Histologic validation of myocardial fibrosis measured by T1 mapping: a systematic review and meta-analysis

Diao, Kai-yue; Yang, Zhi‐gang; Xu, Huayan; Xi, Liu; Zhang, Qin; Shi, Ke; Jiang, Li; Xie, Linjun; Wen, Lingyi; Guo, Ying

doi:10.1186/s12968-016-0313-7

Cited by 120 publications

(90 citation statements)

References 41 publications

(30 reference statements)

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“…By labeling the extracellular myocardial space with gadoliniumbased contrast agent, measurement of native and post-contrast myocardial and blood T1 values allows estimation of the extent of the interstitial myocardial space via the calculation of the percentage or fraction of the myocardial extracellular volume (ECV) [3][4][5][6]. Intended as CMR-derived metrics for myocardial fibrosis [2,[7][8][9][10], ECV supplements native T1 mapping's potential to detect myocardial alterations.…”

Section: Introductionmentioning

confidence: 99%

Cardiac magnetic resonance T1 mapping. Part 1: Aspects of acquisition and evaluation

Reiter

Kräuter

et al. 2018

European Journal of Radiology

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While an enormous number of studies have documented pathological alterations of the myocardial native longitudinal relaxation time (T1) and the fraction of the extracellular myocardial volume (ECV), it has also become clear that continuously evolving T1 mapping sequence, acquisition and evaluation techniques have a substantial impact on quantitative results, making the translation of reported findings into routine clinical use particularly challenging. To provide a basis for the discussion of pathological myocardial T1 and ECV alterations, the present review aims to summarize the methodological aspects of myocardial T1 mapping along with technical and physiological factors influencing results and normal ranges of myocardial native T1 and ECV reported across studies. 2. Sequences and protocols Numerous techniques have been introduced for the generation of cardiac T1 maps [11-22], each of which possesses specific advantages and disadvantages with respect to acquisition time, spatial resolution, accuracy (systematic bias of estimated T1 compared to true T1), and

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Section: Introductionmentioning

confidence: 99%

Cardiac magnetic resonance T1 mapping. Part 1: Aspects of acquisition and evaluation

Reiter

Kräuter

et al. 2018

European Journal of Radiology

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“…Historically, diffuse myocardial fibrosis has been difficult to detect without the inherent risks attached to invasive cardiac biopsy. However, the advent of native myocardial T1 mapping and ECV techniques by CMR now permit the quantification of diffuse fibrosis non-invasively (27) with excellent reproducibility and robust validation against biopsy-proven collagen volume fraction and extracellular space reported in explanted hearts (28) and biopsied patients with dilated cardiomyopathy (29). Two previous studies of anthracycline cardiomyopathy in adults have described abnormal elevation of ECV in cancer survivors 3 years 15 In addition, absolute values of native myocardial T1 and ECV correlated significantly with left ventricular volumes and native myocardial T1 also correlated with LVEF, MAPSE and LAVi.…”

Section: Native Myocardial T1 Mappingdiffuse Fibrosismentioning

confidence: 99%

“…Values are mean SD SD , n (%), or median (25 th to 75 th percentile). ACE = angiotensin converting enzyme; ARB = angiotensin II receptor blocker; CMR = Cardiovascular magnetic resonance; DOX = Equivalent doxorubicin dose; LGE = late gadolinium enhancement; (26) 38 4719 233 423 285 64 (27) 6 (40) 4 (27) 1 75 (27) 2 (13) 17 (26) 32 4815 232 318 283 (…”

Section: Study Limitationsmentioning

confidence: 99%

Long term cardiovascular magnetic resonance phenotyping of anthracycline cardiomyopathy

Harries

Biglino

Baritussio

et al. 2019

International Journal of Cardiology

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Background-Anthracycline cardiomyopathy contributes to the morbidity and mortality of cancer survivors, but long-term data are lacking. This study sought to describe the phenotype of anthracycline cardiomyopathy, the prevalence of myocardial fibrosis and its association with cardiac remodelling, systolic function and clinical outcomes in the long-term. Methods and Results We undertook contrast-enhanced CMR in 81 cancer survivors at median 5 years after anthracycline (mean dose 279 SD 89mg/m 2). Participants were aged 55 SD 14 years; 68% were female. Mean LVEF was impaired (49 SD 12%), driven by a pathological increase in iLVESV (47 SD 23ml/m 2). 19% of participants exhibited LGE, which was associated with significant adverse left ventricular remodelling and reduced systolic function (iLVEDV: 102 SD 34vs83 SD 21ml/m2, p=0.03; iLVESV 61 SD 32vs43 SD 20ml/m 2 , p=0.03; LVEF: 43 SD 11vs50 SD 12%, p=0.03). In subgroup analysis of 36 patients, 36% had elevated native T1 measurements, which was associated with significant adverse left ventricular remodelling (iLVEDV: 97 SD 22vs74 SD 19ml/m 2 , p=0.002; iLVESV: 56 SD 22vs35 SD15ml/m 2 , p=0.005), reduced systolic function (LVEF 44 SD 13 vs 55 SD 9%, p=0.01), and hospitalizations for heart failure (38%vs9%, p=0.03). Absolute native T1 measurements correlated significantly with iLVEDV (p =<0.001, R 2 0.33), iLVESV (p<0.001, R 2 0.36), LVEF (p<0.001, R 2 0.35), LAVi (p=0.04, R 2 0.12) and MAPSE (p =0.02, R 2 0.14). Conclusions-Long-term anthracycline cardiomyopathy is characterized by pathologically increased iLVESV. Both LGE and elevated native T1 measurements were associated with significant adverse cardiac remodelling and reduced systolic function, and the latter with heart failure hospitalizations.

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“…T1 maps acquired before and after Gd enable us to non-invasively derive the extracellular volume (ECV) in a highly reproducible manner that has been well validated against histological analysis. [69][70][71] Colour maps can be generated that display each pixel as the ECV expressed as a percentage (normal being approximately 20 %). In most diseases, elevations in ECV represent collagen/scar (and correspondingly DMF).…”

Section: T1 Mappingmentioning

confidence: 99%

The Prognostic Role of Tissue Characterisation using Cardiovascular Magnetic Resonance in Heart Failure

Adam¹,

Shambrook²,

Flett³

2017

Cardiac Failure Review

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Despite significant advances in heart failure diagnostics and therapy, the prognosis remains poor, with one in three dying within a year of hospital admission. This is at least in part due to the difficulties in risk stratification and personalisation of therapy. The use of left ventricular systolic function as the main arbiter for entrance into clinical trials for drugs and advanced therapy, such as implantable defibrillators, grossly simplifies the complex heterogeneous nature of the syndrome. Cardiovascular magnetic resonance offers a wealth of data to aid in diagnosis and prognostication. The advent of novel cardiovascular magnetic resonance mapping techniques allows us to glimpse some of the pathophysiological mechanisms underpinning heart failure. We review the growing prognostic evidence base using these techniques.

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Histologic validation of myocardial fibrosis measured by T1 mapping: a systematic review and meta-analysis

Cited by 120 publications

References 41 publications

Cardiac magnetic resonance T1 mapping. Part 1: Aspects of acquisition and evaluation

Cardiac magnetic resonance T1 mapping. Part 1: Aspects of acquisition and evaluation

Long term cardiovascular magnetic resonance phenotyping of anthracycline cardiomyopathy

The Prognostic Role of Tissue Characterisation using Cardiovascular Magnetic Resonance in Heart Failure

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