Measurement of myocardial native T1 in cardiovascular diseases and norm in 1291 subjects

<strong>Background</strong> Native T1-mapping provides quantitative myocardial tissue characterization for cardiovascular diseases (CVD), without the need for gadolinium. However, its translation into clinical practice is hindered by differences between techniques and the lack of establi...

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Main Authors: Liu, J, Liu, A, Leal, J, McMillan, F, Francis, J, Greiser, A, Rider, O, Myerson, S, Neubauer, S, Ferreira, V, Piechnik, S
Formato: Journal article
Publicado: BioMed Central 2017
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author Liu, J
Liu, A
Leal, J
McMillan, F
Francis, J
Greiser, A
Rider, O
Myerson, S
Neubauer, S
Ferreira, V
Piechnik, S
author_facet Liu, J
Liu, A
Leal, J
McMillan, F
Francis, J
Greiser, A
Rider, O
Myerson, S
Neubauer, S
Ferreira, V
Piechnik, S
author_sort Liu, J
collection OXFORD
description <strong>Background</strong> Native T1-mapping provides quantitative myocardial tissue characterization for cardiovascular diseases (CVD), without the need for gadolinium. However, its translation into clinical practice is hindered by differences between techniques and the lack of established reference values. We provide typical myocardial T1-ranges for 18 commonly encountered CVDs using a single T1-mapping technique – Shortened Look-Locker Inversion Recovery (ShMOLLI), also used in the large UK Biobank and Hypertrophic Cardiomyopathy Registry study. <strong>Methods</strong> We analyzed 1291 subjects who underwent CMR (1.5-Tesla, MAGNETOM-Avanto, Siemens Healthcare, Erlangen, Germany) between 2009 and 2016, who had a single CVD diagnosis, with mid-ventricular T1-map assessment. A region of interest (ROI) was placed on native T1-maps in the “most-affected myocardium”, characterized by the presence of late gadolinium enhancement (LGE), or regional wall motion abnormalities (RWMA) on cines. Another ROI was placed in the “reference myocardium” as far as possible from LGE/RWMA, and in the septum if no focal abnormality was present. To further define normality, we included native T1 of healthy subjects from an existing dataset after sub-endocardial pixel-erosions. <strong>Results</strong> Native T1 of patients with normal CMR (938 ± 21 ms) was similar compared to healthy subjects (941 ± 23 ms). Across all patient groups (57 ± 19 yrs., 65% males), focally affected myocardium had significantly different T1 value compared to reference myocardium (all p &lt; 0.001). In the affected myocardium, cardiac amyloidosis (1119 ± 61 ms) had the highest native T1 compared to normal and all other CVDs, while iron-overload (795 ± 58 ms) and Anderson-Fabry disease (863 ± 23 ms) had the lowest native reference T1 (all p &lt; 0.001). Future studies designed to detect the large T1 differences between affected and reference myocardium are estimated to require small sample-sizes (n &lt; 50). However, studies designed to detect the small T1 differences between reference myocardium in CVDs and healthy controls can require several thousand of subjects. <strong>Conclusions</strong> We provide typical T1-ranges for common clinical cardiac conditions in the largest cohort to-date, using ShMOLLI T1-mapping at 1.5 T. Sample-size calculations from this study may be useful for the design of future studies and trials that use T1-mapping as an endpoint.
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spelling oxford-uuid:bdee8c50-48bd-43f7-b882-1dc97898b4c82022-03-27T05:35:32ZMeasurement of myocardial native T1 in cardiovascular diseases and norm in 1291 subjectsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:bdee8c50-48bd-43f7-b882-1dc97898b4c8Symplectic Elements at OxfordBioMed Central2017Liu, JLiu, ALeal, JMcMillan, FFrancis, JGreiser, ARider, OMyerson, SNeubauer, SFerreira, VPiechnik, S<strong>Background</strong> Native T1-mapping provides quantitative myocardial tissue characterization for cardiovascular diseases (CVD), without the need for gadolinium. However, its translation into clinical practice is hindered by differences between techniques and the lack of established reference values. We provide typical myocardial T1-ranges for 18 commonly encountered CVDs using a single T1-mapping technique – Shortened Look-Locker Inversion Recovery (ShMOLLI), also used in the large UK Biobank and Hypertrophic Cardiomyopathy Registry study. <strong>Methods</strong> We analyzed 1291 subjects who underwent CMR (1.5-Tesla, MAGNETOM-Avanto, Siemens Healthcare, Erlangen, Germany) between 2009 and 2016, who had a single CVD diagnosis, with mid-ventricular T1-map assessment. A region of interest (ROI) was placed on native T1-maps in the “most-affected myocardium”, characterized by the presence of late gadolinium enhancement (LGE), or regional wall motion abnormalities (RWMA) on cines. Another ROI was placed in the “reference myocardium” as far as possible from LGE/RWMA, and in the septum if no focal abnormality was present. To further define normality, we included native T1 of healthy subjects from an existing dataset after sub-endocardial pixel-erosions. <strong>Results</strong> Native T1 of patients with normal CMR (938 ± 21 ms) was similar compared to healthy subjects (941 ± 23 ms). Across all patient groups (57 ± 19 yrs., 65% males), focally affected myocardium had significantly different T1 value compared to reference myocardium (all p &lt; 0.001). In the affected myocardium, cardiac amyloidosis (1119 ± 61 ms) had the highest native T1 compared to normal and all other CVDs, while iron-overload (795 ± 58 ms) and Anderson-Fabry disease (863 ± 23 ms) had the lowest native reference T1 (all p &lt; 0.001). Future studies designed to detect the large T1 differences between affected and reference myocardium are estimated to require small sample-sizes (n &lt; 50). However, studies designed to detect the small T1 differences between reference myocardium in CVDs and healthy controls can require several thousand of subjects. <strong>Conclusions</strong> We provide typical T1-ranges for common clinical cardiac conditions in the largest cohort to-date, using ShMOLLI T1-mapping at 1.5 T. Sample-size calculations from this study may be useful for the design of future studies and trials that use T1-mapping as an endpoint.
spellingShingle Liu, J
Liu, A
Leal, J
McMillan, F
Francis, J
Greiser, A
Rider, O
Myerson, S
Neubauer, S
Ferreira, V
Piechnik, S
Measurement of myocardial native T1 in cardiovascular diseases and norm in 1291 subjects
title Measurement of myocardial native T1 in cardiovascular diseases and norm in 1291 subjects
title_full Measurement of myocardial native T1 in cardiovascular diseases and norm in 1291 subjects
title_fullStr Measurement of myocardial native T1 in cardiovascular diseases and norm in 1291 subjects
title_full_unstemmed Measurement of myocardial native T1 in cardiovascular diseases and norm in 1291 subjects
title_short Measurement of myocardial native T1 in cardiovascular diseases and norm in 1291 subjects
title_sort measurement of myocardial native t1 in cardiovascular diseases and norm in 1291 subjects
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