- Oral presentation
- Open Access
Quantitative assessment of myocardial extracellular volume fraction in non-ischemic dilated cardiomyopathy and its relation to systolic dysfunction
© Ali et al; licensee BioMed Central Ltd. 2013
- Published: 30 January 2013
- Late Gadolinium Enhancement
- Systolic Dysfunction
- Myocardial Fibrosis
- Inversion Recovery Sequence
- Univariate Linear Regression Analysis
Interstitial myocardial fibrosis is a histological hallmark of non-ischemic dilated cardiomyopathy (DCM), and may play an important role in adverse remodelling and progressive systolic dysfunction. T1-mapping enables non-invasive assessment of diffuse fibrosis by quantification of myocardial extracellular volume fraction (ECV). We hypothesized that CMR would identify a raised ECV in DCM which would correlate with the degree of systolic dysfunction.
Consecutive DCM patients referred for CMR and age/sex-matched healthy controls were prospectively enrolled. Exclusion criteria included a history of recent myocarditis, ischemic heart disease, diabetes, severe hypertension and primary valvular disease. All subjects underwent CMR (1.5T, Siemens Avanto) according to a standardized protocol which included T1-mapping and late gadolinium enhancement (LGE) imaging. Mid-ventricular short-axis T1-maps were acquired using a Modified Look-Locker Inversion recovery sequence prior to contrast and 20 minutes after gadolinium administration (Gadovist 0.1mmol/kg). The pre- and post-contrast T1-maps were co-registered and used with the patient's hematocrit to generate an ECV map.
Baseline clinical and CMR characteristics
Heart rate (bpm)
Systolic BP (mmHg)
Diastolic BP (mmHg)
LVMI (g/m 2 )
ECV is expanded in DCM in proportion to the degree of LV systolic dysfunction. An increased ECV in sections of the heart without clinically obvious LGE suggests the presence of low level myocardial fibrosis or possibly myocardial edema. This technique offers potential for the evaluation of interstitial fibrosis in DCM, although important challenges include the substantial overlap of ECV values between patients and normals. Further work should aim to corroborate these findings with histological validation.
This project was supported by the NIHR Cardiovascular Biomedical Research Unit of Royal Brompton and Harefield NHS Foundation Trust, the British Heart Foundation, and CORDA (research charity).
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.