Human non-contrast T1 values and correlation with histology in diffuse fibrosis

Background: Aortic stenosis (AS) leads to diffuse fibrosis in the myocardium, which is linked to adverse outcome. Myocardial T1 values change with tissue composition. Objective: To test the hypothesis that our recently developed non-contrast cardiac magnetic resonance (CMR) T1 mapping sequence could...

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Main Authors: Bull, S, White, S, Piechnik, S, Flett, A, Ferreira, V, Loudon, M, Francis, J, Karamitsos, T, Prendergast, B, Robson, M, Neubauer, S, Moon, J, Myerson, S
Format: Journal article
Language:English
Published: 2013
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author Bull, S
White, S
Piechnik, S
Flett, A
Ferreira, V
Loudon, M
Francis, J
Karamitsos, T
Prendergast, B
Robson, M
Neubauer, S
Moon, J
Myerson, S
author_facet Bull, S
White, S
Piechnik, S
Flett, A
Ferreira, V
Loudon, M
Francis, J
Karamitsos, T
Prendergast, B
Robson, M
Neubauer, S
Moon, J
Myerson, S
author_sort Bull, S
collection OXFORD
description Background: Aortic stenosis (AS) leads to diffuse fibrosis in the myocardium, which is linked to adverse outcome. Myocardial T1 values change with tissue composition. Objective: To test the hypothesis that our recently developed non-contrast cardiac magnetic resonance (CMR) T1 mapping sequence could identify myocardial fibrosis without contrast agent. Design, setting and patients: A prospective CMR non-contrast T1 mapping study of 109 patients with moderate and severe AS and 33 age- and gendermatched controls. Methods: CMR at 1.5 T, including non-contrast T1 mapping using a shortened modified Look-Locker inversion recovery sequence, was carried out. Biopsy samples for histological assessment of collagen volume fraction (CVF%) were obtained in 19 patients undergoing aortic valve replacement. Results There was a significant correlation between T1 values and CVF% (r=0.65, p=0.002). Mean T1 values were signi ficantly longer in all groups with severe AS (972±33 ms in severe asymptomatic, 1014 ±38 ms in severe symptomatic) than in normal controls (944±16 ms) ( p<0.05). The strongest associations with T1 values were for aortic valve area (r=-0.40, p=0.001) and left ventricular mass index (LVMI) (r=0.36, p=0.008), and these were the only independent predictors on multivariate analysis. Conclusions: Non-contrast T1 values are increased in patients with severe AS and further increase in symptomatic compared with asymptomatic patients. T1 values lengthened with greater LVMI and correlated with the degree of biopsy-quantified fibrosis. This may provide a useful clinical assessment of diffuse myocardial fibrosis in the future.
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spelling oxford-uuid:77f60196-817b-4172-b328-6f057fd316cf2022-03-26T20:27:43ZHuman non-contrast T1 values and correlation with histology in diffuse fibrosisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:77f60196-817b-4172-b328-6f057fd316cfEnglishSymplectic Elements at Oxford2013Bull, SWhite, SPiechnik, SFlett, AFerreira, VLoudon, MFrancis, JKaramitsos, TPrendergast, BRobson, MNeubauer, SMoon, JMyerson, SBackground: Aortic stenosis (AS) leads to diffuse fibrosis in the myocardium, which is linked to adverse outcome. Myocardial T1 values change with tissue composition. Objective: To test the hypothesis that our recently developed non-contrast cardiac magnetic resonance (CMR) T1 mapping sequence could identify myocardial fibrosis without contrast agent. Design, setting and patients: A prospective CMR non-contrast T1 mapping study of 109 patients with moderate and severe AS and 33 age- and gendermatched controls. Methods: CMR at 1.5 T, including non-contrast T1 mapping using a shortened modified Look-Locker inversion recovery sequence, was carried out. Biopsy samples for histological assessment of collagen volume fraction (CVF%) were obtained in 19 patients undergoing aortic valve replacement. Results There was a significant correlation between T1 values and CVF% (r=0.65, p=0.002). Mean T1 values were signi ficantly longer in all groups with severe AS (972±33 ms in severe asymptomatic, 1014 ±38 ms in severe symptomatic) than in normal controls (944±16 ms) ( p<0.05). The strongest associations with T1 values were for aortic valve area (r=-0.40, p=0.001) and left ventricular mass index (LVMI) (r=0.36, p=0.008), and these were the only independent predictors on multivariate analysis. Conclusions: Non-contrast T1 values are increased in patients with severe AS and further increase in symptomatic compared with asymptomatic patients. T1 values lengthened with greater LVMI and correlated with the degree of biopsy-quantified fibrosis. This may provide a useful clinical assessment of diffuse myocardial fibrosis in the future.
spellingShingle Bull, S
White, S
Piechnik, S
Flett, A
Ferreira, V
Loudon, M
Francis, J
Karamitsos, T
Prendergast, B
Robson, M
Neubauer, S
Moon, J
Myerson, S
Human non-contrast T1 values and correlation with histology in diffuse fibrosis
title Human non-contrast T1 values and correlation with histology in diffuse fibrosis
title_full Human non-contrast T1 values and correlation with histology in diffuse fibrosis
title_fullStr Human non-contrast T1 values and correlation with histology in diffuse fibrosis
title_full_unstemmed Human non-contrast T1 values and correlation with histology in diffuse fibrosis
title_short Human non-contrast T1 values and correlation with histology in diffuse fibrosis
title_sort human non contrast t1 values and correlation with histology in diffuse fibrosis
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