The native T1 in remote myocardium of patients with prior chronic infarction is not normal
Journal of Cardiovascular Magnetic Resonance volume 18, Article number: P102 (2016)
Global left ventricular (LV) remodeling after myocardial infarction frequently occurs. Late Gadolinium Enhancement (LGE) CMR allows imaging of focal myocardial scar with areas remote from scar having no hyperenhancement. Myocardial T1 mapping allows quantification of interstitial fibrosis and may be a surrogate for LV remodeling. We sought to determine if there were T1 abnormalities in remote regions (no LGE positive areas) in patients with prior myocardial infarction.
In a prospective IRB-approved study, 12 patients with a history of coronary artery disease (CAD) and chronic myocardial infarction (61 ± 9 years, 9 males) and 10 healthy subjects (52 ± 10 years, 8 males) were recruited to undergo CMR scans. All subjects were in sinus rhythm during CMR study. We assessed native T1 mapping using the slice interleaved T1 sequence in 5 short axis-slices (from apical to basal). The sequence was acquired in a free-breathing ECG-triggered slice-selective bSSFP. T1 mapping of each scan was estimated by voxel-wise curve fitting using a 2-paramter fit model. All images were corrected for in-plane motion between different T1 weighted scans. Native myocardial T1 in healthy subjects were measured over the three mid-ventricular slices by manually drawing epicardial and endocardial contours. The native T1 times of the remote myocardium of the CAD patients were measured by manually drawing a region of interest (ROI) on the three mid-ventricular slices and excluding the infarct area. An unpaired-samples T-test analysis was used to test for statistically significant differences between the two groups.
Patient characteristics are summarized in Table 1. LGE hyperenhancement was observed in all CAD patients. The mean native T1 time in the remote area myocardium of the CAD patients was significantly higher than the native T1 value of the myocardium in the healthy group (1107 ± 36 ms. vs. 1061 ± 32 ms.; p = 0.005) (Figure 1).
Our data suggest there are diffuse changes in remote/normal myocardium resulting in abnormal/higher native T1 times in CAD patients with prior myocardial infarction. Further studies are needed to assess the prognostic value of an abnormal native T1 in the remote region among CAD patients.
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Bellm, S., Kato, S., Shah, R.V. et al. The native T1 in remote myocardium of patients with prior chronic infarction is not normal. J Cardiovasc Magn Reson 18 (Suppl 1), P102 (2016). https://doi.org/10.1186/1532-429X-18-S1-P102