scholarly journals T1 mapping-derived signature of myocardial involvement in idiopathic inflammatory myopathy compared to acute viral myocarditis: a texture-based analysis

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
E Bollache ◽  
AT Huber ◽  
J Lamy ◽  
E Afari ◽  
TM Bacoyannis ◽  
...  
Keyword(s):  
Contrast Agent ◽  
Texture Analysis ◽  
T1 Mapping ◽  
Inflammatory Myopathy ◽  
Viral Myocarditis ◽  
Texture Features ◽  
Idiopathic Inflammatory Myopathy ◽  
Post Contrast ◽  
Myocardial T1 ◽  
Myocardial Involvement

Abstract Funding Acknowledgements Type of funding sources: None. Background. Recent studies revealed the ability of MRI T1 mapping to characterize myocardial involvement in both idiopathic inflammatory myopathy (IIM) and acute viral myocarditis (AVM), as compared to healthy controls. However, neither myocardial T1 nor T2 maps were able to discriminate between IIM and AVM patients, when considering conventional myocardial mean values and derived indices such as lambda and extracellular volume. Purpose. To investigate the ability of T1 mapping-derived texture analysis to differentiate IIM from AVM. Methods. Forty patients, 20 with IIM (51 ± 17 years, 9 men) and 20 with AVM (34 ± 13 years, 16 men) underwent 1.5T MRI T1 mapping using a modified Look-Locker inversion-recovery sequence before and 15 minutes after injection of a gadolinium contrast agent. After manual delineation of endocardial and epicardial borders and co-registration of all inversion time images, native and post-contrast T1 maps were estimated. Myocardial texture analysis was performed on native T1 maps. Textural features such as: autocorrelation, contrast, dissimilarity, energy and sum entropy were used to build a least squares-based linear regression model. Finally, receiver operating characteristic (ROC) analysis was used to investigate the ability of such texture features score to classify IIM vs. AVM patients, compared to the performance of mean myocardial T1. A Wilcoxon rank-sum test was also used to test difference significance between groups. Results. Both native and post-contrast mean myocardial T1 values were comparable between IIM (native: 1022 ± 43 ms; post-contrast: 319 ± 44 ms) and AVM (1056 ± 59 ms, p = 0.07; 318 ± 35 ms, p = 0.90, respectively) groups. Results of ROC analyses are provided in the Table, indicating that a better discrimination between IIM and AVM patients was obtained when using texture features, with higher AUC and accuracy than mean T1 values (Figure). Conclusion. Texture analysis derived from MRI T1 maps without contrast agent injection was able to discriminate between IIM and AVM with higher accuracy, sensitivity and specificity than conventional T1 indices. Such analysis could provide a useful myocardial signature to help diagnose and manage cardiac alterations associated with IIM in patients presenting with myocarditis and primarily suspected of AVM. Table Area under curve (AUC) Accuracy Sensitivity Specificity Native T1 0.67 0.70 0.65 0.75 Post-contrast T1 0.49 0.60 0.25 0.95 Texture features score 0.85 0.82 0.90 0.75 ROC analyses for classification between IIM and AVM patients Abstract Figure

Early detection of myocardial involvement by T1 mapping of cardiac MRI in idiopathic inflammatory myopathy

2018 ◽  
Vol 48 (2) ◽  
pp. 415-422 ◽  
Author(s):  
Liuyu Yu ◽  
Jianhong Sun ◽  
Jiayu Sun ◽  
Jiangbo Li ◽  
Yang Dong ◽  
...  
Keyword(s):  
Early Detection ◽  
Cardiac Mri ◽  
T1 Mapping ◽  
Inflammatory Myopathy ◽  
Idiopathic Inflammatory Myopathy ◽  
Myocardial Involvement

The diagnostic value of GDF-15 for myocardial involvement in idiopathic inflammatory myopathy

Rheumatology ◽  
2020 ◽  
Author(s):  
Mengqian Qiu ◽  
Xiaoxuan Sun ◽  
Xiaoqing Qi ◽  
Xianfang Liu ◽  
Yue Zhang ◽  
...  
Keyword(s):  
Myocardial Injury ◽  
Cardiac Involvement ◽  
Inflammatory Myopathy ◽  
Area Under The Curve ◽  
Idiopathic Inflammatory Myopathy ◽  
Diagnostic Value ◽  
Control Group ◽  
Cellular Volume ◽  
Potential Biomarker ◽  
Myocardial Involvement

Abstract Background Cardiac involvement is a serious complication of idiopathic inflammatory myopathy (IIM). GDF-15 can predict the risk and the prognosis of cardiovascular disease, but its value is unclear in IIM. Objective To investigate the diagnostic value of GDF-15 for myocardial involvement in IIM. Methods A total of 77 IIM patients from May 2018 to August 2020 were included in this retrospective study. Of these, 43 patients underwent cardiac magnetic resonance (CMR) examination. There were 33 SLE patients and 16 healthy people were used as the control group. The concentration of GDF-15 of these groups was measured by ELISA. Results There were significant differences in GDF-15 levels in patients with IIM, SLE and healthy controls (H = 45.291, P<0.001). GDF-15 levels were statistically significant different between IIM patients with the myocardial injury [1484.88(809.07 2835.50) pg/ml] and without myocardial injury [593.26(418.61 784.59) pg/ml, P =0.001]. After adjusted for age, renal function, the risk of myocardial injury in IIM patients increased an average of 0.3% by per increased unit of GDF-15 (odds ratio=1.003, 95% CI: 1.000, 1.007). The level of GDF-15 was positively correlated with extra-cellular volume (ECV) (rs = 0.348, P =0.028). GDF-15 ≥ 929.505 pg/ml (area under the curve=0.856, 95% CI: 0.744, 0.968) predicted myocardial injury in IIM with a sensitivity of 0.75 and specificity of 0.90. Conclusion GDF-15 could serve as a potential biomarker to predict myocardial injury in IIM patients.

scholarly journals Free-breathing post-contrast three-dimensional T1 mapping: Volumetric assessment of myocardial T1 values

2014 ◽  
Vol 73 (1) ◽  
pp. 214-222 ◽  
Author(s):  
Sebastian Weingärtner ◽  
Mehmet Akçakaya ◽  
Sébastien Roujol ◽  
Tamer Basha ◽  
Christian Stehning ◽  
...  
Keyword(s):  
T1 Mapping ◽  
Three Dimensional ◽  
Free Breathing ◽  
Post Contrast ◽  
Volumetric Assessment ◽  
Myocardial T1

scholarly journals FRI0259 THE CLINICAL VALUE OF GDF-15 IN ASSESSING MYOCARDIAL INVOLVEMENT OF IDIOPATHIC INFLAMMATORY MYOPATHY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 714.2-714
Author(s):  
M. Qiu ◽  
X. Sun ◽  
F. Lu ◽  
Q. Wang ◽  
L. Zhou
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Creatine Kinase ◽  
Lupus Erythematosus ◽  
Myocardial Injury ◽  
Cardiac Involvement ◽  
Inflammatory Myopathy ◽  
Idiopathic Inflammatory Myopathy ◽  
Systemic Lupus ◽  
Injury Group ◽  
Myocardial Involvement

Background:Cardiac involvement is a serious complication of idiopathic inflammatory myopathy (IIM). Early diagnosis and intervention can improve prognosis. At present, myocardial biopsy is the gold standard for its diagnosis, but it is not commonly used because of its invasiveness. Biomarkers can be invoked as a non-invasive and convenient choice. The traditional markers of myocardial injury, as troponin and creatine kinase are lack specificity in inflammatory myopathy, so the novel biomarkers are getting attention.GDF-15 can predict the risk of cardiovascular disease and the prognosis of coronary atherosclerosis, heart failure and other diseases.Objectives:This article was intended to investigate the diagnostic value of GDF-15 for myocardial involvement in inflammatory myopathy.Methods:This retrospective study included 54 patients with inflammatory myopathy from May 2018 to October 2019.Of these,30 patients underwent cardiac magnetic resonance examination due to increased myocardial markers, excluding 1 case of severe lung infection. 33 patients with systemic lupus erythematosus (SLE),16 normal patients were used as the control group.The concentration of GDF-15 in the serum of all groups of patients was measured by ELISA.Results:1. There were significantly differences in GDF-15 levels in patients with inflammatory myopathy, systemic lupus erythematosus and normal subjects (H =39.870, P <0.001).2. 29 patients with cardiac magnetic resonance on the basis of the delayed enhancement (LGE) and ECV results were divided into two groups in which 19 patients with myocardial injury group and 10 patients without myocardial injury. The best cut-off value was calculated by ROC curve,and comparing GDF-15 and CKMB with the optimum cut-off values in predicting cardiac involvement in IIM.GDF-15 levels were statistically significant between the myocardial injury group (1765.868±1068.549 pg/ml) and the group without myocardial injury(689.967±458.12 pg/ml)(p =0.0011).At the same time, the creatine kinase isoenzyme (CKMB)(158.583±119.389 U/L vs 57.96±52.673 U/L, p =0.005) was statistically different between the two groups.3.GDF-15≥1005.3650pg/ml (AUC =0.853,95% CI 0.694-1.000) predicted myocardial involvement in inflammatory diseases with a sensitivity of 0.765 and specificity of 0.900.The AUC of the ROC curve for the joint detection of GDF-15 and CKMB was 0.888,95% CI0.757-1.000,with the predicted probability cut-off value in 0.3895, the sensitivity 0.941 and the specificity 0.800.The combined detection of the two increased the sensitivity of myocardial damage detection in IIM patients. 5. After adjusted for age, renal function, the risk of myocardial injury in IIM patients increased by an average of 0.3% per unit of GDF-15(OR =1.003,95% CI 1.000–1.005).Conclusion:GDF-15 can predict myocardial injury in patients with inflammatory myopathy which have high specificity.The prediction sensitivity can be improved by combining with the traditional myocardial enzyme CKMB.More further studies are needed to confirm the specific mechanism of GDF-15 for myocardial involvement to assess the prognosis of such patients and guide further treatment.References:[1]Sultan SM, Ioannou Y, Moss K, Isenberg DA. Outcome in patients with idiopathic inflflammatory myositis: morbidity and mortality. Rheumatology (Oxford) 2002;41:22–6.[2]Lundberg IE, de Visser M, Werth VP. Classification of myositis. Nat Rev Rheumatol. 2018 May;14(5):269-278.[3]Zhang L, Wang GC, Ma L, Zu N (2012) Cardiac involvement in adult polymyositis or dermatomyositis: a systematic review. Clin Cardiol 35(11):686–691.[4]Chen F,Peng Y,Chen M. Diagnostic approach to cardiac involvement in idiopathic inflammatory myopathies.A strategy combining cardiac troponin I but not T assay with other methods[J].Int Heart J,2018;59:256-262Disclosure of Interests:None declared

Role of myocardial T1 mapping in arrhythmogenic right ventricular cardiomyopathy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
G Georgiopoulos ◽  
M Zampieri ◽  
S Molaro ◽  
A Chaloupka ◽  
B Barra ◽  
...  
Keyword(s):  
At Risk ◽  
Right Ventricular ◽  
T1 Mapping ◽  
Arrhythmogenic Right Ventricular Cardiomyopathy ◽  
Left Ventricular ◽  
Ventricular Cardiomyopathy ◽  
Post Contrast ◽  
First Degree Relatives ◽  
Myocardial T1

Abstract Background T1 mapping by cardiovascular magnetic resonance (CMR) is an accurate tool to assess myocardial extracellular space with wider clinical applications in the aetiological characterization of cardiomyopathies. The aims of the study were to explore a possible role of myocardial T1 mapping in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) and in first-degree relatives at risk and to investigate the possible relationship between left ventricular (LV) involvement at CMR and ECG features. Methods Thirty patients with ARVC (47% males, mean age 42±22 years) and 59 first-degree relatives who did not fulfil ARVC diagnostic Task Force criteria, underwent full diagnostic work-up including CMR with native and post-contrast T1 mapping. Results The CMR was abnormal in 26 (86%) patients with ARVC. The RV was affected in isolation in 13 (43%) patients. Prior to T1 mapping assessment, 2 (7%) patients exhibited isolated LV involvement and 11 (36%) patients showed features of biventricular disease. Left ventricular involvement was manifested as detectable LV late gadolinium enhancement (LGE) in 12 out of 13 cases. According to pre-specified septal T1 mapping thresholds, 11 (37%) patients showed abnormally high native T1 values. Myocardial T1 mapping was higher than normal in 5 (17%) patients who would have been classified as exhibiting a normal LV by conventional imaging. The proportion of patients with abnormal T1 values was similar in patients with or without LGE. Myocardial T1 mapping was higher than normal in 22 (37%) of the 59 first-degree relatives. Conclusions Native and/or post contrast myocardial T1 values are raised in almost half of patients with ARVC and in a similar proportion of unaffected first-degree relatives. T1 mapping offers the potential for early detection of LV involvement in patients with ARVC and in first-degree relatives at risk. Funding Acknowledgement Type of funding source: None

scholarly journals Myocardial T1 mapping and determination of partition coefficients at 3 tesla: comparison between gadobenate dimeglumine and gadofosveset trisodium

2018 ◽  
Vol 51 (1) ◽  
pp. 13-19 ◽  
Author(s):  
Marcelo Souto Nacif ◽  
Fabio S. Raman ◽  
Neville Gai ◽  
Jacquin Jones ◽  
Rob J. van der Geest ◽  
...  
Keyword(s):  
Contrast Agent ◽  
Partition Coefficient ◽  
Contrast Agents ◽  
Partition Coefficients ◽  
T1 Mapping ◽  
Gadobenate Dimeglumine ◽  
Blood Pool ◽  
Gadofosveset Trisodium ◽  
Myocardial T1 ◽  
The Mean

Abstract Objective: To compare an albumin-bound gadolinium chelate (gadofosveset trisodium) and an extracellular contrast agent (gadobenate dimeglumine), in terms of their effects on myocardial longitudinal (T1) relaxation time and partition coefficient. Materials and Methods: Study subjects underwent two imaging sessions for T1 mapping at 3 tesla with a modified look-locker inversion recovery (MOLLI) pulse sequence to obtain one pre-contrast T1 map and two post-contrast T1 maps (mean 15 and 21 min, respectively). The partition coefficient was calculated as ΔR1myocardium /ΔR1blood , where R1 is 1/T1. Results: A total of 252 myocardial and blood pool T1 values were obtained in 21 healthy subjects. After gadolinium administration, the myocardial T1 was longer for gadofosveset than for gadobenate, the mean difference between the two contrast agents being −7.6 ± 60 ms (p = 0.41). The inverse was true for the blood pool T1, which was longer for gadobenate than for gadofosveset, the mean difference being 56.5 ± 67 ms (p < 0.001). The partition coefficient (λ) was higher for gadobenate than gadofosveset (0.41 vs. 0.33), indicating slower blood pool washout for gadofosveset than for gadobenate. Conclusion: Myocardial T1 times did not differ significantly between gadobenate and gadofosveset. At typical clinical doses of the contrast agents, partition coefficients were significantly lower for the intravascular contrast agent than for the extravascular agent.

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