise.","authors":"Preethi S Chandrasekaran, Chong Chen, Yingmin Liu, Syed Murtaza Arshad, Christopher Crabtree, Matthew Tong, Yuchi Han, Rizwan Ahmad","doi":"10.1016/j.jocmr.2025.101894","DOIUrl":"10.1016/j.jocmr.2025.101894","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular magnetic resonance (CMR) imaging is a well-established imaging tool for diagnosing and managing cardiac conditions. The integration of exercise stress with CMR (ExCMR) can enhance its diagnostic capacity. Despite recent advances in CMR technology, quantitative ExCMR during exercise remains technically challenging due to motion artifacts and limited spatial and temporal resolution.</p><p><strong>Methods: </strong>This study investigated the feasibility of biventricular functional and hemodynamic assessment using real-time (RT) ExCMR during a staged exercise protocol in 24 healthy volunteers. We employed high acceleration rates and applied a coil-reweighting technique to minimize motion blurring and artifacts. We further applied a beat-selection technique that identified beats from the end-expiratory phase to minimize the impact of respiration-induced through-plane motion on cardiac function quantification. Additionally, results from six patients were presented to demonstrate clinical feasibility.</p><p><strong>Results: </strong>Our findings indicated a consistent decrease in end-systolic volume and stable end-diastolic volume across exercise intensities, leading to increased stroke volume and ejection fraction. The selection of end-expiratory beats modestly enhanced the repeatability of cardiac function parameters, as shown by scan-rescan tests in nine volunteers. High scores from a blinded image quality assessment indicated that coil reweighting effectively minimized motion artifacts.</p><p><strong>Conclusion: </strong>This study demonstrated the feasibility of RT ExCMR with in-magnet exercise in healthy subjects and patients. Our results indicate that high acceleration rates, coil reweighting, and selection of respiratory phase-specific heartbeats enhance image quality and repeatability of quantitative RT ExCMR.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101894"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012730","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":"Reconstruction techniques for accelerating dynamic cardiovascular magnetic resonance imaging.","authors":"Andrew Phair, René M Botnar, Claudia Prieto","doi":"10.1016/j.jocmr.2025.101873","DOIUrl":"10.1016/j.jocmr.2025.101873","url":null,"abstract":"<p><p>Achieving sufficient spatial and temporal resolution for dynamic applications in cardiovascular magnetic resonance (CMR) imaging is a challenging task due to the inherently slow nature of CMR. In order to accelerate scans and allow improved resolution, much research over the past three decades has been aimed at developing innovative reconstruction methods that can yield high-quality images from reduced amounts of k-space data. In this review, we describe the evolution of these reconstruction techniques, with a particular focus on those advances that have shifted the dynamic reconstruction paradigm as it relates to CMR. This review discusses and explains the fundamental ideas behind the success of modern reconstruction algorithms, including parallel imaging, spatio-temporal redundancies, compressed sensing, low-rank methods and machine learning.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101873"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585851","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":"Hemodynamics of distal cerebral arteries are associated with functional outcomes in symptomatic ischemic stroke in middle cerebral artery territory: A four-dimensional flow cardiovascular magnetic resonance study.","authors":"Peirong Jiang, Lixin Liu, Xiuzhu Xu, Yanping Zheng, Jialin Chen, Huiyu Qiao, Lin Lin, Bin Sun, Xihai Zhao, He Wang, Zhensen Chen, Yunjing Xue","doi":"10.1016/j.jocmr.2025.101857","DOIUrl":"10.1016/j.jocmr.2025.101857","url":null,"abstract":"<p><strong>Background: </strong>Cerebrovascular hemodynamics are believed to play an important role in the development of ischemic stroke (IS). However, the relationships between hemodynamics and prognosis are not fully understood. Four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) enables comprehensive characteristics of cerebrovascular hemodynamics. This study aims to investigate the associations of the different hemodynamics derived from 4D flow CMR with IS functional outcomes.</p><p><strong>Methods: </strong>Ninety-one patients (median age 64 years, 62 males) with unilateral IS in middle cerebral artery (MCA) territory were included. All subjects underwent a CMR scan, including 4D flow, three-dimensional (3D) time-of-flight magnetic resonance angiography, and 3D whole brain black-blood high-resolution vessel wall imaging of the MCA. Six hemodynamic parameters, including flow rate, velocity, pulsatility index, time-averaged wall shear stress (TAWSS), oscillatory shear index, and relative residence time (RRT), were calculated for the lesion site, pre-bifurcation M1 (pM1) segment, and the distal M1 and/or first branches of M2 (dM1/M2) segments. Vessel characteristics, such as lumen area, vessel area, wall area, maximum wall thickness, and the degree of stenosis, were calculated at the most stenotic lesion site. The modified Rankin Scale (mRS) scores were assessed at 90 days and 1 year, and an mRS >2 was considered as a poor functional outcome.</p><p><strong>Results: </strong>Lower segment-level TAWSS (odds ratio [OR]: 0.24, P = 0.006 and OR: 0.29, P = 0.014), higher RRT (OR: 2.74, P = 0.007 and OR: 2.40, P = 0.011) of dM1/M2 segments, and lower segment- and lesion-level velocity (OR: 0.40, P = 0.019 and OR: 0.41, P = 0.025; OR: 0.41, P = 0.030 and OR: 0.42, P = 0.040) of pM1 segment were observed to be associated with poor functional outcome at both 90 days and 1 year. Using the cut-off value of 3.58 Pa and 0.29, respectively, TAWSS and RRT of dM1/M2 segments showed moderate performance in distinguishing poor functional outcome from favorable outcome (area under the curve ranging from 0.642-0.687) both at 90 days and 1 year.</p><p><strong>Conclusion: </strong>Distal segmental TAWSS and RRT of dM1/M2 segments were associated with poor functional outcomes. Such alterations in hemodynamics might help in the identification of patients with potentially unfavorable prognosis.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101857"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407769","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":"Society for Cardiovascular Magnetic Resonance reference values (\"normal values\") in cardiovascular magnetic resonance: 2025 update.","authors":"Nadine Kawel-Boehm, Scott J Hetzel, Bharath Ambale-Venkatesh, Gabriella Captur, Calvin W L Chin, Christopher J François, Michael Jerosch-Herold, Judy M Luu, Zahra Raisi-Estabragh, Jitka Starekova, Michael Taylor, Max van Hout, David A Bluemke","doi":"10.1016/j.jocmr.2025.101853","DOIUrl":"10.1016/j.jocmr.2025.101853","url":null,"abstract":"<p><p>Quantitative assessment of morphological and functional cardiac parameters by cardiovascular magnetic resonance (CMR) is essential for research and routine clinical practice. Beyond established parameters of chamber size and function, tissue properties such as relaxation times play an increasing role. Normal reference ranges are required for interpretation of results obtained by quantitative CMR. Since the last publication of the \"normal values review\" in 2020 many new publications related to CMR reference values have been published, which were integrated in this update. The larger sample size provides greater statistical confidence in the estimates of upper and lower limits, and enables further partitioning, e.g., by age and ethnicity for several parameters. Previous topics were expanded by new sections.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101853"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364789","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 radiologic-pathologic correlation in radiomic analysis of myocardium in non-ischemic dilated cardiomyopathy.","authors":"Amine Amyar, Shiro Nakamori, Long Ngo, Masaki Ishida, Satoshi Nakamura, Taku Omori, Keishi Moriwaki, Naoki Fujimoto, Kyoko Imanaka-Yoshida, Hajime Sakuma, Kaoru Dohi, Warren J Manning, Reza Nezafat","doi":"10.1016/j.jocmr.2025.101881","DOIUrl":"10.1016/j.jocmr.2025.101881","url":null,"abstract":"<p><strong>Background: </strong>There is a growing interest in cardiovascular magnetic resonance (CMR) radiomic signatures as novel imaging biomarkers of cardiac disease. However, very little is known about pathological correlates of the radiomics signature of myocardium on CMR sequences. In this study, we sought to investigate the association between CMR myocardial radiomic signatures and histological features in patients with non-ischemic dilated cardiomyopathy (DCM).</p><p><strong>Methods: </strong>CMR images from DCM patients who underwent CMR followed by endomyocardial biopsy within 6 [2-15] days were used to investigate the association between myocardial radiomic signatures measured from native T₁, extra-cellular volume (ECV), late gadolinium enhancement (LGE) and histological features. Radiomic first-order and textural features were computed for each sequence from the mid-septal myocardium near the biopsy region. Hierarchical clustering was then applied to identify distinct radiomic clusters. A representative feature known as the \"medoid\" was identified within each cluster based on its minimal dissimilarity from other features. Logistic regression models were built using one medoid per model to evaluate the association between each medoid and histological feature. Association was determined using odds ratio (OR) with a 95% confidence interval.</p><p><strong>Results: </strong>132 DCM patients (71% male, 94/132; 54 ± 15 years) were included in the study. Clustering analysis unveiled two radiomic clusters for each sequence. For native T₁, the medoids were textural features. The first medoid was associated with fibrosis, inflammation, myocyte hypertrophy, vacuolization, and fat replacement (OR = 2.84 [1.62-5.46]; OR = 2.05 [1.15-4.03]; OR = 2.39 [1.01-6.62]; OR = 2.03 [1.22-3.60]; OR = 0.35 [0.12-0.86]; respectively). The second medoid was associated with nuclear generation (OR = 0.55 [0.31-0.91]). ECV medoids included first-order and textural features. The first-order medoid was associated with fibrosis (OR = 2.97 [1.75-5.46]), myocyte hypertrophy (OR = 3.20 [1.17-10.37]), and nuclear degeneration (OR = 1.66 [1.02-2.89]), while medoid 2 (texture) was associated with fibrosis (OR = 4.44 [2.26-10.00]). LGE medoid 1 (texture) was associated with myocyte hypertrophy (OR = 0.31 [0.10-0.77]), while medoid 2 (texture) was associated with fibrosis (OR = 2.40 [1.38-4.66]) and vacuolization (OR = 2.00 [1.16-3.72]).</p><p><strong>Conclusions: </strong>In DCM patients, CMR radiomic signatures were associated with myocardial tissue composition, as assessed by invasive biopsy.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101881"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673910","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":"Design and rationale of MYOFLAME-19 randomised controlled trial: MYOcardial protection to reduce post-COVID inFLAMmatory heart disease using cardiovascular magnetic resonance Endpoints.","authors":"Valentina O Puntmann, Dietrich Beitzke, Andreas Kammerlander, Inga Voges, Dominik D Gabbert, Marcus Doerr, Bishwas Chamling, Biykem Bozkurt, Juan Carlos Kaski, Erica Spatz, Eva Herrmann, Gernot Rohde, Philipp DeLeuw, Lenka Taylor, Christine Windemuth-Kieselbach, Cornelia Harz, Marta Santiuste, Laura Schoeckel, Juliana Hirayama, Peter C Taylor, Colin Berry, Eike Nagel","doi":"10.1016/j.jocmr.2024.101121","DOIUrl":"10.1016/j.jocmr.2024.101121","url":null,"abstract":"<p><strong>Background: </strong>Cardiac symptoms due to postacute inflammatory cardiac involvement affect a broad segment of previously well people with only mild acute coronavirus disease 2019 (COVID-19) illness and without overt structural heart disease. Cardiovascular magnetic resonance (CMR) imaging can identify the underlying subclinical disease process, which is associated with chronic cardiac symptoms. Specific therapy directed at reducing postacute cardiac inflammatory involvement before development of myocardial injury and impairment is missing.</p><p><strong>Methods: </strong>Prospective multicenter randomized placebo-controlled study of myocardial protection therapy (combined immunosuppressive/antiremodeling) of low-dose prednisolone and losartan. Consecutive symptomatic individuals with a prior COVID-19 infection, no pre-existing significant comorbidities or structural heart disease, undergo standardized assessments with questionnaires, CMR imaging, and cardiopulmonary exercise testing (CPET). Eligible participants fulfilling the criteria of subclinical post-COVID inflammatory heart involvement on baseline CMR examination are randomized to treatment with either verum or placebo for a total of 16 weeks (W16). Participants and investigators remain blinded to the group allocation throughout the study duration. The primary efficacy endpoint is the absolute change of left ventricular ejection fraction to baseline at W16, measured by CMR, between the verum treatment and placebo group by absolute difference, using unpaired t-test confirmatively at a significance level of 0.05 significance level. Secondary endpoints include assessment of changes of symptoms, CMR parameters, and CPET after W16, and frequency of major adverse cardiac events after 1 year. Safety data will be analyzed for frequency, severity, and types of adverse events (AEs) for all treatment groups. The proportion of AEs related to the contrast agent gadobutrol will also be analyzed. A calculated sample size is a total of 280 participants (accounting for 22 subjects (8%) drop out), randomized in 1:1 fashion to 140 in the verum and 140 placebo groups.</p><p><strong>Conclusion: </strong>Myoflame-19 study will examine the efficacy of a myocardial protection therapy in symptomatic participants with post-COVID inflammatory cardiac involvement determined by CMR. The aim of the intervention is to reduce the symptoms and inflammatory myocardial injury, improve exercise tolerance, and preclude the development of cardiac impairment.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101121"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557923","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":"Age-, body surface area-, and sex-specific reference values for cardiovascular magnetic resonance imaging derived ventricular and atrial size and function for Chinese healthy children.","authors":"Ke Xu, Wei Bai, Zhi Yang, Rong Xu, Lin-Jun Xie, Ling-Yi Wen, Chuan Fu, Jie-Qian Zheng, Xin-Mao Ma, Hang Fu, Zhong-Qin Zhou, Cheng-Cheng Zhu, Xiao-Yue Zhou, Hua-Yan Xu, Ying-Kun Guo","doi":"10.1016/j.jocmr.2025.101885","DOIUrl":"10.1016/j.jocmr.2025.101885","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular magnetic resonance (CMR) is crucial for the diagnosis and prognosis of heart disease. However, normal reference values for CMR-derived morphology parameters have not been established for Chinese children. We sought to establish reference values for ventricular and atrial size and function parameters using CMR in healthy Chinese children across a broad age range.</p><p><strong>Methods: </strong>3T CMR scans were performed in 191 healthy children, aged 4-18 years. We used balanced steady-state free precession sequence for analyzing chamber size and function. Reference percentile curves and tables were generated using the generalized additive model for location scale and shape. A meta-analysis was conducted to compare our results with those of relevant previously published studies.</p><p><strong>Results: </strong>Boys generally had greater ventricular volumes and masses after normalization for body surface area (BSA) compared with girls. However, in the youngest age group (4-8 years), differences in volumes or masses between sexes were not found. Additionally, differences were not observed in left ventricular and right ventricular ejection fractions between sexes upon stratifying subjects based on age groups. However, after normalizing for BSA, only the maximal right atrial volume remained significantly greater in boys than that in girls. Age-specific and BSA-specific reference curves revealed non-linear relationships between age/BSA and cardiac parameters. Asian children exhibited significantly smaller chamber sizes compared to those seen in Caucasian children.</p><p><strong>Conclusion: </strong>We report normative CMR ventricular and atrial volume and function in Chinese children based on BSA, age, and sex, which can serve as a reference for future studies and clinical practice.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101885"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692284","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}