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.
Papillary Muscle Viability Correlates with Changes of Functional Mitral Regurgitation in Patients with Nonischemic Dilated Cardiomyopathy
