{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:03:03Z","timestamp":1789534983860,"version":"build-2803163510"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 HL158077"],"award-info":[{"award-number":["R01 HL158077"]}],"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":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Evaluating pulmonary congestion after exercise in heart failure (HF) may reveal perturbations not apparent at rest and provide insight into dyspnea and exercise intolerance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate the reproducibility and exercise\u2010induced alterations in lung water density (LWD) using 3D ultrashort echo time (UTE) MRI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Type<\/jats:title>\n                    <jats:p>Prospective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Field Strength\/Sequence<\/jats:title>\n                    <jats:p>3\u2010T MRI with a prototype 3D stack\u2010of\u2010spirals UTE Volumetric Interpolated Breath\u2010hold Examination (VIBE) sequence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>Sixty\u2010nine HF patients (59\u2009\u00b1\u200912\u2009years; 39 males) across a range of left ventricular ejection fraction (23 HFpEF, 16 HFmrEF, 18 HFimpEF, and 12 HFrEF); 34 healthy subjects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Assessment<\/jats:title>\n                    <jats:p>UTE MRI was performed at rest and after exercise. Images were normalized to yield relative LWD (%). LWD was quantified as the mean normalized pixel intensity within the segmented parenchyma, and lung volume was also measured. Reproducibility was evaluated in a separate scan\/rescan study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Statistical Tests<\/jats:title>\n                    <jats:p>\n                      Shapiro\u2013Wilk test; one\u2010way ANOVA or Kruskal\u2013Wallis test with FDR correction; Student's\n                      <jats:italic>t<\/jats:italic>\n                      \u2010test or Wilcoxon signed\u2010rank test;\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      test or Fisher's exact test; Bland\u2013Altman analysis.\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 was considered significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In healthy controls, LWD decreased significantly after exercise with an absolute change of \u22121.25% (interquartile range [IQR]: \u22122.92% to 0.38%) and relative change of \u22124.35% (IQR: \u22129.55% to 1.30%). Compared with controls, HFpEF showed a significantly greater absolute change (0.47%, IQR: \u22120.91% to 2.10%) and relative change in LWD (1.46%, IQR: \u22122.65% to 6.45%), not apparent in other HF subgroups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.053\u20130.821). Changes in lung volume did not differ between each HF subgroup and healthy controls (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.056\u20130.498). Bland\u2013Altman analysis demonstrated good agreement for LWD and lung volume.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Conclusion<\/jats:title>\n                    <jats:p>Single\u2010breath\u2010hold 3D UTE MRI provides reproducible LWD measurements at rest and enables detection of exercise\u2010induced LWD alterations. This approach captures pulmonary fluid changes following exercise and identifies greater LWD response in HFpEF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Technical Efficacy<\/jats:title>\n                    <jats:p>Stage 1.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jmri.70389","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T12:13:51Z","timestamp":1781784831000},"page":"906-917","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exercise\u2010Induced Alterations in Lung Water Density in Heart Failure Using Single\u2013Breath\u2013Hold\n                    <scp>3D<\/scp>\n                    Ultrashort Echo Time\n                    <scp>MRI<\/scp>"],"prefix":"10.1002","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9270-0749","authenticated-orcid":false,"given":"Hang","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Medicine (Cardiovascular Division) Beth Israel Deaconess Medical Center and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4025-7399","authenticated-orcid":false,"given":"Manuel A.","family":"Morales","sequence":"additional","affiliation":[{"name":"Department of Medicine (Cardiovascular Division) Beth Israel Deaconess Medical Center and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5589-8792","authenticated-orcid":false,"given":"Alexander","family":"Schulz","sequence":"additional","affiliation":[{"name":"Department of Medicine (Cardiovascular Division) Beth Israel 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