Journal of Cardiovascular Magnetic Resonance最新文献

{"title":"Corrigendum to \"4D Flow cardiovascular magnetic resonance consensus statement: 2023 update\" [Journal of Cardiovascular Magnetic Resonance 25 (2023) 40].","authors":"Malenka M Bissell, Francesca Raimondi, Lamia Ait Ali, Bradley D Allen, Alex J Barker, Ann Bolger, Nicholas Burris, Carl-Johan Carlhäll, Jeremy D Collins, Tino Ebbers, Christopher J Francois, Alex Frydrychowicz, Pankaj Garg, Julia Geiger, Hojin Ha, Anja Hennemuth, Michael D Hope, Albert Hsiao, Kevin Johnson, Sebastian Kozerke, Liliana E Ma, Michael Markl, Duarte Martins, Marci Messina, Thekla H Oechtering, Pim van Ooij, Cynthia Rigsby, Jose Rodriguez-Palomares, Arno A W Roest, Alejandro Roldán-Alzate, Susanne Schnell, Julio Sotelo, Matthias Stuber, Ali B Syed, Johannes Töger, Rob van der Geest, Jos Westenberg, Liang Zhong, Yumin Zhong, Oliver Wieben, Petter Dyverfeldt","doi":"10.1016/j.jocmr.2025.101912","DOIUrl":"10.1016/j.jocmr.2025.101912","url":null,"abstract":"","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":"28 1","pages":"101912"},"PeriodicalIF":5.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13265417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148163306","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":"Aortic displacement and hemodynamics are abnormal in patients with Marfan syndrome: A combined four-dimensional balanced steady-state free precession and four-dimensional flow cardiac magnetic resonance study.","authors":"Daan Bosshardt, Renske Merton, Aart J Nederveen, Roland R J van Kimmenade, Moniek G P J Cox, Arthur J H A Scholte, Eric M Schrauben, Daniëlle Robbers-Visser, Maarten Groenink, Pim van Ooij","doi":"10.1016/j.jocmr.2026.102731","DOIUrl":"10.1016/j.jocmr.2026.102731","url":null,"abstract":"<p><strong>Background: </strong>Marfan syndrome (MFS) patients with a history of aortic root surgery (ARS) are at increased risk of type B aortic dissection, possibly because the noncompliant graft fails to absorb systolic forces, leading to undampened flow in the proximal descending aorta (pDAo). In this study, we investigated the magnitude and location of abnormal aortic displacement and wall shear stress (WSS) using cardiac magnetic resonance (CMR) imaging.</p><p><strong>Methods: </strong>We examined 82 MFS patients (32 with ARS, 34 ± 8 years, 36 women) and 45 age- and sex-matched controls, all undergoing four-dimensional high-resolution balanced steady-state free precession and flow CMR. Peak displacement and WSS were calculated using automated aortic segmentations. Heatmaps were created to identify and quantify regions with abnormal displacement and WSS. The surface areas of abnormal displacement and WSS were quantified in four aortic regions. The Wilcoxon signed-rank test was used for comparison of abnormal CMR parameter quantification, and Pearson correlation was used to assess correlations between displacement and WSS.</p><p><strong>Results: </strong>WSS was higher in the proximal (p < 0.001) and distal ascending aorta (Aao) (p = 0.031) of ARS MFS patients compared to native MFS patients. ARS MFS patients had significantly larger surface areas of decreased displacement (p < 0.001; present in 97% (31/32) of ARS MFS patients) and increased WSS (p < 0.001; present in 100% (32/32) of patients) in the proximal Aao. There was a trend toward a larger surface area of increased displacement in the pDAo of ARS MFS patients (p = 0.062; present in 72% (23/32) of patients), mainly located in the outer pDAo. pDAo displacement was positively correlated with pDAo WSS (Pearson r = 0.46 [95% confidence interval: 0.13, 0.70], p = 0.008).</p><p><strong>Conclusion: </strong>Aortic displacement and flow characteristics are abnormal in MFS patients, both with and without a history of ARS. ARS MFS patients exhibit distinct features in both the AAo and descending aorta (DAo), particularly in the proximal DAo, which is the region susceptible to type B aortic dissections.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102731"},"PeriodicalIF":5.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772630","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":"Needle-free myocardial blood flow and reserve quantification using artificial intelligence-enhanced coronary sinus flow magnetic resonance imaging with exercise cardiovascular magnetic resonance.","authors":"Manuel A Morales, Alexander Schulz, Nicole C Y Deng, Tess E Wallace, Eric A Osborn, Warren J Manning, Reza Nezafat","doi":"10.1016/j.jocmr.2026.102684","DOIUrl":"10.1016/j.jocmr.2026.102684","url":null,"abstract":"<p><strong>Background: </strong>Quantification of coronary sinus (CS) flow has been used with pharmacologic stress as a non-invasive surrogate of global myocardial blood flow and coronary flow reserve (CFR). Whether CS flow assessment can be extended to physiological exercise stress remains uncertain. Accurate measurement during exercise is technically challenging due to the small caliber of the CS and its rapidly varying flow dynamics, particularly under exercise conditions. In this study, we evaluated the feasibility of a high-resolution, high-frame-rate cardiovascular magnetic resonance (CMR) approach for measuring post-exercise CS flow and CFR and compared these measures with quantitative myocardial perfusion imaging.</p><p><strong>Methods: </strong>We implemented a phase-contrast sequence with non-interleaved velocity-compensated and velocity-encoded k-space acquisition and truncated phase encoding. Generative artificial intelligence (AI) synthesized high-resolution images from the low-resolution inputs and interpolated intermediate frames, effectively doubling temporal resolution. In a prospective exercise CMR study, patients with stable coronary artery disease (n = 13, 50 ± 20 years) underwent AI-enabled CS flow imaging at 1.1 × 1.1 mm² spatial and 27 ms temporal resolution, performed twice at rest for scan/re-scan repeatability and once after exercise. Quantitative perfusion imaging was performed before and post-exercise. Scan/re-scan repeatability of rest CS flow, and inter-observer repeatability of rest and post-exercise CS flow and CS flow-derived CFR were assessed using intraclass correlation coefficients (ICC). CS flow and CFR were compared with perfusion-derived myocardial blood flow and myocardial perfusion reserve (MPR) using linear regression and Pearson correlation (r).</p><p><strong>Results: </strong>Analysis was successful in all rest and 11 of 13 stress scans; two were excluded due to electrocardiogram (ECG) mis-gating. CS flow showed excellent scan/re-scan (ICC = 0.97 [0.91-0.99]) and inter-observer repeatability (ICC = 0.97 [0.92-0.99]). CS flow showed good correlation with perfusion-derived myocardial blood flow (y = 0.95×, r = 0.61, P = 0.002). CS flow-based CFR also correlated well with perfusion-derived MPR (y = 1.02×, r = 0.67, P = 0.025).</p><p><strong>Conclusion: </strong>We demonstrate the feasibility of a high-resolution, high-frame-rate CMR technique for quantifying post-exercise CS flow and CFR, with excellent repeatability and good agreement with perfusion-derived measures. This approach shows promise for assessing global myocardial perfusion after physiological exercise without pharmacologic stress, warranting further validation.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102684"},"PeriodicalIF":5.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145944043","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 therapeutic response to immunosuppression in IgG4-related coronary disease: The role of coronary wall enhancement cardiovascular magnetic resonance.","authors":"Yun Bai, Yaqi Du, Shuang Ding, Ping Xu, Ranran Zhang, Yiqin Wang, Jiayi Wei, Xiujuan Qu, Pingting Yang, Guan Wang","doi":"10.1016/j.jocmr.2025.102680","DOIUrl":"10.1016/j.jocmr.2025.102680","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular magnetic resonance (CMR) imaging with contrast enhancement (CE) of the coronary artery wall has been proven effective for detecting coronary involvement in IgG4-related disease (IgG4-RD). This study seeks to further investigate the value of coronary wall CE on CMR in assessing treatment response.</p><p><strong>Methods: </strong>We prospectively enrolled 30 IgG4-RD patients with coronary involvement and conducted follow-up evaluations. All participants underwent coronary wall imaging with CMR, both before and after treatment with a combination of glucocorticoids and steroid-sparing immunosuppression. Concurrently, inflammatory-related laboratory markers and IgG4-RD Responder Index (RI) scores were collected and analyzed.</p><p><strong>Results: </strong>Most patients (87% [26/30]) exhibited a significant monthly reduction in total coronary wall CE area (ΔCE area/months = 0.32 [interquartile range (IQR): 0.03-0.88] cm²/month) and contrast-to-noise ratio (CNR) (ΔCNR/months = 0.09 [IQR: 0.01-0.41]/month). Both parameters were positively correlated with monthly changes in inflammatory markers, including ΔIgG4/months (r = 0.366 and 0.388, respectively), Δ erythrocyte sedimentation rate/months (r = 0.617 and 0.539), ΔIgG/months (r = 0.565 and 0.578), and ΔIgE/months (r = 0.512 and 0.499) (all P < 0.05). In the \"heart/pericardium\" organ-specific domain of the IgG4-RD RI, the rate of change in the modified index (RI') incorporating coronary wall CE was significantly greater than that of the standard RI (ΔRI'/months vs ΔRI/months: 0.1 vs 0, P = 0.006). Similarly, in the overall multi-organ assessment, ΔRI'/months showed a significant improvement over ΔRI/months (0.68 vs 0.67, P = 0.006). Moreover, ΔCE area/months correlated positively with both ΔRI/months (r = 0.627, P < 0.001) and ΔRI'/months (r = 0.683, P < 0.001). ΔCNR/months also correlated positively with ΔRI/months (r = 0.500, P = 0.005) and ΔRI'/months (r = 0.548, P = 0.002).</p><p><strong>Conclusion: </strong>Glucocorticoid combined with steroid-sparing immunosuppression therapy is effective in treating IgG4-RD with coronary involvement. Coronary wall CE on CMR emerges as a valuable imaging biomarker that complements serological markers in assessing treatment response. Incorporating coronary wall CE enhances RI scoring, aiding therapeutic decisions and disease monitoring.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102680"},"PeriodicalIF":5.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878494","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":"Noninvasive estimation of right atrial pressure using cardiac magnetic resonance in severe tricuspid regurgitation.","authors":"Jihoon Kim, Jihee Son, Onyou Kim, Ki Hong Choi, Jeong Hoon Yang, Eun Kyoung Kim, Sung-A Chang, Sang-Chol Lee, Seung Woo Park, Sung Mok Kim, Sung-Ji Park","doi":"10.1016/j.jocmr.2026.102710","DOIUrl":"10.1016/j.jocmr.2026.102710","url":null,"abstract":"<p><strong>Background: </strong>While right atrial pressure (RAP) reflects disease severity and carries prognostic value in patients with severe tricuspid regurgitation (TR), its noninvasive estimation remains limited in accuracy. The aim of this study was to evaluate the ability of cardiovascular magnetic resonance imaging (CMR) to estimate RAP by identifying relevant imaging parameters in patients with severe TR.</p><p><strong>Methods: </strong>Between September 2021 and January 2026, 47 consecutive patients who underwent cardiac catheterization and CMR for severe TR were enrolled from a tertiary center. In addition to conventional parameters, right ventricular (RV) and right atrial (RA) strain were measured from apical four-chamber images of CMR. Pressure profiles including the mean RAP were obtained via cardiac catheterization.</p><p><strong>Results: </strong>The median age was 69 years, and secondary TR was the predominant etiology (83.0%). The mean RAP was 10.0 mmHg, and the median interval between catheterization and CMR was 1 day. Among volumetric parameters, indexed RV end-diastolic volume (RVEDVi; r = 0.58, p<0.001), indexed RV end-systolic volume (r = 0.55, p<0.001), and indexed RA end-systolic area (r = 0.33, p = 0.024) were significantly associated with invasively measured RAP. Among functional parameters, RV ejection fraction and RV longitudinal strain were not significantly associated with RAP. In contrast, RA longitudinal strain (r = -0.59, p<0.001) and RA radial strain (r = -0.48, p<0.001) showed significant associations. In a multivariable linear regression model, RVEDVi and RA longitudinal strain remained significantly associated with RAP. The area under the curve for predicting mean RAP >10 mmHg was 0.78 for RVEDVi and 0.82 for RA longitudinal strain.</p><p><strong>Conclusion: </strong>RVEDVi and RA longitudinal strain were significantly associated with invasively measured RAP in patients with severe TR. These findings suggest that CMR has potential as a noninvasive tool for estimating RAP in this population.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102710"},"PeriodicalIF":5.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13246302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147457357","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":"A clinical future for the myocardial phosphocreatine/adenosine triphosphate ratio?","authors":"Adrianus J Bakermans","doi":"10.1016/j.jocmr.2026.102694","DOIUrl":"10.1016/j.jocmr.2026.102694","url":null,"abstract":"","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102694"},"PeriodicalIF":5.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010439","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 magnetic resonance imaging in the German National Cohort (NAKO): Automated segmentation of short-axis cine images and post-processing quality control.","authors":"Peter M Full, Robin T Schirrmeister, Manuel Hein, Maximilian F Russe, Marco Reisert, Clemens Ammann, Karin Halina Greiser, Thoralf Niendorf, Tobias Pischon, Jeanette Schulz-Menger, Klaus H Maier-Hein, Fabian Bamberg, Susanne Rospleszcz, Christopher L Schlett, Christopher Schuppert","doi":"10.1016/j.jocmr.2025.101958","DOIUrl":"10.1016/j.jocmr.2025.101958","url":null,"abstract":"<p><strong>Background: </strong>The prospective, multicenter German National Cohort (NAKO) provides a unique dataset of cardiac magnetic resonance (CMR) cine images. Effective processing of these images requires a robust segmentation and quality control pipeline.</p><p><strong>Methods: </strong>A deep learning model for semantic segmentation, based on the nnU-Net architecture, was applied to full-cycle short-axis cine images from 29,908 baseline participants. The primary objective was to determine data on structure and function for both ventricles (LV, RV), including end-diastolic volumes, end-systolic volumes, and LV myocardial mass. Statistical and visual quality control was performed, including an expert assessment of outliers in morphofunctional parameters, inter- and intra-ventricular phase differences, and LV time-volume curves (TVC). These were adjudicated using a five-point rating scale, ranging from five (excellent) to one (non-diagnostic), with ratings of three or lower subject to exclusion. The predictive value of outlier criteria for inclusion and exclusion was evaluated using receiver operating characteristics analysis.</p><p><strong>Results: </strong>The segmentation model generated complete data for 29,609 of 29,908 participants (99.0%), of whom 5082 (17.0%) underwent visual assessment. Quality assurance yielded a final sample of 26,899 (89.9%) participants with excellent or good quality, excluding 1875 participants due to image quality issues and 835 participants due to segmentation quality issues. TVC was the strongest single discriminator between included and excluded participants (AUC: 0.684). Of the two-category combinations, the pairing of TVC and phases provided the greatest improvement over TVC alone (AUC difference: 0.044; p<0.001). The best performance was observed when all three categories were combined (AUC: 0.748). By extending the quality-controlled sample to include mid-level \"acceptable\" quality ratings, a total of 28,413 (95.0%) participants could be included.</p><p><strong>Conclusion: </strong>The implemented pipeline enabled automated segmentation of an extensive CMR dataset and integrated thorough quality control measures, providing a comprehensive and reliable data resource for quantitative analyses with diminished risk of bias.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101958"},"PeriodicalIF":5.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13265423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064723","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":"Myocardial energy metabolism in heart failure: Systematic review and meta-analysis of Phosphorus-31 magnetic resonance spectroscopy phosphocreatine/adenosine triphosphate ratio.","authors":"Jing Peng, Peng Sun, Jianxiu Lian, Baiyan Jiang, Yang Wu, Minyue Pei, Nan Li, Jiazheng Wang","doi":"10.1016/j.jocmr.2025.101993","DOIUrl":"10.1016/j.jocmr.2025.101993","url":null,"abstract":"<p><strong>Objective: </strong>Phosphorus-31 magnetic resonance spectroscopy (³¹P MRS) is the only non-invasive imaging modality that directly quantifies myocardial energy metabolism in vivo. While extensively studied, its readiness for clinical application in heart failure remains uncertain. This meta-analysis aimed to evaluate the association between myocardial phosphocreatine-to-adenosine triphosphate (PCr/ATP) ratio, measured by ³¹P MRS, and heart failure, as a step toward assessing its translational potential as a clinical biomarker.</p><p><strong>Methods: </strong>We systematically reviewed studies published from January 1, 1990, to December 31, 2024, using PubMed, Embase, and Web of Science. Eligible studies included cohort studies and randomized controlled trials reporting PCr/ATP ratios in heart failure patients and healthy controls. A random-effects model was used to estimate pooled odds ratios. Risk of bias was assessed using the ROBINS-E tool.</p><p><strong>Findings: </strong>Twenty-six observational studies met the inclusion criteria; no randomized trials were identified. Meta-analysis showed a directionally consistent and substantial association between reduced PCr/ATP ratio and heart failure (odds ratio 7.62, 95% CI 4.90-11.85), with moderate between-study heterogeneity (I² = 60% and the prediction interval is [1.35-42.92]). Studies at field strengths >1.5T showed reduced heterogeneity (I² = 18.8%) with a comparable effect size (odds ratio 7.69, 95% CI 5.17-11.43). Prespecified meta-regression did not identify significant moderators (age, female proportion, ejection fraction, NYHA class, field strength, or blood-pool correction; all P≥0.18).</p><p><strong>Interpretation: </strong>These findings support a clinically sizable but heterogeneous association between impaired myocardial energy metabolism-measured by reduced PCr/ATP ratio using ³¹P MRS-and heart failure. The consistency across subgroups, including HFpEF, suggests potential utility in early-stage or diagnostically challenging heart failure. The results support inclusion of PCr/ATP in prospective studies aimed at validating its clinical utility and advancing metabolic imaging toward routine cardiovascular care.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101993"},"PeriodicalIF":6.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12818134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145633841","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":"Free-breathing three-dimensional high-resolution Dixon late gadolinium enhancement imaging for chronic myocardial infarction assessment at 3T.","authors":"Yubo Guo, Shihai Zhao, Jing An, Michaela Schmidt, Karl-Philipp Kunze, Claudia Prieto, Lu Lin, Yining Wang","doi":"10.1016/j.jocmr.2025.102668","DOIUrl":"10.1016/j.jocmr.2025.102668","url":null,"abstract":"<p><strong>Background: </strong>Late gadolinium enhancement (LGE) imaging is considered the imaging reference standard for the diagnosis of myocardial infarction and scarring. The aim of this study is to evaluate a free-breathing high-resolution three-dimensional (3D) Dixon LGE imaging prototype with image navigation (iNAV) in chronic myocardial infarction on a 3T system.</p><p><strong>Methods: </strong>Consecutive myocardial infarction patients were enrolled to undergo CMR examination between February 2024 and January 2025. LGE protocols included breath-hold two-dimensional (2D) phase-sensitive inversion recovery (PSIR) and free-breathing iNAV 3D Dixon acquisitions. Radiologist image quality scoring, contrast ratio (CR), quantitative LGE assessment, and scan time were obtained and reported. Paired t-tests, Wilcoxon signed-rank tests, and repeated-measures ANOVA were used for the comparison.</p><p><strong>Results: </strong>A total of 32 participants (50 years ± 11; 31 male, 1 female) were included. 3D LGE reduced scan time by 2m9s (3D: 4m34s [3m50s, 5m17s], 2D: 6m43s [5m17s, 7m41s], P<0.001). Overall image quality showed no difference (3D: 4 [3, 4], 2D: 4 [3, 5], P = 0.474). 3D LGE showed a trend toward higher image quality scores (3D: 4 [3, 4], 2D: 3 [2, 4], P = 0.053) in patients with respiratory motion artifacts on 2D images. LGE-to-blood CR was significantly higher in the 3D LGE than the 2D LGE images (P<0.001). LGE mass (P = 0.11) and LGE extent (P = 0.02) showed no significant difference between the 3D and 2D LGE datasets.</p><p><strong>Conclusion: </strong>Free-breathing iNAV 3D Dixon LGE is feasible at 3T, achieving comparable image quality and scar quantification to 2D PSIR within shorter scan times. It improves CR and enables simultaneous assessment of myocardial fibrosis and fat infiltration.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102668"},"PeriodicalIF":6.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12811441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145723668","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":"Randomized controlled trial of vericiguat in patients with coronary microvascular dysfunction causing stable chest pain (V-COM): study protocol for a randomized control trial.","authors":"Cho-Kiu Lo, Niki Hiu-Yee Ip, Tsun-Hei Sin, Shui-Yan Ho, Chun-Ka Wong, Frankie Chor-Cheung Tam, Simon Cheung-Chi Lam, Kai Hang Yiu, Michael Shu-Yue Sze, Thomas Tsun-Ho Lam, Alston Conrad Ho-On Chiu, Karen Ka-Ying Li, Ka Chun Un, Esther Yee-Tak Yu, Eric Kwong-Yu Chan, Kevin Ka-Chun Lee, Shing Ching, Derek Pok-Him Lee, Chi-Yuen Wong, Hiu-Lam Chan, Ngai-Yin Chan, Chun-Yu Leung, Ming-Yen Ng","doi":"10.1016/j.jocmr.2026.102744","DOIUrl":"10.1016/j.jocmr.2026.102744","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have shown that ∼50% of patients with stable chest pain have no obstructive coronary artery disease (CAD), yet remain at higher risk of major adverse cardiovascular events (MACE) compared to patients without chest pain. Coronary microvascular dysfunction (CMD) is a major cause of ischemia with no obstructive coronary arteries (INOCA). While therapies for CMD are lacking, Vericiguat, a soluble guanylate cyclase stimulator, has shown improvement in coronary microvascular circulation in animal studies. Quantitative stress cardiovascular magnetic resonance (CMR) allows the quantification of stress myocardial blood flow (MBF) and myocardial perfusion reserve (MPR). This study aims to conduct a randomized controlled trial to determine if Vericiguat improves MBF and MPR in patients with stable chest pain and INOCA caused by CMD.</p><p><strong>Methods/design: </strong>V-COM is a single-blind, randomized controlled trial. Ninety-four patients aged 40-80 years with recurrent stable chest pain, nonobstructive coronary arteries on recent coronary computed tomography (CT) or invasive angiography, and CMD defined by stress CMR (MPR <2.19 or stress MBF <2.19 mL/g/min) will be recruited across six centers in Hong Kong. Participants will be randomized 1:1 to vericiguat plus optimal medical therapy (intervention) or optimal medical therapy alone (control). Vericiguat will be prescribed once daily for 6 months, starting at 2.5 mg and titrated up to a target dose of 10 mg based on systolic blood pressure and tolerability. CMR (including quantitative stress perfusion) will be performed at baseline and 6 months. The primary outcome is the between-group difference in change in stress MBF and MPR from baseline to 6 months. Secondary outcomes include change in six-minute walk distance and Seattle Angina Questionnaire-7 (SAQ-7) scores.</p><p><strong>Discussion: </strong>This study will provide evidence on whether Vericiguat can improve myocardial perfusion in patients with CMD and offer insights into its potential as a novel therapy for CMD.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"102744"},"PeriodicalIF":5.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13254573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147929937","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}