Native T1 Mapping and Extracellular Volume Mapping for the Assessment of Diffuse Myocardial Fibrosis in Dilated Cardiomyopathy

Nakamori, Shiro; Dohi, Kaoru; Ishida, Masaki; Goto, Yoshitaka; Imanaka‐Yoshida, Kyoko; Omori, Taku; Goto, Itaru; Kumagai, Naoto; Fujimoto, Naoki; Ichikawa, Yasutaka; Kitagawa, Kakuya; Yamada, Norikazu; Sakuma, Hajime; M, Ito

doi:10.1016/j.jcmg.2017.04.006

Cited by 188 publications

(132 citation statements)

References 32 publications

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“…Additionally, reproducibility of ECV was not appraised in this study due to the small study sample. Nevertheless, previous studies have observed an excellent inter-reader and inter-system reproducibility of ECV measurements (32).…”

Section: Discussionmentioning

confidence: 89%

Rare Disease: Cardiac Risk Assessment With MRI in Patients With Myotonic Dystrophy Type 1

et al. 2020

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Introduction: To evaluate myocardial strain and extracellular volume in myotonic dystrophy type 1 (DM1) patients as potential imaging biomarkers of subclinical cardiac pathology. Materials and methods:We retrospectively analyzed 9 DM1 patients without apparent cardiac disease who had undergone cardiac magnetic resonance at our center. Patients were age-and sex-matched with healthy controls. The Mann-Whitney U test was used to compare cardiac strain between the two groups. The t-test was used to compare the extracellular volume obtained in DM1 patients with that in healthy subject. Spearman's ρ was used for studying the associations among imaging parameters.Results: Global cardiac strain (median −19.1%; IQR −20.5%, −16.5%) in DM1 patients was lower (p = 0.011) than that in controls (median−21.7%; IQR−22.7%,-21.3%). Global extracellular volume in DM1 patients (median 32.3%; IQR 29.3%,36.8%) was significantly (p = 0.008) higher than that reported in literature in healthy subjects (median 25.6%; IQR 19.9%,31.9%). Global cardiac strain showed a strong, positive correlation with septal strain (ρ = 0.767, p = 0.016) and with both global (ρ = 0.733 p = 0.025) and septal extracellular volume (ρ = 0.767, p = 0.016). Discussion:The increase in cardiac extracellular volume and decrease in strain are signs of early cardiac pathology in DM1. Physicians dealing with DM1 may take into consideration cardiac magnetic resonance as a screening tool to identify early cardiac involvement in this condition.

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Section: Discussionmentioning

confidence: 89%

Rare Disease: Cardiac Risk Assessment With MRI in Patients With Myotonic Dystrophy Type 1

et al. 2020

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“…Recently, extracellular volume fraction (ECV) quantification by CMR T1 mapping technique has been introduced to evaluate DMF in vivo. Previous studies demonstrated that ECV reliably reflect the degree of DMF and, more importantly, is associated with prognosis in various cardiac diseases [12][13][14]. Thus, in this study, we hypothesized that myocardium in liver cirrhosis has structural alterations such as DMF, which could be effectively addressed by CMR.…”

Section: Introductionmentioning

confidence: 89%

“…CMR is best suited for this purpose with its unique ability to characterise myocardial tissues. LGE represents irreversible replacement fibrosis, while ECV represents reversible DMF [10,13]. As myocardial fibrosis is associated with cardiac hypertrophy and a stiff, noncompliant LV [38], application of these two novel CMR techniques is clinically relevant for the indirect assessment of LV compliance or diastolic property.…”

Section: Myocardial Structural Alterations In Cirrhosismentioning

confidence: 99%

Myocardial structural and functional changes in patients with liver cirrhosis awaiting liver transplantation: a comprehensive cardiovascular magnetic resonance and echocardiographic study

Kim

Lee

et al. 2020

Journal of Cardiovascular Magnetic Resonance

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Background: Cardiac dysfunction is increasingly recognized in patients with liver cirrhosis. Nevertheless, the presence or absence of structural alterations such as diffuse myocardial fibrosis remains unclear. We aimed to investigate myocardial structural changes in cirrhosis, and explore left ventricular (LV) structural and functional changes induced by liver transplantation. Methods: This study included 33 cirrhosis patients listed for transplantation and 20 healthy controls. Patients underwent speckle-tracking echocardiography and cardiovascular magnetic resonance (CMR) with extracellular volume fraction (ECV) quantification at baseline (n = 33) and 1 year after transplantation (n = 19).

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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%

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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Native T1 Mapping and Extracellular Volume Mapping for the Assessment of Diffuse Myocardial Fibrosis in Dilated Cardiomyopathy

Cited by 188 publications

References 32 publications

Rare Disease: Cardiac Risk Assessment With MRI in Patients With Myotonic Dystrophy Type 1

Rare Disease: Cardiac Risk Assessment With MRI in Patients With Myotonic Dystrophy Type 1

Myocardial structural and functional changes in patients with liver cirrhosis awaiting liver transplantation: a comprehensive cardiovascular magnetic resonance and echocardiographic study

Long term cardiovascular magnetic resonance phenotyping of anthracycline cardiomyopathy

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