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Cardiovascular Magnetic Resonance in Cardiology Practice
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Cardiovascular Magnetic Resonance in Cardiology Practice

A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Imaging".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 12771

Special Issue Editor

Prof. Dr. Sebastian Kelle

E-Mail Website
Guest Editor
Head of Cardiovascular MRI, Department of Internal Medicine and Cardiology, German Heart Center Berlin and Charité University Medicine Berlin, 13353 Berlin, Germany
Interests: cardiac MRI; CMR; ischemia; cardiomyopathies; inflammation; vascular; stress testing; education; cardiovascular disease; non-invasive imaging

Special Issue Information

Dear Colleagues,

Cardiovascular magnetic resonance (CMR) imaging is a versatile and non-invasive imaging modality that plays an increasingly important role in routine cardiology practice. Recently, new technologies—including T1 mapping, 4D flow, diffusion-weighted and diffusion tensor imaging (DWI/DTI), and chemical exchange saturation transfer (CEST)—have further expanded the role of CMR in the diagnosis, risk stratification, functional assessment, and management of cardiovascular diseases.

The aim of this Special Issue is to collect original clinical and basic research in CMR. Original research articles, reviews, and case reports are welcome. Research areas may include (but are not limited to) the following:

  • CMR in assessing cardiac function and structure;
  • CMR in clinical cardiovascular diseases, such as ischemic heart disease, nonischemic cardiomyopathies, and heart failure;
  • Cardiac magnetic resonance imaging perfusion;
  • 4D flow CMR.

We warmly invite scholars and experts in related fields to contribute to this issue.

Prof. Dr. Sebastian Kelle
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Cardiovascular Development and Disease is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiovascular magnetic resonance imaging
  • cardiac MRI
  • CMR
  • ischemia
  • cardiomyopathies
  • inflammation
  • vascular
  • stress testing
  • education
  • cardiovascular disease
  • non-invasive imaging

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Published Papers (7 papers)

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Research

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14 pages, 1685 KiB  
Article
Prognostic Value of Cardiac Magnetic Resonance Feature Tracking Strain in Aortic Stenosis
by Vasiliki Tsampasian, Ioannis Merinopoulos, Thuwarahan Ravindrarajah, Liam Ring, Ee Ling Heng, Sanjay Prasad and Vassilios S. Vassiliou
J. Cardiovasc. Dev. Dis. 2024, 11(1), 30; https://doi.org/10.3390/jcdd11010030 - 19 Jan 2024
Cited by 1 | Viewed by 1866
Abstract
Background: Recent data have suggested that global longitudinal strain (GLS) could be useful for risk stratification of patients with severe aortic stenosis (AS). In this study, we aimed to investigate the prognostic role of GLS in patients with AS and also its incremental [...] Read more.
Background: Recent data have suggested that global longitudinal strain (GLS) could be useful for risk stratification of patients with severe aortic stenosis (AS). In this study, we aimed to investigate the prognostic role of GLS in patients with AS and also its incremental value in relation to left ventricular ejection fraction (LVEF) and late gadolinium enhancement (LGE). Methods: We analysed all consecutive patients with AS and LGE-CMR in our institution. Survival data were obtained from office of national statistics, a national body where all deaths in England are registered by law. Death certificates were obtained from the general register office. Results: Some 194 consecutive patients with aortic stenosis were investigated with CMR at baseline and followed up for 7.3 ± 4 years. On multivariate Cox regression analysis, only increasing age remained significant for both all-cause and cardiac mortality, while LGE (any pattern) retained significance for all-cause mortality and had a trend to significance for cardiac mortality. Kaplan–Meier survival analysis demonstrated that patients in the best and middle GLS tertiles had significantly better mortality compared to patients in the worst GLS tertiles. Importantly though, sequential Cox proportional-hazard analysis demonstrated that GLS did not have significant incremental prognostic value for all-cause mortality or cardiac mortality in addition to LVEF and LGE. Conclusions: Our study has demonstrated that age and LGE but not GLS are significant poor prognostic indicators in patients with moderate and severe AS. Full article
(This article belongs to the Special Issue Cardiovascular Magnetic Resonance in Cardiology Practice)
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10 pages, 2592 KiB  
Article
Association of Coronary Collaterals and Myocardial Salvage Measured by Serial Cardiac Magnetic Resonance Imaging after Acute Myocardial Infarction
by Jan Pec, Stefan Buchner, Michael Wester, Kurt Debl, Okka W. Hamer, Florian Poschenrieder, Lars S. Maier, Michael Arzt and Stefan Stadler
J. Cardiovasc. Dev. Dis. 2023, 10(12), 473; https://doi.org/10.3390/jcdd10120473 - 24 Nov 2023
Viewed by 1812
Abstract
Background: Coronary collateral flow in angiography has been linked with lower mortality rates in patients with coronary artery disease. However, the relevance of the underlying mechanism is sparse. Therefore, we tested the hypothesis that in patients with acute myocardial infarction (AMI), relevant coronary [...] Read more.
Background: Coronary collateral flow in angiography has been linked with lower mortality rates in patients with coronary artery disease. However, the relevance of the underlying mechanism is sparse. Therefore, we tested the hypothesis that in patients with acute myocardial infarction (AMI), relevant coronary collateral flow is associated with more salvaged myocardium and lower risk of developing heart failure. Methods and Results: Patients with first AMI who received a percutaneous coronary intervention within 24 h after symptom onset were classified visually by assigning a Cohen–Rentrop Score (CRS) ranging between 0 (no collaterals) and 3 (complete retrograde filling of the occluded vessel). All 36 patients included in the analysis underwent cardiac magnetic resonance examination within 3 to 5 days after myocardial infarction and after 12 weeks. Patients with relevant collateral flow (CRS 2–3) to the infarct-related artery had significantly smaller final infarct size compared to those without (7 ± 4% vs. 20 ± 12%, p < 0.001). In addition, both groups showed improvement in left ventricular ejection fraction early after AMI, whereas the recovery was greater in CRS 2–3 (+8 ± 5% vs. +3 ± 5%, p = 0.015). Conclusion: In patients with first AMI, relevant collateral flow to the infarct-related artery was associated with more salvaged myocardium at 12 weeks, translating into greater improvement of systolic left ventricular function. The protective effect of coronary collaterals and the variance of infarct location should be further investigated in larger studies. Full article
(This article belongs to the Special Issue Cardiovascular Magnetic Resonance in Cardiology Practice)
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15 pages, 2794 KiB  
Article
The Presence, Location, and Degree of Late Gadolinium Enhancement in Relation to Myocardial Dysfunction and Poor Prognosis in Patients with Systemic Lupus Erythematosus
by Xiaojin Feng, Peijun Liu, Xiaohang Liu, Tianchen Guo, Xinhao Li, Huaxia Yang, Wei Chen, Yining Wang and Shuyang Zhang
J. Cardiovasc. Dev. Dis. 2023, 10(11), 451; https://doi.org/10.3390/jcdd10110451 - 31 Oct 2023
Viewed by 2006
Abstract
Patients with systemic lupus erythematosus (SLE) typically develop myocardial fibrosis. No studies have investigated the clinical significance of the presence, location, and degree of fibrosis in SLE patients. Seventy-four SLE patients were included. Thirty-seven non-autoimmune disease patients and thirty-seven healthy individuals were included [...] Read more.
Patients with systemic lupus erythematosus (SLE) typically develop myocardial fibrosis. No studies have investigated the clinical significance of the presence, location, and degree of fibrosis in SLE patients. Seventy-four SLE patients were included. Thirty-seven non-autoimmune disease patients and thirty-seven healthy individuals were included as controls. Myocardial fibrosis was evaluated at cardiac magnetic resonance via a qualitative and quantitative assessment of late gadolinium enhancement (LGE). Myocardial function was measured via speckle-tracking echocardiography. All patients were followed up for the occurrence of major adverse cardiac events (MACE). The presence, locations, and degrees of LGE disturbed regional and global myocardial function. The presence of LGE, left ventricular free-wall LGE (LVFW LGE), and severe LGE were all independent predictors of MACE in SLE patients [LGE presence HR: 3.746 (1.434–9.79), p = 0.007; LVFW LGE HR: 2.395 (1.023–5.606), p = 0.044; severe LGE HR: 3.739 (1.241–11.266), p = 0.019]. LGE combined with SLE-related organ damage identified patients at high risk of MACE (p < 0.001). In conclusion, the presence, degree, and location of LGE were associated with myocardial dysfunction. The presence, location, and degree of LGE had the potential to independently predict poor prognosis and improve risk stratification in SLE patients. Full article
(This article belongs to the Special Issue Cardiovascular Magnetic Resonance in Cardiology Practice)
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18 pages, 7562 KiB  
Article
Cardiac Magnetic Resonance, Electromechanical Activation, Kidney Function, and Natriuretic Peptides in Cardiac Resynchronization Therapy Upgrades
by Derek J. Bivona, Pim J. A. Oomen, Yu Wang, Frances L. Morales, Mohamad Abdi, Xu Gao, Rohit Malhotra, Andrew Darby, Nishaki Mehta, Oliver J. Monfredi, J. Michael Mangrum, Pamela K. Mason, Wayne C. Levy, Sula Mazimba, Amit R. Patel, Frederick H. Epstein and Kenneth C. Bilchick
J. Cardiovasc. Dev. Dis. 2023, 10(10), 409; https://doi.org/10.3390/jcdd10100409 - 22 Sep 2023
Cited by 1 | Viewed by 1652
Abstract
As the mechanism for worse prognosis after cardiac resynchronization therapy (CRT) upgrades in heart failure patients with RVP dependence (RVP-HF) has clinical implications for patient selection and CRT implementation approaches, this study’s objective was to evaluate prognostic implications of cardiac magnetic resonance (CMR) [...] Read more.
As the mechanism for worse prognosis after cardiac resynchronization therapy (CRT) upgrades in heart failure patients with RVP dependence (RVP-HF) has clinical implications for patient selection and CRT implementation approaches, this study’s objective was to evaluate prognostic implications of cardiac magnetic resonance (CMR) findings and clinical factors in 102 HF patients (23.5% female, median age 66.5 years old, median follow-up 4.8 years) with and without RVP dependence undergoing upgrade and de novo CRT implants. Compared with other CRT groups, RVP-HF patients had decreased survival (p = 0.02), more anterior late-activated LV pacing sites (p = 0.002) by CMR, more atrial fibrillation (p = 0.0006), and higher creatinine (0.002). CMR activation timing at the LV pacing site predicted post-CRT LV functional improvement (p < 0.05), and mechanical activation onset < 34 ms by CMR at the LVP site was associated with decreased post-CRT survival in a model with higher pre-CRT creatinine and B-type natriuretic peptide (AUC 0.89; p < 0.0001); however, only the higher pre-CRT creatinine partially mediated (37%) the decreased survival in RVP-HF patients. In conclusion, RVP-HF had a distinct CMR phenotype, which has important implications for the selection of LV pacing sites in CRT upgrades, and only chronic kidney disease mediated the decreased survival after CRT in RVP-HF. Full article
(This article belongs to the Special Issue Cardiovascular Magnetic Resonance in Cardiology Practice)
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6 pages, 743 KiB  
Communication
Half-Dose versus Single-Dose Gadobutrol for Extracellular Volume Measurements in Cardiac Magnetic Resonance
by Patrick Doeblin, Fridolin Steinbeis, Martin Witzenrath, Djawid Hashemi, Wensu Chen, Karl Jakob Weiss, Philipp Stawowy and Sebastian Kelle
J. Cardiovasc. Dev. Dis. 2023, 10(8), 316; https://doi.org/10.3390/jcdd10080316 - 26 Jul 2023
Viewed by 1128
Abstract
Background: Cardiac magnetic resonance (CMR) imaging with gadolinium-based contrast agents offers unique non-invasive insights into cardiac tissue composition. Myocardial extracellular volume (ECV) has evolved as an objective and robust parameter with broad diagnostic and prognostic implications. For the gadolinium compound gadobutrol, the recommended [...] Read more.
Background: Cardiac magnetic resonance (CMR) imaging with gadolinium-based contrast agents offers unique non-invasive insights into cardiac tissue composition. Myocardial extracellular volume (ECV) has evolved as an objective and robust parameter with broad diagnostic and prognostic implications. For the gadolinium compound gadobutrol, the recommended dose for cardiac imaging, including ECV measurements, is 0.1 mmol/kg (single dose). This dose was optimized for late enhancement imaging, a measure of focal fibrosis. Whether a lower dose is sufficient for ECV measurements is unknown. We aim to evaluate the accuracy of ECV measurements using a half dose of 0.05 mmol/kg gadobutrol compared to the standard single dose of 0.1 mmol/kg. Methods and results: From a contemporary trial (NCT04747366, registered 10 February 2021), a total of 25 examinations with available T1 mapping before and after 0.05 and 0.1 mmol/kg gadobutrol were analyzed. ECV values were calculated automatically from pre- and post-contrast T1 relaxation times. T1 and ECV Measurements were performed in the midventricular septum. ECV values after 0.05 and 0.1 mmol/kg gadobutrol were correlated (R2 = 0.920, p < 0.001). ECV values after 0.05 mmol/kg had a bias of +0.9% (95%-CI [0.4; 1.4], p = 0.002) compared to 0.1 mmol/kg gadobutrol, with limits of agreement from −1.5 to 3.3%. Conclusions: CMR with a half dose of 0.05 mmol/kg gadobutrol overestimated ECV by 0.9% compared with a full dose of 0.1 mmol/kg, necessitating adjustment of normal values when using half-dose ECV imaging. Full article
(This article belongs to the Special Issue Cardiovascular Magnetic Resonance in Cardiology Practice)
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15 pages, 3007 KiB  
Article
Imaging Predictors of Left Ventricular Functional Recovery after Reperfusion Therapy of ST-Elevation Myocardial Infarction Assessed by Cardiac Magnetic Resonance
by Agneta Virbickiene, Tomas Lapinskas, Christoph D. Garlichs, Stephan Mattecka, Radu Tanacli, Wolfgang Ries, Jan Torzewski, Franz Heigl, Christian Pfluecke, Harald Darius, Hueseyin Ince, Peter Nordbeck, Christian Butter, Andreas Schuster, Steffen Mitzner, Olivija Dobiliene, Ahmed Sheriff and Sebastian Kelle
J. Cardiovasc. Dev. Dis. 2023, 10(7), 294; https://doi.org/10.3390/jcdd10070294 - 11 Jul 2023
Cited by 1 | Viewed by 1717
Abstract
Background: Left ventricular global longitudinal strain (LV GLS) is a superior predictor of adverse cardiac events in patients with myocardial infarction and heart failure. We investigated the ability of morphological features of infarcted myocardium to detect acute left ventricular (LV) dysfunction and predict [...] Read more.
Background: Left ventricular global longitudinal strain (LV GLS) is a superior predictor of adverse cardiac events in patients with myocardial infarction and heart failure. We investigated the ability of morphological features of infarcted myocardium to detect acute left ventricular (LV) dysfunction and predict LV functional recovery after three months in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: Sixty-six STEMI patients were included in the C-reactive protein (CRP) apheresis in Acute Myocardial Infarction Study (CAMI-1). LV ejection fraction (LVEF), LV GLS, LV global circumferential strain (LV GCS), infarct size (IS), area-at-risk (AAR), and myocardial salvage index (MSI) were assessed by CMR 5 ± 3 days (baseline) and 12 ± 2 weeks after (follow-up) the diagnosis of first acute STEMI. Results: Significant changes in myocardial injury parameters were identified after 12 weeks of STEMI diagnosis. IS decreased from 23.59 ± 11.69% at baseline to 18.29 ± 8.32% at follow-up (p < 0.001). AAR and MVO also significantly reduced after 12 weeks. At baseline, there were reasonably moderate correlations between IS and LVEF (r = −0.479, p < 0.001), LV GLS (r = 0.441, p < 0.001) and LV GCS (r = 0.396, p = 0.001) as well as between AAR and LVEF (r = −0.430, p = 0.003), LV GLS (r = 0.501, p < 0.001) and weak with LV GCS (r = 0.342, p = 0.020). At follow-up, only MSI and change in LV GCS over time showed a weak but significant correlation (r = −0.347, p = 0.021). Patients with larger AAR at baseline improved more in LVEF (p = 0.019) and LV GLS (p = 0.020) but not in LV GCS. Conclusion: The CMR tissue characteristics of myocardial injury correlate with the magnitude of LV dysfunction during the acute stage of STEMI. AAR predicts improvement in LVEF and LV GLS, while MSI is a sensitive marker of LV GCS recovery at three months follow-up after STEMI. Full article
(This article belongs to the Special Issue Cardiovascular Magnetic Resonance in Cardiology Practice)
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Review

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12 pages, 1196 KiB  
Review
Cardiovascular Magnetic Resonance Parametric Mapping Techniques for the Assessment of Chronic Coronary Syndromes
by Maria Anna Bazmpani, Chrysovalantou Nikolaidou, Christos A. Papanastasiou, Antonios Ziakas and Theodoros D. Karamitsos
J. Cardiovasc. Dev. Dis. 2022, 9(12), 443; https://doi.org/10.3390/jcdd9120443 - 9 Dec 2022
Cited by 3 | Viewed by 2029
Abstract
The term chronic coronary syndromes encompasses a variety of clinical presentations of coronary artery disease (CAD), ranging from stable angina due to epicardial coronary artery disease to microvascular coronary dysfunction. Cardiac magnetic resonance (CMR) imaging has an established role in the diagnosis, prognostication [...] Read more.
The term chronic coronary syndromes encompasses a variety of clinical presentations of coronary artery disease (CAD), ranging from stable angina due to epicardial coronary artery disease to microvascular coronary dysfunction. Cardiac magnetic resonance (CMR) imaging has an established role in the diagnosis, prognostication and treatment planning of patients with CAD. Recent advances in parametric mapping CMR techniques have added value in the assessment of patients with chronic coronary syndromes, even without the need for gadolinium contrast administration. Furthermore, quantitative perfusion CMR techniques have enabled the non-invasive assessment of myocardial blood flow and myocardial perfusion reserve and can reliably identify multivessel coronary artery disease and microvascular dysfunction. This review summarizes the clinical applications and the prognostic value of the novel CMR parametric mapping techniques in the setting of chronic coronary syndromes and discusses their strengths, pitfalls and future directions. Full article
(This article belongs to the Special Issue Cardiovascular Magnetic Resonance in Cardiology Practice)
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