Document Detail

Interstitial Fibrosis, Left Ventricular Remodeling and Myocardial Mechanical Behavior in a Population-Based Multi-ethnic Cohort: MESA Study.
MedLine Citation:
PMID:  24550436     Owner:  NLM     Status:  Publisher    
BACKGROUND: -Tagged cardiac magnetic resonance (CMR) provides detailed information on regional myocardial function and mechanical behavior. T1 mapping by CMR allows non-invasive quantification of myocardial extracellular expansion (ECE) which has been related to interstitial fibrosis in previous clinical and sub-clinical studies. We assessed gender associated differences in the relation of ECE to LV remodeling and myocardial systolic and diastolic deformation in a large community based multi-ethnic population.
METHODS AND RESULTS: -Mid-ventricular mid-wall peak circumferential shortening and early diastolic strain rate (EDSR); LV torsion and torsional recoil rate were determined using CMR tagging. Mid ventricular short axis T1 maps were acquired in the same examination pre and post-contrast injection using Modified Look-Locker Inversion Recovery sequence (MOLLI). Multivariable linear regression (B= estimated regression coefficient) was used to adjust for risk factors and sub-clinical disease measures. Of 1230 participants, 114 participants had visible myocardial scar by late gadolinium enhancement. Participants without visible myocardial scar (n=1116) had no previous history of clinical events. In the latter group, multivariable linear regression demonstrated that lower post-contrast T1 times, reflecting greater ECE were associated with lower circumferential shortening (B=-0.1, p=0.0001), lower end diastolic volume index (LVEDVi) (B=0.6, p=0.0001) and lower LV end diastolic mass index (LVMi) (B=0.4, p=0.0001). In addition, lower post-contrast T1 times were associated with lower EDSR (B=0.01, p=0.03) in women only; and lower LV torsion (B=0.005, p=0.03) a lower LV ejection fraction (B=0.2, p=0.01) in men only.
CONCLUSIONS: -Greater ECE is associated with reduced LVEDVi and LVMi in a large multi-ethnic population without history of previous cardiovascular events. In addition, greater ECE is associated with reduced circumferential shortening, lower EDSR, and a preserved ejection fraction in women; while in men, greater ECE is associated with greater LV dysfunction manifested as reduced circumferential shortening, reduced LV Torsion and reduced ejection fraction.
Sirisha Donekal; Bharath A Venkatesh; Yuan Chang Liu; Chia-Ying Liu; Kihei Yoneyama; Colin O Wu; Marcelo Nacif; Antoinette S Gomes; W Gregory Hundley; David A Bluemke; Joao A C Lima
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-2-18
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  -     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2014 Feb 
Date Detail:
Created Date:  2014-2-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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