Diagnostic and prognostic significance of cardiovascular magnetic resonance native myocardial T1 mapping in patients with pulmonary hypertension
Abstract Background Native T1 may be a sensitive, contrast-free, non-invasive cardiovascular magnetic resonance (CMR) marker of myocardial tissue changes in patients with pulmonary artery hypertension. However, the diagnostic and prognostic value of native T1 mapping in this patient group has not be...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2018-12-01
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| Series: | Journal of Cardiovascular Magnetic Resonance |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12968-018-0501-8 |
| _version_ | 1797204987916320768 |
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| author | Laura C. Saunders Chris S. Johns Neil J. Stewart Charlotte J. E. Oram David A. Capener Valentina O. Puntmann Charlie A. Elliot Robin C. Condliffe David G. Kiely Martin J. Graves Jim M. Wild Andy J. Swift |
| author_facet | Laura C. Saunders Chris S. Johns Neil J. Stewart Charlotte J. E. Oram David A. Capener Valentina O. Puntmann Charlie A. Elliot Robin C. Condliffe David G. Kiely Martin J. Graves Jim M. Wild Andy J. Swift |
| author_sort | Laura C. Saunders |
| collection | DOAJ |
| description | Abstract Background Native T1 may be a sensitive, contrast-free, non-invasive cardiovascular magnetic resonance (CMR) marker of myocardial tissue changes in patients with pulmonary artery hypertension. However, the diagnostic and prognostic value of native T1 mapping in this patient group has not been fully explored. The aim of this work was to determine whether elevation of native T1 in myocardial tissue in pulmonary hypertension: (a) varies according to pulmonary hypertension subtype; (b) has prognostic value and (c) is associated with ventricular function and interaction. Methods Data were retrospectively collected from a total of 490 consecutive patients during their clinical 1.5 T CMR assessment at a pulmonary hypertension referral centre in 2015. Three hundred sixty-nine patients had pulmonary hypertension [58 ± 15 years; 66% female], an additional 39 had pulmonary hypertension due to left heart disease [68 ± 13 years; 60% female], 82 patients did not have pulmonary hypertension [55 ± 18; 68% female]. Twenty five healthy subjects were also recruited [58 ±4 years); 51% female]. T1 mapping was performed with a MOdified Look-Locker Inversion Recovery (MOLLI) sequence. T1 prognostic value in patients with pulmonary arterial hypertension was assessed using multivariate Cox proportional hazards regression analysis. Results Patients with pulmonary artery hypertension had elevated T1 in the right ventricular (RV) insertion point (pulmonary hypertension patients: T1 = 1060 ± 90 ms; No pulmonary hypertension patients: T1 = 1020 ± 80 ms p < 0.001; healthy subjects T1 = 940 ± 50 ms p < 0.001) with no significant difference between the major pulmonary hypertension subtypes. The RV insertion point was the most successful T1 region for discriminating patients with pulmonary hypertension from healthy subjects (area under the curve = 0.863) however it could not accurately discriminate between patients with and without pulmonary hypertension (area under the curve = 0.654). T1 metrics did not contribute to prediction of overall mortality (septal: p = 0.552; RV insertion point: p = 0.688; left ventricular free wall: p = 0.258). Systolic interventricular septal angle was a significant predictor of T1 in patients with pulmonary hypertension (p < 0.001). Conclusions Elevated myocardial native T1 was found to a similar extent in pulmonary hypertension patient subgroups and is independently associated with increased interventricular septal angle. Native T1 mapping may not be of additive value in the diagnostic or prognostic evaluation of patients with pulmonary artery hypertension. |
| first_indexed | 2024-04-24T08:43:58Z |
| format | Article |
| id | doaj.art-1553f1d71a0f44ba852ee09d966f87a1 |
| institution | Directory Open Access Journal |
| issn | 1532-429X |
| language | English |
| last_indexed | 2024-04-24T08:43:58Z |
| publishDate | 2018-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Cardiovascular Magnetic Resonance |
| spelling | doaj.art-1553f1d71a0f44ba852ee09d966f87a12024-04-16T13:56:49ZengElsevierJournal of Cardiovascular Magnetic Resonance1532-429X2018-12-0120111110.1186/s12968-018-0501-8Diagnostic and prognostic significance of cardiovascular magnetic resonance native myocardial T1 mapping in patients with pulmonary hypertensionLaura C. Saunders0Chris S. Johns1Neil J. Stewart2Charlotte J. E. Oram3David A. Capener4Valentina O. Puntmann5Charlie A. Elliot6Robin C. Condliffe7David G. Kiely8Martin J. Graves9Jim M. Wild10Andy J. Swift11POLARIS, Academic Radiology, Department of Infection, Immunity and Cardiovascular Disease, University of SheffieldPOLARIS, Academic Radiology, Department of Infection, Immunity and Cardiovascular Disease, University of SheffieldPOLARIS, Academic Radiology, Department of Infection, Immunity and Cardiovascular Disease, University of SheffieldPOLARIS, Academic Radiology, Department of Infection, Immunity and Cardiovascular Disease, University of SheffieldPOLARIS, Academic Radiology, Department of Infection, Immunity and Cardiovascular Disease, University of SheffieldInstitute for Experimental and Translational Cardio Vascular Imaging, University Hospital FrankfurtPulmonary Vascular Disease Unit, Sheffield Teaching Hospitals NHS TrustPulmonary Vascular Disease Unit, Sheffield Teaching Hospitals NHS TrustPulmonary Vascular Disease Unit, Sheffield Teaching Hospitals NHS TrustUniversity of Cambridge School of Clinical Medicine, Cambridge UniversityPOLARIS, Academic Radiology, Department of Infection, Immunity and Cardiovascular Disease, University of SheffieldPOLARIS, Academic Radiology, Department of Infection, Immunity and Cardiovascular Disease, University of SheffieldAbstract Background Native T1 may be a sensitive, contrast-free, non-invasive cardiovascular magnetic resonance (CMR) marker of myocardial tissue changes in patients with pulmonary artery hypertension. However, the diagnostic and prognostic value of native T1 mapping in this patient group has not been fully explored. The aim of this work was to determine whether elevation of native T1 in myocardial tissue in pulmonary hypertension: (a) varies according to pulmonary hypertension subtype; (b) has prognostic value and (c) is associated with ventricular function and interaction. Methods Data were retrospectively collected from a total of 490 consecutive patients during their clinical 1.5 T CMR assessment at a pulmonary hypertension referral centre in 2015. Three hundred sixty-nine patients had pulmonary hypertension [58 ± 15 years; 66% female], an additional 39 had pulmonary hypertension due to left heart disease [68 ± 13 years; 60% female], 82 patients did not have pulmonary hypertension [55 ± 18; 68% female]. Twenty five healthy subjects were also recruited [58 ±4 years); 51% female]. T1 mapping was performed with a MOdified Look-Locker Inversion Recovery (MOLLI) sequence. T1 prognostic value in patients with pulmonary arterial hypertension was assessed using multivariate Cox proportional hazards regression analysis. Results Patients with pulmonary artery hypertension had elevated T1 in the right ventricular (RV) insertion point (pulmonary hypertension patients: T1 = 1060 ± 90 ms; No pulmonary hypertension patients: T1 = 1020 ± 80 ms p < 0.001; healthy subjects T1 = 940 ± 50 ms p < 0.001) with no significant difference between the major pulmonary hypertension subtypes. The RV insertion point was the most successful T1 region for discriminating patients with pulmonary hypertension from healthy subjects (area under the curve = 0.863) however it could not accurately discriminate between patients with and without pulmonary hypertension (area under the curve = 0.654). T1 metrics did not contribute to prediction of overall mortality (septal: p = 0.552; RV insertion point: p = 0.688; left ventricular free wall: p = 0.258). Systolic interventricular septal angle was a significant predictor of T1 in patients with pulmonary hypertension (p < 0.001). Conclusions Elevated myocardial native T1 was found to a similar extent in pulmonary hypertension patient subgroups and is independently associated with increased interventricular septal angle. Native T1 mapping may not be of additive value in the diagnostic or prognostic evaluation of patients with pulmonary artery hypertension.http://link.springer.com/article/10.1186/s12968-018-0501-8Pulmonary hypertensionT1 mappingCardiovascular magnetic resonanceMOLLI |
| spellingShingle | Laura C. Saunders Chris S. Johns Neil J. Stewart Charlotte J. E. Oram David A. Capener Valentina O. Puntmann Charlie A. Elliot Robin C. Condliffe David G. Kiely Martin J. Graves Jim M. Wild Andy J. Swift Diagnostic and prognostic significance of cardiovascular magnetic resonance native myocardial T1 mapping in patients with pulmonary hypertension Journal of Cardiovascular Magnetic Resonance Pulmonary hypertension T1 mapping Cardiovascular magnetic resonance MOLLI |
| title | Diagnostic and prognostic significance of cardiovascular magnetic resonance native myocardial T1 mapping in patients with pulmonary hypertension |
| title_full | Diagnostic and prognostic significance of cardiovascular magnetic resonance native myocardial T1 mapping in patients with pulmonary hypertension |
| title_fullStr | Diagnostic and prognostic significance of cardiovascular magnetic resonance native myocardial T1 mapping in patients with pulmonary hypertension |
| title_full_unstemmed | Diagnostic and prognostic significance of cardiovascular magnetic resonance native myocardial T1 mapping in patients with pulmonary hypertension |
| title_short | Diagnostic and prognostic significance of cardiovascular magnetic resonance native myocardial T1 mapping in patients with pulmonary hypertension |
| title_sort | diagnostic and prognostic significance of cardiovascular magnetic resonance native myocardial t1 mapping in patients with pulmonary hypertension |
| topic | Pulmonary hypertension T1 mapping Cardiovascular magnetic resonance MOLLI |
| url | http://link.springer.com/article/10.1186/s12968-018-0501-8 |
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