Native T1 and T2 provide distinctive signatures in hypertrophic cardiac conditions - Comparison of uremic, hypertensive and hypertrophic cardiomyopathy
Native T1 and T2 provide distinctive signatures in hypertrophic cardiac conditions - Comparison of uremic, hypertensive and hypertrophic cardiomyopathy
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DOI：
10.1016/j.ijcard.2020.03.002
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发表时间：
2020-05-01
影响因子：
3.5
通讯作者：
Puntmann, Valentina O.
中科院分区：
文献类型：
--
作者：
Arcari, Luca;Hinojar, Rocio;Puntmann, Valentina O.
目的：慢性肾脏病（CKD）患者的心脏重构主要表现为左室肥厚伴舒张功能障碍和心力衰竭。既往研究显示，CKD伴弥漫性纤维化患者的T1标测值增加。天然T1是一种非特异性读数，也可能与心肌内液体增加有关。我们检查了伴随的T1和T2映射特征，并与其他肥大性疾病进行了比较。在这项前瞻性多中心研究中，将接受常规临床心脏磁共振（CMR）成像的连续CKD患者（n = 154）与高血压患者（n = 154）进行比较。结果：所有患者组中天然T1显著升高，而天然T2仅在CKD中显著升高（p < 0.001 vs.所有组）。在患者组中，天然T1和T2相互关联，并且关联强度具有条件特异性（CKD r = 0.558，HTN r = 0.324，均p < 0.001; HCM r = 0.157，p = 0.05）。天然T1和T2在所有CKD分期中类似地相关（S3 r = 0.501，S4 0.586，S5 r = 0.424，p < 0.001）。正常对照组与患者组之间，天然T1是最强的心肌梗死（曲线下面积，AUC HCM：0.97; CKD：0.97，HTN 0.98），CKD与sHCM之间的天然T2（AUC 0.90）和CKD与HTN之间的天然T1和T2（AUC分别为0.83和0.80），p < 0.001。结论：我们的发现揭示了常见肥厚性心脏表型的不同CMR特征。在所有条件下，天然T1升高，表明存在病理性肥大性重塑。显著升高的天然T2是CKD特异性的，表明心肌内液体的重要作用。(c)2020年，任作家。由爱思唯尔有限公司出版。这是一篇开放获取的文章，获得了CC BY-NC-ND许可证（http：//creativecommons.org/licenses/by-nc-nd/4.0/）。
Aims: Profound left ventricular (LV) hypertrophy with diastolic dysfunction and heart failure is the cardinal manifestation of heart remodelling in chronic kidney disease (CKD). Previous studies related increased T1 mapping values in CKD with diffuse fibrosis. Native T1 is a non-specific readout that may also relate to increased intramyocardial fluid. We examined concomitant T1 and T2 mapping signatures and undertook comparisons with other hypertrophic conditions.Methods: In this prospective multicentre study, consecutive CKD patients (n = 154) undergoing routine clinical cardiac magnetic resonance (CMR) imaging were compared with patients with hypertensive (HTN, n= 163) and hypertrophic cardiomyopathy (HCM, n = 158), and normotensive controls (n= 133).Results: Native T1 was significantly higher in all patient groups, whereas native T2 in CKD only (p < 0.001 vs. all groups). Native T1 and T2 were interrelated in patient groups and the strength of association was condition specific (CKD r = 0.558, HTN r = 0.324, both p < 0.001; HCM r = 0.157, p = 0.05). Native T1 and T2 were similarly correlated in all CKD stages (S3 r = 0.501, S4 0.586, S5 r = 0.424, p < 0.001 for all). Native T1was the strongest myocardial discriminator between patients and controls (area under the curve, AUC HCM: 0.97; CKD: 0.97, HTN 0.98), native T2 between CKD vsHCM(AUC 0.90) and native T1 and T2 between CKD vs HTN (AUC: 0.83 and 0.80 respectively), p < 0.001 for all.Conclusions: Our findings reveal different CMR signatures of common hypertrophic cardiac phenotypes. Native T1 was raised in all conditions, indicating the presence of pathologic hypertrophic remodelling. Markedly raised native T2 was CKD-specific, suggesting a prominent role of intramyocardial fluid. (c) 2020 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).