Effect of cellular and extracellular pathology assessed by T1 mapping on regional contractile function in hypertrophic cardiomyopathy

Journal of Cardiovascular Magnetic Resonance

Research

Graham R. Law¹  Stephen P. Page²  David P. Ripley³  John P. Greenwood³  James R. Foley³  Graham J. Fent³  Adam K. McDiarmid³  Sven Plein³  Tarique A. Musa³  Bara Erhayiem³  Pankaj Garg³  Laura E. Dobson³  Peter P. Swoboda³  David A. Broadbent⁴ 

[1] Division of Epidemiology and Biostatistics, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK;Inherited Cardiovascular Conditions Service, Leeds General Infirmary, LS1 3EX, Leeds, UK;Multidisciplinary Cardiovascular Research Centre (MCRC) & Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, LS2 9JT, Leeds, UK;Multidisciplinary Cardiovascular Research Centre (MCRC) & Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, LS2 9JT, Leeds, UK;Department of Medical Physics and Engineering, Leeds Teaching Hospitals NHS Trust, Leeds, UK;

关键词: Hypertrophic cardiomyopathy;    T1 mapping;    Extracellular volume;    Strain;    Tissue tagging;    Feature tracking;   

DOI  :  10.1186/s12968-017-0334-x

 received in 2017-01-10, accepted in 2017-01-27,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundRegional contractile dysfunction is a frequent finding in hypertrophic cardiomyopathy (HCM). We aimed to investigate the contribution of different tissue characteristics in HCM to regional contractile dysfunction.MethodsWe prospectively recruited 50 patients with HCM who underwent cardiovascular magnetic resonance (CMR) studies at 3.0 T including cine imaging, T1 mapping and late gadolinium enhancement (LGE) imaging. For each segment of the American Heart Association model segment thickness, native T1, extracellular volume (ECV), presence of LGE and regional strain (by feature tracking and tissue tagging) were assessed. The relationship of segmental function, hypertrophy and tissue characteristics were determined using a mixed effects model, with random intercept for each patient.ResultsIndividually segment thickness, native T1, ECV and the presence of LGE all had significant associations with regional strain. The first multivariable model (segment thickness, LGE and ECV) demonstrated that all strain parameters were associated with segment thickness (P < 0.001 for all) but not ECV. LGE (Beta 2.603, P = 0.024) had a significant association with circumferential strain measured by tissue tagging.In a second multivariable model (segment thickness, LGE and native T1) all strain parameters were associated with both segment thickness (P < 0.001 for all) and native T1 (P < 0.001 for all) but not LGE.ConclusionImpairment of contractile function in HCM is predominantly associated with the degree of hypertrophy and native T1 but not markers of extracellular fibrosis (ECV or LGE). These findings suggest that impairment of contractility in HCM is mediated by mechanisms other than extracellular expansion that include cellular changes in structure and function. The cellular mechanisms leading to increased native T1 and its prognostic significance remain to be established.

【 授权许可】

CC BY   
© The Author(s). 2017