Left ventricular function recovery in peripartum cardiomyopathy: a cardiovascular magnetic resonance study by myocardial T1 and T2 mapping
Abstract Background Peripartum cardiomyopathy (PPCM) is rare and potentially life-threatening; its etiology remains unclear. Imaging characteristics on cardiovascular magnetic resonance (CMR) and their prognostic significance have rarely been studied. We sought to determine CMR’s prognostic value in...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-01-01
|
| Series: | Journal of Cardiovascular Magnetic Resonance |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12968-019-0590-z |
| _version_ | 1827279328008732672 |
|---|---|
| author | Yao-Dan Liang Yuan-Wei Xu Wei-Hao Li Ke Wan Jia-Yu Sun Jia-Yi Lin Qing Zhang Xiao-Yue Zhou Yu-Cheng Chen |
| author_facet | Yao-Dan Liang Yuan-Wei Xu Wei-Hao Li Ke Wan Jia-Yu Sun Jia-Yi Lin Qing Zhang Xiao-Yue Zhou Yu-Cheng Chen |
| author_sort | Yao-Dan Liang |
| collection | DOAJ |
| description | Abstract Background Peripartum cardiomyopathy (PPCM) is rare and potentially life-threatening; its etiology remains unclear. Imaging characteristics on cardiovascular magnetic resonance (CMR) and their prognostic significance have rarely been studied. We sought to determine CMR’s prognostic value in PPCM by using T1 and T2 mapping techniques. Methods Data from 21 PPCM patients from our CMR registry database were analyzed. The control group comprised 20 healthy age-matched females. All subjects underwent comprehensive contrast-enhanced CMR. T1 and T2 mapping using modified Look-Locker inversion recovery and T2 prep balanced steady-state free precession sequences, respectively. Ventricular size and function, late gadolinium enhancement (LGE), myocardial T1 value, extracellular volume (ECV), and T2 value were analyzed. Transthoracic echocardiography was performed at baseline and during follow-up. The recovered left ventricular ejection fraction (LVEF) was defined as LVEF ≥50% on echocardiography follow-up after at least 6 months of the diagnosis. Results CMR imaging showed that the PPCM patients had severely impaired LVEF and right ventricular ejection fraction (LVEF: 26.8 ± 10.6%; RVEF: 33.9 ± 14.6%). LGE was seen in eight (38.1%) cases. PPCM patients had significantly higher native T1 and ECV (1345 ± 79 vs. 1212 ± 32 ms, P < 0.001; 33.9 ± 5.2% vs. 27.1 ± 3.1%, P < 0.001; respectively) and higher myocardial T2 value (42.3 ± 3.7 vs. 36.8 ± 2.3 ms, P < 0.001) than did the normal controls. After a median 2.5-year follow-up (range: 8 months-5 years), six patients required readmission for heart failure, two died, and 10 showed left ventricular function recovery. The LVEF-recovered group showed significantly lower ECV (30.7 ± 2.1% vs. 36.8 ± 5.6%, P = 0.005) and T2 (40.6 ± 3.0 vs. 43.9 ± 3.7 ms, P = 0.040) than the unrecovered group. Multivariable logistic regression analysis showed ECV (OR = 0.58 for per 1% increase, P = 0.032) was independently associated with left ventricular recovery in PPCM. Conclusions Compared to normal controls, PPCM patients showed significantly higher native T1, ECV, and T2. Native T1, ECV, and T2 were associated with LVEF recovery in PPCM. Furthermore, ECV could independently predict left ventricular function recovery in PPCM. |
| first_indexed | 2024-04-24T08:17:11Z |
| format | Article |
| id | doaj.art-787bab2eb2e7429abab473c76f750140 |
| institution | Directory Open Access Journal |
| issn | 1532-429X |
| language | English |
| last_indexed | 2024-04-24T08:17:11Z |
| publishDate | 2020-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Cardiovascular Magnetic Resonance |
| spelling | doaj.art-787bab2eb2e7429abab473c76f7501402024-04-17T03:08:32ZengElsevierJournal of Cardiovascular Magnetic Resonance1532-429X2020-01-0122111010.1186/s12968-019-0590-zLeft ventricular function recovery in peripartum cardiomyopathy: a cardiovascular magnetic resonance study by myocardial T1 and T2 mappingYao-Dan Liang0Yuan-Wei Xu1Wei-Hao Li2Ke Wan3Jia-Yu Sun4Jia-Yi Lin5Qing Zhang6Xiao-Yue Zhou7Yu-Cheng Chen8Department of Cardiology, West China Hospital, Sichuan UniversityDepartment of Cardiology, West China Hospital, Sichuan UniversityDepartment of Cardiology, West China Hospital, Sichuan UniversityDepartment of Geriatrics, West China Hospital, Sichuan UniversityDepartment of Radiology, West China Hospital, Sichuan UniversityDepartment of Cardiology, West China Hospital, Sichuan UniversityDepartment of Cardiology, West China Hospital, Sichuan UniversityMR Collaboration, Siemens Healthineers Ltd.Department of Cardiology, West China Hospital, Sichuan UniversityAbstract Background Peripartum cardiomyopathy (PPCM) is rare and potentially life-threatening; its etiology remains unclear. Imaging characteristics on cardiovascular magnetic resonance (CMR) and their prognostic significance have rarely been studied. We sought to determine CMR’s prognostic value in PPCM by using T1 and T2 mapping techniques. Methods Data from 21 PPCM patients from our CMR registry database were analyzed. The control group comprised 20 healthy age-matched females. All subjects underwent comprehensive contrast-enhanced CMR. T1 and T2 mapping using modified Look-Locker inversion recovery and T2 prep balanced steady-state free precession sequences, respectively. Ventricular size and function, late gadolinium enhancement (LGE), myocardial T1 value, extracellular volume (ECV), and T2 value were analyzed. Transthoracic echocardiography was performed at baseline and during follow-up. The recovered left ventricular ejection fraction (LVEF) was defined as LVEF ≥50% on echocardiography follow-up after at least 6 months of the diagnosis. Results CMR imaging showed that the PPCM patients had severely impaired LVEF and right ventricular ejection fraction (LVEF: 26.8 ± 10.6%; RVEF: 33.9 ± 14.6%). LGE was seen in eight (38.1%) cases. PPCM patients had significantly higher native T1 and ECV (1345 ± 79 vs. 1212 ± 32 ms, P < 0.001; 33.9 ± 5.2% vs. 27.1 ± 3.1%, P < 0.001; respectively) and higher myocardial T2 value (42.3 ± 3.7 vs. 36.8 ± 2.3 ms, P < 0.001) than did the normal controls. After a median 2.5-year follow-up (range: 8 months-5 years), six patients required readmission for heart failure, two died, and 10 showed left ventricular function recovery. The LVEF-recovered group showed significantly lower ECV (30.7 ± 2.1% vs. 36.8 ± 5.6%, P = 0.005) and T2 (40.6 ± 3.0 vs. 43.9 ± 3.7 ms, P = 0.040) than the unrecovered group. Multivariable logistic regression analysis showed ECV (OR = 0.58 for per 1% increase, P = 0.032) was independently associated with left ventricular recovery in PPCM. Conclusions Compared to normal controls, PPCM patients showed significantly higher native T1, ECV, and T2. Native T1, ECV, and T2 were associated with LVEF recovery in PPCM. Furthermore, ECV could independently predict left ventricular function recovery in PPCM.https://doi.org/10.1186/s12968-019-0590-zPeripartum cardiomyopathyCardiovascular magnetic resonanceExtracellular volumeT1 mappingT2 mappingLeft ventricular function recovery |
| spellingShingle | Yao-Dan Liang Yuan-Wei Xu Wei-Hao Li Ke Wan Jia-Yu Sun Jia-Yi Lin Qing Zhang Xiao-Yue Zhou Yu-Cheng Chen Left ventricular function recovery in peripartum cardiomyopathy: a cardiovascular magnetic resonance study by myocardial T1 and T2 mapping Journal of Cardiovascular Magnetic Resonance Peripartum cardiomyopathy Cardiovascular magnetic resonance Extracellular volume T1 mapping T2 mapping Left ventricular function recovery |
| title | Left ventricular function recovery in peripartum cardiomyopathy: a cardiovascular magnetic resonance study by myocardial T1 and T2 mapping |
| title_full | Left ventricular function recovery in peripartum cardiomyopathy: a cardiovascular magnetic resonance study by myocardial T1 and T2 mapping |
| title_fullStr | Left ventricular function recovery in peripartum cardiomyopathy: a cardiovascular magnetic resonance study by myocardial T1 and T2 mapping |
| title_full_unstemmed | Left ventricular function recovery in peripartum cardiomyopathy: a cardiovascular magnetic resonance study by myocardial T1 and T2 mapping |
| title_short | Left ventricular function recovery in peripartum cardiomyopathy: a cardiovascular magnetic resonance study by myocardial T1 and T2 mapping |
| title_sort | left ventricular function recovery in peripartum cardiomyopathy a cardiovascular magnetic resonance study by myocardial t1 and t2 mapping |
| topic | Peripartum cardiomyopathy Cardiovascular magnetic resonance Extracellular volume T1 mapping T2 mapping Left ventricular function recovery |
| url | https://doi.org/10.1186/s12968-019-0590-z |
| work_keys_str_mv | AT yaodanliang leftventricularfunctionrecoveryinperipartumcardiomyopathyacardiovascularmagneticresonancestudybymyocardialt1andt2mapping AT yuanweixu leftventricularfunctionrecoveryinperipartumcardiomyopathyacardiovascularmagneticresonancestudybymyocardialt1andt2mapping AT weihaoli leftventricularfunctionrecoveryinperipartumcardiomyopathyacardiovascularmagneticresonancestudybymyocardialt1andt2mapping AT kewan leftventricularfunctionrecoveryinperipartumcardiomyopathyacardiovascularmagneticresonancestudybymyocardialt1andt2mapping AT jiayusun leftventricularfunctionrecoveryinperipartumcardiomyopathyacardiovascularmagneticresonancestudybymyocardialt1andt2mapping AT jiayilin leftventricularfunctionrecoveryinperipartumcardiomyopathyacardiovascularmagneticresonancestudybymyocardialt1andt2mapping AT qingzhang leftventricularfunctionrecoveryinperipartumcardiomyopathyacardiovascularmagneticresonancestudybymyocardialt1andt2mapping AT xiaoyuezhou leftventricularfunctionrecoveryinperipartumcardiomyopathyacardiovascularmagneticresonancestudybymyocardialt1andt2mapping AT yuchengchen leftventricularfunctionrecoveryinperipartumcardiomyopathyacardiovascularmagneticresonancestudybymyocardialt1andt2mapping |