- Poster presentation
- Open Access
Pre-contrast T1 mapping for detection of myocardial fibrosis in asymptomatic and symptomatic aortic stenosis
© Bull et al; licensee BioMed Central Ltd. 2012
- Published: 1 February 2012
- Aortic Stenosis
- Late Gadolinium Enhancement
- Myocardial Fibrosis
- Shorten Modify
- Diffuse Fibrosis
Aortic stenosis (AS) leads to diffuse fibrosis in the myocardium which may impair cardiac function. Existing techniques (late gadolinium enhancement [LGE]) are not good at detecting diffuse, as opposed to focal, fibrosis. Pre-contrast T1-mapping may identify changes in the myocardium without the need for exogenous contrast, and our aim was to investigate its ability to detect diffuse fibrosis in patients with AS.
96 patients with moderate or severe AS were compared to 96 age-and gender-matched controls. Patients were categorized by severity of valve lesion (moderate: peak aortic velocity 3-4 m/s, severe: >4m/s) and symptoms. There were 80 asymptomatic patients under conservative management, and 16 patients with severe symptomatic AS awaiting valve replacement surgery (AVR). Biopsy samples for histological assessment of fibrosis were obtained in 11 of the latter group. All subjects underwent CMR at 1.5T which included pre-contrast T1-mapping using the Shortened Modified Look-Locker Inversion recovery (ShMOLLI) sequence. Average T1 values in the myocardium were analysed on a per-case basis.
Pre-contrast T1 values are increased in patients with AS compared to age- and gender-matched controls, particularly in the symptomatic patients, and these correlated with histological degrees of fibrosis. This suggests that pre-contrast T1 values may provide a useful assessment of diffuse myocardial fibrosis and may be a useful marker for monitoring AS progression.
British Heart Foundation, Heart Research UK, Oxford Biomedical Research Centre, National Institute for Health Research.
This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.