Stress CMR T1-mapping technique for assessment of coronary microvascular dysfunction in a rabbit model of type II diabetes mellitus: Validation against histopathologic changes

Abstract

BackgroundCoronary microvascular dysfunction (CMD) is an early character of type 2 diabetes mellitus (T2DM), and is indicative of adverse events. The present study aimed to validate the performance of the stress T1 mapping technique on cardiac magnetic resonance (CMR) for identifying CMD from a histopathologic perspective and to establish the time course of CMD-related parameters in a rabbit model of T2DM.MethodsNew Zealand white rabbits (n = 30) were randomly divided into a control (n = 8), T2DM 5-week (n = 6), T2DM 10-week (n = 9), and T2DM 15-week (n = 7) groups. The CMR protocol included rest and adenosine triphosphate (ATP) stress T1-mapping imaging using the 5b(20b)3b-modified look-locker inversion-recovery (MOLLI) schema to quantify stress T1 response (stress ΔT1), and first-pass perfusion CMR to quantify myocardial perfusion reserve index (MPRI). After the CMR imaging, myocardial tissue was subjected to hematoxylin-eosin staining to evaluate pathological changes, Masson trichrome staining to measure collagen volume fraction (CVF), and CD31 staining to measure microvascular density (MVD). The associations between CMR parameters and pathological findings were determined using Pearson correlation analysis.ResultsThe stress ΔT1 values were 6.21 ± 0.59%, 4.88 ± 0.49%, 3.80 ± 0.40%, and 3.06 ± 0.54% in the control, T2DM 5-week, 10-week, and 15-week groups, respectively (p < 0.001) and were progressively weakened with longer duration of T2DM. Furthermore, a significant correlation was demonstrated between the stress ΔT1 vs. CVF and MVD (r = −0.562 and 0.886, respectively; p < 0.001).ConclusionThe stress T1 response correlated well with the histopathologic measures in T2DM rabbits, indicating that it may serve as a sensitive CMD-related indicator in early T2DM.

Potential of non-contrast stress T1 mapping for the assessment of myocardial injury in hypertrophic cardiomyopathy

“…Autopsy in patients with heart failure with preserved ejection fraction revealed that microvascular density was correlated with the severity of myocardial fibrosis [ 36 ]. Ma et al reported that T1 reactivity showed positive high correlation with microvascular density and negative moderate correlation with collagen volume fraction measured by histology in a rabbit model of type 2 diabetes mellitus, indicating that impaired microvascular function is associated with myocardial injury [ 37 ]. Furthermore, T1 reactivity is useful to assess myocardial injury by differentiating myocardial tissue characteristics without a gadolinium contrast agent and can be also available for the patient with severe chronic kidney disease [ 12 , 13 ].…”