Purpose
The purpose of our study is to optimize diagnosis algorithm in hypertrophic cardiomyopathy (HCM) using T1 mapping of myocardium.
To estimate native T1,
ECV and LGE segmentally and quantify their association with contractile dysfunction in the same segment in patients with HCM.
Methods and Materials
We performed 40 cardiac magnetic resonance studies on AchievaTX 3T scanner in the age of HCM patients (n=30) from 17 to 71 and n=10 -control group.
Modified Look-Locker Inversion Recovery (MOLLI) T1 maps and LGE images were obtained for three slices (apical,
medial and basal) in ventricular short axis plane before,
3 min and 20 min after the contrast agent injection.
Assessment of T1 values and ECV values was based on 3 short axis slices,
in areas where focal fibrosis was excluded.
Analysis was carried...
Results
For all patients,
significant or even maximum degree of hypertrophic changes have been found at the anterior- and posterior-septal segments of the basal myocardium.
At the same time,
myocardium hypertrophy was minimal at the apical segments.
The native T1 value was around 1300±44ms (p<0.01),
that is significantly higher than the control group(1093±23,7ms).
Mean post- contrast myocardium T1 were (497±62ms p>0,05).
Mean of ECV was 28±4,5%,
which was higher then the group(25,8±1,9%).
We obtained individually association of every value (EDWT,
native T1,
LGE) with the strain...
Conclusion
The advent of absolute T1 measurement techniques allows by definition of the ECV to quantify the entire range of fibrosis either diffuse nor focal.
We’ve found influence of contractile dysfunction of LV myocardium as with the degree of myocardial hypertrophy,
and with the native T1.
We can sum up presence of the effect of changes in LV myocardial structure and function at the cellular and extracellular level directly on the process of myocardial contractility disturbance.
References
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Baars E.N.,
Germans T.,
et al.: In-vivoT1 cardiovascular magnetic resonance study of diffuse myocardial fibrosis in hypertrophic cardiomyopathy Journal of Cardiovascular Magnetic Resonance 2014,
16:28
2. Swoboda P.P.,
Larghat A.,
Zaman A.,
et al.: Comparison of magnetic resonance feature tracking for systolic and diastolic strain rate calculation with spatial modulation of magnetixation imaging analysis.
J MagnReson Imaging 2015;41:1000-12.
3.
Miller C.A.,
Naish J.H.,
Bishop P.,
etal.:Comprehensive validation of cardiovascular magneticresonance techniques for the assessment of myocardial extracellular volume.
CircCardiovascImaging.
2013;6:373–83