Advances in Clinical Cardiovascular Magnetic Resonance Imaging

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: 25 April 2024 | Viewed by 3102

Special Issue Editors


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Guest Editor
1. Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy
2. U.O.C. Bioingegneria, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy
Interests: cardiac imaging; blood disorders; gender differences; cardiovascular disease; women
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
1. Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy
2. U.O.C. Bioingegneria, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy
Interests: cardiovascular magnetic resonance image analysis; multimodal cardiac image fusion; medical imaging
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are delighted to launch a Special Issue of the Journal of Clinical Medicine entitled “Advances in Clinical Cardiovascular Magnetic Resonance Imaging”.

Due to its comprehensive nature and ability to provide valuable information regarding different aspects of heart health, cardiovascular magnetic resonance (CMR) has evolved into an indispensable tool in the realm of cardiology. CMR provides an accurate and reproducible assessment of cardiac function, including measurements of ejection fraction, ventricular volumes, wall motion abnormalities, and strain. CMR can accurately detect changes in the myocardial tissue composition, like edema or fibrosis, and it has the capacity to differentiate and measure various substances present in the myocardium, such as fat, iron, or amyloid deposits. This unique ability to characterize myocardial tissue aids in diagnosing specific cardiac conditions and monitoring their progression without the need for invasive procedures. Moreover, CMR's ability to provide high-resolution images with excellent tissue contrast enables the accurate and detailed evaluation of myocardial perfusion.

CMR data could also be combined with data from other image modalities, as well as clinical data, to enhance cardiac disease characterization and personalize the patient’s therapeutic path.

Readers will gain insights into the current state of the art in the clinical applications of CMR imaging, understanding its role in improving patient care and risk stratification. Furthermore, the issue will explore exciting new developments and achievements in the field of CMR imaging.

We welcome the submission of original research and review articles. Topics of interest include, but are not limited to, the following keywords.

Dr. Antonella Meloni
Prof. Vincenzo Positano
Guest Editors

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 Clinical Medicine is an international peer-reviewed open access semimonthly 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 2600 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

  • myocardial tissue characterization
  • quantitative mapping
  • cardiac function
  • stress CMR
  • phase-contrast MRI
  • cardiac masses
  • cardiomyopathies
  • congenital heart diseases
  • cardiotoxicity
  • diffusion tensor imaging(DTI)
  • multimodal imaging including CMR
  • applications of radiomics to CMR image analysis
  • artificial Intelligence applications to CMR image analysis and CMR data interpretation

Published Papers (4 papers)

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Research

12 pages, 1998 KiB  
Article
Impact of Cardiac Magnetic Resonance on the Diagnosis of Left Ventricular Noncompaction—A 15-Year Experience
by Natalia Ojrzyńska-Witek, Magdalena Marczak, Łukasz Mazurkiewicz, Joanna Petryka-Mazurkiewicz, Barbara Miłosz, Jacek Grzybowski and Mateusz Śpiewak
J. Clin. Med. 2024, 13(4), 949; https://doi.org/10.3390/jcm13040949 - 07 Feb 2024
Viewed by 530
Abstract
The aim of this study was to assess the impact of cardiac magnetic resonance (CMR) on the diagnosis in patients with known or suspected left ventricular noncompaction (LVNC). We retrospectively reviewed the medical charts of 12,811 consecutive patients who had CMR studies between [...] Read more.
The aim of this study was to assess the impact of cardiac magnetic resonance (CMR) on the diagnosis in patients with known or suspected left ventricular noncompaction (LVNC). We retrospectively reviewed the medical charts of 12,811 consecutive patients who had CMR studies between 2008 and 2022 in a large tertiary center. We included patients referred for CMR because of known or suspected LVNC. The study sample consisted of 333 patients, 193 (58.0%) male, median age 39.0 (26.8–51.0) years. Among 74 patients fulfilling the echocardiographic LVNC criteria, the diagnosis was confirmed in 54 (73.0%) cases. In 259 patients with ultrasound-based suspicion of LVNC, CMR led to an LVNC diagnosis in 82 (31.7%) patients. In both groups, CMR led to a new diagnosis in 89 cases (10 (13.5%) and 79 (30.5%)). A quantity of 38 (5.4%) patients were diagnosed with dilated cardiomyopathy, 11 (1.4%) patients were diagnosed with hypertrophic cardiomyopathy, and 21 (4.1%) patients were diagnosed with unclassified cardiomyopathy. In four patients with suspected LVNC, a myocardial trabeculation was a secondary result of dilatation due to coronary heart disease. In five cases, valvular heart disease was found. Four patients were diagnosed with athlete’s heart. Other diagnoses (arrhythmogenic right ventricular cardiomyopathy, peripartum cardiomyopathy, hypokinetic non-dilated cardiomyopathy, sarcoidosis, amyloidosis, and ventricular septum defect) were found in six patients. CMR is a valuable tool in the evaluation of cardiac muscle and in differentiating LVNC and other cardiac diseases. Full article
(This article belongs to the Special Issue Advances in Clinical Cardiovascular Magnetic Resonance Imaging)
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15 pages, 3199 KiB  
Article
Atrial and Ventricular Strain Imaging Using CMR in the Prediction of Ventricular Arrhythmia in Patients with Myocarditis
by Riccardo Cau, Francesco Pisu, Jasjit S. Suri, Gianluca Pontone, Tommaso D’Angelo, Yunfei Zha, Rodrigo Salgado and Luca Saba
J. Clin. Med. 2024, 13(3), 662; https://doi.org/10.3390/jcm13030662 - 23 Jan 2024
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Abstract
(1) Objective: Myocarditis can be associated with ventricular arrhythmia (VA), individual non-invasive risk stratification through cardiovascular magnetic resonance (CMR) is of great clinical significance. Our study aimed to explore whether left atrial (LA) and left ventricle (LV) myocardial strain serve as independent [...] Read more.
(1) Objective: Myocarditis can be associated with ventricular arrhythmia (VA), individual non-invasive risk stratification through cardiovascular magnetic resonance (CMR) is of great clinical significance. Our study aimed to explore whether left atrial (LA) and left ventricle (LV) myocardial strain serve as independent predictors of VA in patients with myocarditis. (2) Methods: This retrospective study evaluated CMR scans in 141 consecutive patients diagnosed with myocarditis based on the updated Lake Louise criteria (29 females, mean age 41 ± 20). The primary endpoint was VA; this encompassed ventricular fibrillation, sustained ventricular tachycardia, nonsustained ventricular tachycardia, and frequent premature ventricular complexes. LA and LV strain function were performed on conventional cine SSFP sequences. (3) Results: After a median follow-up time of 23 months (interquartile range (18–30)), 17 patients with acute myocarditis reached the primary endpoint. In the multivariable Cox regression analysis, LA reservoir (hazard ratio [HR] and 95% confidence interval [CI]: 0.93 [0.87–0.99], p = 0.02), LA booster (0.87 95% CI [0.76–0.99], p = 0.04), LV global longitudinal (1.26 95% CI [1.02–1.55], p = 0.03), circumferential (1.37 95% CI [1.08–1.73], p = 0.008), and radial strain (0.89 95% CI [0.80–0.98], p = 0.01) were all independent determinants of VA. Patients with LV global circumferential strain > −13.3% exhibited worse event-free survival compared to those with values ≤ −13.3% (p < 0.0001). (4) Conclusions: LA and LV strain mechanism on CMR are independently associated with VA events in patients with myocarditis, independent to LV ejection fraction, and late gadolinium enhancement location. Incorporating myocardial strain parameters into the management of myocarditis may improve risk stratification. Full article
(This article belongs to the Special Issue Advances in Clinical Cardiovascular Magnetic Resonance Imaging)
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14 pages, 2553 KiB  
Article
Cardiac Magnetic Resonance Identifies Responders to Cardiac Resynchronization Therapy with an Assessment of Septal Scar and Left Ventricular Dyssynchrony
by Camilla Kjellstad Larsen, Otto A. Smiseth, Jürgen Duchenne, Elena Galli, John Moene Aalen, Mathieu Lederlin, Jan Bogaert, Erik Kongsgaard, Cecilia Linde, Martin Penicka, Erwan Donal, Jens-Uwe Voigt and Einar Hopp
J. Clin. Med. 2023, 12(22), 7182; https://doi.org/10.3390/jcm12227182 - 20 Nov 2023
Viewed by 735
Abstract
Background: The response to cardiac resynchronization therapy (CRT) depends on septal viability and correction of abnormal septal motion. This study investigates if cardiac magnetic resonance (CMR) as a single modality can identify CRT responders with combined imaging of pathological septal motion (septal [...] Read more.
Background: The response to cardiac resynchronization therapy (CRT) depends on septal viability and correction of abnormal septal motion. This study investigates if cardiac magnetic resonance (CMR) as a single modality can identify CRT responders with combined imaging of pathological septal motion (septal flash) and septal scar. Methods: In a prospective, multicenter, observational study of 136 CRT recipients, septal scar was assessed using late gadolinium enhancement (LGE) (n = 127) and septal flash visually from cine CMR sequences. The primary endpoint was CRT response, defined as ≥15% reduction in LV end-systolic volume with echocardiography after 6 months. The secondary endpoint was heart transplantation or death of any cause assessed after 39 ± 13 months. Results: Septal scar and septal flash were independent predictors of CRT response in multivariable analysis (both p < 0.001), while QRS duration and morphology were not. The combined approach of septal scar and septal flash predicted CRT response with an area under the curve of 0.86 (95% confidence interval (CI): 0.78–0.94) and was a strong predictor of long-term survival without heart transplantation (hazard ratio 0.27, 95% CI: 0.10–0.79). The accuracy of the approach was similar in the subgroup with intermediate (130–150 ms) QRS duration. The combined approach was superior to septal scar and septal flash alone (p < 0.01). Conclusions: The combined assessment of septal scar and septal flash using CMR as a single-image modality identifies CRT responders with high accuracy and predicts long-term survival. Full article
(This article belongs to the Special Issue Advances in Clinical Cardiovascular Magnetic Resonance Imaging)
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18 pages, 2358 KiB  
Article
Phenotypic Clustering of Beta-Thalassemia Intermedia Patients Using Cardiovascular Magnetic Resonance
by Antonella Meloni, Michela Parravano, Laura Pistoia, Alberto Cossu, Emanuele Grassedonio, Stefania Renne, Priscilla Fina, Anna Spasiano, Alessandra Salvo, Sergio Bagnato, Calogera Gerardi, Zelia Borsellino, Filippo Cademartiri and Vincenzo Positano
J. Clin. Med. 2023, 12(21), 6706; https://doi.org/10.3390/jcm12216706 - 24 Oct 2023
Viewed by 878
Abstract
We employed an unsupervised clustering method that integrated demographic, clinical, and cardiac magnetic resonance (CMR) data to identify distinct phenogroups (PGs) of patients with beta-thalassemia intermedia (β-TI). We considered 138 β-TI patients consecutively enrolled in the Myocardial Iron Overload in Thalassemia (MIOT) Network [...] Read more.
We employed an unsupervised clustering method that integrated demographic, clinical, and cardiac magnetic resonance (CMR) data to identify distinct phenogroups (PGs) of patients with beta-thalassemia intermedia (β-TI). We considered 138 β-TI patients consecutively enrolled in the Myocardial Iron Overload in Thalassemia (MIOT) Network who underwent MR for the quantification of hepatic and cardiac iron overload (T2* technique), the assessment of biventricular size and function and atrial dimensions (cine images), and the detection of replacement myocardial fibrosis (late gadolinium enhancement technique). Three mutually exclusive phenogroups were identified based on unsupervised hierarchical clustering of principal components: PG1, women; PG2, patients with replacement myocardial fibrosis, increased biventricular volumes and masses, and lower left ventricular ejection fraction; and PG3, men without replacement myocardial fibrosis, but with increased biventricular volumes and masses and lower left ventricular ejection fraction. The hematochemical parameters and the hepatic and cardiac iron levels did not contribute to the PG definition. PG2 exhibited a significantly higher risk of future cardiovascular events (heart failure, arrhythmias, and pulmonary hypertension) than PG1 (hazard ratio-HR = 10.5; p = 0.027) and PG3 (HR = 9.0; p = 0.038). Clustering emerged as a useful tool for risk stratification in TI, enabling the identification of three phenogroups with distinct clinical and prognostic characteristics. Full article
(This article belongs to the Special Issue Advances in Clinical Cardiovascular Magnetic Resonance Imaging)
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