Comprehensive Cardiac MRI Protocol

Patient scanning was performed with a 3.0-T or a 1.5-T system (Tim Trio and Aera, Siemens, Erlangen, Germany). Detailed imaging information was reported previously[9 (link),10 (link)]. All patients underwent standard cine imaging for acquisition of left and right ventricular mass and function, along with LGE imaging in matching slice locations. Patients were further categorized if the left ventricular end-diastolic volume index (LVEDV_i) was enlarged in comparison to reference values[18 ], and LVEF was ≤50%. LGE presence was quantified visually and the extent of enhancement was quantified by using the full width half maximum signal intensity (FWHM) threshold cut-off and expressed as a percent of the LV myocardium[19 (link)]. From 2007, T2w inversion recovery images were included into the protocol and myocardial oedema was evaluated by assessing the ratio of the signal intensity in the LV myocardium compared to the skeletal muscle (musculus pectoralis major or minor). Since 2009, patients also underwent acquisition of T1 mapping and ECV calculations. Image analysis was performed with MASS v15 and QMASS MR (Medis Medical Imaging Systems, Leiden, the Netherlands).