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Abstract-Increased aortic stiffness is related to increased ventricular stiffness and remodeling. Myocardial fibrosis is the pathophysiological hallmark of failing heart. We investigated the relationship between noninvasive imaging markers of myocardial fibrosis, native T1, and late gadolinium enhancement, respectively, and aortic stiffness in ventricular remodeling. Consecutive patients with known dilated cardiomyopathy (n=173) underwent assessment of cardiac volumes and function, T1 mapping, scar imaging, and pulse wave velocity, a measure of aortic stiffness. Asymptomatic healthy volunteers served as controls (n=47). Controls and patients showed an increase in pulse wave velocity with age, which was accelerated in the presence of cardiovascular disease. On the contrary, native T1 increased with age in patients, but not in controls. Pulse wave velocity was associated with native T1 in the presence of disease, but not in health. Native T1 showed a strong relationship with markers of structural and functional left ventricular remodeling and diastolic impairment. Ischemic and nonischemic pathophysiology of ventricular remodeling showed a similar slope of relationship between pulse wave velocity and native T1. However, in nonischemic patients, increase in pulse wave velocity was associated with greater increase in native T1. Aortic stiffness is related to age, and this process is accelerated in the presence of disease. On the contrary, increase in interstitial myocardial fibrosis is associated with age in the presence of disease. Patients with ischemic and nonischemic dilated cardiomyopathy have a similar relationship between native T1 and pulse wave velocity, which is stronger in the

NCT02407197; Results.

Aims Severe tricuspid regurgitation (TR) has adverse effects on outcomes, with limited therapeutic options. We report the outcomes of patients undergoing percutaneous annuloplasty as a treatment of  ≥severe functional TR in a single centre. Methods and results Prospective, single-arm, single-centre study that enrolled 24 consecutive patients with at least severe functional TR undergoing percutaneous annuloplasty with Cardioband system between 2019 and 2021. Clinical and echocardiographic data were prospectively collected, with a mean follow-up of 279 ± 246 days. At baseline, 66.6% were in New York Heart Association (NYHA) Classes III and IV and 100% had significant oedema. Technical success was 91.6%. At the end of follow-up, there was one death. Echocardiography showed a significant reduction in septolateral annular diameter of 10.4 mm (P < 0.001) that remained stable at the end of follow-up. The severity of the TR was also reduced. About 81.8% of patients were in NYHA Classes I and II. The number of patients with significant oedema decreased to 46% (P = 0.01). Six-minute walk distance improved by 68.8 m (P = 0.12). Conclusion Percutaneous annuloplasty with Cardioband system is an effective and safe treatment for patients with symptomatic, ≥severe functional TR. Annular reduction and TR severity reduction remained significant and sustained for 1 year. Patients experienced improvements in quality of life and exercise capacity.

Background T1 and T2 mapping detect myocardial fibrosis and oedema respectively. T1 values show segmental variation in mid ventricular SAX slice, making the identification of regional pathology difficult.We tested the reproducibility of T1 and T2 mapping in health and disease and regional variations of T2 values. Methods Patients with non-ischaemic cardiomyopathy (NICM, n-10), ischaemic heart disease (IHD, n-10) and 10 controls underwent T1 and T2 mapping in a single SAX slice on a 3T scanner using MOLLI and T2 multi-echo sequence. Two independent observers measured T1 and T2 values from quantitative maps in six standardised regions of interest. Intra- and inter-observer reproducibility of T1 and T2 mapping was assessed using Bland-Altman plots and Pearson’s correlation. Results Age was significantly higher in IHD group (p < 0.05). Patients with NICM had increased EDV (p < 0.05), IHD patients had increased ESV (p < 0.05) and decreased EF (p < 0.05). Intra- and inter-observer agreements for T1 (r = 0.988; r = 0.965) and T2 (r = 0.978; r = 0.948) values across the whole cohort were very high (p < 0.001 for all agreements). Similarly, the intra- and inter-observer coefficients of variation (CoV) for T1 (0.66%; 1.19%) and T2 (1.85%; 2.5%) values were low. There was no significant difference between segmental T2 values in theSAX slice (p = 0.205). Conclusions T1 and T2 mapping are highly reproducible techniques. T2 maps show no segmentalvariation. Our study suggests that a single normal range of T2 values could be applied to the entire mid-ventricular SAX slice. Future work should aim to create a normal range of T2 values for this purpose.

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