scholarly journals Cardiac MRI utilizing late gadolinium enhancement (LGE) and T1 mapping in the detection of radiation induced heart disease

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Anthony Ricco ◽  
Alexander Slade ◽  
Justin M. Canada ◽  
John Grizzard ◽  
Franklin Dana ◽  
...  
Keyword(s):  
Heart Disease ◽  
Late Gadolinium Enhancement ◽  
Cardiac Mri ◽  
T1 Mapping ◽  
Gadolinium Enhancement ◽  
Radiation Induced

scholarly journals Cardiac MRI utilizing late gadolinium enhancement (LGE) and T1 mapping in the detection of radiation induced heart disease

2020 ◽  
Author(s):  
Anthony Ricco ◽  
Alexander Slade ◽  
Justin Canada ◽  
John Grizzard ◽  
Franklin Dana ◽  
...  
Keyword(s):  
Late Gadolinium Enhancement ◽  
Myocardial Fibrosis ◽  
Cardiac Mri ◽  
T1 Mapping ◽  
Myocardial Damage ◽  
Smoking History ◽  
Tumor Type ◽  
Clinical Factors ◽  
Gadolinium Enhancement ◽  
Cross Sectional

Abstract Background and Purpose: Radiotherapy has been associated with late dose-dependent cardiovascular toxicity. In this cross-sectional pilot study, radiation dose distributions were correlated with areas of localized and diffuse myocardial fibrosis as measured by novel cardiac MRI (CMR) sequences including late gadolinium enhancement (LGE) and T1 mapping with the goal to identify early markers of myocardial damage.Materials and Methods: Twenty-eight patients with chest tumors including lung, breast, esophagus, and lymphoma underwent CMR per study protocol on average 46.4 months (range 1.7-344.5) after radiotherapy. Patients without pretreatment cardiac history were included if the volume of heart receiving 5 Gy or more was at least 10% (V5Gy≥10%). The association of LGE with cardiac dosimetric factors, clinical factors (e.g., tumor type, smoking history, BMI), , and T1 values was analyzed. Results: Cardiac maximum (Dmax) and mean dose (Dmean) equivalent to doses delivered in 2 Gy fractions (EQD2) were on average 50.9 Gy (range 6.2-108.0) and 8.2 Gy (range 1.0-35.7), respectively, compared to 60.8 Gy (40.8-108.0) and 6.8 Gy (1.8-21.8) among the 9 patients with LGE. Doses were not different between patients with and without LGE (p=0.16 and 0.56, respectively). The average T1 value of the left ventricle myocardium was 1009 ms (range 933-1117). No significant correlation was seen for heart Dmax and Dmean and T1 values (p=0.14 and 0.58, respectively). In addition, no significant association between clinical factors and the development of LGE was identified.Conclusions: No relation between cardiac doses, the presence of LGE or T1 values was observed. Further study is needed to determine the benefit of CMR for detecting radiotherapy-related myocardial fibrosis.

scholarly journals Cardiac MRI utilizing late gadolinium enhancement (LGE) and T1 mapping in the detection of radiation induced heart disease

2020 ◽  
Author(s):  
Anthony Ricco ◽  
Alexander Slade ◽  
Justin Canada ◽  
John Grizzard ◽  
Franklin Dana ◽  
...  
Keyword(s):  
Late Gadolinium Enhancement ◽  
Myocardial Fibrosis ◽  
Cardiac Mri ◽  
T1 Mapping ◽  
Myocardial Damage ◽  
Smoking History ◽  
Tumor Type ◽  
Clinical Factors ◽  
Gadolinium Enhancement ◽  
Cross Sectional

Abstract Background and Purpose Radiotherapy has been associated with late dose-dependent cardiovascular toxicity. In this cross-sectional pilot study, radiation dose distributions were correlated with areas of localized and diffuse myocardial fibrosis as measured by novel cardiac MRI (CMR) sequences including late gadolinium enhancement (LGE) and T1 mapping with the goal to identify early markers of myocardial damage. Materials and Methods Twenty-eight patients with chest tumors including lung, breast, esophagus, and lymphoma underwent CMR per study protocol on average 46.4 months (range 1.7-344.5) after radiotherapy. Patients without pretreatment cardiac history were included if the volume of heart receiving 5 Gy or more was at least 10% (V5Gy≥10%). The association of LGE with cardiac dosimetric factors, clinical factors (e.g., tumor type, smoking history, BMI), , and T1 values was analyzed. Results Cardiac maximum (Dmax) and mean dose (Dmean) equivalent to doses delivered in 2 Gy fractions (EQD2) were on average 50.9 Gy (range 6.2-108.0) and 8.2 Gy (range 1.0-35.7), respectively, compared to 60.8 Gy (40.8-108.0) and 6.8 Gy (1.8-21.8) among the 9 patients with LGE. Doses were not different between patients with and without LGE (p=0.16 and 0.56, respectively). The average T1 value of the left ventricle myocardium was 1009 ms (range 933-1117). No significant correlation was seen for heart Dmax and Dmean and T1 values (p=0.14 and 0.58, respectively). In addition, no significant association between clinical factors and the development of LGE was identified. Conclusions No relation between cardiac doses, the presence of LGE or T1 values was observed. Further study is needed to determine the benefit of CMR for detecting radiotherapy-related myocardial fibrosis.

Abstract 10958: Identification of Right Ventricular Myocardial Infarction With Late Gadolinium Enhancement in Chronic Ischemic Heart Disease: Comparison With Pathological Findings

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yan Chaowu ◽  
Li Li ◽  
Fang Wei ◽  
Li Hua ◽  
Wang Yang
Keyword(s):  
Myocardial Infarction ◽  
Heart Disease ◽  
Late Gadolinium Enhancement ◽  
Ischemic Heart Disease ◽  
Ischemic Heart ◽  
Pathological Findings ◽  
Chronic Ischemic Heart Disease ◽  
Gadolinium Enhancement ◽  
Right Ventricular Myocardial Infarction ◽  
Replacement Fibrosis

Introduction: Late gadolinium enhancement (LGE) has the potential to become an excellent technique in the diagnosis of right ventricular myocardial infarction (RVMI). However, the gold standard, pathological findings from patients, is still unavailable to validate the true value of LGE. Hypothesis: We hypothesized that LGE might correspond with histological infarction in RVMI. Methods: 36 transplant candidates (35 M /1F) with chronic ischemic heart disease were studied prospectively with LGE. According to the 12-segment-model, the pathological findings of RV were compared with the previous in vivo LGE after heart transplantation. Results: Histological RVMI was detected in 7 patients, and corresponded with all LGE segments (n=23) and 2 non-LGE segments. A generalize linear mix effect model showed non-significant difference (P=0.152) between the results of LGE and histological infraction. In identifying the RV segments with histological infarction, sensitivity and specificity of LGE was 92.0% (95%CI 74.0% to 99.0%) and 100% (95%CI 99.9% to 100.0%), respectively. Furthermore, RV segments without LGE mainly included two pathological patterns: histologically normal myocardium (n=372) or the admixture of viable myocardium and scattered replacement fibrosis (n=35). In the non-LGE RV segments, wall motion abnormality was associated with volume fraction of collagen (11.4±6.5% vs 4.3±2.2%, P<0.001) and the presence of ischemia (96.4% vs 1.7%, P<0.001). Conclusions: The RV segments with LGE corresponded closely with histological infarction in ischemic heart disease. However, RV segments without LGE might be histologically normal myocardium or intermixed with scattered replacement fibrosis. Further studies are required to evaluate the significance of scattered replacement fibrosis in the non-LGE segments.

The Prognostic Value of Late Gadolinium Enhancement in Nonischemic Heart Disease

2019 ◽  
Vol 27 (3) ◽  
pp. 545-561
Author(s):  
Zorana Mrsic ◽  
Negareh Mousavi ◽  
Edward Hulten ◽  
Marcio Sommer Bittencourt
Keyword(s):  
Heart Disease ◽  
Late Gadolinium Enhancement ◽  
Prognostic Value ◽  
Gadolinium Enhancement

scholarly journals P0254MYOCARDIAL TISSUE CHARACTERIZATION IN LIVING KIDNEY DONORS 5 YEARS AFTER NEPHRECTOMY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Anna Price ◽  
Victoria Stoll ◽  
Ravi Vijapurapu ◽  
Kirsty McGee ◽  
Roman Wesolowski ◽  
...  
Keyword(s):  
Late Gadolinium Enhancement ◽  
T1 Mapping ◽  
Cardiac Fibrosis ◽  
Left Ventricular ◽  
Healthy Controls ◽  
Gadolinium Enhancement ◽  
Post Contrast ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
Lv Mass

Abstract Background and Aims Uraemic cardiomyopathy is characterized by left ventricular (LV) hypertrophy, diastolic dysfunction and myocardial fibrosis. Diffuse interstitial fibrosis of the myocardium, assessed using cardiac magnetic resonance imaging (CMR) techniques of native T1-mapping and extracellular volume (ECV), has been demonstrated in end stage chronic kidney disease (CKD) and in patients with stage 3 CKD and normal left ventricular mass. In living kidney donors estimated glomerular filtration rate (eGFR) declines by a third after donation, with 60% having a resultant eGFR comparable with stage 3 CKD. Recent studies have demonstrated small increases in LV mass at 12 months after donation as well as functional sequelae of reduced global circumferential strain and apical torsion. We sought to establish whether living kidney donors had CMR evidence of diffuse interstitial cardiac fibrosis which might contribute to observed functional correlates. Method A cross sectional blinded study of living kidney donors (n=50) and healthy controls (n=45) who underwent 3 Tesla CMR and blood samples for biomarkers of fibrosis. A modified look-locker inversion recovery (MOLLI) 5(3)3 sampling scheme was used for T1 mapping followed by T2 mapping sequences at the mid LV slice. Five minutes after the administration of gadolinium (Gadovist®) contrast (0.15mmol/kg), standard T1-weighted gradient echo inversion recovery images were repeated for the assessment of late gadolinium enhancement (assessment for focal fibrosis). Post contrast MOLLI images were acquired using identical slice positions as native images using a 4(1)3(1)2 sampling scheme 15 minutes after the administration of gadolinium. Native and post contrast T1 time was used to calculate ECV. Results There were no differences in demographics between groups; age (donors 54 ± 12yrs vs. healthy controls 50 ± 13yrs, p=0.128), ethnicity (89% Caucasian) or male gender (37%). LV mass and volumes were not significantly different. Forty four donors and 34 controls consented to receive gadolinium contrast. Native T1 in the septal mid LV slice was not significantly different between groups (donors 1223 ± 35ms vs. controls 1210 ± 36ms, p=0.102). There was also no difference in T2 time of the septal mid LV slice (donors 40 ± 2ms vs. controls 40 ± 4ms vs. p=0.455). Late gadolinium enhancement was seen in five living kidney donors in a right ventricular insertion point pattern but there was no mid wall or ischaemic pattern enhancement. There was no difference in septal ECV at the mid LV slice (donors 25 ± 2% vs. controls 25 ± 2%, p=0.896). There was also no corresponding difference in fibroblast growth factor-23 (RU/ml) in donors 74 [58-105] vs. controls 59 [47-75], p=0.081 or soluble α-klotho (pg/ml) in donors 610 [503-810] vs. controls 703 [550-955], p=0.061. Conclusion Septal T1 times and ECV in living kidney donors at 5 years from donation are no different from healthy controls. Biomarkers of cardiac fibrosis are also comparable to healthy controls in this small cohort. We found no CMR evidence of the ultrastructural changes reported in uraemic cardiomyopathy in the hearts of living kidney donors at 5 years from donation.

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