Daniel Messroghli

Matthew Lee

CMR has roles in the diagnosis and risk stratification of heart failure. CMR is the reference "gold" standard method of assessing cardiac structure and function. CMR reduces the sample size required in heart failure clinical trials. CMR has been used in several key heart failure trials to assess cardiac remodelling. 

Kim-Lien Nguyen

Heart failure is a complex clinical syndrome with many causes. Although imperfect, the left ventricular ejection fraction (LVEF) serves as a surrogate marker for combined LV function and structural phenotyping of heart failure. Cardiac imaging provides information about structure, tissue composition, and function. As a diagnostic modality with high spatial resolution and no ionizing radiation exposure, cardiovascular MRI is valuable for accurate EF quantification and phenotypic characterization. However, several barriers exist for widespread implementation of quantitative MRI in  heart failure. Examples of challenges include accessibility to and standardization of cardiovascular imaging pulse sequences for probing myocardial tissue structure and function.

Sebastian Kozerke

Cardiac Magnetic Resonance offers a multitude of contrast mechanisms across spatiotemporal scales to further improve diagnosis, stratification and interventions in heart failure patients. In this presentation the focus is put on hyperpolarized metabolic and diffusion tensor imaging to unravel the interplay of energy supply and myofiber contractile reserve in conjunction with biophysical modeling of left-ventricular function and dysfunction. It is shown that statistical learning and, in particular, physics-informed neural networks offer approaches for rapid personalization, detection and prediction of failing hearts.

Maxim Terekhov¹, David Lohr¹, Michael Hock¹, Maya Bille¹, Steffen Baltes¹, Ibrahim A. Elabyad¹, Florian Schnitter², Julia Aures¹, Theresa Reiter², Wolfgang Bauer^1,2, Ulrich Hofmann², and Laura M. Schreiber^1
1Chair of Molecular and Cellular Imaging, University Hospital Würzburg, Comprehensive Heart Failure Center, Wuerzburg, Germany, ²Department of Internal Medicine I, Cardiology, University Hospital Würzburg, Wuerzburg, Germany

Cardiac MRI at 7T is a developing methodology capable to increase physical sensitivity and spatial resolution of the cardiac MR-images. T₂*-quantification at 7T  is of particular interest because it is highly sensitive to cardiac microstructure and has the potential to improve data quality on cardiac tissue remodeling in both acute and chronic cardiac diseases compared to clinical B₀-field. In this work, we present the results of a pilot study correlating the multi-slice T₂*-data with late-gadolinium-enhancement and first-pass-perfusion results in the large animal model of myocardial infarction.  8 pigs measured prior and at three dates after inducing myocardial infarction are analyzed. 

Jae Mo Park^1,2,3, Galen D Reed⁴, Jeff Liticker¹, William C Putnam⁵, Alvin Chandra^6,7, Katarina Yaros⁶, Aneela Afzal^1,6, James MacNamara⁶, Ronald G Hall⁵, Crystal E Harrison¹, Alagar Muthukumar⁶, Colby Ayers⁶, James de Lemos⁶, Craig R Malloy^1,6, Hsiao-Ching Li^6,7, Barbara Haley^6,7, and Vlad G Zaha^1,6
1Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, United States, ²Radiology, University of Texas Southwestern Medical Center, Dallas, TX, United States, ³Electrical and Computer Engineering, University of Texas at Dallas, Richardson, TX, United States, ⁴GE Healthcare, Dallas, TX, United States, ⁵Pharmacy Practice, Texas Tech University, Dallas, TX, United States, ⁶Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States, ⁷Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, United States

This study evaluates the feasibility of hyperpolarized 13C MRS for detection of early metabolic response in the myocardium of patients after anthracycline treatment. Patients with breast cancer were studied using hyperpolarized [1-13C]pyruvate before and after doxorubicin. Appearance of [13C]bicarbonate was significantly decreased after doxorubicin compared to the baseline exam while no change in [1-13C]lactate was detected. The reproducibility of hyperpolarized exams was examined by two injections of hyperpolarized [1-13C]pyruvate. The study demonstrates that hyperpolarized 13C spectra of the heart are sensitive to early injury of the mitochondria after doxorubicin therapy in patients with breast cancer in a reproducible manner.

Ladislav Valkovic^1,2, Andrew Apps¹, Jane Ellis¹, Damian J Tyler^1,3, Stefan Neubauer¹, Albrecht Ingo Schmid⁴, Oliver J Rider¹, and Christopher T Rodgers^1,5
1Oxford Centre for Clinical Magnetic Resonance Research (OCMR), RDM Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom, ²Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia, ³Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom, ⁴High Field MR Center, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria, ⁵Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom

Impaired cardiac energetics are characterized by a reduced phosphocreatine to adenosine-triphosphate ratio (PCr/ATP), however, changes in inorganic phosphate (Pi) may impact the Gibbs energy of ATP hydrolysis earlier in the disease process. Quantifying this in the diabetic heart may help explain latent diastolic dysfunction. Therefore, we used STEAM ³¹P-MRS at 7T to measure Pi/PCr in a type 2 diabetic (T2DM) cohort, and demonstrated an increased Pi/PCr in the diabetic human heart in comparison to healthy subjects. No correlation between PCr/ATP and Pi/PCr hints that multiple mechanisms contribute to these perturbations with candidates including impairment of CK flux and substrate inflexibility.

Arvin Arani¹, Jessica Magnuson¹, Joshua D. Trzasko¹, Yi Sui¹, Kevin J. Glaser¹, Armando Manduca¹, Richard L. Ehman¹, Sudhakar K. Venkatesh¹, and Philip A. Araoz^1
1Mayo Clinic, Rochester, MN, United States

Light chain (AL) cardiac amyloidosis is a disease where abnormal proteins are deposited in the heart tissue, commonly resulting in elevated myocardial stiffness. In cases with poor prognosis, autologous hematopoietic stem cell transplantation is used as a therapy.  However, organ response monitoring is currently limited and challenging.  The goal of this study is to evaluate the feasibility of using cardiac magnetic resonance elastography (MRE) to monitor changes in left ventricular (LV) myocardial stiffness after stem cell transplantation for treatment of AL amyloidosis. MRE detected a statistically significant (p=0.007) decrease in LV stiffness (mean decrease: 1.6±0.7 kPa, 17.0±7.4%) post therapy.

Daeun Kim¹, Rodrigo A. Lobos¹, Jaume Coll-Font^2,3,4, Maaike van den Boomen^2,3,4, John Conklin^2,5,6, Jianing Pang⁷, Daniel Staeb⁸, Peter Speier⁹, Xiaoming Bi¹⁰, Brian Ghoshhajra^5,6, Justin P. Haldar¹, and Christopher T. Nguyen^2,3,4
1Department of Electrical and Computer Engineering, University of Southern California, Los Angeles, CA, United States, ²A. A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, United States, ³Cardiovascular Research Center, Cardiology Division, Massachusetts General Hospital, Charlestown, MA, United States, ⁴Department of Medicine, Harvard Medical School, Boston, MA, United States, ⁵Department of Radiology, Massachusetts General Hospital, Charlestown, MA, United States, ⁶Department of Radiology, Harvard Medical School, Boston, MA, United States, ⁷Siemens Medical Solutions USA Inc., Chicago, IL, United States, ⁸Siemens Healthcare Pty Ltd, Melbourne, Australia, ⁹Siemens Healthcare GmbH, Erlangen, Germany, ¹⁰Siemens Medical Solutions USA Inc., Los Angeles, CA, United States

Conventional clinical cardiac MRI protocols use a large number (>20) of breath-holds for capturing cinemagraphic (CINE) scans of the heart in various views. We hypothesize simultaneous multi-slice (SMS) CINE can be further accelerated using a reduced FOV and a novel approach based on Region-Optimized Virtual (ROVir) coils, which can potentially achieve single breath-hold whole heart CINE. We demonstrated the feasibility of combining SMS and ROVir for highly accelerated CINE imaging (8-fold reduced scan time), enabling single breath-hold whole ventricular acquisition. Single breath-hold SMS+ROVir whole-heart CINE yielded cardiac function parameters with no significant bias when compared to SMS CINE.

Gastao Cruz¹, Alina Hua¹, Camila Munoz¹, Tevfik Ismail¹, Amedeo Chiribiri¹, René M. Botnar¹, and Claudia Prieto^1
1School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom

Conventional myocardial perfusion imaging requires free breathing acquisitions, with high spatial and temporal resolution. Leveraging the underlying redundant anatomic information to improve this multi-contrast application is challenging due to motion. Here a novel Low Rank Motion Corrected (LRMC) reconstruction is proposed to enable highly accelerated, motion corrected free breathing first pass myocardial perfusion imaging. This approach combines low rank subspace modelling (to resolve contrast) and non-rigid motion fields (to correct respiratory motion). The proposed approach successfully corrects respiratory motion and considerably improves image quality compared to conventional iterative SENSE reconstruction.