In-vivo T1 cardiovascular magnetic resonance study of diffuse myocardial fibrosis in hypertrophic cardiomyopathy.
In-vivo T1 cardiovascular magnetic resonance study of diffuse myocardial fibrosis in hypertrophic cardiomyopathy.
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DOI：
10.1186/1532-429x-16-28
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发表时间：
2014-04-25
期刊：
影响因子：
--
通讯作者：
Hofman MB
中科院分区：
文献类型：
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作者：
Brouwer WP;Baars EN;Germans T;de Boer K;Beek AM;van der Velden J;van Rossum AC;Hofman MB
在肥厚型心肌病（HCM）中，尸检研究显示局灶性和弥漫性胶原纤维沉积增加。晚期钆增强成像（LGE）检测局灶性纤维化，但不能描述间质纤维化。我们假设，T1标测，这是用来确定心肌细胞外容积分数（ECV），可以检测弥漫性间质纤维化的HCM患者。采用改良Look-Phase反转恢复（MOLLI）脉冲序列的T1标测来计算显性HCM患者（n = 16）和健康对照者（n = 14）的ECV。在用LGE排除局灶性纤维化的区域测定ECV。相对于对照组，HCM患者总组的平均ECV值未显示出显著变化（0.26 ± 0.03 vs 0.26 ± 0.02，p = 0.83）。此外，LGE阳性HCM患者的ECV与LGE阴性HCM患者相当（0.27 ± 0.03 vs 0.25 ± 0.03，p = 0.12）。该研究表明，HCM患者在心肌中具有与健康对照相似的ECV（例如，间质纤维化），而没有LGE。因此，T1标测在HCM中的额外临床价值似乎有限，但需要未来更大规模的研究来确定这种新技术在HCM中的临床和预后潜力。
In hypertrophic cardiomyopathy (HCM), autopsy studies revealed both increased focal and diffuse deposition of collagen fibers. Late gadolinium enhancement imaging (LGE) detects focal fibrosis, but is unable to depict interstitial fibrosis. We hypothesized that with T1 mapping, which is employed to determine the myocardial extracellular volume fraction (ECV), can detect diffuse interstitial fibrosis in HCM patients. T1 mapping with a modified Look-Locker Inversion Recovery (MOLLI) pulse sequence was used to calculate ECV in manifest HCM (n = 16) patients and in healthy controls (n = 14). ECV was determined in areas where focal fibrosis was excluded with LGE. The total group of HCM patients showed no significant changes in mean ECV values with respect to controls (0.26 ± 0.03 vs 0.26 ± 0.02, p = 0.83). Besides, ECV in LGE positive HCM patients was comparable with LGE negative HCM patients (0.27 ± 0.03 vs 0.25 ± 0.03, p = 0.12). This study showed that HCM patients have a similar ECV (e.g. interstitial fibrosis) in myocardium without LGE as healthy controls. Therefore, the additional clinical value of T1 mapping in HCM seems limited, but future larger studies are needed to establish the clinical and prognostic potential of this new technique within HCM.