Comprehensive validation of cardiovascular magnetic resonance techniques for the assessment of myocardial extracellular volume.
Christopher A. Miller,Josephine H. Naish,Paul N. Bishop,Glyn Coutts,David Clark,Sha Zhao,Simon Ray,Nizar Yonan,Simon G. Williams,Andrew S. Flett,James C. Moon,Andreas Greiser,Geoffrey J. M. Parker,Matthias Schmitt +13 more
Reads0
Chats0
TLDR
DynEq-CMR–derived ECV shows a good correlation with histological collagen volume fraction throughout the whole heart, and varied significantly according to contrast dose, myocardial region, and sex.Abstract:
Background— Extracellular matrix expansion is a key element of ventricular remodeling and a potential therapeutic target. Cardiovascular magnetic resonance (CMR) T1-mapping techniques are increasingly used to evaluate myocardial extracellular volume (ECV); however, the most widely applied methods are without histological validation. Our aim was to perform comprehensive validation of (1) dynamic-equilibrium CMR (DynEq-CMR), where ECV is quantified using hematocrit-adjusted myocardial and blood T1 values measured before and after gadolinium bolus; and (2) isolated measurement of myocardial T1, used as an ECV surrogate.
Methods and Results— Whole-heart histological validation was performed using 96 tissue samples, analyzed for picrosirius red collagen volume fraction, obtained from each of 16 segments of the explanted hearts of 6 patients undergoing heart transplantation who had prospectively undergone CMR before transplantation (median interval between CMR and transplantation, 29 days). DynEq-CMR–derived ECV was calculated from T1 measurements made using a modified Look-Locker inversion recovery sequence before and 10 and 15 minutes post contrast. In addition, ECV was measured 2 to 20 minutes post contrast in 30 healthy volunteers. There was a strong linear relationship between DynEq-CMR–derived ECV and histological collagen volume fraction ( P <0.001; within-subject: r =0.745; P <0.001; r 2=0.555 and between-subject: r =0.945; P <0.01; r 2=0.893; for ECV calculated using 15-minute postcontrast T1). Correlation was maintained throughout the entire heart. Isolated postcontrast T1 measurement showed significant within-subject correlation with histological collagen volume fraction ( r =−0.741; P <0.001; r 2=0.550 for 15-minute postcontrast T1), but between-subject correlations were not significant. DynEq-CMR–derived ECV varied significantly according to contrast dose, myocardial region, and sex.
Conclusions— DynEq-CMR–derived ECV shows a good correlation with histological collagen volume fraction throughout the whole heart. Isolated postcontrast T1 measurement is insufficient for ECV assessment.read more
Citations
More filters
Journal ArticleDOI
Increased myocardial extracellular volume assessed by cardiovascular magnetic resonance T1 mapping and its determinants in type 2 diabetes mellitus patients with normal myocardial systolic strain
Yukun Cao,Wenjuan Zeng,Yue Cui,Xiangchuang Kong,Miao Wang,Jie Yu,Shan Zhang,Jing Song,Xu Yan,Andreas Greiser,Heshui Shi +10 more
TL;DR: Type 2 diabetes mellitus patients with normalMyocardial systolic strain exhibit increased native T1 values and ECVs indicative of myocardial extracellular interstitial expansion, which might be related to poor glycemic control.
Journal ArticleDOI
Myocardial Extracellular Volume Fraction Adds Prognostic Information Beyond Myocardial Replacement Fibrosis.
Eric Y. Yang,Mohamad G. Ghosn,Mohammad A. Khan,Nickalaus L. Gramze,Gerd Brunner,Gerd Brunner,Faisal Nabi,Vijay Nambi,Vijay Nambi,Vijay Nambi,Sherif F. Nagueh,Duc T. Nguyen,Edward A. Graviss,Erik B. Schelbert,Christie M. Ballantyne,Christie M. Ballantyne,William A. Zoghbi,Dipan J. Shah +17 more
TL;DR: ECV measures of diffuse myocardial fibrosis were associated with HF outcomes, despite exclusion of replacement fibrosis segments from their derivation and even among patients without any scar, suggesting ECV may have a synergistic role with LGE in HF risk assessment.
Journal ArticleDOI
Review of T1 Mapping Methods: Comparative Effectiveness Including Reproducibility Issues
David M. Higgins,James C. Moon +1 more
TL;DR: Challenges for delivery of T1 mapping to healthcare are examined, including validation, quality control, and protocol transfer between MR systems and key methodology considerations for early adopters are highlighted.
Journal ArticleDOI
Prevalence and pattern of cardiovascular magnetic resonance late gadolinium enhancement in highly trained endurance athletes
Blanca Domenech-Ximenos,Blanca Domenech-Ximenos,M Sanz-De La Garza,Susanna Prat-Gonzalez,Álvaro Sepúlveda-Martínez,Álvaro Sepúlveda-Martínez,F. Crispi,K. Duran-Fernandez,Rosario J. Perea,Bart Bijnens,Bart Bijnens,Marta Sitges +11 more
TL;DR: High endurance training load was associated with larger bi-ventricular and bi-atrial sizes and a slight reduction of biventricular ejection fraction, as compared to controls in both genders, and those athletes with focal LGE demonstrated globally higher myocardial ECV values.
Journal ArticleDOI
Employing Extracellular Volume Cardiovascular Magnetic Resonance Measures of Myocardial Fibrosis to Foster Novel Therapeutics.
TL;DR: The cardiology community now requires phase 2 and 3 clinical trials to examine strategies for the regression/prevention of MF and eventually biomarkers to identify MF without reliance on cardiovascular magnetic resonance.
References
More filters
Journal ArticleDOI
Statistical methods for assessing agreement between two methods of clinical measurement.
TL;DR: An alternative approach, based on graphical techniques and simple calculations, is described, together with the relation between this analysis and the assessment of repeatability.
Journal ArticleDOI
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
Manuel D. Cerqueira,Neil J. Weissman,Vasken Dilsizian,Alice K. Jacobs,Sanjiv Kaul,Warren K. Laskey,Dudley J. Pennell,John A. Rumberger,Thomas J. Ryan,Mario S. Verani +9 more
TL;DR: Attempts to standardize options for all cardiac imaging modalities should be based on the sound principles that have evolved from cardiac anatomy and clinical needs, and selection of standardized methods must bebased on the following criteria.
Journal ArticleDOI
Standardized Myocardial Segmentation and Nomenclature for Tomographic Imaging of the Heart
Manuel D. Cerqueira,Neil J. Weissman,Vasken Dilsizian,Alice K. Jacobs,Sanjiv Kaul,Warren K. Laskey,Dudley J. Pennell,John A. Rumberger,Thomas J. Ryan,Mario S. Verani +9 more
TL;DR: A remarkable committee was convened: The American Heart Association Writing Group on Myocardial Segmentation and Registration for Cardiac Imaging came to an agreement upon all aspects of nomenclature and anatomic descriptions of the heart.
Journal ArticleDOI
Pathological hypertrophy and cardiac interstitium. Fibrosis and renin-angiotensin-aldosterone system.
Karl T. Weber,C G Brilla +1 more
TL;DR: It can be concluded that arterial hypertension together with elevated circulating aldosterone are associated with cardiac fibroblast involvement and the resultant heterogeneity in tissue structure and the stage is set to prevent pathological LVH resulting from myocardial fibrosis as well as to reverse it.
Journal ArticleDOI
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
Manuel D. Cerqueira,Neil J. Weissman,Vasken Dilsizian,Alice K. Jacobs,Sanjiv Kaul,Warren K. Laskey,Dudley J. Pennell,John A. Rumberger,Thomas J. Ryan,Mario S. Verani +9 more
TL;DR: In this article, the authors proposed a standardization of the angles for cardiac planes, number of segments, slice display and thickness, nomenclature for segments and assignment of segments to coronary arterial territories.