Myocardial tissue characterization using magnetic resonance noncontrast T1 mapping in hypertrophic and dilated cardiomyopathy

Sairia Dass, Joseph J. Suttie, Stefan K. Piechnik, Vanessa M. Ferreira, Cameron J. Holloway, Rajarshi Banerjee, Masliza Mahmod, Lowri Cochlin, Theodoros D. Karamitsos, Matthew D. Robson, Hugh Watkins, Stefan Neubauer

Research output: Contribution to journalArticle

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Abstract

Background - Noncontrast magnetic resonance T1 mapping reflects a composite of both intra- and extracellular signal. We hypothesized that noncontrast T1 mapping can characterize the myocardium beyond that achieved by the well-established late gadolinium enhancement (LGE) technique (which detects focal fibrosis) in both hypertrophic (HCM) and dilated (DCM) cardiomyopathy, by detecting both diffuse and focal fibrosis. Methods and Results - Subjects underwent Cardiovascular Magnetic Resonance imaging at 3T (28 HCM, 18 DCM, and 12 normals). Matching short-axis slices were acquired for cine, T1 mapping, and LGE imaging (0.1 mmol/kg). Circumferential strain was measured in the midventricular slice, and 31P magnetic resonance spectroscopy was acquired for the septum of the midventricular slice. Mean T1 relaxation time was increased in HCM and DCM (HCM 1209±28 ms, DCM 1225±42 ms, normal 1178±13 ms, P<0.05). There was a weak correlation between mean T1 and LGE (r=0.32, P<0.001). T1 values were higher in segments with LGE than in those without (HCM with LGE 1228±41 ms versus no LGE 1192±79 ms, P<0.01; DCM with LGE 1254±73 ms versus no LGE 1217±52 ms, P<0.01). However, in both HCM and DCM, even in segments unaffected by LGE, T1 values were significantly higher than normal (P<0.01). T1 values correlated with disease severity, being increased as wall thickness increased in HCM; conversely, in DCM, T1 values were highest in the thinnest myocardial segments. T1 values also correlated significantly with circumferential strain (r=0.42, P<0.01). Interestingly, this correlation remained statistically significant even for the slices without LGE (r=0.56, P=0.04). Finally, there was also a statistically significant negative correlation between T1 values and phosphocreatine/adenosine triphosphate ratios (r=-0.59, P<0.0001). Conclusions - In HCM and DCM, noncontrast T1 mapping detects underlying disease processes beyond those assessed by LGE in relatively low-risk individuals.

Original languageEnglish
Pages (from-to)726-733
Number of pages8
JournalCirculation: Cardiovascular Imaging
Volume5
Issue number6
DOIs
Publication statusPublished - Nov 2012
Externally publishedYes

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Hypertrophic Cardiomyopathy
Gadolinium
Dilated Cardiomyopathy
Magnetic Resonance Spectroscopy
Fibrosis
Phosphocreatine
Myocardium
Adenosine Triphosphate
Magnetic Resonance Imaging

Keywords

  • Dilated cardiomyopathy
  • Hypertrophic cardiomyopathy
  • Magnetic resonance imaging
  • T1 mapping
  • Tissue characterization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Myocardial tissue characterization using magnetic resonance noncontrast T1 mapping in hypertrophic and dilated cardiomyopathy. / Dass, Sairia; Suttie, Joseph J.; Piechnik, Stefan K.; Ferreira, Vanessa M.; Holloway, Cameron J.; Banerjee, Rajarshi; Mahmod, Masliza; Cochlin, Lowri; Karamitsos, Theodoros D.; Robson, Matthew D.; Watkins, Hugh; Neubauer, Stefan.

In: Circulation: Cardiovascular Imaging, Vol. 5, No. 6, 11.2012, p. 726-733.

Research output: Contribution to journalArticle

Dass, S, Suttie, JJ, Piechnik, SK, Ferreira, VM, Holloway, CJ, Banerjee, R, Mahmod, M, Cochlin, L, Karamitsos, TD, Robson, MD, Watkins, H & Neubauer, S 2012, 'Myocardial tissue characterization using magnetic resonance noncontrast T1 mapping in hypertrophic and dilated cardiomyopathy', Circulation: Cardiovascular Imaging, vol. 5, no. 6, pp. 726-733. https://doi.org/10.1161/CIRCIMAGING.112.976738
Dass, Sairia ; Suttie, Joseph J. ; Piechnik, Stefan K. ; Ferreira, Vanessa M. ; Holloway, Cameron J. ; Banerjee, Rajarshi ; Mahmod, Masliza ; Cochlin, Lowri ; Karamitsos, Theodoros D. ; Robson, Matthew D. ; Watkins, Hugh ; Neubauer, Stefan. / Myocardial tissue characterization using magnetic resonance noncontrast T1 mapping in hypertrophic and dilated cardiomyopathy. In: Circulation: Cardiovascular Imaging. 2012 ; Vol. 5, No. 6. pp. 726-733.
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T1 - Myocardial tissue characterization using magnetic resonance noncontrast T1 mapping in hypertrophic and dilated cardiomyopathy

AU - Dass, Sairia

AU - Suttie, Joseph J.

AU - Piechnik, Stefan K.

AU - Ferreira, Vanessa M.

AU - Holloway, Cameron J.

AU - Banerjee, Rajarshi

AU - Mahmod, Masliza

AU - Cochlin, Lowri

AU - Karamitsos, Theodoros D.

AU - Robson, Matthew D.

AU - Watkins, Hugh

AU - Neubauer, Stefan

PY - 2012/11

Y1 - 2012/11

N2 - Background - Noncontrast magnetic resonance T1 mapping reflects a composite of both intra- and extracellular signal. We hypothesized that noncontrast T1 mapping can characterize the myocardium beyond that achieved by the well-established late gadolinium enhancement (LGE) technique (which detects focal fibrosis) in both hypertrophic (HCM) and dilated (DCM) cardiomyopathy, by detecting both diffuse and focal fibrosis. Methods and Results - Subjects underwent Cardiovascular Magnetic Resonance imaging at 3T (28 HCM, 18 DCM, and 12 normals). Matching short-axis slices were acquired for cine, T1 mapping, and LGE imaging (0.1 mmol/kg). Circumferential strain was measured in the midventricular slice, and 31P magnetic resonance spectroscopy was acquired for the septum of the midventricular slice. Mean T1 relaxation time was increased in HCM and DCM (HCM 1209±28 ms, DCM 1225±42 ms, normal 1178±13 ms, P<0.05). There was a weak correlation between mean T1 and LGE (r=0.32, P<0.001). T1 values were higher in segments with LGE than in those without (HCM with LGE 1228±41 ms versus no LGE 1192±79 ms, P<0.01; DCM with LGE 1254±73 ms versus no LGE 1217±52 ms, P<0.01). However, in both HCM and DCM, even in segments unaffected by LGE, T1 values were significantly higher than normal (P<0.01). T1 values correlated with disease severity, being increased as wall thickness increased in HCM; conversely, in DCM, T1 values were highest in the thinnest myocardial segments. T1 values also correlated significantly with circumferential strain (r=0.42, P<0.01). Interestingly, this correlation remained statistically significant even for the slices without LGE (r=0.56, P=0.04). Finally, there was also a statistically significant negative correlation between T1 values and phosphocreatine/adenosine triphosphate ratios (r=-0.59, P<0.0001). Conclusions - In HCM and DCM, noncontrast T1 mapping detects underlying disease processes beyond those assessed by LGE in relatively low-risk individuals.

AB - Background - Noncontrast magnetic resonance T1 mapping reflects a composite of both intra- and extracellular signal. We hypothesized that noncontrast T1 mapping can characterize the myocardium beyond that achieved by the well-established late gadolinium enhancement (LGE) technique (which detects focal fibrosis) in both hypertrophic (HCM) and dilated (DCM) cardiomyopathy, by detecting both diffuse and focal fibrosis. Methods and Results - Subjects underwent Cardiovascular Magnetic Resonance imaging at 3T (28 HCM, 18 DCM, and 12 normals). Matching short-axis slices were acquired for cine, T1 mapping, and LGE imaging (0.1 mmol/kg). Circumferential strain was measured in the midventricular slice, and 31P magnetic resonance spectroscopy was acquired for the septum of the midventricular slice. Mean T1 relaxation time was increased in HCM and DCM (HCM 1209±28 ms, DCM 1225±42 ms, normal 1178±13 ms, P<0.05). There was a weak correlation between mean T1 and LGE (r=0.32, P<0.001). T1 values were higher in segments with LGE than in those without (HCM with LGE 1228±41 ms versus no LGE 1192±79 ms, P<0.01; DCM with LGE 1254±73 ms versus no LGE 1217±52 ms, P<0.01). However, in both HCM and DCM, even in segments unaffected by LGE, T1 values were significantly higher than normal (P<0.01). T1 values correlated with disease severity, being increased as wall thickness increased in HCM; conversely, in DCM, T1 values were highest in the thinnest myocardial segments. T1 values also correlated significantly with circumferential strain (r=0.42, P<0.01). Interestingly, this correlation remained statistically significant even for the slices without LGE (r=0.56, P=0.04). Finally, there was also a statistically significant negative correlation between T1 values and phosphocreatine/adenosine triphosphate ratios (r=-0.59, P<0.0001). Conclusions - In HCM and DCM, noncontrast T1 mapping detects underlying disease processes beyond those assessed by LGE in relatively low-risk individuals.

KW - Dilated cardiomyopathy

KW - Hypertrophic cardiomyopathy

KW - Magnetic resonance imaging

KW - T1 mapping

KW - Tissue characterization

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