Abstract
Recently, the possibilities of heart magnetic resonance (MR) imaging have expanded significantly thanks to the introduction of magnetic resonance imaging. An important role in the diagnosis of left ventricular dysfunction is played by T1 and T2 mapping – with the calculation of extracellular volume (ECV). It is proved that, in patients with dilatated cardiomyopathy, the use of T-1 and ECV-mapping allows to assess the degree of myocardial damage by detecting diffuse fibrosis. ECV can be increased due to diffuse fibrosis and edema, therefore, in this group of patients it is advisable to conduct additional T2-mapping in order to detect edema. Indicators of MR-parametric mapping have not only diagnostic, but also prognostic significance. According to reports, ECV is a strong independent predictor of adverse cardiovascular events and has excellent potential predictive value.
References
- Salerno М., Kramer С.М. Advances in parametric mapping with CMR imaging. JACC Cardiovasc. Imaging. 2013; 6 (7): 806–22. DOI: 10.1016/j.jcmg.2013.05.005
-
Pradella S., Grazzini G., Brandani M., Calistri L., Nardi C., Mori F. et al. Cardiac magnetic resonance in patients with mitral valve prolapse: Focus on late gadolinium enhancement and T1 mapping. Eur. Radiol. 2019; 29: 1546–54. DOI: 10.1007/s00330-018-5634-5
- Messroghli D.R., Moon J.C., Ferreira V.M., GrosseWortmann L., He T., Kellman P. et al. Clinical recommendations for cardiovascular magnetic resonance mapping of T1, T2, T2* and extracellular volume: A consensus statement by the Society for Cardiovascular Magnetic Resonance (SCMR) endorsed by the European Association for Cardiovascular Imaging (EACVI). JACC Cardiovasc. Imaging. 2017; 19: 75. DOI: 10.1186/s12968-017-0389-8
- Lagan J., Schmitt M., Miller C.A. Clinical applications of multi-parametric CMR in myocarditis and systemic inflammatory diseases. Int. J. Cardiovasc. Imaging. 2018; 34 (1): 35–54. DOI: 10.1007/S10554-017-1063-9
- Haaf P., Garg P., Messroghli D.R., Broadbent D.A., Greenwood J.P., Plein S. Cardiac T1 mapping and Extracellular Volume (ECV) in clinical practice: a comprehensive review. J. Cardiovasc. Magn. Reson. 2016; 18: 89. DOI: 10.1186/s12968-016-0308-4
- Burt J.R., Zimmerman S.L., Kamel I.R., Halushka M., Bluemke D.A. Myocardial T1 mapping: Techniques and potential applications. RadioGraphics. 2014; 34: 377–95.
- Puntmann V.O., Voigt T., Chen Z., Mayr M., Karim R., Rhode K. et al. Native T1-mapping in differentiation of normal myocardium from diffuse disease in hypertrophic and dilated cardiomyopathy. J. Am. Coll. Cardiol. Img. 2013; 6: 475–84.
- Bull S., White S.K., Piechnik S.K., Flett A.S., Ferreira V.M., Loudon M. et al. Human non-contrast T1 values and correlation with histology in diffuse fibrosis. Heart. 2013; 99: 932–7. DOI: 10.1136/heartjnl-2012-303052
- Bulluck H., White S.K., Rosmini S., Bhuva A., Treibel T.A., Fontana M. et al. T1 mapping and T2 mapping at 3T for quantifying the area-at-risk in reperfused STEMI patients. J. Cardiovasc. Magn. Reson. 2015; 17: 73. DOI: 10.1186/s12968-015-0173-6 . Published Online First: 2015/08/13.
- Roy C., Slimani A., Meester C., Amzulescu M., Pasquet A., Vancraeynest D. et al. Age and sex corrected normal reference values of T1, T2 T2* and ECV in healthy subjects at 3T CMR. J. Cardiovasc. Magn. Reson. 2017; 19: 72. DOI: 10.1186/s12968-017-0371-5
- Flagg E.R., Santos Lima A.P., Kallianos K.G., Ordovas K.G. Nonischemic cardiomyopathies. Radiol. Clin. N. Am. 2019; 57: 67–73. DOI: 10.1016/j.rcl.2018.08. 003 0033-8389/19
- Diao K., Yang Z., Xu H., Liu X., Zhang Q., Shi K. et al. Histologic validation of myocardial fibrosis measured by T1 mapping: a systematic review and meta-analysis. J. Cardiovasc. Magn. Reson. 2017; 18 (1): 92.
- Bandula S., Banypersad S.M., Sado D., Flett A.S., Punwani S., Taylor S.A. et al. Measurement of tissue interstitial volume in healthy patients and those with amyloidosis with equilibrium contrast-enhanced MR imaging. Radiology. 2013; 268: 858–64. DOI: 10.1148/radiol.13121889
- Radunski U.K., Lund G.K., Stehning C., Schnackenburg B., Bohnen S., Adam G. et al. CMR in patients with severe myocarditis. Diagnostic value of quantitative tissue markers including extracellular volume imaging. J. Am. Coll. Cardiol. Img. 2014; 7: 667–75. DOI: 10.1016/j.jcmg.2014.02.005
- Ho C.Y., Abbasi S.A., Neilan T.G., Shah R.V., Chen Y., Heydari B. et al. T1 measurements identify extracellular volume expansion in hypertrophic cardiomyopathy sarcomere mutation carriers with and without left ventricular hypertrophy. Circ. Cardiovasc. Imaging. 2013; 6: 415–22. DOI: 10.1161/CIRCIMAGING.112.000333
- Yuan Y., Cai J., Tsui Y., Wang J., Alwalid O., Shen X. et al. CMR-derived extracellular volume fraction (ECV) in asymptomatic heart transplant recipients: correlations with clinical features and myocardial edema. Int. J. Cardiovasc. Imaging. 2018; 34: 1959–67. DOI: 10.1007/s10554-018-1421-2
- Ide S., Riesenkampff E., Chiasson D.A., Dipchand A.I., Kantor P.F., Chaturvedi R.R. et al. Histological validation of cardiovascular magnetic resonance T1 mapping markers of myocardial fibrosis in paediatric heart transplant recipients. J. Cardiovasc. Magn. Reson. 2017; 19 (1): 10. DOI: 10.1186/S12968-017-0326-X
- Shivraman G., Yiu-Cho C., Ali M., Georgeta M., Sanjay R., Raman S.V., Simanetty O.P. et al. T2 quantification for improved detection of myocardial edema. J. Cardiovasc. Magn. Reson. 2009; 11 (1): 56. DOI: 10.1186/1532429X-11-56
- Boomen M., Slart R.H.J.A., Hulleman E.V., Dierckx R.A.J.O., Velthuis B.K., van der Harst P. et al. Native T1 reference values for nonischemic cardiomyopathies and populations with increased cardiovascular risk: A systematic review and meta-analysis. J. Magn. Reson. Imaging.2018; 47: 891–912. DOI: 10.1002/jmri.25885
- Mikami Y., Cornhill A., Heydari B., Joncas S.X., Almehmadi F., Zahrani M. et al. Objective criteria for septal fibrosis in non-ischemic dilated cardiomyopathy: validation for the prediction of future cardiovascular events. J. Cardiovasc. Magn. Reson. 2016; 18: 82. DOI: 10.1186/s12968-016-0300-z
- Gao P., Yee R., Gula L., Krahn A.D., Skanes A., LeongSit P. et al. Prediction of arrhythmic events in ischemic and dilated cardiomyopathy patients referred for implantable cardiac defibrillator: evaluation of multiple scar quanti-fication measures for late gadolinium enhancement magnetic resonance imaging. Circ. Cardiovasc. Imaging. 2012; 5: 448–56. DOI: 10.1161/CIRCIMAGING.111.971549
- McMurray J.J., Packer M., Desai A.S., Gong J., Lefkowitz M.P., Rizkala A.R. et al. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N. Engl. J. Med. 2014; 371: 993–1004. DOI: 10.1056/NEJMoa1409077
- Lehrke S., Lossnitzer D., Schöb M., Steen H., Merten C., Kemmling H. et al. Use of cardiovascular magnetic resonance for risk stratification in chronic heart failure: prognostic value of late gadolinium enhancement in patients with non-ischaemic dilated cardiomyopathy. Heart. 2011; 97: 727–32. DOI: 10.1136/hrt.2010.205542
- Iles L.M., Ellims A.H., Llewellyn H., Hare J.L., Kaye D.M., McLean C.A. et al. Histological validation of cardiac magnetic resonance analysis of regional and diffuse interstitial myocardial fibrosis. Eur. Heart J. Cardiovasc. Imaging. 2015; 16: 14–22. DOI: 10.1093/ehjci/je1482
- Weber K.T., Brilla C.G. Pathological hypertrophy and cardiac interstitium: fibrosis and renin-angiotensinaldosterone system. Circulation. 1991; 83 (6): 1849–65. DOI: 10.1161/01.CIR.83.6.1849
- Moon J.C., Sachdev B., Elkington A.G., McKenna W.J., Mehta A., Pennell D.J. et al. Gadolinium enhanced cardiovascular magnetic resonance in Anderson-Fabry disease: evidence for a disease specific abnormality of the myocardial interstitium. Eur. Heart J. 2003; 24 (23): 2151–5. DOI: 10.1016/j.ehj.2003.09.017
- Rubinshtein R., Glockner J.F., Ommen S.R., Araoz P.A., Ackerman M.J., Sorajja P. et al. Characteristics and clinical significance of late gadolinium enhancement by contrast-enhanced magnetic resonance imaging in patients with hypertrophic cardiomyopathy. Circ. Heart Fail. 2010; 3: 51–8. DOI: 10.1161/CIRCHEARTFAILURE. 109.854026
- ParkC.H., Choi E.-Y., Kwon H.M., Hong B.K., Lee B.K., Yoon Y.W. et al. Quantitative T2 mapping for detecting myocardial edema after reperfusion of myocardial infarction: validation and comparison with T2-weighted images. Int. J. Cardiovasc. Imaging. 2013; 29: 65–72. DOI: 10.1007/s10554-013-0256-0
- Alter P., Rupp H. Late gadolinium enhancement and higher risk of arrhythmias fibrosis or increased ventricular wall stress? J. Am. Coll. Cardiol. 2011; 58 (11): 1194. DOI: 10.1016/j.jacc.2011.03.061
- Siepen F., Seitz S.A., Giannitsis E., Katus H.A., Steen H., Abdel H. et al. Non-invasive measurement of myocardial extracellular volume using T1 mapping as a novel biomarker of diffuse fibrosis in dilated cardiomyopathy. J. Cardiovasc. Magn. Reson. 2013; 15 (Suppl. 1): E113. DOI: 10.1186/1532-429X-15-S1-E113
- Nguyen C., Fan Zh., Xie Y., Dawkins J., Tseliou E., Bi X. et al. In vivo contrast free chronic myocardial infarction characterization using diffusion-weighted cardiovascular magnetic resonance. J. Cardiovasc. Magn. Reson. 2014; 16: 68. DOI: 10.1186/s12968-014-0068-y
- Abdullah O.M., Drakos S.G., Diakos N.A., Wever-Pinzon O., Kfoury A.G., Stehlik J. et al. Characterization of diffuse fibrosis in the failing human heart via diffusion tensor imaging and quantitative histological validation. NMR Biomed. 2014; 27: 1378–86. DOI: 10.1002/nbm.3200
- Hinojar R., Varma N., Child N., Goodman B., Jabbour A., Yu C.Y. et al. T1 mapping in discrimination of hypertrophic phenotypes: hypertensive heart disease and hypertrophic cardiomyopathy: findings from the international t1 multicenter cardiovascular magnetic resonance study. Circ. Cardiovasc. Imaging. 2015; 8: e003285. DOI: 10.1161/CIRCIMAGING.115.003285
- Schalla S., Bekkers S.C., Dennert R., van Suylen R.J., Waltenberger J., Leiner T. et al. Replacement and reactive myocardial fibrosis in idiopathic dilated cardiomyopathy: comparison of magnetic resonance imaging with right ventricular biopsy. Eur. J. Heart Fail. 2010; 12: 227–31. DOI: 10.1093/eurjhf/hfq004
- Voigt A., Elgeti T., Durmus T., Idiz M.E., Butler C., Beling M. et al. Cardiac magnetic resonance imaging in dilated cardiomyopathy in adults – toward identification of myocardial inflammation. Eur. Radiol. 2011; 21 (5): 925–35. DOI: 10.1007/S00330-010-1985-2
- Messroghli D.R., Walters K., Plein S., Sparrow P., Friedrich M.G., Ridgway J.P. et al. Myocardial T1 mapping: application to patients with acute and chronic myocardial infarction. Magn. Reson. Med. 2007; 58 (1): 34–40. DOI: 10.1002/mrm.21272
- Kali A., Choi E.Y., Sharif B., Kim Y.J., Bi X., Spottiswoode B. et al. Native T1 mapping by 3-T CMR imaging for characterization of chronic myocardial infarctions. J. Am. Coll. Cardiol. Img.2015; 8: 1019–30. DOI: 10.1016/j.jcmd.2015.04.018
- Ntusi N.A.B., Piechnik S.K., Francis J.M., Ferreira V.M., Matthews P.M., Robson M.D. et al. Diffuse myocardial fibrosis and inflammation in rheumatoid arthritis: insights from CMR T1 mapping. J. Am. Coll. Cardiol. Img. 2015; 8: 526–36. DOI: 10.1016/j.jcmd.2014.12.025
- Ntusi N.A., Piechnik S.K., Francis J.M., Ferreira V.M., Rai A.B., Matthews P.M. et al. Subclinical myocardial inflammation and diffuse fibrosis are common in systemic sclerosis – a clinical study using myocardial T1-mapping and extracellular volume quantification. J. Cardiovasc. Magn. Reson. 2014; 16: 21. DOI: 10.1186/1532-429X-16-21
- Herskowitz A., Soule L.M., Mellits E.D., Traill T.A., Achuff S.C., Reitz B.A. et al. Histologic predictors of acute cardiac rejection in human endomyocardial biopsies: a multivariate analysis. J. Am. Coll. Cardiol. 1987; 9: 802–10.
- Imran M., Wang L., McCrohon J., Yu C., Holloway C., Otton J. et al. Native T1 mapping in the diagnosis of cardiac allograft rejection a prospective histologically validated study. JACC Cardiovasc. Imaging. 2019: 12 (8 Pt 2): 1618–28. DOI: 10.1016/j.jcmg.2018.10.027
- Miller C.A., Naish J.H., Shaw S.M., Yonan N., Williams S.G., Clark D. et al. Multiparametric cardiovascular magnetic resonance surveillance of acute cardiac allograft rejection and characterisation of transplantation-associated myocardial injury: a pilot study. J. Cardiovasc. Magn. Reson. 2014; 16: 52. DOI: 10.1186/S12968-014-0052-6
- Carrick D., Haig C., Rauhalammi S., Ahmed N., Mordi I., McEntegart M. et al. Pathophysiology of LV remodeling in survivors of STEMI: inflammation, remote myocardium, and prognosis. JACC Cardiovasc. Imaging. 2015; 8: 779–89. DOI: 10.1016/j.jcmd.2015.03.007
- Nakamori S., Alakbarli J., Bellm S., Motiwala S.R., Addae G., Manning W.J. et al. Native T1 value in the remote myocardium is independently associated with left ventricular dysfunction in patients with prior myocardial infarction. J. Magn. Reson. Imaging. 2017; 46 (4): 1073–81. DOI: 10.1002/jmri.25652 . Epub 2017 Feb 2.
- Volders P.G., Willems I.E., Cleutjens J.P., Arends J.W., Havenith M.G., Daemen M.J. Interstitial collagen is increased in the non-infarcted human myocardium after myocardial infarction. J. Mol. Cell. Cardiol.1993; 25: 1317–23.
- Araujo-Filho J.A.B., Assuncao A.N. Jr, Tavares de Melo M.D., Bière L., Lima C.R., Dantas R.N. Jr. et al. Myocardial T1 mapping and extracellular volume quantification in patients with left ventricular non-compaction cardiomyopathy. Eur. Heart J. Cardiovasc. Imaging. 2018; 19: 888–95. DOI: 10.1093/ehjci/jey022
- Kato S., Nakamori S., Roujol S., Delling F.N., Akhtari S., Jang J. et al. Relationship between native papillary muscle T1 time and severity of functional mitral regurgitation in patients with non-ischemic dilated cardiomyopathy. J. Cardiovasc. Magn. Reson. 2016; 18: 79. DOI: 10.1186/s12968-016-0301-y
- Thomsen H.S. ESUR guideline: Gadolinium-based contrast media and nephrogenic systemic fibrosis. Eur. Radiol. 2007; 17: 2692–6.
- Dass S., Suttie J.J., Piechnik S.K., Ferreira V.M., Holloway C.J., Banerjee R. et al. Myocardial tissue characterization using magnetic resonance noncontrast T1 mapping in hypertrophic and dilated cardiomyopathy. Circ. Cardiovasc. Imaging. 2012; 5 (6): 726–33. DOI: 10.1161/CIRCIMAGING.112.976738
- Dall'Armellina E., Piechnik S.K., Ferreira V.M., Si Q.L., Robson M.D., Francis J.M. et al. Cardiovascular magnetic resonance by noncontrast T1-mapping allows assessment of severity of injury in acute myocardial infarction. J. Cardiovasc. Magn. Reson. 2012; 14 (1): 15. DOI: 10.1186/1532-429X-15-15
- Priori S.G., Blomström-Lundqvist C., Mazzanti A., Blom N., Borggrefe M., Camm J. et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: the task force for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death of the European Society of Cardiology (ESC). Eur. Heart J. 2015; 36: 2793–867. DOI: 10.1093/eurheart/ehv316
- Juillière Y., Danchin N., Briançon S., Khalife K., Ethèvenot G., Balaud A. et al. Dilated cardiomyopathy: longterm follow-up and predictors of survival. Int. J. Cardiol. 1988; 21: 269–77. DOI: 10.1007/BF00812370
- Bockeria O.L., Shadaniya Ya.R., Averina I.I., Mironenko M.Yu., Dontsova V.I., Soboleva N.N. The use of indicators of myocardial deformation in the selection of patients for cardiac resynchronization therapy. Annals of Arithmology. 2011; 1: 30–4 (in Russ.).
- Tachi M., Amano Y., Inui K., Takeda M., Yamada F., Asai K. et al. Relationship of postcontrast myocardial T1 value and delayed enhancement to reduced cardiac function and serious arrhythmia in dilated cardiomyopathy with left ventricular ejection fraction less than 35. Acta Radiol. 2016; 57 (4): 430–6. DOI: 10.1177/0284185115580840
- Brown P.F., Miller C., Di Marco A., Schmitt M. Towards cardiac MRI based risk stratification in idiopathic dilated cardiomyopathy. Heart. 2018; 105 (4): 270–5. DOI: 10.1136/heartjnl-2018-313767
- Zhuang B., Sirajuddin A., Wang S., Arai A., Zhao S., Lu M. Prognostic value of T1 mapping and extracellular volume fraction in cardiovascular disease: a systematic review and meta-analysis. Heart Fail. Rev. 2018; 23: 723–31. DOI: 10.1007/S00330-019-06470-8
- Rommel K.P., Lücke C., Lurz P. Diagnostic and prognostic value of CMR T. Rev. Esp. Cardiol. (Engl. Ed.). 2017; 70: 848–55.
About the authors
Madina M. Kodzova, Postgraduate, orcid.org/0000-0002-6007-2984
