Native left ventricular myocardial T1 spatial heterogeneity in non-ischemic dilated cardiomyopathy
© Kashem et al. 2016
Published: 27 January 2016
Myocardial fibrosis is involved in the pathology of non-ischemic dilated cardiomyopathy (NICM). Recently, the application of native (non-contrast) myocardial T1 measurement has been proposed as an imaging biomarker of cardiac remodeling. However, spatial heterogeneity in T1 measurements has been observed across different segments and slices. Furthermore, T1 values measured with current T1 mapping sequences are influenced by myocardial T2 values. The objective of this study was to 1) assess the spatial heterogeneity of T1 measurements across different segments and slices in healthy subjects and patients, and 2) determine the association of native T1 with myocardial structure and function.
We prospectively studied 39 NICM patients (LVEF≤50% without evidence of prior infarction by CMR) and 30 subjects with normal LV systolic function without known cardiovascular disease. CMR was performed using a 1.5-T MRI scanner (Philips Achieva). Native T1 mapping was performed using slice-interleaved T1 mapping sequence (STONE) . T2 mapping was performed using slice-interleaved T2 mapping . Voxel-wise T1 and T2 were estimated using a 2-parameter and 3-parameter model . All images were corrected for motion . T1, T2, and extra-cellular volume (ECV) measurements were measured using a 16 segments AHA model across the base, mid, and apical LV.
In NICM, native myocardial T1 is elevated in a homogeneous manner, suggesting a global (not regional) abnormality in myocardial tissue composition. This low variability is similar between healthy and NICM patients across different segments. For subjects with NICM, native T1 is associated with biventricular systolic function and left atrial volume, and may represent a non-contrast marker of tissue remodeling in this cohort.
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