Key result
Major depressive disorder linked to ~3-point lower myocardial oxygenation signal response versus healthy controls.
Why the study?
Patients with major depressive disorder with anxious distress (MDD-A) frequently experience cardiovascular symptoms associated with poorer prognosis, prompting quantitative evaluation of myocardial alterations using oxygenation-sensitive CMR and mapping-derived entropy analysis.
Does 3.0T oxygenation-sensitive CMR and mapping-derived entropy analysis detect early myocardial alterations and correlate with symptom severity in medication-naïve patients with major depressive disorder with anxious distress compared to healthy controls?
Observational (n=119)
Does 3.0T oxygenation-sensitive CMR and mapping-derived entropy analysis detect early myocardial alterations and correlate with symptom severity in medication-naïve patients with major depressive disorder with anxious distress compared to healthy controls?
Oxygenation-sensitive CMR signal intensity change and mapping-derived myocardial T1/T2 entropy detect subclinical myocardial alterations that correlate with cardiovascular and psychiatric symptom severity in medication-naïve patients with major depressive disorder with anxious distress.
Supports possible myocardial involvement in anxious MDD; leaves open CMR utility for risk stratification pending validation.
BACKGROUND: Patients with major depressive disorder with anxious distress (MDD-A) frequently experience cardiovascular symptoms (CVS), which are associated with impaired quality of life and poorer long-term prognosis. This study aimed to quantitatively evaluate myocardial alterations in MDD-A patients using oxygenation-sensitive cardiovascular magnetic resonance (OS-CMR) and mapping-derived entropy analysis, and to explore their associations with CVS as well as the severity of depressive and anxiety symptoms. METHODS: In this prospective study, 58 consecutively enrolled medication-naïve patients with MDD-A diagnosed according to DSM-5 criteria and 61 healthy controls were included. All participants underwent CMR examinations at 3.0T. Left ventricular (LV) function, native T1 and T2 values, T1-entropy and T2-entropy, LV strain parameters, and oxygenation-sensitive signal intensity change (OS-SI%) were measured and compared between the two groups. Associations between CMR-derived parameters and CVS, anxiety symptom severity, and depressive symptom severity were assessed separately. A p value < 0.05 was considered statistically significant. RESULTS: Compared with healthy controls, patients with MDD-A exhibited significantly higher T1-entropy (8.3 ± 0.3 vs. 7.5 ± 0.3, p < 0.001) and T2-entropy (9.2 ± 0.4 vs. 8.1 ± 0.3, p < 0.001), whereas OS-SI% was significantly lower (11.4 ± 7.5% vs. 14.5 ± 4.5%, p = 0.007). After adjustment for age, sex, smoking status, and heart rate, multivariable regression analyses revealed that OS-SI% was inversely associated with HAMD scores (β = -0.205, p = 0.043) and HAMA scores (β = -0.453, p < 0.001), and inversely associated with CVS (OR= 0.801, p = 0.002). T1-entropy (β = 4.105, p = 0.022) and T2-entropy (β = 2.793, p = 0.042) were positively associated with HAMD scores. CONCLUSION: OS-SI% and mapping-derived myocardial entropy measures may serve as valuable noninvasive imaging biomarkers for assessing early myocardial alterations in patients with MDD-A.
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Jin et al. (2026) conducted an observational in Major depressive disorder with anxious distress (MDD-A) (n=119). Major depressive disorder with anxious distress (MDD-A) vs. Healthy controls was evaluated on Oxygenation-sensitive signal intensity change (OS-SI%) (p=0.007). Patients with MDD-A had lower myocardial oxygenation-sensitive signal intensity change (11.4% vs 14.5%, p=0.007) and higher T1/T2-entropy (p<0.001) than healthy controls.
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