Quantification of extracellular matrix expansion by CMR in infiltrative heart disease.
Quantification of extracellular matrix expansion by CMR in infiltrative heart disease.
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DOI：
10.1016/j.jcmg.2012.04.006
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发表时间：
2012-09
影响因子：
14
通讯作者：
Kwong, Raymond Y.
中科院分区：
文献类型：
--
作者：
Mongeon, Francois-Pierre;Jerosch-Herold, Michael;Coelho-Filho, Otavio Rizzi;Blankstein, Ron;Falk, Rodney H.;Kwong, Raymond Y.
关键词：
本研究的目的是进行直接定量心肌细胞外容积分数（ECF）与T1加权心脏磁共振成像（CMR）在怀疑有浸润性心脏病的患者。浸润性心脏病是指心肌内异常物质的积聚。晚期钆增强（LGE）的定性评估仍然是疑似心肌浸润患者CMR评价的最常用方法。这种技术是广泛可用的，并且可以以可再现和标准化的方式进行。然而，由于心肌浸润在细胞间隙的细胞外基质扩张的程度，到目前为止，不适合无创定量与LGE。我们对38例（平均年龄68 ± 15岁）被转诊评估浸润性心脏病的患者和9例健康志愿者（作为对照组）进行了3-T CMR。对比剂注射前后采用Look梯度回波T1定量测定节段性心肌分配系数。通过将钆的组织分配系数与血液中的血浆体积分数（来源于血清红细胞压积）进行比较，获得ECF。还在匹配位置进行了电影CMR和LGE成像。17名患者（45%）患有心脏淀粉样变性（CA）（活检证实或临床高度可能），20名（53%）患有非淀粉样心肌病，1名患有溶酶体贮积病。与非淀粉样心肌病患者（0.33，p < 0.0001）和志愿者（0.24，p <0.0001）相比，CA患者（0.49）的中位总体ECF显著更高。ECF与视觉评估的节段性LGE（r = 0.80，p < 0.0001）和LV质量指数（r = 0.69，p < 0.0001）密切相关，反映了心肌浸润的严重程度。在CA患者中，ECF在LGE节段中最高，尽管在没有定性LGE的节段中ECF仍然升高。CMR ECF定量确定了与志愿者相比，CA患者的间质空间显著扩张。进一步的研究使用这种技术的诊断和评估心肌浸润的严重程度是必要的。
The aim of this study was to perform direct quantification of myocardial extracellular volume fraction (ECF) with T1-weighted cardiac magnetic resonance (CMR) imaging in patients suspected to have infiltrative heart disease. Infiltrative heart disease refers to accumulation of abnormal substances within the myocardium. Qualitative assessment of late gadolinium enhancement (LGE) remains the most commonly used method for CMR evaluation of patients suspected with myocardial infiltration. This technique is widely available and can be performed in a reproducible and standardized manner. However, the degree of extracellular matrix expansion due to myocardial infiltration in the intercellular space has, to date, not been amenable to noninvasive quantification with LGE. We performed 3-T CMR in 38 patients (mean age 68 ± 15 years) who were referred for assessment of infiltrative heart disease and also in 9 healthy volunteers as control subjects. The T1 quantification by Look-Locker gradient-echo before and after contrast determined segmental myocardial partition coefficients. The ECF was obtained by referencing the tissue partition coefficient for gadolinium to the plasma volume fraction in blood, derived from serum hematocrit. Cine CMR and LGE imaging in matching locations were also performed. Seventeen patients (45%) had cardiac amyloidosis (CA) (biopsy-confirmed or clinically highly probable), 20 (53%) had a non-amyloid cardiomyopathy, and 1 had lysosomal storage disease. Median global ECF was substantially higher in CA patients (0.49) compared with non-amyloid cardiomyopathy patients (0.33, p < 0.0001) and volunteers (0.24, p < 0.0001). The ECF strongly correlated with visually assessed segmental LGE (r = 0.80, p < 0.0001) and LV mass index (r = 0.69, p < 0.0001), reflecting severity of myocardial infiltration. In patients with CA, ECF was highest in segments with LGE, although it remained elevated in segments without qualitative LGE. The CMR ECF quantification identified substantial expansion of the interstitial space in patients with CA compared with volunteers. Further studies using this technique for diagnosis and assessment of the severity of myocardial infiltration are warranted.
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DOI：
10.1186/1532-429x-13-16
发表时间：
2011-03-04
期刊：
Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
影响因子：
--
作者：
Schelbert EB;Testa SM;Meier CG;Ceyrolles WJ;Levenson JE;Blair AJ;Kellman P;Jones BL;Ludwig DR;Schwartzman D;Shroff SG;Wong TC
通讯作者：
Wong TC
DOI：
10.1161/circimaging.108.842096
发表时间：
2010-11
期刊：
Circulation. Cardiovascular imaging
影响因子：
--
作者：
Broberg CS;Chugh SS;Conklin C;Sahn DJ;Jerosch-Herold M
通讯作者：
Jerosch-Herold M
DOI：
10.1152/ajpheart.00429.2008
发表时间：
2008-09-01
影响因子：
4.8
作者：
Jerosch-Herold, Michael;Sheridan, David C.;Hershberger, Ray E.
通讯作者：
Hershberger, Ray E.
影响因子：
24
作者：
Mewton, Nathan;Liu, Chia Ying;Croisille, Pierre;Bluemke, David;Lima, Joao A. C.
通讯作者：
Lima, Joao A. C.
影响因子：
2.8
作者：
Ha, JW;Ommen, SR;Oh, JK
通讯作者：
Oh, JK