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Exercise cardiovascular magnetic resonance (Ex-CMR) quantifies cardiac volumetric indices under physiological stress. Using Ex-CMR, this study developed a non-invasive imaging marker, the myocardial dynamic index (MDI), for evaluating cardiac dyspnea. Methods: MDI derived from a work-volume loop model integrates rest and stress LV end-diastolic and end-systolic volumes with supine exercise workload, accounting for body size and LV mass.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/exercise-cardiovascular-magnetic-resonance-myocardial-dynamic-index-an-non-invasive-imaging-marker-associated-with-cardiac-dyspnea/439194/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/exercise-cardiovascular-magnetic-resonance-myocardial-dynamic-index-an-non-invasive-imaging-marker-associated-with-cardiac-dyspnea/439194.png","ImageObject",300,407,{"name":92,"@type":93},"\tCallum ","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-05","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What problem does the study address about dyspnea diagnosis?","Question",{"text":113,"@type":114},"Diagnosing whether dyspnea is cardiac or non-cardiac can be challenging when resting cardiac tests show no clear abnormalities.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How is the myocardial dynamic index (MDI) derived in the study?",{"text":118,"@type":114},"MDI is calculated from the Ex-CMR work-volume loop model, combining rest and stress LV volumes with supine exercise workload while accounting for body size and LV mass.",{"name":120,"@type":111,"acceptedAnswer":121},"What did the study find about MDI’s diagnostic performance?",{"text":122,"@type":114},"MDI was independently associated with cardiac dyspnea, improved AUC from 0.86 to 0.93 when added to a base model, and correlated strongly with the VO2 max index.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},439194,1791175406,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146,"preview_page_count":4},137451211410,"https://ap-avatar.wpscdn.com/avatar/2000bb0a9246f588df?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786362646172706240","Journal of Cardiovascular Magnetic Resonance 27 (2025) 101981  \nContents lists available at ScienceDirect  \nJournal of Cardiovascular Magnetic Resonance  \njournal [homepage:](homepage: www.sciencedirect.com/journal/joc mr)[ www.sciencedirect.com/journal/joc mr](homepage: www.sciencedirect.com/journal/joc mr)  \nOriginal Research  \nExercise cardiovascular magnetic resonance myocardial dynamic index: Anon-invasive imaging marker associated with cardiac dyspnea  \nFahime Ghanbaria, Jennifer Rodrigueza, Manuel A. Moralesa, Long H. Ngoa, Connie W. Tsaoa, Jeremy M. Robbinsa, Deepa M. Gopalc, David M. Systromd, Aaron B. Waxmand,  \nWarren J. Manninga,b, Reza Nezafata,⁎  \na Departments of Medicine (Cardiovascular Division) Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA b Departments of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA  \nc Division of Cardiovascular Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA  \nd Department of Medicine (Division of Pulmonary and Critical Care), Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA  \nA R T I C L E I N F O  \nKeywords:  \nExercise-CMR  \nWork-volume loop model Myocardial dynamic index Non-invasive imaging marker Cardiac dyspnea  \nVO2 max index  \nA B S T R A C T  \nBackground: Identifying the cause of dyspnea (i.e., cardiac vs. non-cardiac) can be challenging in the absence of significant resting cardiac abnormalities. Exercise cardiovascular magnetic resonance (Ex-CMR) enables quantification of cardiac volumetric indices under physiological stress. Using Ex-CMR, we sought to develop a non-invasive imaging marker, referred to as the myocardial dynamic index (MDI), and to demonstrate its potential for evaluating cardiac dyspnea.  \nMethods: MDI is a metric derived from Ex-CMR work-volume loop model that integrates rest and stress left ventricular (LV) end-diastolic and end-systolic volumes with workload measured during supine exercise, while accounting for body size and LV mass. To evaluate MDI as a marker of cardiac dyspnea, we retrospectively analyzed data from a prospective multicenter study measuring MDI in patients with cardiac or non-cardiac dyspnea. All had invasive exercise testing before Ex-CMR. Cardiac dyspnea was defined by established invasive and non-invasive criteria, including HFpEF (early to advanced) and HFmrEF. Non-cardiac dyspnea patients had normal invasive hemodynamics and cardiac function. Univariable and multivariable logistic regression identified clinical and imaging predictors of cardiac dyspnea. A base model incorporating clinical and rest CMR variables was compared to a model that included the base model plus MDI. Diagnostic performance was assessed using receiver operating characteristic analysis and compared using the DeLong test. MDI scan/re-scan reproducibility over one year, inter- and intraobserver reproducibility, and correlation with VO₂ max were evaluated.  \nResults: Among 93 patients (66 with cardiac dyspnea, 27 with non-cardiac dyspnea), MDI was lower in patients with cardiac dyspnea (25.9 ± 9.5 vs. 45.1 ± 10.7 mL·W/g/m², p \u003C 0.0001). The base model included age, body mass index, NYHA class, and left atrial strain. In multivariable analysis, MDI emerged as the only independent predictor of cardiac dyspnea when added to the base model. Inclusion of MDI improved the AUC from 0.86 to 0.93 (p = 0.012), while MDI alone yielded an AUC of 0.91. A strong correlation was observed between MDI and the VO₂ max index (r = 0.84, p \u003C 0.0001). Reproducibility was excellent.  \nConclusion: Ex-CMR MDI is independently associated with cardiac dyspnea and strongly correlates with the VO₂ max index. It aids in differentiating cardiac from non-cardiac dyspnea and provides incremental diagnostic value beyond conventional clinical and resting imaging parameters.  \nAbbreviations: ACEIs, angiotensin-converti","cbCaiocnsLTYlBeB","https://ap.wps.com/l/cbCaiocnsLTYlBeB","pdf",3508677,11,"English","# Original Research\n## Introduction\n## Methods\n## Results\n## Conclusion\n## Abbreviations","[{\"question\":\"What problem does the study address about dyspnea diagnosis?\",\"answer\":\"Diagnosing whether dyspnea is cardiac or non-cardiac can be challenging when resting cardiac tests show no clear abnormalities.\"},{\"question\":\"How is the myocardial dynamic index (MDI) derived in the study?\",\"answer\":\"MDI is calculated from the Ex-CMR work-volume loop model, combining rest and stress LV volumes with supine exercise workload while accounting for body size and LV mass.\"},{\"question\":\"What did the study find about MDI’s diagnostic performance?\",\"answer\":\"MDI was independently associated with cardiac dyspnea, improved AUC from 0.86 to 0.93 when added to a base model, and correlated strongly with the VO2 max index.\"}]","Exercise cardiovascular magnetic resonance myocardial dynamic index - An non-invasive imaging marker associated with cardiac dyspnea | PDF",1790687745,28]