{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:46:13Z","timestamp":1790621173464,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"publisher","award":["23SCISA1145192"],"award-info":[{"award-number":["23SCISA1145192"]}],"id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 HL165238"],"award-info":[{"award-number":["R01 HL165238"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2026,3]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Cardiac magnetic resonance (MR) enables assessment of myocardial oxygenation without contrast media. However, how myocardial oxygen metabolism is altered in light chain cardiac amyloidosis (AL\u2010CA) patients remains poorly understood.<\/jats:p>\n <\/jats:sec>\n \n Purpose<\/jats:title>\n To leverage newly developed MR techniques for the evaluation of altered myocardial oxygen metabolism in AL\u2010CA patients.<\/jats:p>\n <\/jats:sec>\n \n Study Type<\/jats:title>\n Prospective.<\/jats:p>\n <\/jats:sec>\n \n Subjects<\/jats:title>\n Twenty participants: 10 AL\u2010CA patients (8 males) and 10 healthy controls (HCs; 8 males).<\/jats:p>\n <\/jats:sec>\n \n Sequence<\/jats:title>\n 3\u2009T, cine imaging, T1 mapping, first\u2010pass perfusion imaging, and asymmetric spin echo prepared (ASEprep) sequence.<\/jats:p>\n <\/jats:sec>\n \n Assessment<\/jats:title>\n \n All subjects underwent cine imaging for left ventricular global longitudinal strain (LVGLS), pre\u2010 and post\u2010contrast T1 mapping for extracellular volume (ECV), and ASEprep sequence for myocardial oxygen extraction fraction (mOEF) mapping. Myocardial blood flow (MBF) was derived from first\u2010pass perfusion images, and myocardial oxygen consumption (MVO\n 2<\/jats:sub>\n ) and myocardial external efficiency (MEE) were quantified.\n <\/jats:p>\n <\/jats:sec>\n \n Statistical Tests<\/jats:title>\n \n T<\/jats:italic>\n \u2010test,\n U<\/jats:italic>\n test, Firth penalized logistic regression, a one\u2010way analysis of variance, and correlation analysis.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Compared with HCs, AL\u2010CA patients demonstrated higher mOEF (0.66\u2009\u00b1\u20090.04 vs. 0.59\u2009\u00b1\u20090.02), native T1 (1395.4\u2009\u00b1\u2009109.25 vs. 1236.97\u2009\u00b1\u200941.32), and ECV (40.39\u2009\u00b1\u20098.99 vs. 25.48\u2009\u00b1\u20092.03), but lower MBF (0.08[0.08, 0.12] vs. 0.13[0.11, 0.15]), MVO\n 2<\/jats:sub>\n (0.06\u2009\u00b1\u20090.01 vs. 0.08\u2009\u00b1\u20090.01), and LVGLS (\u221213.34\u2009\u00b1\u20093.75 vs. \u221217.65\u2009\u00b1\u20091.78). MEE (63.2\u2009\u00b1\u200921.18 vs. 77.15\u2009\u00b1\u200919.68,\n p<\/jats:italic>\n \u2009=\u20090.156) in AL\u2010CA patients was reduced, whereas total MVO\n 2<\/jats:sub>\n (6.25\u2009\u00b1\u20092.98 vs. 4.6\u2009\u00b1\u20091.27,\n p<\/jats:italic>\n \u2009=\u20090.115) was increased, though not statistically significant. mOEF correlated strongly with LV mass (\n r<\/jats:italic>\n \u2009=\u20090.72), moderately with ECV (\n r<\/jats:italic>\n \u2009=\u20090.60), native T1 (\n r<\/jats:italic>\n \u2009=\u20090.64), LVGLS (\n r<\/jats:italic>\n \u2009=\u2009\u22120.52), and MBF (\n r<\/jats:italic>\n \u2009=\u2009\u22120.65). MVO\n 2<\/jats:sub>\n correlated moderately with ECV (\n r<\/jats:italic>\n \u2009=\u2009\u22120.57), native T1 (\n r<\/jats:italic>\n \u2009=\u2009\u22120.56), and LV mass (\n r<\/jats:italic>\n \u2009=\u2009\u22120.60). MEE correlated strongly with LVEF (\n r<\/jats:italic>\n \u2009=\u20090.78) and moderately with LVGLS (\n r<\/jats:italic>\n \u2009=\u20090.59).\n <\/jats:p>\n <\/jats:sec>\n \n Data Conclusion<\/jats:title>\n \n Our pilot cardiac MR study demonstrated the feasibility of quantifying myocardial oxygenation and mechanical efficiency in AL\u2010CA. Elevated mOEF and reduced MBF suggest microvascular dysfunction from amyloid infiltration, while impaired MEE and increased total MVO\n 2<\/jats:sub>\n underscore metabolic\u2013mechanical uncoupling.\n <\/jats:p>\n <\/jats:sec>\n \n Evidence Level<\/jats:title>\n 2.<\/jats:p>\n <\/jats:sec>\n \n Technical Efficacy<\/jats:title>\n Stage 1.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jmri.70152","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T12:54:05Z","timestamp":1760446445000},"page":"848-856","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Altered Myocardial Oxygenation and Impaired Energy Efficiency: A Pilot Study in Patients With Light Chain Cardiac Amyloidosis"],"prefix":"10.1002","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3598-5981","authenticated-orcid":false,"given":"Liya","family":"Dai","sequence":"first","affiliation":[{"name":"Zhejiang Key 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