Histological validation of cardiac magnetic resonance <i>T</i><sub>1</sub> mapping for detecting diffuse myocardial fibrosis in diabetic rabbits

Zeng, Mu Sheng; Zhang, Nan; He, Yi; Wen, Zhaoying; Wang, Zhanhong; Zhao, Yishen; Greiser, Andreas; An, Jing; Jing, Bin; Zhang, Xin; Fan, Zhanming; Li, Debiao

doi:10.1002/jmri.25268

Cited by 29 publications

(17 citation statements)

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“…Our study showed that the ECV value was strongly correlated with CVF, and the postcontrast T1 value was moderately associated with the CVF value. The main reason is likely that the gadolinium agent (as an extracellular contrast agent) could not pass through the cell membrane and enter the cell; therefore, the postcontrast T1 value was mainly associated with the contrast agent concentration in the extracellular matrix, which is consistent with the ndings of our previous studies [23,29] and another study [28] . In addition, our study showed that the ECV value was higher than CVF, possibly because the CVF value re ects only the extracellular collagen ber content, whereas the ECV value can also indicate mucus matrix, lipid, and necrosis components outside cells.…”

Section: Discussionsupporting

confidence: 90%

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Quantification of Early Diffuse Myocardial Fibrosis Through 7.0 T Cardiovascular Magnetic Resonance T1 Mapping in a Type 1 Diabetic Mellitus Mouse Model

Zhang

Shi

Yang

et al. 2021

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Background Diffuse myocardial interstitial fibrosis (DMIF) is a key factor for heart failure (HF) in diabetic cardiomyopathy. This study examined the accuracy of the qualitative and quantitative evaluation of early DMIF in a type 1 diabetes mellitus (T1DM) mouse model through 7.0 T cardiac magnetic resonance imaging-based T1 mapping.Methods Eight-week-old C57Bl/6J male mice were randomly divided into control (n = 20) and T1DM (n = 30, induced by a low dose streptozotocin dose of 60 mg/kg) groups. The progression of DMIF was examined every 4 weeks until 24 weeks after successful establishment of the model. Cardiac functional and morphological parameters were evaluated through echocardiography by using a high-resolution ultrasound cardiovascular system. A 7.0 T CMR scan was performed using the pre- and post-contrast GRE Look–Locker inversion recovery T1 mapping sequence. The extracellular volume fraction (ECV) was calculated from CMR and hematocrit data. Sirius Red staining was simultaneously performed in each group to detect DMIF and calculate the collagen volume fraction (CVF). Differences in ECV and CVF values between two groups were analyzed using one-way analysis of variance. The correlation between ECV and CVF values was assessed using the Pearson test.Results Six mice were included every 4 weeks in the control and T1DM groups for statistical analysis. Compared with the control group, a progressive decrease in FS, EF, and E/A ratio was observed in the T1DM group. In the T1DM group, both ECV and CVF values were gradually increased during diabetes progression. A marked increase in ECV and CVF values was observed at 12 weeks in the T1DM group than in the control group (ECV: 32.5% ± 1.6% vs 28.1% ± 1.8%, P = 0.002; CVF: 6.9% ± 1.8% vs 3.3% ± 1.1%, P < 0.01). ECV values showed a strong correlation with CVF in the T1DM group (r = 0.856, P < 0.001).Conclusion ECV is a reliable and feasible imaging marker that can be used to quantitatively assess dynamic DMIF changes in T1DM mice. In addition, ECV could accurately detect DMIF in the early stage and thus can be used as an imaging tool for early intervention in T1DM mice in the future.

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Section: Discussionsupporting

confidence: 90%

“…In our experimental study, no LGE regions were observed in the myocardium in the T1DM group. Meanwhile, Zhang [28] and Zeng [29] have reported the same result. Some studies have indicated the presence of LGE regions in some patients with DM.…”

Section: Discussionmentioning

confidence: 60%

Quantification of Early Diffuse Myocardial Fibrosis Through 7.0 T Cardiovascular Magnetic Resonance T1 Mapping in a Type 1 Diabetic Mellitus Mouse Model

Zhang

Shi

Yang

et al. 2021

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“…The ECV measurements in this study had not previously been validated in a monkey model. Given the close agreement of ECV among various species [39, 40], it is reasonable to assume that the ECV measurement in a monkey is still valid, although direct rigorous validation remains to be performed by histopathology. While we did monitor blood pressures immediately before and after CMR study, we did not have pressure data during the CMR study to normalize CMR results.…”

Section: Discussionmentioning

confidence: 99%

MR extracellular volume mapping and non-contrast T1ρ mapping allow early detection of myocardial fibrosis in diabetic monkeys

Zhang

Zeng²,

Chen

et al. 2019

Eur Radiol

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Objective To detect diffuse myocardial fibrosis in different severity levels of left ventricular diastolic dysfunction (DD) in spontaneous type 2 diabetes mellitus (T2DM) rhesus monkeys. Methods Eighteen spontaneous T2DM and nine healthy monkeys were studied. Echocardiography was performed for diastolic function classification. Cardiac magnetic resonance (CMR) imaging was performed to obtain extracellular volume fraction (ECV) maps and T1ρ maps at two different spin-locking frequencies. ECV values, T1ρ values, and myocardial fibrosis index (mFI) values which are based on the dispersion of T1ρ, were calculated. Global peak diastolic longitudinal strain rates (GSrL) were also obtained. Results Echocardiography results showed mild DD in nine T2DM monkeys and moderate DD in the other nine. The global ECV values were significantly different among healthy animals as compared with animals with mild DD or moderate DD, and the ECV values of animals with moderate DD were significantly higher as compared with those of mild DD. The mFI values increased progressively from healthy animals to those with mild DD and then to those with moderate DD. Diastolic function indicators (e.g., early diastolic mitral annulus velocity, GSrL) correlated well with ECV and mFI. Conclusions Monkeys with T2DM exhibit increased ECV, T1ρ, and mFI values, which may be indicative of the expansion of extracellular volume and the deposition of excessive collagen. T1ρ mapping may have the potential to be used for diffuse myocardial fibrosis assessment. Key Points • Monkeys with T2DM exhibit increased ECV, T1ρ, and mFI values, which may be indicative of the expansion of extracellular volume and the deposition of excessive collagen . • The relationship between diastolic dysfunction and diffuse myocardial fibrosis may be demonstrated by imaging markers . • Non-contrast T1ρ mapping may have the potential to be used for diffuse myocardial assessment . Electronic supplementary material The online version of this article (10.1007/s00330-018-5950-9) contains supplementary material, which is available to authorized users.

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“…CMR T1 mapping was recently shown to possibly be capable of overcoming this weakness through quantification of the T1 value and extracellular volume (ECV) within the myocardium as an imaging marker to assess the myocardial interstitial matrix [ 9 ]. Previous studies in diabetic patients and animals have indicated the presence of diffuse myocardial fibrosis based on histological evidence [ 10 , 11 ]. Some studies also revealed that diabetic patients had lower post-contrast myocardial T1 values and greater ECVs, suggestive of extracellular interstitial expansion compared with healthy subjects, although the left ventricular volumes and ejection fractions were normal [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Increased myocardial extracellular volume assessed by cardiovascular magnetic resonance T1 mapping and its determinants in type 2 diabetes mellitus patients with normal myocardial systolic strain

Cao

Zeng

Cui

et al. 2018

Cardiovasc Diabetol

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BackgroundCardiac magnetic resonance (CMR) T1 mapping and tissue-tracking strain analysis are useful quantitative techniques that can characterize myocardial tissue and mechanical alterations, respectively, in patients with early diabetic cardiomyopathy. The purpose of this study was to assess the left ventricular myocardial T1 value, extracellular volume fraction (ECV), and systolic strain in asymptomatic patients with type 2 diabetes mellitus (T2DM) and their underlying relationships with clinical parameters.MethodsWe recruited 50 T2DM patients (mean age: 55 ± 7 years; 28 males) and 32 sex-, age-and BMI-matched healthy volunteers to undergo contrast-enhanced CMR examinations. The myocardial native T1, post-contrast T1 and ECV values of the left ventricle were measured from T1 and ECV maps acquired using the modified Look-Locker inversion recovery technique. The left ventricular global systolic strain and the strain rates were evaluated using routine cine images and tissue-tracking analysis software. The baseline clinical and biochemical indices were collected before the CMR examination.ResultsThe myocardial ECV and native T1 values were significantly higher in the diabetic patients than in the controls. (ECV: 27.4 ± 2.5% vs. 24.6 ± 2.2%, p < 0.001; native T1: 1026.9 ± 30.0 ms vs. 1011.8 ± 26.0 ms, p = 0.022). However, the left ventricular global systolic strain, strain rate, volume, myocardial mass, ejection fraction, and left atrial volume were similar between the diabetic patients and the healthy controls. In the diabetic patients, the native T1 values were independently correlated with the hemoglobin A1c levels (standardized β = 0.368, p = 0.008). The ECVs were independently associated with the hemoglobin A1c levels (standardized β = 0.389, p = 0.002), angiotensin-converting enzyme inhibitor (ACEI) treatment (standardized β = − 0.271, p = 0.025) and HCT values (standardized β = − 0.397, p = 0.001).ConclusionsType 2 diabetes mellitus patients with normal myocardial systolic strain exhibit increased native T1 values and ECVs indicative of myocardial extracellular interstitial expansion, which might be related to poor glycemic control. The amelioration of myocardial interstitial matrix expansion might be associated with ACEI treatment. A valid assessment of the association of glucose control and ACEI treatment with myocardial fibrosis requires notably larger trials.

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Histological validation of cardiac magnetic resonance T₁ mapping for detecting diffuse myocardial fibrosis in diabetic rabbits

Abstract: ECV has a very strong correlation with pathological CVF, and can be used to assess the degree of diffuse myocardial fibrosis better than the postcontrast T value. Precontrast T value has no significant correlation with diffuse myocardial fibrosis. J. Magn. Reson. Imaging 2016;44:1179-1185.

Cited by 29 publications

References 31 publications

Quantification of Early Diffuse Myocardial Fibrosis Through 7.0 T Cardiovascular Magnetic Resonance T1 Mapping in a Type 1 Diabetic Mellitus Mouse Model

Quantification of Early Diffuse Myocardial Fibrosis Through 7.0 T Cardiovascular Magnetic Resonance T1 Mapping in a Type 1 Diabetic Mellitus Mouse Model

MR extracellular volume mapping and non-contrast T1ρ mapping allow early detection of myocardial fibrosis in diabetic monkeys

Increased myocardial extracellular volume assessed by cardiovascular magnetic resonance T1 mapping and its determinants in type 2 diabetes mellitus patients with normal myocardial systolic strain

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Histological validation of cardiac magnetic resonance T1 mapping for detecting diffuse myocardial fibrosis in diabetic rabbits

Cited by 29 publications

References 31 publications

Quantification of Early Diffuse Myocardial Fibrosis Through 7.0 T Cardiovascular Magnetic Resonance T1 Mapping in a Type 1 Diabetic Mellitus Mouse Model

Quantification of Early Diffuse Myocardial Fibrosis Through 7.0 T Cardiovascular Magnetic Resonance T1 Mapping in a Type 1 Diabetic Mellitus Mouse Model

MR extracellular volume mapping and non-contrast T1ρ mapping allow early detection of myocardial fibrosis in diabetic monkeys

Increased myocardial extracellular volume assessed by cardiovascular magnetic resonance T1 mapping and its determinants in type 2 diabetes mellitus patients with normal myocardial systolic strain

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Histological validation of cardiac magnetic resonance T₁ mapping for detecting diffuse myocardial fibrosis in diabetic rabbits