Magnetic Resonance Parameters Research Articles

Molecular NMR shieldings, J-couplings, and magnetizabilities from numeric atom-centered orbital based density-functional calculations

Abstract This paper reports and benchmarks a new implementation of nuclear magnetic resonance shieldings, magnetizabilities, and J-couplings for molecules within semilocal density functional theory, based on numeric atom-centered orbital (NAO) basis sets. NAO basis sets are attractive for the calculation of these nuclear magnetic resonance (NMR) parameters because NAOs provide accurate atomic orbital representations especially near the nucleus, enabling high-quality results at modest computational cost. Moreover, NAOs are readily adaptable for linear scaling methods, enabling efficient calculations of large systems. The paper has five main parts: (1) It reviews the formalism of density functional calculations of NMR parameters in one comprehensive text to make the mathematical background available in a self-contained way. (2) The paper quantifies the attainable precision of NAO basis sets for shieldings in comparison to specialized Gaussian basis sets, showing similar performance for similar basis set size. (3) The paper quantifies the precision of calculated magnetizabilities, where the NAO basis sets appear to outperform several established Gaussian basis sets of similar size. (4) The paper quantifies the precision of computed J-couplings, for which a group of customized NAO basis sets achieves precision of ∼ Hz for smaller basis set sizes than some established Gaussian basis sets. (5) The paper demonstrates that the implementation is applicable to systems beyond 1,000 atoms in size.

Quantitative MR imaging biomarkers for distinguishing inflammatory pancreatic mass and pancreatic cancer-a systematic review and meta-analysis.

To evaluate the diagnostic performance of quantitative magnetic resonance (MR) imaging biomarkers in distinguishing between inflammatory pancreatic masses (IPM) and pancreatic cancer (PC). A literature search was conducted using PubMed, Embase, the Cochrane Library, and Web of Science through August 2023. Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) was used to evaluate the risk of bias and applicability of the studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were calculated using the DerSimonian-Laird method. Univariate meta-regression analysis was used to identify the potential factors of heterogeneity. Twenty-four studies were included in this meta-analysis. The two main types of IPM, mass-forming pancreatitis (MFP) and autoimmune pancreatitis (AIP), differ in their apparent diffusion coefficient (ADC) values. Compared with PC, the ADC value was higher in MFP but lower in AIP. The pooled sensitivity/specificity of ADC were 0.80/0.85 for distinguishing MFP from PC and 0.82/0.84 for distinguishing AIP from PC. The pooled sensitivity/specificity for the maximal diameter of the upstream main pancreatic duct (dMPD) was 0.86/0.74, with a cutoff of dMPD ≤ 4 mm, and 0.97/0.52, with a cutoff of dMPD ≤ 5 mm. The pooled sensitivity/specificity for perfusion fraction (f) was 0.82/0.68, and 0.82/0.77 for mass stiffness values. Quantitative MR imaging biomarkers are useful in distinguishing between IPM and PC. ADC values differ between MFP and AIP, and they should be separated for consideration in future studies. Quantitative MR parameters could serve as non-invasive imaging biomarkers for differentiating malignant pancreatic neoplasms from inflammatory masses of the pancreas, and hence help to avoid unnecessary surgery. • Several quantitative MR imaging biomarkers performed well in differential diagnosis between inflammatory pancreatic mass and pancreatic cancer. • The ADC value could discern pancreatic cancer from mass-forming pancreatitis or autoimmune pancreatitis, if the two inflammatory mass types are not combined. • The diameter of main pancreatic duct had the highest specificity for differentiating autoimmune pancreatitis from pancreatic cancer.

Recent advances in multimodal imaging in tetralogy of fallot and double outlet right ventricle.

In the ever-evolving field of medical imaging, this review highlights significant advancements in preoperative and postoperative imaging for Tetralogy of Fallot (TOF) and double outlet right ventricle (DORV) over the past 18 months. This review showcases innovations in echocardiography such as 3D speckle tracking echocardiography (3DSTE) for assessing right ventricle-pulmonary artery coupling (RVPAC) and Doppler velocity reconstruction (DoVeR) for intracardiac flow fields evaluation. Furthermore, advances in assessment of cardiovascular anatomy using computed tomography (CT) improve the integration of imaging in ablation procedures. Additionally, the inclusion of cardiac magnetic resonance (CMR) parameters as risk score predictors for morbidity, and mortality and for timing of pulmonary valve replacement (PVR) indicates its significance in clinical management. The utilization of 4D flow techniques for postoperative hemodynamic assessment promises new insights into pressure mapping. Lastly, emerging technologies such as 3D printing and 3D virtual reality are expected to improve image quality and surgical confidence in preoperative planning. Developments in multimodality imaging in TOF and DORV are poised to shape the future of clinical practice in this field.

DFT and EPR study of spin-assisted processes in poly(3-alkylthiophene) oligomers and their composites

Correlations of spin, electronic and magnetic resonance parameters of charge carriers stabilized in poly(3-alkylthiophene) oligomers with their band structure, polymerization degree, side substitutes, and conformation established by using the density functional theory and electron paramagnetic resonance methods. The comparison of calculated and experimental data identified spin distribution on oligomer chains with different conformations. The type and size of alkyl substituent of polymer matrix governs the band gap, mobility, and spin-orbit coupling of polaron charge carriers. The introduce of small aromatic additives between oligomer chains initiates their self-assembly crystallization and formation of organic:organic spinterfase which accelerate spin-assisted electronic and magnetic processes in the composite. The research revealed that embedding aromatic hydrocarbons into oligomer bulk allows continuous and discrete handling of electronic spin-assisted processes carrying out in respective organic/organic composites. The key role of spinterfacial effects in the development of a new generation of molecular devices with actively tuned spin-assisted functionality is described.

Review of High Dimensional Neural Network Potentials

Over the past few years, machine learning potentials (MLPs) have been fully developed and can now be applied to a variety of large-scale atomic simulations. MLPs encompass a number of different machine learning algorithms, of which neural network potentials are the most dominant and representative, and have achieved great success. This review focuses on the second generation of neural network potentials, high-dimensional neural network potentials (HDNNPs). While HDNNP has accomplished noteworthy results in the implementation of ion diffusion, nuclear magnetic resonance parameters, defect formation, and thermal conductivity, it still encounters hurdles in the compilation of training datasets, transferability, accuracy constraints, and the management of multiple chemical species. In spite of this, HDNNP remains a highly promising methodology. Looking forward, we anticipate the development of more specialized software for HDNNP to augment research efficiency and lower the barrier to usage.

Dynamic and relativistic effects on Pt-Pt indirect spin-spin coupling in aqueous solution studied by abinitio molecular dynamics and two- vs four-component density functional NMR calculations.

Treating 195Pt nuclear magnetic resonance parameters in solution remains a considerable challenge from a quantum chemistry point of view, requiring a high level of theory that simultaneously takes into account the relativistic effects, the dynamic treatment of the solvent-solute system, and the dynamic electron correlation. A combination of Car-Parrinello molecular dynamics (CPMD) and relativistic calculations based on two-component zeroth order regular approximation spin-orbit Kohn-Sham (2c-ZKS) and four-component Dirac-Kohn-Sham (4c-DKS) Hamiltonians is performed to address the solvent effect (water) on the conformational changes and JPtPt1 coupling. A series of bridged PtIII dinuclear complexes [L1-Pt2(NH3)4(Am)2-L2]n+ (Am = α-pyrrolidonate and pivalamidate; L = H2O, Cl-, and Br-) are studied. The computed Pt-Pt coupling is strongly dependent on the conformational dynamics of the complexes, which, in turn, is correlated with the trans influence among axial ligands and with the angle N-C-O from the bridging ligands. The J-coupling is decomposed in terms of dynamic contributions. The decomposition reveals that the vibrational and explicit solvation contributions reduce JPtPt1 of diaquo complexes (L1 = L2 = H2O) in comparison to the static gas-phase magnitude, whereas the implicit solvation and bulk contributions correspond to an increase in JPtPt1 in dihalo (L1 = L2 = X-) and aquahalo (L1 = H2O; L2 = X-) complexes. Relativistic treatment combined with CPMD shows that the 2c-ZKS Hamiltonian performs as well as 4c-DKS for the JPtPt1 coupling.

Cine-cardiac magnetic resonance to distinguish between ischemic and non-ischemic cardiomyopathies: a machine learning approach.

This work aimed to derive a machine learning (ML) model for the differentiation between ischemic cardiomyopathy (ICM) and non-ischemic cardiomyopathy (NICM) on non-contrast cardiovascular magnetic resonance (CMR). This retrospective study evaluated CMR scans of 107 consecutive patients (49 ICM, 58 NICM), including atrial and ventricular strain parameters. We used these data to compare an explainable tree-based gradient boosting additive model with four traditional ML models for the differentiation of ICM and NICM. The models were trained and internally validated with repeated cross-validation according to discrimination and calibration. Furthermore, we examined important variables for distinguishing between ICM and NICM. A total of 107 patients and 38 variables were available for the analysis. Of those, 49 were ICM (34 males, mean age 60 ± 9years) and 58 patients were NICM (38 males, mean age 56 ± 19years). After 10 repetitions of the tenfold cross-validation, the proposed model achieved the highest area under curve (0.82, 95% CI [0.47-1.00]) and lowest Brier score (0.19, 95% CI [0.13-0.27]), showing competitive diagnostic accuracy and calibration. At the Youden's index, sensitivity was 0.72 (95% CI [0.68-0.76]), the highest of all. Analysis of predictions revealed that both atrial and ventricular strain CMR parameters were important for the identification of ICM patients. The current study demonstrated that using a ML model, multi chamber myocardial strain, and function on non-contrast CMR parameters enables the discrimination between ICM and NICM with competitive diagnostic accuracy. A machine learning model based on non-contrast cardiovascular magnetic resonance parameters may discriminate between ischemic and non-ischemic cardiomyopathy enabling wider access to cardiovascular magnetic resonance examinations with lower costs and faster imaging acquisition. • The exponential growth in cardiovascular magnetic resonance examinations may require faster and more cost-effective protocols. • Artificial intelligence models can be utilized to distinguish between ischemic and non-ischemic etiologies. • Machine learning using non-contrast CMR parameters can effectively distinguish between ischemic and non-ischemic cardiomyopathies.

Determination of SWCNT biosensor for bisphosphonate–2X(X = Mg2+, Ca2+, Sr2+) delivery in bone cell through electromagnetic and thermodynamic analysis using QM/MC methods

PurposeBisphosphonate (BP) medications can be applied to prohibit the damage of bone density and the remedy of bone illnesses such as osteoporosis. As the metal chelating of phosphonate groups are nearby large with six O atoms possessing the high negative charge, these compounds are active toward producing the chelated complexes through drug design method. BP agents have attracted much attention for the clinical treatment of some skeletal diseases depicted by enhancing of osteoclast-mediated bone resorption.Design/methodology/approachIn this work, it has been accomplished the CAM-B3LYP/6–311+G(d, p)/LANL2DZ to estimate the susceptibility of SWCNT for adsorbing alendronate, ibandronate, neridronate and pamidronate chelated to two metal cations of 2Mg2+, 2Ca2+, 2Sr2+ through nuclear magnetic resonance and thermodynamic parameters. Therefore, the data has explained that the feasibility of using SWCNT and BP agents becomes the norm in metal chelating of drug delivery system which has been selected through alendronate → 2X, ibandronate → 2X, neridronate → 2X and pamidronate → 2X (X = Mg2+/Ca2+/Sr2+) complexes.FindingsThe thermodynamic results have exhibited that the substitution of 2Ca2+ cation by 2Sr2+ cation in the structure of bioactive glasses can be efficient for treating vertebral complex fractures. However, it has been observed the most fluctuation in the Gibbs free energy for BPs → 2Sr2+ at 300 K. Furthermore, Monte Carlo simulation has resulted by increasing the dielectric constant in the aqueous medium can enhance the stability and efficiency of BP drugs for preventing the loss of bone density and treating the osteoporosis.Originality/valueAccording to this research, by incorporation of chelated 2Mg2+, 2Ca2+ and 2Sr2+ cations to BP drugs adsorbed onto (5, 5) armchair SWCNT, the network compaction would increase owing to the larger atomic radius of Sr2+ cation rather than Ca2+ and Mg2+, respectively.

Effects of intramolecular hydrogen bonding on nuclear magnetic resonance, electron paramagnetic resonance and molecular docking studies: Mexiletine molecule.

In this study, the molecular structure of the mexiletine molecule was investigated. Since the Mexiletine molecule is a drug active ingredient, its molecular structure and spectroscopic properties are important. The effects of intramolecular hydrogen bonding on Nuclear Magnetic Resonance Parameters (NMR), Electron Paramagnetic Resonance (EPR) parameters and molecular docking studies were examined in the mexiletine molecule. The effects of intramolecular hydrogen bonding on EPR parameters and molecular docking studies are the most important steps for this study. Conformational space scanning required for molecular structure calculations was carried out with the Molecular Mechanic Force Field method. DFT method with 6-311 + + G(d,p) basis set level was used to obtain the most stable structure among the conformations. NMR parameters (1H and 13C chemical shift values) were also performed using the same basis set as the DFT method. The radicals created to calculate the Electron Paramagnetic Resonance parameters were modeled using the DFT/B3LYP/6-311 + + G(d,p) method basis set level. Molecular Docking studies were carried out with the Autodock vina program.

NMR spectroscopy of a 18O-labeled rhodium paddlewheel complex: Isotope shifts, 103Rh-103Rh spin-spin coupling, and 103Rh singlet NMR.

Despite the importance of rhodium complexes in catalysis, and the favorable 100% natural abundance of the spin-1/2 103Rh nucleus, there are few reports of 103Rh nuclear magnetic resonance (NMR) parameters in the literature. In part, this is the consequence of the very low gyromagnetic ratio of 103Rh and its dismal NMR sensitivity. In a previous paper [Harbor-Collins et al., J. Chem. Phys. 159, 104 307 (2023)], we demonstrated an NMR methodology for 1H-enhanced 103Rh NMR and demonstrated an application to the 103Rh NMR of the dirhodium formate paddlewheel complex. In this paper, we employ selective 18O labeling to break the magnetic equivalence of the 103Rh spin pair of dirhodium formate. This allows the estimation of the 103Rh-103Rh spin-spin coupling and provides access to the 103Rh singlet state. We present the first measurement of a 18O-induced 103Rh secondary isotope shift as well as the first instance of singlet order generated in a 103Rh spin pair. The field-dependence of 103Rh singlet relaxation is measured by field-cycling NMR experiments.

Brain Structures in a Human Embryo Imaged with MR Microscopy.

To delineate brain microstructures in human embryos during the formation of the various major primordia by MR microscopy, with different contrasts appropriate for each target. We focused mainly on the internal structures in the cerebral cortex and the accessory nerves of the brain. To find appropriate sequence parameters, we measured nuclear magnetic resonance (NMR) parameters and created kernel density plots of T1 and T2 values. We performed T1-weighted gradient echo imaging with parameters similar to those used in the previous studies. We performed T2*-weighted gradient echo imaging to delineate the target structures with the appropriate sequence parameters according to the NMR parameter and flip angle measurements. We also performed high-resolution imaging with both T1- and T2*-weighted sequences. T1, T2, and T2* values of the target tissues were positively correlated and shorter than those of the surrounding tissues. In T1-weighted images with a voxel size of (30 µm)3 and (20 µm)3, various organs and tissues and the agarose gel were differentiated as in previous studies, and the structure of approximately 40 µm in size was depicted, but the detailed structures within the cerebral cortex and the accessory nerves were not delineated. In T2*-weighted images with a voxel size of (30 µm)3, the layered structure within the cerebral cortex and the accessory nerves were clearly visualized. Overall, T1-weighted images provided more information than T2*-weighted images, but important internal brain structures of interest were visible only in T2*-weighted images. Therefore, it is essential to perform MR microscopy with different contrasts. We have visualized brain structures in a human embryo that had not previously been delineated by MR microscopy. We discussed pulse sequences appropriate for the structures of interest. This methodology would provide a way to visualize crucial embryological information about the anatomical structure of human embryos.

Kiosk 2R-TA-07 - Cardiovascular Magnetic Resonance and Echocardiography Parameters for Prediction of Health-related Quality of Life Scores in Hypertrophic Cardiomyopathy

Kiosk 2R-TA-07 - Cardiovascular Magnetic Resonance and Echocardiography Parameters for Prediction of Health-related Quality of Life Scores in Hypertrophic Cardiomyopathy

Kiosk 5R-TB-02 - Prognostic Value of Different Echocardiographic and Cardiac Magnetic Resonance Parameters in Patients with AL Amyloidosis

Kiosk 5R-TB-02 - Prognostic Value of Different Echocardiographic and Cardiac Magnetic Resonance Parameters in Patients with AL Amyloidosis

Electron Spin Resonance Spectrum Simulations of Possible Radicals of the Ketoprofen Molecule

In this study, the molecular structure of Ketoprofen molecule, which is the drug active ingredient , was revealed by using the Density Functional Theory method and the Molecular Mechanical Force Field method. First of all, conformational space scanning in the Ketoprofen molecule was performed by the Molecular Mechanical Force Field method. The most stable structure of the ketoprofen molecule was found with the help of the Density Functional Theory method. The geometry parameters of the ketoprofen molecule and the Nuclear Magnetic Resonance parameters were calculated with the help of the Density Functional Theory method. Possible radicals were modeled using the most stable structure of the ketoprofen molecule. Electron Spin Resonance parameters of these possible radicals were calculated with the Density Functions Theory method. The calculated Electron Spin Resonance parameters were used in the JEOL IsoSimu/Fa Version 2.2.0 simulation program and theoretical Electron Spin Resonance spectra of possible radicals were obtained.

De Novo Donor-Specific Antibodies after Heart Transplantation: A Comprehensive Guide for Clinicians

Antibodies directed against donor-specific human leukocyte antigens (HLAs) can be detected de novo after heart transplantation and play a key role in long-term survival. De novo donor-specific antibodies (dnDSAs) have been associated with cardiac allograft vasculopathy, antibody-mediated rejection, and mortality. Advances in detection methods and international guideline recommendations have encouraged the adoption of screening protocols among heart transplant units. However, there is still a lack of consensus about the correct course of action after dnDSA detection. Treatment is usually started when antibody-mediated rejection is present; however, some dnDSAs appear years before graft failure is detected, and at this point, damage may be irreversible. In particular, class II, anti-HLA-DQ, complement binding, and persistent dnDSAs have been associated with worse outcomes. Growing evidence points towards a more aggressive management of dnDSA. For that purpose, better diagnostic tools are needed in order to identify subclinical graft injury. Cardiac magnetic resonance, strain techniques, or coronary physiology parameters could provide valuable information to identify patients at risk. Treatment of dnDSA usually involves plasmapheresis, intravenous immunoglobulin, immunoadsorption, and ritxumab, but the benefit of these therapies is still controversial. Future efforts should focus on establishing effective treatment protocols in order to improve long-term survival of heart transplant recipients.

Cerebral hypometabolism mediates the effect of stroke volume on cognitive impairment in heart failure patients.

The present study aimed to phenotype the cerebral structural and glucose metabolic alterations in patients with heart failure (HF) using simultaneous positron emission tomography (PET)/magnetic resonance (MR) and to investigate their relationship to cardiac biomarkers and cognitive performance. Forty-two HF patients caused by ischaemic heart disease (mean age 67.2±10.4, 32 males) and 32 age- and sex-matched healthy volunteers (mean age 61.3±4.8, 18 males) were included in this study. Participants underwent simultaneous cerebral fluorine-18 (18 F) fluorodeoxyglucose PET/MR followed by cardiac MR scan, and neuropsychological scores were obtained to assess cognitive performance. The grey matter volume (GMV) and standardized uptake value ratio (SUVR) were calculated to examine cerebral structural and metabolic alterations. Cardiac biomarkers included cardiac MR parameters and cardiac serum laboratory tests. Mediation analysis was performed to explore the associations among cerebral alterations, cardiac biomarkers, and cognitive performance. HF patients demonstrated notable cognitive impairment compared with normal controls (P<0.001). Furthermore, HF patients exhibited regional brain hypometabolism in the bilateral calcarine cortex, caudate nucleus, thalamus, hippocampus, precuneus, posterior cingulate cortex, lingual and olfactory cortex, and GMV reduction in bilateral thalamus and hippocampus (cluster level at P<0.05, Gaussian random field correction). The SUVR of the hypometabolic brain regions was correlated with the Montreal Cognitive Assessment (MoCA) scores (r=0.55, P = 0.038) and cardiac stroke volume (r=0.49, P=0.002). Cerebral hypometabolism played a key role in the relationship between the decreased stroke volume and MoCA scores, with a mediation effect of 33.2%. HF patients suffered cerebral metabolic and structural alterations in regions associated with cognition. The observed correlation between cardiac stroke volume and cognitive impairment underscored the potential influence of cerebral hypometabolism, suggesting that cerebral hypometabolism due to chronic systemic hypoperfusion may significantly contribute to cognitive impairment in HF patients.

Can simple 'molecular' corrections outperform projector augmented-wave density functional theory in the prediction of 35 Cl electric field gradient tensor parameters for chlorine-containing crystalline systems?

Many-body expansion (MBE) fragment approaches have been applied to accurately compute nuclear magnetic resonance (NMR) parameters in crystalline systems. Recent examples demonstrate that electric field gradient (EFG) tensor parameters can be accurately calculated for 14 N and 17 O. A key additional development is the simple molecular correction (SMC) approach, which uses two one-body fragment (i.e., isolated molecule) calculations to adjust NMR parameter values established using 'benchmark' projector augmented-wave (PAW) density functional theory (DFT) values. Here, we apply a SMC using the hybrid PBE0 exchange-correlation (XC) functional to see if this can improve the accuracy of calculated 35 Cl EFG tensor parameters. We selected eight organic and two inorganic crystal structures and considered 15 chlorine sites. We find that this SMC improves the accuracy of computed values for both the 35 Cl quadrupolar coupling constant (CQ ) and the asymmetry parameter ( ) by approximately 30% compared with benchmark PAW DFT values. We also assessed a SMC that offers local improvements not only in terms of the quality of the XC functional but simultaneously in the quality of the description of relativistic effects via the inclusion of spin-orbit effects. As the inorganic systems considered contain heavy atoms bonded to the chlorine atoms, we find further improvements in the accuracy of calculated 35 Cl EFG tensor parameters when both a hybrid functional and spin-orbit effects are included in the SMC. On the contrary, for chlorine-containing organics, the inclusion of spin-orbit relativistic effects using a SMC does not improve the accuracy of computed 35 Cl EFG tensor parameters.

Impact of early stages of CKD with and without proteinuria on cardiac remodelling in UK Biobank cohort

Abstract Background Chronic kidney disease (CKD) is an established predictor of left atrial (LA) and left ventricular (LV) morphological and functional changes, which translate into excessive cardiovascular morbidity and mortality. However, a focussed study exploring the impact of early stages of CKD defined as stage 1 (eGFR &amp;gt; 90 mL/min per 1.73 m2 + albuminuria) and stage 2 (eGFR 60–89 mL/min per 1.73 m2) with and without proteinuria on cardiac magnetic resonance (CMR) parameters is lacking. Purpose In this study, we analysed CMR structural and functional changes in participants with early stages of CKD in the UK Biobank population. Methods 41,095 participants from the UK Biobank imaging study were categorised into CKD stages. We calculated eGFR using the CKD-EPI 2021 equation and proteinuria was ascertained by the urinary protein creatinine ratio (defined as &amp;gt;30mg/mmol). We sought associations between CKD stages (exposure) and CMR parameters: LV end-diastolic volume (LVEDV), LV end-systolic volume (LVESV), LV stroke volume (LVSV), LV ejection fraction (LVEF), LV global functional index (LVGFI), LV myocardial contractile function (LVMCF), LV mass (LVM), LV mass-to-volume ratio (LVMVR), LV global longitudinal strain (GLS), LV global radial strain (GRS), LV global circumferential strain (GCS), LA maximum volume and left atrial emptying fraction. In the multivariable regression model, we adjusted for covariates including age, sex, ethnicity, height, body mass index, hypertension, diabetes, smoking status, and hyperlipidaemia Results Among the participants, 26,779 (65.1%) had normal kidney function, 2,787 (6.8%) stage 1 CKD, 10,534 (25.6%) stage 2 CKD without proteinuria, 689 (1.7%) stage 2 CKD with proteinuria, 241 (0.6%) CKD stage 3A (eGFR 59-45mL/min per 1.73 m2) without proteinuria, 28 (0.1%) stage 3A with proteinuria and 37 (0.1%) with more advanced CKD defined as stages 3B and above. Approximately 8 years after characterisation of CKD stages these participants underwent CMR. Using adjusted multivariable regression models setting normal kidney function as the reference group, the presence of proteinuria in stage 3 CKD was associated with smaller LV volume, lower LVM and more impaired LV function (LVSV beta=-11ml, 95% confidence interval (CI): -5 to -16ml and GLS beta=0.9%, 95% CI: 0.2 to 1.7%). Conclusions This study highlights the relationship between proteinuria in the early stages of CKD and cardiac remodelling patterns using CMR. CKD sub-characterisation with presence or absence of proteinuria should be considered for risk stratification.Figure 1

Prognostic value of different echocardiographic and cardiac magnetic resonance parameters in patients with AL amyloidosis

Abstract Introduction Light chain amyloidosis (AL) is a systemic disease, highlighting its infiltration at the myocardium. Recent advances in imaging have increased the suspicion of cardiac involvement. Current risk stratification models are based exclusively on serum biomarkers. We studied the prognostic value of echocardiographic and cardiac magnetic resonance (cMRI) parameters in a cohort of patients with a confirmed diagnosis of AL amyloidosis. Methods Retrospective observational study of consecutive patients diagnosed with AL amyloidosis by the Hematology Department in our center between 1999-2022. All had to have quantification of biomarkers (free light chains -dFLC-, NTpro-BNP and troponin T -TnT-) and transthoracic echocardiography (TTE) at diagnosis, collecting clinical and epidemiological characteristics and complementary tests. Results Of a total of 71 diagnoses of AL amyloidosis, 39 patients who met the inclusion criteria were selected, most diagnosed in the last 5 years. The mean age was 65.2 ± 12.9 years old, 56.4% male. The sample was divided according to the Mayo Clinic risk stratification model, into low (I-II, 33%) and high (III-IV, 67%) risk stages. Cardiac imaging variables were analyzed using Bootstrap statistics increasing the database to 150 patients (Table 1). Among echocardiographic variables, patients in the high-risk groups had greater systolic dysfunction of both ventricles, diastolic dysfunction, myocardial thickness, and pericardial effusion was observed more frequently. Among patients with cMRI (53.8%), we highlight the presence of an interventricular septal thickness ≥12 mm (47.6%) and a late gadolinium enhancement (LGE) in the left ventricle (66.6%, LV), most with a diffuse subendocardial pattern. In our cohort, the presence of LGE, greater maximum LV thickness, and increased LV extracellular volume (ECV) were significantly associated with the Mayo Clinic high-risk stages groups. Finally, a global longitudinal strain &amp;gt; -11.5% by TTE, and a T1 mapping &amp;gt; 1042 ms or ECV &amp;gt; 49% by cMRI, were significantly associated with a reduction in overall survival (Figure 1). Conclusions There are cardiac imaging variables that have prognostic implications and could have a role in risk stratification of patients with AL amyloidosis. Its inclusion in new risk stratification models along with serum biomarkers should be considered.Table 1Figure 1

Comprehensive analysis of risk factors for the severity of immune checkpoint inhibitor-associated myocarditis in cancer patients

Abstract Purpose To explore the predictive significance of patients’ clinical features and examination results, including blood laboratory tests, echocardiogram, cardiovascular magnetic resonance (CMR), and electrocardiogram (ECG), for the severity of immune checkpoint inhibitors (ICIs)-associated myocarditis. Methods Data from a real-world cohort of 81 cancer patients who developed ICI-associated myocarditis after immunotherapy were retrospectively analyzed. Myocarditis of Common Terminology Criteria for Adverse Events (CTCAE) grades 3-5 and the development of the major adverse cardiovascular event (MACE) were set as endpoints. Logistic regression was used to evaluate each parameter’s value in predicting myocarditis of grades 3-5 and MACE. Results Eventually, CTCAE grades 3-5 and MACE developed in 43/81 (53.1%) and 28/81 (34.6) cases, respectively. The occurrence of CTCAE grades 3-5 (HR, 95%CI: 4.48, 2.02-9.91, p&amp;lt;0.001) and MACE (HR, 95%CI: 16.21, 6.93-37.94, p&amp;lt;0.001) were strongly related to patients’ overall survival from ICI-associated myocarditis to death. The likelihood of CTCAE grades 3-5 and MACE increased with the accumulation of organs affected by the ICI-associated adverse events and initial clinical symptoms. Concurrent systematic therapies during ICI treatment did not raise the risk of myocarditis severity, while prior chemotherapy did. Apart from the classical cardiac markers, such as myoglobin, brain natriuretic peptide, and troponin T, a higher neutrophil ratio was also related to poorer cardiac outcomes, whereas a higher lymphocyte and monocyte ratios were predictors of favorable cardiac outcomes. Besides, the CD4+ T cell ratio and CD4/CD8 ratio were negatively related to CTCAE grades 3-5. Several cardiovascular magnetic resonance parameters were associated with myocarditis severity. In contrast, the predictive value of echocardiography and electrocardiogram was weak. Conclusions This study comprehensively evaluated the prognostic value of different patients’ clinical factors and examination results and discovered several predictors of severe ICI-associated myocarditis, which will facilitate early detection of severe ICI-associated myocarditis in patients receiving immunotherapy.