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Fadl SA, Revels JW, Rezai Gharai L, Hanneman K, Dana F, Proffitt EK, Grizzard JD. Cardiac MRI of Hereditary Cardiomyopathy. Radiographics 2022; 42:625-643. [PMID: 35275782 DOI: 10.1148/rg.210147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Hereditary cardiomyopathy comprises a heterogeneous group of diseases of the cardiac muscle that are characterized by the presence of genetic mutations. Cardiac MRI is central to evaluation of patients with cardiomyopathy owing to its ability to allow evaluation of many different tissue properties in a single examination. For example, cine MRI is the standard of care for assessment of myocardial structure and function. It clearly shows regions of asymmetric wall thickening that are typical of hypertrophic cardiomyopathy and allows it to be differentiated from other hereditary disorders such as Fabry disease or transthyretin cardiac amyloidosis that produce concentric hypertrophy. Late gadolinium enhancement provides a different tissue property and allows these latter two causes of concentric hypertrophy to be distinguished on the basis of their enhancement appearances (Fabry disease shows midwall basal inferolateral enhancement, and amyloidosis shows global subendocardial enhancement). Native T1 mapping may similarly allow differentiation between Fabry disease and amyloidosis without the use of contrast material. T2*-weighted MRI is important in the detection and quantification of iron overload cardiomyopathy. Other hereditary entities for which comprehensive MRI has proven essential include Danon disease, familial dilated cardiomyopathy, hereditary muscular dystrophy, arrhythmogenic right ventricular cardiomyopathy, and ventricular noncompaction. As a result of the diagnostic power of cardiac MRI, cardiac MRI examinations are being requested with increasing frequency, not only in academic centers but also in community practices. The genetic background, pathophysiologic characteristics, and clinical presentation of patients with hereditary cardiomyopathy are described; the characteristic cardiac MRI features of hereditary cardiomyopathy are discussed; and the role of MRI in risk stratification, treatment, and prognostication in patients with cardiomyopathy is reviewed. ©RSNA, 2022 Online supplemental material is available for this article.
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Affiliation(s)
- Shaimaa A Fadl
- From the Department of Radiology, Virginia Commonwealth University Health Systems, 1250 E Marshall St, Richmond, VA 23219 (S.A.F., L.R.G., F.D., E.K.P., J.D.G.); Department of Radiology, University of New Mexico, Albuquerque, NM (J.W.R.); and Department of Medical Imaging, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ont, Canada (K.H.)
| | - Jonathan W Revels
- From the Department of Radiology, Virginia Commonwealth University Health Systems, 1250 E Marshall St, Richmond, VA 23219 (S.A.F., L.R.G., F.D., E.K.P., J.D.G.); Department of Radiology, University of New Mexico, Albuquerque, NM (J.W.R.); and Department of Medical Imaging, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ont, Canada (K.H.)
| | - Leila Rezai Gharai
- From the Department of Radiology, Virginia Commonwealth University Health Systems, 1250 E Marshall St, Richmond, VA 23219 (S.A.F., L.R.G., F.D., E.K.P., J.D.G.); Department of Radiology, University of New Mexico, Albuquerque, NM (J.W.R.); and Department of Medical Imaging, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ont, Canada (K.H.)
| | - Kate Hanneman
- From the Department of Radiology, Virginia Commonwealth University Health Systems, 1250 E Marshall St, Richmond, VA 23219 (S.A.F., L.R.G., F.D., E.K.P., J.D.G.); Department of Radiology, University of New Mexico, Albuquerque, NM (J.W.R.); and Department of Medical Imaging, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ont, Canada (K.H.)
| | - Franklin Dana
- From the Department of Radiology, Virginia Commonwealth University Health Systems, 1250 E Marshall St, Richmond, VA 23219 (S.A.F., L.R.G., F.D., E.K.P., J.D.G.); Department of Radiology, University of New Mexico, Albuquerque, NM (J.W.R.); and Department of Medical Imaging, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ont, Canada (K.H.)
| | - Elizabeth Kate Proffitt
- From the Department of Radiology, Virginia Commonwealth University Health Systems, 1250 E Marshall St, Richmond, VA 23219 (S.A.F., L.R.G., F.D., E.K.P., J.D.G.); Department of Radiology, University of New Mexico, Albuquerque, NM (J.W.R.); and Department of Medical Imaging, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ont, Canada (K.H.)
| | - John D Grizzard
- From the Department of Radiology, Virginia Commonwealth University Health Systems, 1250 E Marshall St, Richmond, VA 23219 (S.A.F., L.R.G., F.D., E.K.P., J.D.G.); Department of Radiology, University of New Mexico, Albuquerque, NM (J.W.R.); and Department of Medical Imaging, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ont, Canada (K.H.)
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Xie J, Liu Y, Wei X, Ye W, Ma Z, Lu G, Tan Z, Li T, Wang Y, Zhao L, Lu M, Li X, Chen Y, Liu H. Relationship Between Fragmented QRS Complex and Left Ventricular Fibrosis and Function in Patients With Danon Disease. Front Cardiovasc Med 2022; 9:790917. [PMID: 35299984 PMCID: PMC8923125 DOI: 10.3389/fcvm.2022.790917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 01/21/2022] [Indexed: 12/02/2022] Open
Abstract
Background Fragmented QRS (f-QRS) complex on the surface ECG is a cardiac conduction abnormality that indicates myocardial scarring. The relationship between the f-QRS complex and cardiac status in patients with Danon disease (DD) remains unclear and will be explored in this study. Methods Patients with genetically confirmed DD and cardiac magnetic resonance imaging (CMR) examinations were recruited from multiple centers. The number of leads, pattern, score, and segmental distribution of the f-QRS complex were assessed by surface 12-lead ECG. Cardiac status, such as left ventricular (LV) volume, function, and extent of late gadolinium enhancement (LGE), was demonstrated by CMR. The segmental distribution of LGE was also assessed. Correlations between the f-QRS and cardiac status were assessed. Results Fifteen patients (14 men) with DD who underwent 12-lead ECG and CMR imaging were included. The f-QRS complex was documented in all patients (n = 15, 100%). Three patterns of f-QRS were found, with the notched R/S pattern (74%) being the most common, followed by fragmented QRS (16%) and various RSR' (11%). The fragmented QRS pattern showed an association with a higher level of myocardial fibrosis (LGE > 35%). The burden of f-QRS in each patient was assessed by the number of leads with f-QRS (median 7, range 2–12) and the f-QRS score (median 9, range 2–33). In the correlation analysis, the f-QRS score was positively correlated with LGE% (r = 0.726, p = 0.002), negatively correlated with LV ejection function (LVEF; r = −0.617, p = 0.014) as evaluated by CMR. In the local distribution, f-QRS score and LGE% were both predominant in the LV free wall but did not correlate well among the anterior, lateral, and inferior segments. Conclusion In this DD cohort, the quantitative f-QRS was correlated well with myocardial fibrosis burden and LV dysfunction in general. This finding suggests that f-QRS can be used as a simple screening tool to assess cardiac status in patients with DD.
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Affiliation(s)
- Jiajun Xie
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yang Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xiaoyu Wei
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Weitao Ye
- Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zelan Ma
- Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Guanyu Lu
- Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zekun Tan
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Tingyu Li
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yining Wang
- Department of Radiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Lei Zhao
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Minjie Lu
- Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaohu Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yucheng Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
- Yucheng Chen,
| | - Hui Liu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- *Correspondence: Hui Liu
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Wei X, Zhao L, Xie J, Liu Y, Du Z, Zhong X, Ye W, Wang Y, Chen Y, Lu M, Liu H. Cardiac Phenotype Characterization at MRI in Patients with Danon Disease: A Retrospective Multicenter Case Series. Radiology 2021; 299:303-310. [PMID: 33754825 DOI: 10.1148/radiol.2021203996] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Danon disease (DD) is a rare X-chromosome-linked dominant lysosomal glycogen storage disease. Its features have seldom been reported by using cardiac MRI. This case series aimed to evaluate cardiac features of DD on the basis of MRI observations from five centers in China. From January 2010 to May 2019, 16 patients with DD (13 male patients [81%]; median age, 19 years; age range, 14-44 years) underwent MRI. The most frequent DD cardiomyopathy manifestation was symmetric hypertrophy cardiomyopathy (HCM) phenotype (nine of 16; 56%), followed by asymmetric HCM phenotype (six of 16; 38%) and dilated cardiomyopathy phenotype (one of 16; 6%). The characteristic late gadolinium enhancement features included midbasal septum sparing (14 of 16; 88%) and apex involvement (16 of 16; 100%) with a base-to-apex increasing tendency, free wall involvement (15 of 16; 94%), and extensive subendocardium involvement (14 of 16; 88%). Abnormal T2 signal (seven of 16; 44%) and resting perfusion defect (14 of 16; 88%) were not uncommon in patients with DD. Furthermore, the cardiac MRI features of DD cohort in this study were compared with those of DD in previous literature and with genetically confirmed sarcomeric HCM.
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Affiliation(s)
- Xiaoyu Wei
- From the Department of Radiology (X.W., X.Z., W.Y., H.L.) and Guangdong Cardiovascular Institute (Y.L.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China; School of Medicine, South China University of Technology, Guangzhou, China (X.W., H.L.); Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (L.Z.); Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China (J.X.); Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Z.D.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.W.); Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Y.C.); Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.L.); The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China (H.L.)
| | - Lei Zhao
- From the Department of Radiology (X.W., X.Z., W.Y., H.L.) and Guangdong Cardiovascular Institute (Y.L.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China; School of Medicine, South China University of Technology, Guangzhou, China (X.W., H.L.); Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (L.Z.); Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China (J.X.); Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Z.D.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.W.); Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Y.C.); Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.L.); The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China (H.L.)
| | - Jiajun Xie
- From the Department of Radiology (X.W., X.Z., W.Y., H.L.) and Guangdong Cardiovascular Institute (Y.L.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China; School of Medicine, South China University of Technology, Guangzhou, China (X.W., H.L.); Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (L.Z.); Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China (J.X.); Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Z.D.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.W.); Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Y.C.); Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.L.); The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China (H.L.)
| | - Yang Liu
- From the Department of Radiology (X.W., X.Z., W.Y., H.L.) and Guangdong Cardiovascular Institute (Y.L.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China; School of Medicine, South China University of Technology, Guangzhou, China (X.W., H.L.); Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (L.Z.); Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China (J.X.); Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Z.D.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.W.); Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Y.C.); Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.L.); The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China (H.L.)
| | - Zhicheng Du
- From the Department of Radiology (X.W., X.Z., W.Y., H.L.) and Guangdong Cardiovascular Institute (Y.L.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China; School of Medicine, South China University of Technology, Guangzhou, China (X.W., H.L.); Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (L.Z.); Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China (J.X.); Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Z.D.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.W.); Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Y.C.); Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.L.); The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China (H.L.)
| | - Xiaomei Zhong
- From the Department of Radiology (X.W., X.Z., W.Y., H.L.) and Guangdong Cardiovascular Institute (Y.L.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China; School of Medicine, South China University of Technology, Guangzhou, China (X.W., H.L.); Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (L.Z.); Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China (J.X.); Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Z.D.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.W.); Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Y.C.); Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.L.); The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China (H.L.)
| | - Weitao Ye
- From the Department of Radiology (X.W., X.Z., W.Y., H.L.) and Guangdong Cardiovascular Institute (Y.L.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China; School of Medicine, South China University of Technology, Guangzhou, China (X.W., H.L.); Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (L.Z.); Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China (J.X.); Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Z.D.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.W.); Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Y.C.); Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.L.); The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China (H.L.)
| | - Yining Wang
- From the Department of Radiology (X.W., X.Z., W.Y., H.L.) and Guangdong Cardiovascular Institute (Y.L.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China; School of Medicine, South China University of Technology, Guangzhou, China (X.W., H.L.); Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (L.Z.); Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China (J.X.); Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Z.D.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.W.); Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Y.C.); Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.L.); The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China (H.L.)
| | - Yucheng Chen
- From the Department of Radiology (X.W., X.Z., W.Y., H.L.) and Guangdong Cardiovascular Institute (Y.L.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China; School of Medicine, South China University of Technology, Guangzhou, China (X.W., H.L.); Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (L.Z.); Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China (J.X.); Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Z.D.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.W.); Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Y.C.); Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.L.); The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China (H.L.)
| | - Minjie Lu
- From the Department of Radiology (X.W., X.Z., W.Y., H.L.) and Guangdong Cardiovascular Institute (Y.L.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China; School of Medicine, South China University of Technology, Guangzhou, China (X.W., H.L.); Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (L.Z.); Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China (J.X.); Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Z.D.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.W.); Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Y.C.); Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.L.); The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China (H.L.)
| | - Hui Liu
- From the Department of Radiology (X.W., X.Z., W.Y., H.L.) and Guangdong Cardiovascular Institute (Y.L.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China; School of Medicine, South China University of Technology, Guangzhou, China (X.W., H.L.); Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (L.Z.); Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China (J.X.); Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Z.D.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.W.); Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Y.C.); Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.L.); The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China (H.L.)
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