BackgroundMyocardial fibrosis is being increasingly recognised as a common final pathway of a wide range of diseases. Thus, the development of an accurate and convenient method to evaluate myocardial fibrosis is of major importance. Although T1 mapping is a potential alternative for myocardial biopsy, validation studies are limited to small numbers and vary regarding technical facets, and include only a restricted number of disease. A systematic review and meta-analysis was conducted to objectively and comprehensively evaluate the performance of T1 mapping on the quantification of myocardial fibrosis using cardiovascular magnetic resonance (CMR).MethodsPubMed, EMBASE and the Cochrane Library databases were searched for studies applying T1 mapping to measure myocardial fibrosis and that validated the results via histological analysis. A pooled correlation coefficient between the CMR and histology measurements was used to evaluate the performance of the T1 mapping.ResultsA total of 15 studies, including 308 patients who had CMR and myocardial biopsy were included and the pooled correlation coefficient between ECV measured by T1 mapping and biopsy for the selected studies was 0.884 (95% CI: 0.854, 0.914) and was not notably heterogeneous chi-squared = 7.44; P = 0.489 for the Q test and I^2 = 0.00%).ConclusionsThe quantitative measurement of myocardial fibrosis via T1 mapping is associated with a favourable overall correlation with the myocardial biopsy measurements. Further studies are required to determine the calibration of the T1 mapping results for the biopsy findings of different cardiomyopathies.

Background: A growing body of evidence suggests that in the face of life adversity, threats, or other major stressful events, resilience is more conducive to individual adaptation and growth. Material/Methods: The Connor-Davidson Resilience Scale and the Chinese Perceived Stress Scale were used to evaluate the resilience and perceived stress of 600 medical staff members from the radiology departments in 32 public hospitals in Sichuan Province, China, respectively. Multiple linear regression was used to analyze factors related to resilience. Results: The total resilience score was 65.76±17.26, wherein the toughness dimension score was 33.61±9.52, the strength dimension score was 21.25±5.50, and the optimism dimension score was 10.91±3.15. There was a significant negative correlation between perceived stress and resilience (r=-0.635, P<0.001). According to multivariate analysis, the total perceived stress score (b=-1.318, P<0.001), gender (b=-4.738, P<0.001), knowledge of COVID-19 (b=2.884, P=0.043), knowledge of COVID-19 protective measures (b=3.260, P=0.042), and availability of adequate protective materials (b=-1.268, P=0.039) were independent influencing factors for resilience. Conclusions: The resilience level of the medical staff in the radiology departments during the outbreak of COVID-19 was generally low, particularly regarding toughness. More attention should be paid to resilience influence factors such as high perceived stress, female gender, lack of understanding of COVID-19 and protective measures, and lack of protective materials, and targeted interventions should be undertaken to improve the resilience level of the medical staff in the radiology departments during the outbreak of COVID-19.

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Background Increasing studies demonstrated that the cardiac involvements are related to Coronavirus Disease 2019 (COVID‐19). Thus, we investigated the clinical characteristics of COVID‐19 patients and further determined the risk factors for cardiac involvements in them. Methods and Results We analyzed data from 102 consecutive laboratory‐confirmed and hospitalized COVID‐19 patients (52 women; age, 19–87 years). Epidemiological and demographic characteristics, clinical features, routine laboratory tests (including cardiac injury biomarkers), echocardiography, electrocardiography, chest imaging findings, management methods, and clinical outcomes were collected. Patients were divided into acute cardiac injury (ACI), with and without cardiac marker abnormities groups according to different level of cardiac markers. In this research, cardiac involvements were found in 72 of the 102 (70.6%) patients: tachycardia (n=20), electrocardiography abnormities (n=23), echocardiography abnormities (n=59), elevated myocardial enzymes (n=55), and acute myocardial injury (n=9). Eight ACI patients were aged >60 years; seven of them had two or more underlying comorbidities (hypertension, diabetes, cardiovascular diseases, chronic obstructive pulmonary disease and chronic kidney disease). Novel coronavirus pneumonia (NCP) was much more severe in the ACI patients than in patients with non‐definite ACI (p<0.001). Multivariate analyses showed that C‐reactive protein (CRP) levels, old age, NCP severity, and underlying comorbidities were the risk factors for cardiac abnormalities in COVID‐19 patients. Conclusions Cardiac involvements are common in COVID‐19 patients. Elevated CRP levels, old age, underlying comorbidities, and NCP severity are the main risk factors for cardiac involvement in COVID‐19 patients. More attention should be given to cardiovascular protection during COVID‐19 treatment for mortality reduction.

BackgroundEarly detection of subclinical myocardial dysfunction in patients with diabetes mellitus (DM) is essential for recommending therapeutic interventions that can prevent or reverse heart failure, thereby improving the prognosis in such patients. This study aims to quantitatively evaluate left ventricular (LV) myocardial deformation and perfusion using cardiovascular magnetic resonance (CMR) imaging in patients with type 2 diabetes mellitus (T2DM), and to investigate the association between LV subclinical myocardial dysfunction and coronary microvascular perfusion.MethodsWe recruited 71 T2DM patients and 30 healthy individuals as controls who underwent CMR examination. The T2DM patients were subdivided into two groups, namely the newly diagnosed DM group (n = 31, patients with diabetes for ≤ 5 years) and longer-term DM group (n = 40, patients with diabetes > 5 years). LV deformation parameters, including global peak strain (PS), peak systolic strain rate, and peak diastolic strain rate (PSDR), and myocardial perfusion parameters such as upslope, time to maximum signal intensity (TTM), and max signal intensity (Max SI, were measured and compared among the three groups. Pearson’s correlation was used to evaluate the correlation between LV deformation and perfusion parameters.ResultsPooled data from T2DM patients showed a decrease in global longitudinal, circumferential, and radial PDSR compared to healthy individuals, apart from lower upslope. In addition, increased TTM and reduced Max SI were found in the longer-term diabetics compared to the normal subjects (p < 0.017 for all). Multivariable linear regression analysis showed that T2DM was independently associated with statistically significant CMR parameters, except for TTM (β = 0.137, p = 0.195). Further, longitudinal PDSR was significantly associated with upslope (r = − 0.346, p = 0.003) and TTM (r = 0.515, p < 0.001).ConclusionsOur results imply that a contrast-enhanced 3.0T CMR can detect subclinical myocardial dysfunction and impaired myocardial microvascular perfusion in the early stages of T2DM, and that the myocardial dysfunction is associated with impaired coronary microvascular perfusion.Electronic supplementary materialThe online version of this article (10.1186/s12933-018-0782-0) contains supplementary material, which is available to authorized users.

• PVs variants are helpful for providing anatomical road map to ablation. • PV variants are common. • DSCT could recognize these anatomic features before ablation as a non-invasive imaging.

2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2017;46:1368-1376.

Background: Since the outbreak of the Coronavirus Disease 2019 (COVID-19) inChina, respiratory manifestations of the disease have been observed. However, as a fatal comorbidity, acute myocardial injury (AMI) in COVID-19 patients has not been previously investigated in detail. We investigated the clinical characteristics of COVID-19 patients with AMI and determined the risk factors for AMI in them. Methods:We analyzed data from 53 consecutive laboratory-confirmed and hospitalized COVID-19 patients (28 men, 25 women; age, 19-81 years). We collected information on epidemiological and demographic characteristics, clinical features, routine laboratory tests (including cardiac injury biomarkers), echocardiography, electrocardiography, imaging findings, management methods, and clinical outcomes.Results: Cardiac complications were found in 42 of the 53 (79.25%) patients: tachycardia (n=15), electrocardiography abnormities (n=11), diastolic dysfunction (n=20), elevated myocardial enzymes (n=30), and AMI (n=6). All the six AMI patients were aged >60 years; five of them had two or more underlying comorbidities (hypertension, diabetes, cardiovascular diseases, and chronic obstructive pulmonary disease). Novel coronavirus pneumonia (NCP) severity was higher in the AMI patients than in patients with non-definite AMI (p<0.001). All the AMI patients required care in intensive care unit; of them, three died, two remain hospitalized.Multivariate analyses showed that C-reactive protein (CRP) levels, NCP severity, and underlying comorbidities were the risk factors for cardiac abnormalities in COVID-19 patients.All rights reserved. No reuse allowed without permission. author/funder, who has granted medRxiv a license to display the preprint in perpetuity.