Keywords: Myocardium, Myocardium, SLE

Motivation: Early detection of myocardial injury in Systemic lupus erythematosus (SLE) patients is important.

Goal(s): Find a clinical biomarker for preclinical myocardial injury in SLE patients.

Approach: CMR-FT (Cardiac Magnetic Resonance Feature Tracking) technology and CVI 42 software were used to measure cardiac functional parameters and myocardial strain parameters for SLE patients with/without subclinical myocardial injury and healthy controls.

Results: Compared to the control group, the circumferential strain (CS) and longitudinal strain (LS) were found to be reduced in patients with subclinical myocardial injury in SLE. The CMR-FT technology was able to detect changes in myocardial strain before a decrease in ejection fraction occurred.

Impact: Early detection of myocardial injury in SLE patients and proactive treatment are important for improving patient outcomes. This study found that CMR-FT quantitative technique can identify subclinical myocardial damage in patients with SLE.

Keywords: Endocrine, Diabetes

Motivation: Diabetes Mellitus causes systemic changes in lipids of multiple organs. Previous studies have shown that receptor for advanced glycation end products (RAGE) and its tail binding partner diaphanous 1 (Diaph1) are key mediators of metabolic changes in T1D mice. 

Goal(s): To use ¹H-MRS and CSE-MRI to investigate the metabolic effects of the RAGE-DIAPH1 interaction antagonist, RAGE229, in T1D murine hearts and hind limb.

Approach: 18 mice were divided into 3 cohorts (Rage229/+db, RegDiet/+db, RegDiet/-db) and scanned using ¹H-MRS and CSE-MRI.

Results: Inhibition of RAGE-DIAPH1 interaction by RAGE229 leads to significant reduction in triglyceride levels in hearts and hind limb of T1D mice.

Impact: The results of this study set the stage for further testing of RAGE229 as potential therapeutic adjuncts in alleviating metabolic dysfunction in T1D.

Keywords: Atherosclerosis, Molecular Imaging

Motivation: Cardiovascular disease is the main cause and disease of morbidity and mortality in the world, and atherosclerosis causes more than 90% of cardiovascular diseases.

Goal(s): Early diagnosis and timely treatment of atherosclerosis to reduce the morbidity and mortality of residents.

Approach: In the development of atherosclerosis, reducing the content of macrophages which derived foam cells can reverse the formation of atherosclerotic plaque.

Results: The dextran sulfate in the nanoparticles can target SR-A of activated macrophages in atherosclerosis, and then the nanoparticles undergo phase transformation in macrophages to induce apoptosis.

Impact: The nanoparticles have multi-mode molecular imaging capabilities, and have excellent targeting performance. Under LIFU, it can undergo phase transformation and induce apoptosis of macrophages, providing a promising strategy for the diagnosis and treatment of atherosclerotic plaque in the future.

Keywords: Inflammation, Infiltration, Myocardium

Motivation: To evaluate the diagnosis and follow-up value of CMR-TT in myocarditis. To explore more treatment strategies for myocarditis and the potential mechanism. 

Goal(s): Using 7.0T CMR-TT to evaluate the effect of nicotinamide mononucleotide (NMN)  for experimental autoimmune myocarditis and exploring the potential mechanism.

Approach: Lewis rats were induced to be autoimmune myocarditis by porcine cardiac myosin and treated by NMN. The strains of rats were detected by 7.0T CMR-TT. Histopathology, biochemistry and ELISA were used for myocardial damage and ferroptosis.

Results: Strains reduction in EAM was alleviated by NMN. The changes of cardiac and ferroptosis biomarkers were relieved by NMN. 

Impact: CMR-TT can provide the imaging evidence for the diagnosis and follow-up of myocarditis. The study will provide more options and targets for clinicians to treat myocarditis.

Keywords: Inflammation, Infiltration, Quantitative Imaging

Motivation: Patients with liver cirrhosis often have heart-related physiological and pathological changes.

Goal(s): The aim of this study is to investigate the effectiveness of using multiple parameters for cardiac MRI quantification in identifying subtle cardiac structural and functional changes in patients with liver cirrhosis.

Approach: Cardiac MRI methods were employed, along with Mann-Whitney U tests and Spearman correlation analyses for Statistical analyses.

Results: Our results indicated that MRI showed an increase in myocardial fibrosis parameters, and there was a positive correlation between liver T1 relaxation time and myocardial T1 relaxation time. 

Impact: This study could lead to improved understanding of heart diseases associated with cirrhosis, helping to create better diagnostic and treatment plans, ultimately improving patients' quality of life.

Keywords: Inflammation, Infiltration, Heart

Motivation: To evaluate the prevalence of cardiac involvement in mild, non-hospitalized, recovered COVID-19 patients

Goal(s): investigate the changes of cardiac structure and function by comparing multiparametrical cardiac MR

Approach: This prospective study enrolled 39 unhospitalized COVID-19 patients.

Results: Four patients had the same late gadolinium enhancement (LGE) pattern at baseline and repeated CMR and 5 female patients had myocardial T2 ratio >2 but with normal T2 value in post-COVID-19 CMR. All other CMR parameters were in normal ranges before and after COVID-19 infection.

Impact: This knowledge has an important role in can help alleviate wide social concern on COVID-19 related myocarditis.

Keywords: Inflammation, Infiltration, Inflammation

Motivation: The study on correlation between blood neutrophil-to-lymphocyte ratio (NLR) and cardiac magnetic resonance perfusion imaging (CMRI) quantitative indexes in patients with  cardiac syndrome X (CSX) is few.

Goal(s): To investigate the relationship between the blood neutrophil/lymphocyte ratio (NLR) and the mean value and coefficient of variation of the magnetic resonance myocardial first pass perfusion parameters in patients with cardiac syndrome X.

Approach: A total of 53 patients with CSX and 43 patients  with unstable angina pectoris (UAP) were evaluated using MR myocardial perfusion and blood routine examination.

Results: A negative correlation was observed between the myocardial perfusion index in CSX  and blood NLR.

Impact: It is provided further evidence for the potential utility of NLR as a diagnostic marker for CSX.

Keywords: Hematology, Oncology, Radiotherapy, 5D, cardiac

Motivation: Current radiotherapy treatment planning does not account for cardiac substructure motion during the respiratory and cardiac cycle, thus leading to suboptimal treatment plans.

Goal(s): To develop a free breathing 5D MRI framework to characterize cardiac and respiratory motion of the heart for use in radiotherapy treatment planning.

Approach: A double gated (cardiac and respiratory) radial bSSFP acquisition and constrained reconstruction pipeline were implemented and motion and tested in five volunteers.

Results: Left ventricle centroid analysis showed 5D images provided significant motion characterization. Advanced reconstruction allows <5 min scan time.

Impact: The primary impact of this work will be on patients receiving thoracic radiotherapy. More accurate treatment planning and sparing of sensitive cardiac substructures will improve patient outcomes and reduce long term cardiotoxicities.

Keywords: Myocardium, Heart, Immune checkpoint inhibitor; Myocarditis; Cardiac magnetic resonance; Feature-tracking; Strain

Motivation: Myocarditis is a potentially fatal complication of immune checkpoint inhibitors (ICI). More diagnostic tools are needed beside enzymes.

Goal(s): Data on CMR characteristics of ICI myocarditis is limited, especially the new strain analysis.

Approach: The study compared the cardiac functional and stain parameters between patients with ICI associated myocarditis and controls. The parameters included  LVEF, CO, CI, EDV/BSA, ESV/BSA, and SV/BSA, incidence rate of myocardial edema and LGE, LS, CS, RS (global and segmental).

Results: For patients with ICI associated myocarditis, LVEF, ESV/BSA, CS (basal, mid, apical and global) and LS (mid, apical and global) may be effective parameters to identify myocardial injury.

Impact: Some CMR strain parameters and cardiac function indicators significantly impaired, which may be helpful for early detection and to evaluate treatment effectiveness of ICI associated myocarditis. 

Keywords: Myocardium, Cardiovascular, CMR-FT, Hypertension, T2DM

Motivation: Hypertension and type 2 diabetes mellitus (T2DM)-related cardiac damage have a partial common pathological mechanism^[1].

Goal(s): To investigate the effects of hypertension on left cardiac structure and deformation in patients with T2DM using cardiac magnetic resonance feature tracking.

Approach: The balanced steady-state free precession cine sequence and commercial software, cvi42, were used for image acquisition and post-processing. Covariance and multivariate linear regression were used for statistical analysis.

Results: Hypertension has additive effects on left atrial and left ventricular geometry and strain in patients with diabetes.

Impact: Our findings regarding the additive effect of hypertension in patients with diabetes provides a basis for clinical management and treatment of these comorbidities.

Keywords: Heart Failure, Cardiovascular

Motivation: Cardiovascular involvement in systemic lupus erythematosus (SLE) patients is common and serious; early and accurate identification of the cardiac dysfunction is crucial.

Goal(s): Our goal was to investigate the potential role of hemodynamic force (HDF) in early recognizing impaired cardiac function in SLE.

Approach: Left ventricular (LV) HDF and strain analysis were performed based on long-axis cine imaging using feature-tracking in 36 SLE patients and 34 healthy volunteers.

Results: The force ratio between transverse and longitudinal direction was larger in SLE patients with no difference of strain analysis, indicating that the orientation of HDF altered in LV.

Impact: This study demonstrated that HDF analysis can early detect systolic dysfunction in SLE in advance of significant decrease of LV EF, which may contribute to the early diagnosis of cardiac involvement and prognosis improvement of patients.

Keywords: Myocardium, Safety, Youth-onset T2D, CMR, 4D flow MRI

Motivation: Increasing prevalence of youth-onset type 2 diabetes (T2D) is a global concern and characterized by a higher risk for hyperuricemia, a strong risk factor for cardiovascular disease (CVD). 

Goal(s): Studies have shown that serum uric acid (SUA) lowering in the general population may confer cardiovascular protection, but there have been no studies on its effectiveness in young adults with T2D. 

Approach: Here, we hypothesized aggressive SUA lowering using single intravenous infusion dose of the uricase, pegloticase, will attenuate cardiac magnetic resonance imaging (CMR) markers of CVD in young adults with T2D. 

Results: Unexpectedly, we documented impaired CMR-based global longitudinal strain after pegloticase infusion.

Impact: Our study demonstrates the impacts of a drug therapy to reduce serum uric acid in youth-onset T2D and its impact on cardiovascular function using CMR. A comprehensive examination of the cardiovascular effects of the therapy is required for youth-onset T2D.

Keywords: Myocardium, Kidney, chronic kidney disease, Cardiac magnetic resonance, T2 mapping, biomarkers, NT-pro BNP

Motivation: We can use the positive correlation between natural T2 value and NT-pro BNP to achieve early clinical detection, diagnosis and treatment of myocardial abnormalities caused by chronic kidney disease, thereby improving the prognosis of patients with CKD.

Goal(s): Our aim was to analyze the relationship between native T2 value and NT-pro BNP over stage progression.

Approach: CMR is performed on a 3.0-T scanner. Cardiac data were assessed using CVI.42. Pearson, Spearman coefficients and ANOVA analysis were used to analyze the data.

Results: There was a statistically significant difference in autologous T2 value between different CKD groups. and NT-pro BNP. Subgroups stratified by eGFR showed a significantly differential correlation between NT-pro BNP and native T2 value.

Impact: We can use the positive correlation between natural T2 value and NT-pro BNP to achieve early clinical detection, diagnosis and treatment of myocardial abnormalities caused by chronic kidney disease, thereby improving the prognosis of patients with CKD.

Keywords: Myocardium, Preclinical, RAFF2, Rotating frame relaxations, myocardial infarct

Motivation: Current MRI techniques are insufficiently sensitive to determine specific physiological changes in the myocardium after infarction.

Goal(s): To optimize sensitivity of RAFF2 technique to specific tissue changes of the myocardium after myocardial infarct (MI) by modulating the durations of P-packets of RAFF2 pulses.

Approach: Mice hearts are imaged ex vivo 7 days after the factitious myocardial infarction by using different durations of P-packets of the RAFF2 along with other rotating frame relaxation techniques.

Results: Duration of the RAFF2 pulse have an impact on relaxation maps and contrast of MI area compared to the remote area. Increased rotating frame relaxation times were also detected.

Impact: This study presents novel application of RAFF2 technique for quantitative ex vivo assessment of mice myocardium after infarction. This method allows to study physiological changes in the myocardium with high sensitivity.

Keywords: Inflammation, Infiltration, Cardiomyopathy

Motivation: Development of a non-contrast differential method for cardiac inflammatory disease

Goal(s): Accurate identification of cardiac sarcoidosis and myocarditis

Approach: Cardiac cine imaging to project T2 values using T2prep-based T2 mapping with dynamic multiple trigger-delay framework

Results: Diastolic cine T2 values (54.2msec.) discriminated cardiac sarcoidosis from myocarditis with an AUC of 0.879, sensitivity of 86%, and specificity of 77%.

Impact: This method is a new technique that captures changes in myocardial properties during the cardiac cycle without the use of contrast media.