In-vivo T1 cardiovascular magnetic resonance study of diffuse myocardial fibrosis in hypertrophic cardiomyopathy

Journal of Cardiovascular Magnetic Resonance

Mark BM Hofman¹  Albert C van Rossum³  Jolanda van der Velden²  Aernout M Beek⁴  Karin de Boer⁴  Tjeerd Germans⁴  Emma N Baars¹  Wessel P Brouwer³ 

[1] Department of Physics and Medical Technology, ICaR-VU, VU University Medical Center, Amsterdam, the Netherlands;Department of Physiology, ICaR-VU, VU University Medical Center, Amsterdam, the Netherlands;Interuniversity Cardiology Institute of the Netherlands, Utrecht, the Netherlands;Department of Cardiology, ICaR-VU, VU University Medical Center, De Boelelaan 1117, Amsterdam 1081 HV, the Netherlands

关键词: Extracellular volume fraction;    HCM;    Diffuse fibrosis;    CMR;    T1 mapping;   

Others  :  801378
DOI  :  10.1186/1532-429X-16-28

 received in 2012-01-31, accepted in 2014-03-17,  发布年份 2014

【 摘 要 】

Background

In hypertrophic cardiomyopathy (HCM), autopsy studies revealed both increased focal and diffuse deposition of collagen fibers. Late gadolinium enhancement imaging (LGE) detects focal fibrosis, but is unable to depict interstitial fibrosis. We hypothesized that with T1 mapping, which is employed to determine the myocardial extracellular volume fraction (ECV), can detect diffuse interstitial fibrosis in HCM patients.

Methods

T1 mapping with a modified Look-Locker Inversion Recovery (MOLLI) pulse sequence was used to calculate ECV in manifest HCM (n = 16) patients and in healthy controls (n = 14). ECV was determined in areas where focal fibrosis was excluded with LGE.

Results

The total group of HCM patients showed no significant changes in mean ECV values with respect to controls (0.26 ± 0.03 vs 0.26 ± 0.02, p = 0.83). Besides, ECV in LGE positive HCM patients was comparable with LGE negative HCM patients (0.27 ± 0.03 vs 0.25 ± 0.03, p = 0.12).

Conclusions

This study showed that HCM patients have a similar ECV (e.g. interstitial fibrosis) in myocardium without LGE as healthy controls. Therefore, the additional clinical value of T1 mapping in HCM seems limited, but future larger studies are needed to establish the clinical and prognostic potential of this new technique within HCM.

【 授权许可】

   
2014 Brouwer et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】

• [1]Maron BJ: Hypertrophic Cardiomyopathy: a Systematic Review. JAMA 2002, 287:1308-20.
• [2]St John Sutton MG, Lie JT, Anderson KR, O’Brien PC, Frye RL: Histopathological specificity of hypertrophic obstructive cardiomyopathy. Myocardial fibre disarray and myocardial fibrosis. Br Heart J 1980, 44:433-43.
• [3]Unverferth DV, Baker PB, Pearce LI, Lautman J, Roberts WC: Regional myocyte hypertrophy and increased interstitial myocardial fibrosis in hypertrophic cardiomyopathy. Am J Cardiol 1987, 59:932-6.
• [4]Factor SM, Butany J, Sole MJ, Wigle ED, Williams WC, Rojkind M: Pathologic fibrosis and matrix connective tissue in the subaortic myocardium of patients with hypertrophic cardiomyopathy. J Am Coll Cardiol 1991, 17:1343-51.
• [5]Shirani J, Pick R, Roberts WC, Maron BJ: Morphology and significance of the left ventricular collagen network in young patients with hypertrophic cardiomyopathy and sudden cardiac death. J Am Coll Cardiol 2000, 35:36-44.
• [6]Moon JCC, Reed E, Sheppard MN, Elkington AG, Ho S, Burke M, Petrou M, Pennell DJ: The histologic basis of late gadolinium enhancement cardiovascular magnetic resonance in hypertrophic cardiomyopathy. J Am Coll Cardiol 2004, 43:2260-4.
• [7]Flett AS, Hayward MP, Ashworth MT, Hansen MS, Taylor AM, Elliott PM, McGregor C, Moon JC: Equilibrium Contrast Cardiovascular Magnetic Resonance for the Measurement of Diffuse Myocardial Fibrosis: Preliminary Validation in Humans. Circulation 2010, 122:138-44.
• [8]Sibley CT, Noureldin RA, Gai N, Nacif MS, Liu S, Turkbey EB, Mudd JO, van der Geest RJ, Lima JA, Halushka MK, Bluemke DA: T1 Mapping in cardiomyopathy at cardiac MR: comparison with endomyocardial biopsy. Radiology 2012, 265:724-32.
• [9]Klues HG, Schiffers A, Maron BJ: Phenotypic spectrum and patterns of left ventricular hypertrophy in hypertrophic cardiomyopathy: morphologic observations and significance as assessed by two-dimensional echocardiography in 600 patients. J Am Coll Cardiol 1995, 26:1699-708.
• [10]Rohrer M, Bauer H, Mintorovitch J, Requardt M, Weinmann HJ: Comparison of magnetic properties of MRI contrast media solutions at different magnetic field strengths. Invest Radiol 2005, 40:715-24.
• [11]Messroghli DR, Greiser A, Fröhlich M, Dietz R, Schulz-Menger J: Optimization and validation of a fully-integrated pulse sequence for modified look-locker inversion-recovery (MOLLI) T1 mapping of the heart. J Magn Reson Imaging 2007, 26:1081-6.
• [12]Amado LC, Gerber BL, Gupta SN, Rettmann DW, Szarf G, Schock R, Nasir K, Kraitchman DL, Lima JA: Accurate and objective infarct sizing by contrast-enhanced magnetic resonance imaging in a canine myocardial infarction model. JACC 2004, 44:2383-9.
• [13]Messroghli DR, Rudolph A, Abdel-Aty H, Wassmuth R, Kuhne T, Dietz R, Schulz-Menger J: An open-source software tool for the generation of relaxation time maps in magnetic resonance imaging. BMC Med Imaging 2010, 10:16. BioMed Central Full Text
• [14]Messroghli DR: MRmap V1 2 Documentation. 2010. http://sourceforge.net/projects/mrmap/ webcite
• [15]Jerosch-Herold M, Sheridan DC, Kushner JD, Nauman D, Burgess D, Dutton D, Alharethi R, Li D, Hershberger RE: Cardiac magnetic resonance imaging of myocardial contrast uptake and blood flow in patients affected with idiopathic or familial dilated cardiomyopathy. Am J Physiol Heart Circ Physiol 2008, 295:1234-42.
• [16]Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK, Pennell DJ, Rumberger JA, Ryan T, Verani MS: American Heart Association Writing Group on Myocardial Segmentation and Registration for Cardiac Imaging. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation 2002, 105:539-42. Review
• [17]Ugander M, Oki AJ, Hsu LY, Kellman P, Greiser A, Aletras AH, Sibley CT, Chen MY, Bandettini WP, Arai AE: Extracellular volume imaging by magnetic resonance imaging provides insights into overt and sub-clinical myocardial pathology. Eur Heart J 2012, 33:1268-78.
• [18]Sado DM, Flett AS, Banypersad SM, White SK, Maestrini V, Quarta G, Lachmann RH, Murphy E, Mehta A, Hughes DA, McKenna WJ, Taylor AM, Hausenloy DJ, Hawkins PN, Elliott PM, Moon JC: Cardiovascular magnetic resonance measurement of myocardial extracellular volume in health and disease. Heart 2012, 98:1436-41.
• [19]Flett AS, Sado DM, Quarta G, Mirabel M, Pellerin D, Herrey AS, Hausenloy DJ, Ariti C, Yap J, Kolvekar S, Taylor AM, Moon JC: Diffuse myocardial fibrosis in severe aortic stenosis: an equilibrium contrast cardiovascular magnetic resonance study. Eur Heart J Cardiovasc Imaging 2012, 13:819-26.
• [20]Chow K, Flewitt J, Green J, Friedrich MG, Thompson R: Characterization of myocardial T1 and partition coefficient as a function of time after gadolinium delivery in healthy subjects. Proc Intl Soc Mag Reson Med 2011, 19:1373.
• [21]White SK, Sado DM, Fontana M, Banypersad SM, Maestrini V, Flett AS, Piechnik SK, Robson MD, Hausenloy DJ, Sheikh AM, Hawkins PN, Moon JC: T1 Mapping for Myocardial Extracellular Volume Measurement by CMR: Bolus Only Versus Primed Infusion Technique. JACC Cardiovasc Imaging 2013, 6:955-62.
• [22]Sipola P, Magga J, Husso M, Jääskeläinen P, Peuhkurinen K, Kuusisto J: Cardiac MRI assessed left ventricular hypertrophy in differentiating hypertensive heart disease from hypertrophic cardiomyopathy attributable to a sarcomeric gene mutation. Eur Radiol 2011, 21:1383-89.
• [23]Coelho-Filho OR, Mongeon FP, Mitchell R, Moreno H Jr, Nadruz W Jr, Kwong R, Jerosch-Herold M: The Role of Transcytolemmal Water Exchange in Magnetic Resonance Measurements of Diffuse Myocardial Fibrosis in Hypertensive Heart Disease. Circ Cardiovasc Imaging 2013, 1:134-141.
• [24]Lombardi R, Betocchi S, Losi MA, Tocchetti CG, Aversa M, Miranda M, D’Alessandro G, Cacace A, Ciampi Q, Chiariello M: Myocardial Collagen Turnover in Hypertrophic Cardiomyopathy. Circulation 2003, 108:1455-60.
• [25]Ho CY, López B, Coelho-Filho OR, Lakdawala NK, Cirino AL, Jarolim P, Kwong R, González A, Colan SD, Seidman JG, Díez J, Seidman CE: Myocardial Fibrosis as an Early Manifestation of Hypertrophic Cardiomyopathy. N Engl J Med 2010, 363:552-563.
• [26]Hsu LY, Ingkanisorn WP, Kellman P, Aletras AH, Arai AE: Quantitative myocardial infarction on delayed enhancement MRI. Part II: clinical application of an automated feature analysis and combined thresholding infarct sizing algorithm. J Magn Reson Imaging 2006, 23:309-14.