Document Detail


Evaluation of diffuse myocardial fibrosis in heart failure with cardiac magnetic resonance contrast-enhanced T1 mapping.
MedLine Citation:
PMID:  19007595     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to investigate a noninvasive method for quantifying diffuse myocardial fibrosis with cardiac magnetic resonance imaging (CMRI). BACKGROUND: Diffuse myocardial fibrosis is a fundamental process in pathologic remodeling in cardiomyopathy and is postulated to cause increased cardiac stiffness and poor clinical outcomes. Although regional fibrosis is easily imaged with cardiac magnetic resonance, there is currently no noninvasive method for quantifying diffuse myocardial fibrosis. METHODS: We performed CMRI on 45 subjects (25 patients with heart failure, 20 control patients), on a clinical 1.5-T CMRI scanner. A prototype T(1) mapping sequence was used to calculate the post-contrast myocardial T(1) time as an index of diffuse fibrosis; regional fibrosis was identified by delayed contrast enhancement. Regional and global systolic function was assessed by cine CMRI in standard short- and long-axis planes, with echocardiography used to evaluate diastology. An additional 9 subjects underwent CMRI and endomyocardial biopsy for histologic correlation. RESULTS: Post-contrast myocardial T(1) times correlated histologically with fibrosis (R = -0.7, p = 0.03) and were shorter in heart failure subjects than controls (383 +/- 17 ms vs. 564 +/- 23 ms, p < 0.0001). The T(1) time of heart failure myocardium was shorter than that in controls even when excluding areas of regional fibrosis (429 +/- 22 ms vs. 564 +/- 23 ms, p < 0.0001). The post-contrast myocardial T(1) time shortened as diastolic function worsened (562 +/- 24 ms in normal diastolic function vs. 423 +/- 33 ms in impaired diastolic function vs. 368 +/- 20 ms in restrictive function, p < 0.001). CONCLUSIONS: Contrast-enhanced CMRI T(1) mapping identifies changes in myocardial T(1) times in heart failure, which appear to reflect diffuse fibrosis.
Authors:
Leah Iles; Heinz Pfluger; Arintaya Phrommintikul; Joshi Cherayath; Pelin Aksit; Sandeep N Gupta; David M Kaye; Andrew J Taylor
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  52     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-11-14     Completed Date:  2008-12-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1574-80     Citation Subset:  AIM; IM    
Affiliation:
Alfred Hospital and Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Analysis of Variance
Body Surface Potential Mapping
Case-Control Studies
Female
Fibrosis / diagnosis
Gadolinium DTPA / diagnostic use*
Heart Failure / diagnosis*
Heart Failure, Diastolic / diagnosis
Heart Failure, Systolic / diagnosis
Humans
Image Enhancement / methods*
Image Processing, Computer-Assisted
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Myocardium / pathology*
Probability
Prospective Studies
Reference Values
Severity of Illness Index
Chemical
Reg. No./Substance:
80529-93-7/Gadolinium DTPA
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2008 Nov 4;52(19):1581-3   [PMID:  19007596 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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