Myocardial Native T1 Time in Patients With Hypertrophic Cardiomyopathy

Introduction: In hypertrophic cardiomyopathy (HCM), there are significant variations in left ventricular (LV) wall thickness and fibrosis, which necessitates a volumetric coverage. Slice-interleaved T1 (STONE) mapping sequence allows for the assessment of native T1 time with complete coverage of LV myocardium. Hypothesis: We hypothesized that STONE sequence is useful for the assessment of regional native T1 time abnormality in HCM patients. Methods: Twenty-four septal HCM patients (56±16 years) and 10 healthy adult control subjects (57±15 years) were studied. Native T1 mapping was performed using STONE sequence which enables acquisition of 5 slices in the short-axis plane within a 90 sec free-breathing scan. We measured LV native T1 time and maximum LV wall thickness in each 16 segments from 3 slices (basal-, mid- and apical-slice) and evaluated the relationship between LV native T1 time and wall thickness. Late gadolinium enhanced (LGE) MRI was acquired to assess presence of myocardial enhancement. Results: In HCM patients, LV native T1 time was significantly elevated compared to healthy controls, regardless of presence or absence of LGE (mean native T1 time; LGE (+) segments (n=27), 1139±55 msec; LGE (-) segments (n=351), 1118±55 msec; healthy control (n=160),1065±35 msec; p<0.001 by one-way ANOVA, 6 segments were excluded from analysis due to artifacts). Among 351 segments without LGE, native LV T1 time was diffusely elevated over the 16 segments (Figure). Significant positive correlation was found between LV wall thickness and native LV T1 time (y=1013+8.7x, p<0.001). Conclusions: In HCM, substantial number of segments without LGE showed elevated native T1 time, and native T1 time was correlated with LV wall thickness. Multi-slice T1 mapping by using STONE sequence could be advantageous to overcome limited cardiac coverage of conventional single-slice T1 mapping technique and to accurately detect the diffuse myocardial fibrosis in HCM patients.

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MYOCARDIAL TISSUE CHARACTERIZATION USING NATIVE T1 TIME PREDICTS THE OCCURRENCE OF ADVERSE EVENTS IN PATIENTS WITH CHRONIC KIDNEY DISEASE AND SEVERE AORTIC STENOSIS

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(21)03122-3 ◽

2021 ◽

Vol 77 (18) ◽

pp. 1766

Author(s):

Jay Ramchand ◽

Jean-Pierre Iskandar ◽

Rishi Puri ◽

Michael Chetrit ◽

Louise Burrell ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Adverse Events ◽

Aortic Stenosis ◽

Tissue Characterization ◽

Severe Aortic Stenosis ◽

Myocardial Tissue ◽

Native T1 ◽

Myocardial Tissue Characterization ◽

Native T1 Time

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Left ventricular native T1 time and the risk of atrial fibrillation recurrence after pulmonary vein isolation in patients with paroxysmal atrial fibrillation

International Journal of Cardiology ◽

10.1016/j.ijcard.2015.11.073 ◽

2016 ◽

Vol 203 ◽

pp. 848-854 ◽

Cited By ~ 5

Author(s):

Shingo Kato ◽

Murilo Foppa ◽

Sébastien Roujol ◽

Tamer Basha ◽

Sophie Berg ◽

...

Keyword(s):

Atrial Fibrillation ◽

Pulmonary Vein ◽

Pulmonary Vein Isolation ◽

Paroxysmal Atrial Fibrillation ◽

Left Ventricular ◽

Atrial Fibrillation Recurrence ◽

Native T1 ◽

Native T1 Time

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Radiomic Analysis of Myocardial Native T1 Imaging Discriminates Between Hypertensive Heart Disease and Hypertrophic Cardiomyopathy

JACC Cardiovascular Imaging ◽

10.1016/j.jcmg.2018.11.024 ◽

2019 ◽

Vol 12 (10) ◽

pp. 1946-1954 ◽

Cited By ~ 28

Author(s):

Ulf Neisius ◽

Hossam El-Rewaidy ◽

Shiro Nakamori ◽

Jennifer Rodriguez ◽

Warren J. Manning ◽

...

Keyword(s):

Heart Disease ◽

Hypertrophic Cardiomyopathy ◽

Hypertensive Heart Disease ◽

Native T1

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Native T1 mapping for differential diagnosis of left ventricular hypertrophy

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeab090.054 ◽

2021 ◽

Vol 22 (Supplement_2) ◽

Author(s):

D Lavall ◽

NH Vosshage ◽

S Stoebe ◽

T Denecke ◽

A Hagendorff ◽

...

Keyword(s):

Differential Diagnosis ◽

Heart Disease ◽

Hypertrophic Cardiomyopathy ◽

Cardiac Amyloidosis ◽

T1 Mapping ◽

Hypertensive Heart Disease ◽

Left Ventricular ◽

Characteristic Analysis ◽

Native T1 ◽

Healthy Control

Abstract Funding Acknowledgements Type of funding sources: None. Purpose The aim of this study was to investigate native T1 mapping cardiac magnetic resonance (CMR) tomography for the differential diagnosis of left ventricular (LV) hypertrophy. Background Mapping techniques are useful to characterize myocardial tissue abnormalities, particularly cardiac amyloidosis. However, specific cut-off values to differentiate LV hypertrophic phenotypes on 3.0 tesla CMR scanners have not been established, yet. Methods We retrospectively identified patients in the CMR database of Leipzig university hospital with increased LV wall thickness (≥12mm diameter at end-diastole) who were referred for the evaluation of LV hypertrophy or ischemia between 2017 and 2020 on a 3T scanner (Philips Achieva). Patients with suspected or confirmed myocarditis were excluded. Diagnosis of cardiac amyloidosis was made by either biopsy or non-invasively by bone scintigraphy and screening for monoclonal gammopathy. T1 mapping was measured as global mean value from 3 short axis slices of the LV. Results 128 consecutive patients were included in the study. 31 subjects without evidence of structural heart disease served as healthy control. The final diagnosis was cardiac amyloidosis in 24 patients (5 patients with light-chain, 18 with transthyretin amyloidosis, 1 undetermined), hypertrophic cardiomyopathy in 24, and hypertensive heart disease in 80 patients. Mean age of patients was 65 ± 13years, 84% were male. LV mass was increased in patients with LV hypertrophy compared to healthy control (p < 0.001). Native T1 values of the LV myocardium were higher in patients with cardiac amyloidosis (1409 ± 59ms, p < 0.0001 vs. all other groups) compared to healthy control (1225 ± 21ms), patients with hypertrophic cardiomyopathy (HCM; 1263 ± 43ms) and hypertensive heart disease (HHD; 1257 ± 41ms) (Figure). Patients with hypertrophic cardiomyopathy and hypertensive heart disease did not differ in their native T1 values, but both groups were increased compared to healthy control (p < 0.01). Receiver operating characteristic analysis of native T1 values demonstrated an area under the curve for the detection of cardiac amyloidosis of 0.9954 (p < 0.0001) vs. hypertrophic cardiomyopathy, hypertensive heart disease and healthy control. The optimal cut-off value was 1341ms, with a sensitivity of 100% and a specificity of 97%. Conclusion Native T1 mapping has high diagnostic accuracy for the diagnosis of cardiac amyloidosis among patients with LV hypertrophy. These data need confirmation in a prospective clinical trial. Study ID DRKS00022048

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Abstract 14783: Relationship Between Native Papillary Muscle T1 Time and Severity of Functional Mitral Regurgitation in Patients With Non-ischemic Dilated Cardiomyopathy

Circulation ◽

10.1161/circ.132.suppl_3.14783 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Shingo Kato ◽

Sébastien Roujol ◽

Francesca Delling ◽

Shadi Akhtari ◽

Jihye Jang ◽

...

Keyword(s):

Mitral Regurgitation ◽

Dilated Cardiomyopathy ◽

Papillary Muscle ◽

T1 Mapping ◽

Functional Mitral Regurgitation ◽

Diffuse Fibrosis ◽

Regurgitant Fraction ◽

Native T1 ◽

Non Ischemic Dilated Cardiomyopathy ◽

Native T1 Time

Introduction: Functional mitral regurgitation is one of the severe complications of non-ischemic dilated cardiomyopathy (DCM). Non-contrast native T1 mapping has emerged as a non-invasive method to evaluate myocardial fibrosis. Hypothesis: We hypothesized that papillary muscle native T1 time is correlated with severity of functional mitral regurgitation in DCM patients. Methods: Forty DCM patients (55±13 years) and 20 healthy adult control subjects (54±13 years) were studied. Native T1 mapping was performed using a slice interleaved T1 mapping sequence (STONE) which enables acquisition of 5 slices in the short-axis plane within a 90 sec free-breathing scan. We measured papillary muscle diameter, length and shortening. DCM patients were allocated into 2 groups based on the presence or absence of functional mitral regurgitation. Results: Papillary muscle T1 time was significantly elevated in DCM patients with mitral regurgitation (n=22) in comparison to those without mitral regurgitation (n=18) (anterior papillary muscle: 1127±36 msec vs 1063±16 msec, p<0.001; posterior papillary muscle: 1124±30 msec vs 1062±19 msec, p<0.001), but LV T1 time was similar (1129±38 msec vs 1134±58 msec, p=0.93). Multivariate linear regression analysis showed that papillary muscle native T1 time (β=0.109, 95%CI: 0.048-0.170, p=0.001) and tenting height (β=1.334, 95%CI: 0.434-2.234, p=0.005) are significantly correlated with mitral regurgitant fraction. Elevated papillary muscle T1 time was associated with larger diameter, longer length and decreased papillary muscle shortening (all p values <0.05). Conclusions: In DCM, papillary muscle native T1 time is significantly elevated and related to mitral regurgitant fraction. These results suggest that papillary muscle diffuse fibrosis might be associated with severity of mitral regurgitation in this population.

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