Association between myocardial fibrosis, as assessed with cardiac magnetic resonance T1 mapping, and persistent dyspnea after pulmonary embolism

International Journal of Cardiology: Heart & Vasculature

Mazdak Tavoly¹  René Holst²  Øyvind Jervan²  Oliver Geier³  Frederikus A. Klok⁴  Jostein Gleditsch⁵  Einar Hopp⁶  Waleed Ghanima⁷ 

[1] Corresponding author at: Department of radiology, Østfold Hospital Trust, Kalnesveien 300, 1714 Grålum, Norway.;Institute of Clinical Medicine, University of Oslo, Oslo, Norway;Department of Cardiology, Østfold Hospital, Kalnes, Norway;Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden;Department of Radiology, Østfold Hospital, Kalnes, Norway;Department of Research, Østfold Hospital, Kalnes, Norway;Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway;

关键词: Cardiac Magnetic Resonance;    Pulmonary Embolism;    T1-mapping;    Dyspnea;    Myocardial fibrosis;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Persistent dyspnea is a common symptom after pulmonary embolism (PE). However, the pathophysiology of persistent dyspnea is not fully clarified. This study aimed to explore possible associations between diffuse myocardial fibrosis, as assessed by cardiac magnetic resonance (CMR) T1 mapping, and persistent dyspnea in patients with a history of PE. Methods: CMR with T1 mapping and extracellular volume fraction (ECV) calculations were performed after PE in 51 patients with persistent dyspnea and in 50 non-dyspneic patients. Patients with known pulmonary disease, heart disease and CTEPH were excluded. Results: Native T1 was higher in the interventricular septum in dyspneic patients compared to non-dyspneic patients; difference 13 ms (95% CI: 2–23 ms). ECV was also significantly higher in patients with dyspnea; difference 0.9 percent points (95% CI: 0.04–1.8 pp). There was no difference in native T1 or ECV in the left ventricular lateral wall. Native T1 in the interventricular septum had an adjusted Odds Ratio of 1.18 per 10 ms increase (95% CI: 0.99–1.42) in predicting dyspnea, and an adjusted Odds Ratio of 1.47 per 10 ms increase (95% CI: 1.10–1.96) in predicting Incremental Shuttle Walk Test (ISWT) score < 1020 m. Conclusion: Septal native T1 and ECV values were higher in patients with dyspnea after PE compared with those who were fully recovered suggesting a possible pathological role of myocardial fibrosis in the development of dyspnea after PE. Further studies are needed to validate our findings and to explore their pathophysiological role and clinical significance.

【 授权许可】

Unknown