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
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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
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Clinical recommendations for cardiovascular magnetic resonance mapping of T1, T2, T2 and extracellular volume: A consensus statement by the Society for Cardiovascular Magnetic Resonance (SCMR) endorsed by the European Association for Cardiovascular Imaging (EACVI)
Daniel Messroghli,James C. Moon,Vanessa M Ferreira,Lars Grosse-Wortmann,Taigang He,Peter Kellman,Julia Mascherbauer,Reza Nezafat,Michael Salerno,Erik B. Schelbert,Andrew J. Taylor,Richard B. Thompson,Martin Ugander,Ruud B. van Heeswijk,Matthias G. Friedrich +14 more
TL;DR: This document provides a summary of the existing evidence for the clinical value of parametric mapping in the heart as of mid 2017, and gives recommendations for practical use in different clinical scenarios for scientists, clinicians, and CMR manufacturers.
Journal ArticleDOI
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.
Paul A. Heidenreich,Biykem Bozkurt,David Aguilar,Larry A. Allen,Joni J. Byun,Monica Colvin,Anita Deswal,Mark H. Drazner,Shannon M. Dunlay,Linda R. Evers,James C. Fang,Savitri Fedson,Gregg C. Fonarow,Salim S. Hayek,Adrian F. Hernandez,Prateeti Khazanie,Michelle M. Kittleson,Christopher S. Lee,Mark S. Link,Carmelo A. Milano,Lorraine C. Nnacheta,Alexander T. Sandhu,Lynne W. Stevenson,Orly Vardeny,Amanda R. Vest,Clyde W. Yancy +25 more
TL;DR: The "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure" as discussed by the authors provides patient-centric recommendations for clinicians to prevent, diagnose, and manage patients with heart failure.
Journal ArticleDOI
Myocardial T1 mapping and extracellular volume quantification: a Society for Cardiovascular Magnetic Resonance (SCMR) and CMR Working Group of the European Society of Cardiology consensus statement
James C. Moon,Daniel Messroghli,Peter Kellman,Stefan K. Piechnik,Matthew D. Robson,Martin Ugander,Peter D. Gatehouse,Andrew E. Arai,Matthias G. Friedrich,Stefan Neubauer,Jeanette Schulz-Menger,Jeanette Schulz-Menger,Erik B. Schelbert +12 more
TL;DR: This document provides recommendations for clinical and research T1 and ECV measurement, based on published evidence when available and expert consensus when not, and addresses controversies in the field.
Journal ArticleDOI
T1-mapping in the heart: accuracy and precision
Peter Kellman,Michael S. Hansen +1 more
TL;DR: The technical aspects of key T1-mapping methods and imaging protocols are described and their limitations including the factors that influence their accuracy, precision, and reproducibility are described.
Journal ArticleDOI
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines
TL;DR: The 2022 guideline as discussed by the authors provides patient-centric recommendations for clinicians to prevent, diagnose, and manage patients with heart failure, with the intent to improve quality of care and align with patients' interests.
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