Purpose To accelerate cardiac cine at 7 tesla using simultaneous multi‐slice (SMS) acquisition with self‐calibration to resolve misalignment between calibration and imaging data due to breathing motion. Methods A spoiled‐gradient echo cine sequence was modified with radiofrequency phase‐cycled SMS excitations. A Fourier encoding strategy was applied along the cardiac phase dimension to allow for slice untangling and split‐slice GRAPPA calibration. Split‐slice GRAPPA was coupled with regular GRAPPA (SMS‐GRAPPA) and L1‐SPIRiT (SMS‐L1SPIRiT) for image reconstruction. 3‐slice SMS cine MRI was evaluated in ten subjects against single‐slice cine MRI in terms of SNR and contrast‐to‐noise ratio and slice leakage. Results SNR decreased significantly from 10.1 ± 7.1 for single‐slice cine to 7.4 ± 2.8 for SMS‐GRAPPA (P = 0.02) and was recovered to 9.0 ± 4.5 with SMS‐L1SPIRiT (P = 0.02). Contrast to noise ratio decreased significantly from 14.5 ± 8.1 for single‐slice cine to 5.6 ± 3.6 for SMS‐GRAPPA (P < 0.0001) and increased slightly but significantly back to 6.7 ± 4.4 for SMS‐L1SPIRiT (P = 0.03). Specific absorption rate restrictions imposed a reduced nominal flip angle (−37 ± 7%, P = 0.02) for 3‐slice SMS excitations compared to single‐slice acquisitions. SMS slice leakage increased significantly from apex (8.6 ± 6.5 %) to base (13.1 ± 4.1 %, P = 0.03) in the left ventricle. Conclusion Three‐fold acceleration of cine at 7T was achieved using the proposed SMS technique. Fourier encoding self‐calibration and regularized image reconstruction enabled simultaneous acquisition of three slices without significant SNR decrease but significant CNR decrease linked to the reduced nominal excitation flip angle.

Background Heart failure- (HF) and arrhythmia-related complications are the main causes of morbidity and mortality in patients with nonischemic dilated cardiomyopathy (NIDCM). Cardiovascular magnetic resonance (CMR) imaging is a noninvasive tool for risk stratification based on fibrosis assessment. Diffuse interstitial fibrosis in NIDCM may be a limitation for fibrosis assessment through late gadolinium enhancement (LGE), which might be overcome through quantitative T1 and extracellular volume (ECV) assessment. T1 and ECV prognostic value for arrhythmia-related events remain poorly investigated. We asked whether T1 and ECV have a prognostic value in NIDCM patients. Methods This prospective multicenter study analyzed 225 patients with NIDCM confirmed by CMR who were followed up for 2 years. CMR evaluation included LGE, native T1 mapping and ECV values. The primary endpoint was the occurrence of a major adverse cardiovascular event (MACE) which was divided in two groups: HF-related events and arrhythmia-related events. Optimal cutoffs for prediction of MACE occurrence were calculated for all CMR quantitative values. Results Fifty-eight patients (26%) developed a MACE during follow-up, 42 patients (19%) with HF-related events and 16 patients (7%) arrhythmia-related events. T1 Z-score (p = 0.008) and global ECV (p = 0.001) were associated with HF-related events occurrence, in addition to left ventricular ejection fraction (p < 0.001). ECV > 32.1% (optimal cutoff) remained the only CMR independent predictor of HF-related events occurrence (HR 2.15 [1.14–4.07], p = 0.018). In the arrhythmia-related events group, patients had increased native T1 Z-score and ECV values, with both T1 Z-score > 4.2 and ECV > 30.5% (optimal cutoffs) being independent predictors of arrhythmia-related events occurrence (respectively, HR 2.86 [1.06–7.68], p = 0.037 and HR 2.72 [1.01–7.36], p = 0.049). Conclusions ECV was the sole independent predictive factor for both HF- and arrhythmia-related events in NIDCM patients. Native T1 was also an independent predictor in arrhythmia-related events occurrence. The addition of ECV and more importantly native T1 in the decision-making algorithm may improve arrhythmia risk stratification in NIDCM patients. Trial registration NCT02352129. Registered 2nd February 2015—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02352129