Abstract 14244: Gender-Specific Association Between Serum Markers of Systemic Inflammation and Interstitial Cardiac Fibrosis: The Multi-Ethnic Study of Atherosclerosis (MESA)

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Victor Nauffal ◽  
Bharath Ambale Venkatesh ◽  
Colin Wu ◽  
Hossein Bahrami ◽  
Russell Tracy ◽  
...  
Keyword(s):  
Systemic Inflammation ◽  
T1 Mapping ◽  
Cardiac Fibrosis ◽  
Ventricular Remodeling ◽  
Volume Fraction ◽  
Interstitial Fibrosis ◽  
Extracellular Volume ◽  
Inverse Association ◽  
Post Contrast ◽  
Markers Of Inflammation

Introduction: Inflammation contributes to pathogenic ventricular remodeling. Recently, T1 mapping has been used to non-invasively measure interstitial myocardial fibrosis. We examined the association between baseline markers of systemic inflammation and interstitial fibrosis measured using T1 mapping at 10 years follow-up in MESA. Methods and Results: 1,156 participants underwent cardiac magnetic resonance imaging with T1 mapping. All analyses were stratified by gender. Three hierarchical multivariable linear regression models were constructed to assess the risk-adjusted association of baseline C-reactive protein (CRP), interleukin 6 (IL-6) and fibrinogen with 25 minutes post-contrast myocardial T1 time (T1Myo25). Shorter T1Myo25 reflect increasing levels of interstitial fibrosis. We found a non-linear relationship between IL-6 and T1Myo25 in males (Figure 1A). A significant negative association between T1Myo25 and increasing levels of IL-6 was found in males that reversed at IL-6 levels ≥2.7pg/ml. Moreover in males, increasing levels of fibrinogen were significantly negatively associated with T1Myo25, while a similar but non-significant trend was found for CRP (Figure 1B). In women, there was a similar inverse association between T1Myo25 and increasing levels of all three markers of systemic inflammation prior to adjusting for body mass index that became statistically non-significant following adjustment (Figure 1B). Similar associations with markers of inflammation were found using extracellular volume fraction and T1Myo12 as measures of interstitial fibrosis. Conclusions: Markers of systemic inflammation in males, particularly IL-6 and fibrinogen, are independently associated with increased interstitial fibrosis. In females, this association may be mediated by the obesity-induced inflammatory-state. These findings highlight the early role of inflammation in the pathogenesis of heart failure.

scholarly journals Quantification of Early Diffuse Myocardial Fibrosis Through 7.0 T Cardiovascular Magnetic Resonance T1 Mapping in a Type 1 Diabetic Mellitus Mouse Model

2021 ◽  
Author(s):  
Hongkai Zhang ◽  
Chun-Yan Shi ◽  
Lin Yang ◽  
Nan Zhang ◽  
Guo-qi Li ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Mouse Model ◽  
T1 Mapping ◽  
Volume Fraction ◽  
Interstitial Fibrosis ◽  
Early Stage ◽  
Extracellular Volume ◽  
Control Group ◽  
Post Contrast

Abstract Background Diffuse myocardial interstitial fibrosis (DMIF) is a key factor for heart failure (HF) in diabetic cardiomyopathy. This study examined the accuracy of the qualitative and quantitative evaluation of early DMIF in a type 1 diabetes mellitus (T1DM) mouse model through 7.0 T cardiac magnetic resonance imaging-based T1 mapping.Methods Eight-week-old C57Bl/6J male mice were randomly divided into control (n = 20) and T1DM (n = 30, induced by a low dose streptozotocin dose of 60 mg/kg) groups. The progression of DMIF was examined every 4 weeks until 24 weeks after successful establishment of the model. Cardiac functional and morphological parameters were evaluated through echocardiography by using a high-resolution ultrasound cardiovascular system. A 7.0 T CMR scan was performed using the pre- and post-contrast GRE Look–Locker inversion recovery T1 mapping sequence. The extracellular volume fraction (ECV) was calculated from CMR and hematocrit data. Sirius Red staining was simultaneously performed in each group to detect DMIF and calculate the collagen volume fraction (CVF). Differences in ECV and CVF values between two groups were analyzed using one-way analysis of variance. The correlation between ECV and CVF values was assessed using the Pearson test.Results Six mice were included every 4 weeks in the control and T1DM groups for statistical analysis. Compared with the control group, a progressive decrease in FS, EF, and E/A ratio was observed in the T1DM group. In the T1DM group, both ECV and CVF values were gradually increased during diabetes progression. A marked increase in ECV and CVF values was observed at 12 weeks in the T1DM group than in the control group (ECV: 32.5% ± 1.6% vs 28.1% ± 1.8%, P = 0.002; CVF: 6.9% ± 1.8% vs 3.3% ± 1.1%, P < 0.01). ECV values showed a strong correlation with CVF in the T1DM group (r = 0.856, P < 0.001).Conclusion ECV is a reliable and feasible imaging marker that can be used to quantitatively assess dynamic DMIF changes in T1DM mice. In addition, ECV could accurately detect DMIF in the early stage and thus can be used as an imaging tool for early intervention in T1DM mice in the future.

scholarly journals T1 and T2 Mapping in Cardiology: “Mapping the Obscure Object of Desire”

Cardiology ◽  
2017 ◽  
Vol 138 (4) ◽  
pp. 207-217 ◽  
Author(s):  
Sophie Mavrogeni ◽  
Dimitris Apostolou ◽  
Panayiotis Argyriou ◽  
Stella Velitsista ◽  
Lilika Papa ◽  
...  
Keyword(s):  
Heart Failure ◽  
T1 Mapping ◽  
Clinical Decision Making ◽  
Volume Fraction ◽  
T2 Mapping ◽  
Extracellular Volume ◽  
Diffuse Fibrosis ◽  
Post Contrast ◽  
Cardiac Amyloid ◽  
Native T1

The increasing use of cardiovascular magnetic resonance (CMR) is based on its capability to perform biventricular function assessment and tissue characterization without radiation and with high reproducibility. The use of late gadolinium enhancement (LGE) gave the potential of non-invasive biopsy for fibrosis quantification. However, LGE is unable to detect diffuse myocardial disease. Native T1 mapping and extracellular volume fraction (ECV) provide knowledge about pathologies affecting both the myocardium and interstitium that is otherwise difficult to identify. Changes of myocardial native T1 reflect cardiac diseases (acute coronary syndromes, infarction, myocarditis, and diffuse fibrosis, all with high T1) and systemic diseases such as cardiac amyloid (high T1), Anderson-Fabry disease (low T1), and siderosis (low T1). The ECV, an index generated by native and post-contrast T1 mapping, measures the cellular and extracellular interstitial matrix (ECM) compartments. This myocyte-ECM dichotomy has important implications for identifying specific therapeutic targets of great value for heart failure treatment. On the other hand, T2 mapping is superior compared with myocardial T1 and ECM for assessing the activity of myocarditis in recent-onset heart failure. Although these indices can significantly affect the clinical decision making, multicentre studies and a community-wide approach (including MRI vendors, funding, software, contrast agent manufacturers, and clinicians) are still missing.

scholarly journals CMR-based T1-mapping offers superior diagnostic value compared to longitudinal strain-based assessment of relative apical sparing in cardiac amyloidosis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Dennis Korthals ◽  
Grigorios Chatzantonis ◽  
Michael Bietenbeck ◽  
Claudia Meier ◽  
Philipp Stalling ◽  
...  
Keyword(s):  
Cardiac Amyloidosis ◽  
Longitudinal Strain ◽  
T1 Mapping ◽  
Volume Fraction ◽  
Extracellular Volume ◽  
Left Ventricular ◽  
Cine Imaging ◽  
Characteristic Analysis ◽  
Post Contrast ◽  
Native T1

AbstractCardiac amyloidosis (CA) is an infiltrative disease. In the present study, we compared the diagnostic accuracy of cardiovascular magnetic resonance (CMR)-based T1-mapping and subsequent extracellular volume fraction (ECV) measurement and longitudinal strain analysis in the same patients with (a) biopsy-proven cardiac amyloidosis (CA) and (b) hypertrophic cardiomyopathy (HCM). N = 30 patients with CA, N = 20 patients with HCM and N = 15 healthy control patients without relevant cardiac disease underwent dedicated CMR studies. The CMR protocol included standard sequences for cine-imaging, native and post-contrast T1-mapping and late-gadolinium-enhancement. ECV measurements were based on pre- and post-contrast T1-mapping images. Feature-tracking analysis was used to calculate 3D left ventricular longitudinal strain (LV-LS) in basal, mid and apical short-axis cine-images and to assess the presence of relative apical sparing. Receiver-operating-characteristic analysis revealed an area-under-the-curve regarding the differentiation of CA from HCM of 0.984 for native T1-mapping (p < 0.001), of 0.985 for ECV (p < 0.001) and only 0.740 for the “apical-to-(basal + midventricular)”-ratio of LV-LS (p = 0.012). A multivariable logistical regression analysis showed that ECV was the only statistically significant predictor of CA when compared to the parameter LV-LS or to the parameter “apical-to-(basal + midventricular)” LV-RLS-ratio. Native T1-mapping and ECV measurement are both superior to longitudinal strain measurement (with assessment of relative apical sparing) regarding the appropriate diagnosis of CA.

Myocardial extracellular volume fraction quantification based on T1 mapping at 3 T: quality optimization by contour-based registration and segmental analysis

2021 ◽  
pp. 028418512110671
Author(s):  
Ling Lin ◽  
Xu-Hui Zhou ◽  
Mei Zheng ◽  
Qiu-Xia Xie ◽  
Qian Tao ◽  
...  
Keyword(s):  
Image Quality ◽  
T1 Mapping ◽  
Volume Fraction ◽  
Extracellular Volume ◽  
Extracellular Volume Fraction ◽  
Left Ventricular ◽  
Repeated Measurements ◽  
Related Factors ◽  
Post Contrast

Background Myocardial extracellular volume fraction (ECV) assessment can be affected by various technical and subject-related factors. Purpose To evaluate the role of contour-based registration in quantification of ECV and investigate normal segment-based myocardial ECV values at 3T. Material and Methods Pre- and post-contrast T1 mapping images of the left ventricular basal, mid-cavity, and apical slices were obtained in 26 healthy volunteers. ECV maps were generated using motion correction with and without contour-based registration. The image quality of all ECV maps was evaluated by a 4-point scale. Slices were dichotomized according to the occurrence of misregistration in the source data. Contour-registered ECVs and standard ECVs were compared within each subgroup using analysis of variance for repeated measurements and generalized linear mixed models. Results In all three slices, higher quality of ECV maps were found using contour-registered method than using standard method. Standard ECVs were statistically different from contour-registered ECVs in global (26.8% ± 2.8% vs. 25.8% ± 2.4%; P = 0.001), mid-cavity (25.4% ± 3.1% vs. 24.3% ± 2.5%; P = 0.016), and apical slices (28.7% ± 4.1% vs. 27.2% ± 3.4%; P = 0.010). In the misregistration subgroups, contour-registered ECVs were lower with smaller SDs (basal: 25.2% ± 1.8% vs. 26.7% ± 2.6%; P = 0.038; mid-cavity: 24.4% ± 2.3% vs. 26.8% ± 3.1%; P = 0.012; apical: 27.5% ± 3.6% vs. 29.7% ± 4.5%; P = 0.016). Apical (27.2% ± 3.4%) and basal-septal ECVs (25.6% ± 2.6%) were statistically higher than mid-cavity ECV (24.3% ± 2.5%; both P < 0.001). Conclusion Contour-based registration can optimize image quality and improve the precision of ECV quantification in cases demonstrating ventricular misregistration among source images.

scholarly journals Fast calculation software for modified Look-Locker inversion recovery (MOLLI) T1 mapping

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yoon-Chul Kim ◽  
Khu Rai Kim ◽  
Hyelee Lee ◽  
Yeon Hyeon Choe
Keyword(s):  
T1 Mapping ◽  
Volume Fraction ◽  
Extracellular Volume ◽  
Computation Time ◽  
Software Tool ◽  
Extracellular Volume Fraction ◽  
Inversion Recovery ◽  
Least Square ◽  
Post Contrast ◽  
T1 Map

Abstract Background The purpose of this study was to develop a software tool and evaluate different T1 map calculation methods in terms of computation time in cardiac magnetic resonance imaging. Methods The modified Look-Locker inversion recovery (MOLLI) sequence was used to acquire multiple inversion time (TI) images for pre- and post-contrast T1 mapping. The T1 map calculation involved pixel-wise curve fitting based on the T1 relaxation model. A variety of methods were evaluated using data from 30 subjects for computational efficiency: MRmap, python Levenberg–Marquardt (LM), python reduced-dimension (RD) non-linear least square, C++ single- and multi-core LM, and C++ single- and multi-core RD. Results Median (interquartile range) computation time was 126 s (98–141) for the publicly available software MRmap, 261 s (249–282) for python LM, 77 s (74–80) for python RD, 3.4 s (3.1–3.6) for C++ multi-core LM, and 1.9 s (1.9–2.0) for C++ multi-core RD. The fastest C++ multi-core RD and the publicly available MRmap showed good agreement of myocardial T1 values, resulting in 95% Bland–Altman limits of agreement of (− 0.83 to 0.58 ms) and (− 6.57 to 7.36 ms) with mean differences of − 0.13 ms and 0.39 ms, for the pre- and post-contrast, respectively. Conclusion The C++ multi-core RD was the fastest method on a regular eight-core personal computer for pre- or post-contrast T1 map calculation. The presented software tool (fT1fit) facilitated rapid T1 map and extracellular volume fraction map calculations.

scholarly journals Cardiac magnetic resonance assessment of right ventricular remodeling after anthracycline therapy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Thiago Ferreira de Souza ◽  
Thiago Quinaglia Silva ◽  
Lígia Antunes-Correa ◽  
Zsofia D. Drobni ◽  
Felipe Osório Costa ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Right Ventricular ◽  
Ventricular Remodeling ◽  
Interstitial Fibrosis ◽  
Systolic Dysfunction ◽  
Extracellular Volume ◽  
Increased Risk ◽  
Tissue Characteristics ◽  
A Prospective Study

AbstractThere are limited data on the effects of anthracyclines on right ventricular (RV) structure, function, and tissue characteristics. The goal of this study was to investigate the effects of anthracyclines on the RV using cardiac magnetic resonance (CMR). This was a post-hoc analysis of a prospective study of 27 breast cancer (BC) patients (51.8 ± 8.9 years) using CMR prior, and up to 3-times after anthracyclines (240 mg/m2) to measure RV volumes and mass, RV extracellular volume (ECV) and cardiomyocyte mass (CM). Before anthracyclines, LVEF (69.4 ± 3.6%) and RVEF (55.6 ± 9%) were normal. The median follow-up after anthracyclines was 399 days (IQR 310–517). The RVEF reached its nadir (46.3 ± 6.8%) after 9-months (P < 0.001). RV mass-index and RV CM decreased to 13 ± 2.8 g/m2 and 8.13 ± 2 g/m2, respectively, at 16-months after anthracyclines. The RV ECV expanded from 0.26 ± 0.07 by 0.14 (53%) to 0.40 ± 0.1 (P < 0.001). The RV ECV expansion correlated with a decrease in RV mass-index (r = −0.46; P < 0.001) and the increase in CK-MB. An RV ESV index at baseline above its median predicted an increased risk of LV dysfunction post-anthracyclines. In BC patients treated with anthracyclines, RV atrophy, systolic dysfunction, and a parallel increase of diffuse interstitial fibrosis indicate a cardiotoxic response on a similar scale as previously seen in the systemic left ventricle.

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