Cardiovascular magnetic resonance measurement of myocardial extracellular volume in health and disease

Sado, Daniel; Flett, Andrew; Banypersad, Sanjay M.; White, Steven K; Maestrini, Viviana; Quarta, Giovanni; Lachmann, Robin; Murphy, Elaine; Mehta, Atul; Hughes, D.A.; McKenna, William J.; Taylor, Andrew M.; Hausenloy, Derek J.; Hawkins, Philip N.; Elliott, Perry; Moon, James

doi:10.1136/heartjnl-2012-302346

Cited by 289 publications

(218 citation statements)

References 38 publications

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“…Furthermore, Thompson et al showed that reduced non-contrast myocardial T1 values are the most sensitive and specific cardiovascular MRI parameter in patients with AFD irrespective of sex and LV morphology and function [71]. ECV in AFD is normal compared to healthy volunteers whereas ECV is higher in other diseases [72].…”

Section: Anderson Fabry Disease (Afd)mentioning

confidence: 99%

T1, T2 Mapping and Extracellular Volume Fraction (ECV): Application, Value and Further Perspectives in Myocardial Inflammation and Cardiomyopathies

Roller¹,

Harth²,

Schneider³

et al. 2015

Fortschr Röntgenstr

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!Cardiac magnetic resonance imaging (CMRI) is a versatile diagnostic tool. One of its main advantages is the possibility of tissue characterization. T1-weighted images for scar and T2-weighted images for edema visualization are key methods for tissue characterization. Otherwise these sequences are strongly limited for the detection of diffuse myocardial pathologies. Recently, rapid technical innovations have generated new techniques. T1, T2 mapping and evaluation of the extracellular volume fraction (ECV) allow quantification of diffuse myocardial pathologies and showed great potential in the visualization of fibrosis, edema, amyloid, iron overload and lipid. In the future these techniques might enable the detection of early cardiac involvement, even act as a prognosticator. Moreover, therapy monitoring and follow-up might be possible due to versatile parameter quantification with these new techniques. Key points:▶ CMR allows for tissue characterization via T1-and T2-weighted sequences.▶ In cases of diffuse, global myocardial pathologies, correct image interpretation with traditional CMR sequences might be difficult.▶ T1, T2 mapping and ECV can quantify diffuse, global myocardial pathologies.

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Section: Anderson Fabry Disease (Afd)mentioning

confidence: 99%

T1, T2 Mapping and Extracellular Volume Fraction (ECV): Application, Value and Further Perspectives in Myocardial Inflammation and Cardiomyopathies

Roller¹,

Harth²,

Schneider³

et al. 2015

Fortschr Röntgenstr

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“…[15][16][17][18][19] CMR impacts a variety of clinical management issues ranging from diagnosis and family screening to procedural planning for septal reduction therapy. 20,25,[38][39][40][41] Newer data demonstrate that extensive LGE, occupying ≥15 % LV myocardium, identifies patients at an increased sudden death risk and these patients may ultimately benefit from ICD placement for primary prevention. 2,15 These observations help to justify an expanded role of CMR in the routine assessment of patients with HCM.…”

Section: Resultsmentioning

confidence: 99%

“…38,39 Although CMR findings may be suggestive of a phenocopy in a patient undergoing evaluation for HCM, CMR findings in themselves are not diagnostic and must be considered within the clinical contest of an individual patient.…”

Section: Infiltrative Cardiomyopathymentioning

confidence: 99%

“…49 It has been postulated that T1 mapping may emerge as a diagnostic imaging marker in differentiating pathological cardiovascular diseases such as HCM from that of other forms of LV hypertrophy (such as Fabry's disease 39 or amyloidosis 38 ) and that this technique may prove to be superior to LGE for risk stratification in HCM. However, to date, there has been no link between T1 mapping and cardiovascular outcomes within HCM.…”

mentioning

confidence: 99%

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The Role of Cardiac MRI in the Diagnosis and Risk Stratification of Hypertrophic Cardiomyopathy

Rowin¹,

Maron²

2016

Arrhythmia &Amp; Electrophysiology Review

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Hypertrophic cardiomyopathy (HCM), the most common genetic cardiomyopathy, is a disease characterised by substantial heterogeneity. Although the majority of patients with HCM remain asymptomatic with near-normal longevity, a small, but important, subset remain at risk for a wide range of clinical outcomes including sudden death. Cardiovascular magnetic resonance (CMR), with its high spatial resolution and tomographic imaging capability, has emerged as an imaging modality particularly well suited to characterise the phenotypic expression of HCM. CMR helps in the diagnosis of HCM by identifying areas of hypertrophy not well visualised by echocardiography, providing more accurate wall thickness measurements and differentiating HCM from other causes of left ventricular (LV) hypertrophy. CMR has led to the identification of novel subgroups of patients with HCM, including those with LV apical aneurysms (a subgroup at increased risk for ventricular arrhythmias and thromboembolic stroke), as well as abnormalities that contribute to LV outflow obstruction. Additionally, contrast-enhanced CMR with late-gadolinium enhancement (LGE) has recognised patients with extensive LGE (≥15 % LV myocardium) as individuals who may be at increased risk of sudden death, independent of other high-risk features, with implications on management strategies including consideration for primary prevention implantable cardioverter defibrillator therapy. These observations justify an expanded role of CMR in the routine clinical assessment of patients with HCM.

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“…[1][2][3] Diagnostic tools such as ECG and echocardiography remain fundamental to diagnosis and treatment of HCM but cardiac MRI (CMR) improves diagnostic accuracy and provides additional phenotypic information in patients with established disease (Figure 2). [4][5][6][7] For example, in one study, CMR identified hypertrophy in about 10% of sarcomere mutation carriers thought to have normal wall thickness by echocardiography. 8 Novel CMR sequences, such as T1 mapping, provide quantitative estimates of the myocardial extracellular volume (ECV) (and therefore a surrogate measure of interstitial fibrosis) 5 and, in one study, an increase in ECV was reported in individuals with sarcomere mutations but without LV hypertrophy.…”

Section: Hypertrophic Cardiomyopathy Cardiac Imaging and Circulating mentioning

confidence: 99%

Almanac 2014: Cardiomyopathies.

Guttmann¹,

Mohiddin²,

Elliott³

2015

Cardiol Croat.

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SAŽETAK: Kardiomiopatije su bolesti miokarda koje se ne mogu objasniti abnormalnim uvjetima punjenja niti promjenama koronarnih arterija. One se klasifi ciraju u više morfoloških i funkcionalnih fenotipova čiji uzrok mogu biti genetički i negenetički mehanizmi. Dominantne teme u radovima objavljenima u razdoblju 2012.-2013. slične su onima navedenima u Almanahu 2011.: uporaba (i interpretacija) genetskog testiranja, razvoj i primjena novih neinvazivnih tehnika slikovne dijagnostike te uporaba serumskih biomarkera u procesu dijagnoze i za prognozu. Važna inovacija od posljednjeg Almanaha jest razvoj sofi sticiranijih modela za predviđanje neželjenih kliničkih događaja. SUMMARY:Cardiomyopathies are myocardial disorders that are not explained by abnormal loading conditions and coronary artery disease. They are classifi ed into a number of morphological and functional phenotypes that can be caused by genetic and non-genetic mechanisms. The dominant themes in papers published in 2012-2013 are similar to those reported in Almanac 2011, namely, the use (and interpretation) of genetic testing, development and application of novel non-invasive imaging techniques and use of serum biomarkers for diagnosis and prognosis. An important innovation since the last Almanac is the development of more sophisticated models for predicting adverse clinical events.CITATION: Cardiol Croat. 2014;9(11-12):543-557. | DOI: http://dx

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Cardiovascular magnetic resonance measurement of myocardial extracellular volume in health and disease

Abstract: Myocardial ECV, assessed non-invasively in the septum with equilibrium contrast cardiovascular magnetic resonance, shows gender differences in normal individuals and disease-specific variability. Therefore, ECV shows early potential to be a useful biomarker in health and disease.

Cited by 289 publications

References 38 publications

T1, T2 Mapping and Extracellular Volume Fraction (ECV): Application, Value and Further Perspectives in Myocardial Inflammation and Cardiomyopathies

T1, T2 Mapping and Extracellular Volume Fraction (ECV): Application, Value and Further Perspectives in Myocardial Inflammation and Cardiomyopathies

The Role of Cardiac MRI in the Diagnosis and Risk Stratification of Hypertrophic Cardiomyopathy

Almanac 2014: Cardiomyopathies.

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