Abstract
Introduction. Dilated cardiomyopathy (DCMP) is often associated with progression of heart failure and ventricular arrhythmias. Magnetic resonance imaging of the heart with delayed contrast can detect focal (irreversible) myocardial fibrosis or scar, and using T1 mapping, it is possible to quantify diffuse / interstitial (reversible) myocardial fibrosis, which is associated with global cardiac dysfunction in patients with DCMP. Objective: to determine the significance of post-contrast T1 myocardial time in assessing structural changes in the left ventricle for dysfunction and ventricular arrhythmias in patients with dilated cardiomyopathy and a left ventricular ejection fraction (LVEF) of less than 40%.
Material and methods. The study included 16 patients with DCMP with a low ejection fraction of the left ventricle (LVEF <40%). The dependence of the post-contrast values of T1 of the myocardium and the volume of focal myocardial fibrosis (%) was evaluated with delayed contrast from LVEF, end-diastolic volume (EDV). A comparative analysis of the values of T1, VA and the degree of fibrotic lesion of the LV myocardium was also performed.
Results. In patients with LVEF <35%, the post-contrast value of myocardial T1 significantly correlated with LVEF (r=0.457, P<0.05) and EDV (r=-0.695 P<0.05). No relationship was found between the volume of focal fibrosis with LVEF (r=-0.077, P>0.1) and the post-contrast value of T1 (p>0.05). However, a statistically significant correlation of ventricular arrhytmia with the volume of focal fibrosis was revealed in the general group of patients (r=0.846, p=0.001) and in the group of patients with LVEF <35% (r=0.855, p=0.001).
Conclusion. The post-contrast value of T1 of the myocardium was significantly correlated with the LV ejection fraction only with LVEF <35%. No statistically significant relationship was found between the post-contrast value of T1 of the myocardium and the volume of focal changes.
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About the authors
- Madina M. Kodzova, Postgraduate, orcid.org/0000-0002-6007-2984
- Lyudmila A. Yurpol'skaya, Dr. Med. Sc., Leading Researcher, orcid.org/0000-0001-7780-2405
- Vladimir N. Makarenko, Dr. Med. Sc., Professor, Head of Department, orcid.org/0000-0002-8700-7592
- Leo A. Bockeria, Dr. Med. Sc., Professor, Academician of RAS and RAMS, President, orcid.org/0000-0002-6180-2619
