Document Detail


Extracellular volume imaging by magnetic resonance imaging provides insights into overt and sub-clinical myocardial pathology.
MedLine Citation:
PMID:  22279111     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Conventional late gadolinium enhancement (LGE) cardiac magnetic resonance can detect myocardial infarction and some forms of non-ischaemic myocardial fibrosis. However, quantitative imaging of extracellular volume fraction (ECV) may be able to detect subtle abnormalities such as diffuse fibrosis or post-infarct remodelling of remote myocardium. The aims were (1) to measure ECV in myocardial infarction and non-ischaemic myocardial fibrosis, (2) to determine whether ECV varies with age, and (3) to detect sub-clinical abnormalities in 'normal appearing' myocardium remote from regions of infarction.
METHODS AND RESULTS: Cardiac magnetic resonance ECV imaging was performed in 126 patients with T1 mapping before and after injection of gadolinium contrast. Conventional LGE images were acquired for the left ventricle. In patients with a prior myocardial infarction, the infarct region had an ECV of 51 ± 8% which did not overlap with the remote 'normal appearing' myocardium that had an ECV of 27 ± 3% (P < 0.001, n = 36). In patients with non-ischaemic cardiomyopathy, the ECV of atypical LGE was 37 ± 6%, whereas the 'normal appearing' myocardium had an ECV of 26 ± 3% (P < 0.001, n = 30). The ECV of 'normal appearing' myocardium increased with age (r = 0.28, P = 0.01, n = 60). The ECV of 'normal appearing' myocardium remote from myocardial infarctions increased as left ventricular ejection fraction decreased (r = -0.50, P = 0.02).
CONCLUSION: Extracellular volume fraction imaging can quantitatively characterize myocardial infarction, atypical diffuse fibrosis, and subtle myocardial abnormalities not clinically apparent on LGE images. Taken within the context of prior literature, these subtle ECV abnormalities are consistent with diffuse fibrosis related to age and changes remote from infarction.
Authors:
Martin Ugander; Abiola J Oki; Li-Yueh Hsu; Peter Kellman; Andreas Greiser; Anthony H Aletras; Christopher T Sibley; Marcus Y Chen; W Patricia Bandettini; Andrew E Arai
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Intramural     Date:  2012-01-24
Journal Detail:
Title:  European heart journal     Volume:  33     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-15     Completed Date:  2012-07-30     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  1268-78     Citation Subset:  IM    
Affiliation:
Cardiovascular and Pulmonary Branch, National Heart, Lung and Blood Institute, National Institutes of Health, US Department of Health and Human Services, 10 Center Drive, Bethesda, MD 20892-1061, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Cardiac Volume
Cardiomyopathies / pathology*,  physiopathology
Contrast Media / diagnostic use
Fibrosis / pathology
Gadolinium DTPA / diagnostic use
Humans
Magnetic Resonance Angiography / methods*
Male
Middle Aged
Myocardial Infarction / pathology*,  physiopathology
Myocardium / pathology*
Observer Variation
Prospective Studies
Ventricular Dysfunction, Left / pathology
Ventricular Remodeling
Grant Support
ID/Acronym/Agency:
ZIA HL004607-11/HL/NHLBI NIH HHS; ZIA HL004607-12/HL/NHLBI NIH HHS; ZIA HL004607-14/HL/NHLBI NIH HHS; ZID HL006140-01/HL/NHLBI NIH HHS; ZID HL006140-02/HL/NHLBI NIH HHS; [1 Z01 HL004607-08/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Contrast Media; 80529-93-7/Gadolinium DTPA
Comments/Corrections

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