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Tsai CC, Ng SH, Chen YL, Juan YH, Wang CH, Lin G, Chien CW, Lin YC, Lin YC, Huang YC, Huang PC, Wang JJ. T1 and T2∗ relaxation time in the parcellated myocardium of healthy Taiwanese participants: A single center study. Biomed J 2020; 44:S132-S143. [PMID: 35735082 PMCID: PMC9039095 DOI: 10.1016/j.bj.2020.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 08/11/2020] [Accepted: 08/24/2020] [Indexed: 01/08/2023] Open
Abstract
Background Quantitative maps from cardiac MRI provide objective information for myocardial tissue. The study aimed to report the T1 and T2∗ relaxation time and its relationship with clinical parameters in healthy Taiwanese participants. Methods Ninety-three participants were enrolled between 2014 and 2016 (Males/Females: 43/50; age: 49.7 ± 11.3/49.9 ± 10.3). T1 and T2∗ weighted images were obtained by MOLLI recovery and 3D fully flow compensated gradient echo sequences with a 3T MR scanner, respectively. The T1 map of the myocardium was parcellated into 16 partitions from the American Heart Association. The septal part of basal, mid-cavity, and apical view was selected for the T2∗ map. The difference of quantitative map by sex and age groups were evaluated by Student's TTEST and ANOVA, respectively. The relationship between T1, T2∗ map, and clinical parameters, such as ejection fraction, pulse rate, and blood pressures, were evaluated with partial correlation by controlling BMI and age. Results Male participants decreased T1 relaxation time in partitions which located in the mid-cavity and apical before 55 years old compared with females (Male/Female: 1143.1.4 ± 72.0–1191.1 ± 37.0/1180.1 ± 54.5–1326.1 ± 113.3 msec, p < 0.01). For female participants, T1 relaxation time was correlated negatively with systolic pressure (p < 0.01) and pulse rate (p < 0.01) before 45 years old. Besides, T1 and T2∗ relaxation time were positively and negatively correlated with ejection fraction and pulse rate after 45 years old in male participants, respectively. Decreased T2∗ relaxation time could be noticed in participants after 45 years old compared with youngers (26.0 ± 6.5/21.9 ± 8.0 msec; 25.2 ± 5.0/21.6 ± 7.2 msec, p < 0.05). Conclusion Reference T1 and T2∗ relaxation time from cardiac MRI in healthy Taiwanese participants were provided with sex and age-dependent manners. The relationship between clinical parameters and T1 or T2∗ relaxation time was also established and could be further investigated for its potential application in healthy/sub-healthy participants.
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Snel GJH, van den Boomen M, Hernandez LM, Nguyen CT, Sosnovik DE, Velthuis BK, Slart RHJA, Borra RJH, Prakken NHJ. Cardiovascular magnetic resonance native T 2 and T 2* quantitative values for cardiomyopathies and heart transplantations: a systematic review and meta-analysis. J Cardiovasc Magn Reson 2020; 22:34. [PMID: 32393281 PMCID: PMC7212597 DOI: 10.1186/s12968-020-00627-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 04/16/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The clinical application of cardiovascular magnetic resonance (CMR) T2 and T2* mapping is currently limited as ranges for healthy and cardiac diseases are poorly defined. In this meta-analysis we aimed to determine the weighted mean of T2 and T2* mapping values in patients with myocardial infarction (MI), heart transplantation, non-ischemic cardiomyopathies (NICM) and hypertension, and the standardized mean difference (SMD) of each population with healthy controls. Additionally, the variation of mapping outcomes between studies was investigated. METHODS The PRISMA guidelines were followed after literature searches on PubMed and Embase. Studies reporting CMR T2 or T2* values measured in patients were included. The SMD was calculated using a random effects model and a meta-regression analysis was performed for populations with sufficient published data. RESULTS One hundred fifty-four studies, including 13,804 patient and 4392 control measurements, were included. T2 values were higher in patients with MI, heart transplantation, sarcoidosis, systemic lupus erythematosus, amyloidosis, hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM) and myocarditis (SMD of 2.17, 1.05, 0.87, 1.39, 1.62, 1.95, 1.90 and 1.33, respectively, P < 0.01) compared with controls. T2 values in iron overload patients (SMD = - 0.54, P = 0.30) and Anderson-Fabry disease patients (SMD = 0.52, P = 0.17) did both not differ from controls. T2* values were lower in patients with MI and iron overload (SMD of - 1.99 and - 2.39, respectively, P < 0.01) compared with controls. T2* values in HCM patients (SMD = - 0.61, P = 0.22), DCM patients (SMD = - 0.54, P = 0.06) and hypertension patients (SMD = - 1.46, P = 0.10) did not differ from controls. Multiple CMR acquisition and patient demographic factors were assessed as significant covariates, thereby influencing the mapping outcomes and causing variation between studies. CONCLUSIONS The clinical utility of T2 and T2* mapping to distinguish affected myocardium in patients with cardiomyopathies or heart transplantation from healthy myocardium seemed to be confirmed based on this meta-analysis. Nevertheless, variation of mapping values between studies complicates comparison with external values and therefore require local healthy reference values to clinically interpret quantitative values. Furthermore, disease differentiation seems limited, since changes in T2 and T2* values of most cardiomyopathies are similar.
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Affiliation(s)
- G J H Snel
- Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
| | - M van den Boomen
- Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Charlestown, MA, 02129, USA
| | - L M Hernandez
- Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - C T Nguyen
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Charlestown, MA, 02129, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Charlestown, MA, 02129, USA
| | - D E Sosnovik
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Charlestown, MA, 02129, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Charlestown, MA, 02129, USA
- Division of Health Sciences and Technology, Harvard-MIT, 7 Massachusetts Avenue, Cambridge, MA, 02139, USA
| | - B K Velthuis
- Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - R H J A Slart
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
- Department of Biomedical Photonic Imaging, University of Twente, Dienstweg 1, 7522 ND, Enschede, The Netherlands
| | - R J H Borra
- Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - N H J Prakken
- Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
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Camporeale A, Pieroni M, Pieruzzi F, Lusardi P, Pica S, Spada M, Mignani R, Burlina A, Bandera F, Guazzi M, Graziani F, Crea F, Greiser A, Boveri S, Ambrogi F, Lombardi M. Predictors of Clinical Evolution in Prehypertrophic Fabry Disease. Circ Cardiovasc Imaging 2020; 12:e008424. [PMID: 30943767 DOI: 10.1161/circimaging.118.008424] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND In prehypertrophic Fabry disease, low myocardial T1 values, reflecting sphingolipid storage, are associated with early structural and ECG changes. The correlations between T1 values and functional parameters have not been explored. Furthermore, the potential prognostic role of T1 in predicting disease worsening is still unknown. METHODS ECG, 2D echocardiography, cardiopulmonary test, and cardiac magnetic resonance were performed in 44 Fabry patients without left ventricular hypertrophy (35.7±14.5 years, 68.2% females). After a 12-month follow-up, clinical stability was evaluated using Fabry Stabilization Index. RESULTS At baseline, T1 values showed a negative correlation with left ventricular mass ( r=-0.79; P<0.0001), maximum wall thickness ( r=-0.79; P<0.0001), Sokolow-Lyon Index ( r=-0.54; P<0.0001), left atrial volume ( r=-0.49; P<0.0002), and Mainz Severity Score Index ( r=-0.61; P<0.0001). No significant differences in systo-diastolic function and exercise capacity were observed comparing normal and low T1 Fabry patients. Arrhythmias were reported in 2 females with low T1 and late gadolinium enhancement. Five patients (40.0±12.4 years, 2 females) showed clinical worsening (Fabry Stabilization Index >20%) at follow-up. Higher left ventricular wall thickness (odds ratio, 2.61; CI, 1.04-6.57; P=0.04), left atrial volume (odds ratio, 1.24; CI, 1.02-1.51; P=0.03), and lower T1 values (odds ratio, 0.98; CI, 0.96-0.99; P=0.03) at baseline were independently associated with clinical worsening at follow-up. CONCLUSIONS In prehypertrophic Fabry disease, low T1 values correlate with early electrocardiographic, morphological cardiac changes, and worsening of global disease severity but are not associated with functional abnormalities. The presence of low T1 values is a risk factor for disease worsening, thus representing a potential new tool in prognostic stratification and therapeutic approach.
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Affiliation(s)
- Antonia Camporeale
- Multimodality Cardiac Imaging Section (A.C., S.P., M.L.), IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy
| | - Maurizio Pieroni
- Department of Cardiology, San Donato Hospital, Arezzo, Italy (M.P.)
| | - Federico Pieruzzi
- Department of Medicine and Surgery, University of Milano Bicocca, Nephrology and Dialysis Unit, ASST-Monza San Gerardo Hospital, Italy (F.P.)
| | - Paola Lusardi
- Department of Cardiology, Humanitas Hospital, Torino, Italy (P.L.)
| | - Silvia Pica
- Multimodality Cardiac Imaging Section (A.C., S.P., M.L.), IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy
| | - Marco Spada
- Department of Pediatrics, University of Torino, Italy (M.S.)
| | - Renzo Mignani
- Nephrology and Dialysis Department, Infermi Hospital, Rimini, Italy (R.M.)
| | - Alessandro Burlina
- Department of Neurology, S. Bassiano Hospital, Bassano del Grappa, Italy (A.B.)
| | - Francesco Bandera
- University Cardiology Department (F.B., M.G.), IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy.,Department of Biomedical Sciences for Health (F.B., M.G.), University of Milan, Milano, Italy
| | - Marco Guazzi
- University Cardiology Department (F.B., M.G.), IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy.,Department of Biomedical Sciences for Health (F.B., M.G.), University of Milan, Milano, Italy
| | - Francesca Graziani
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (F.G.)
| | - Filippo Crea
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy (F.C.)
| | | | - Sara Boveri
- Scientific Directorate (S.B.), IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy
| | - Federico Ambrogi
- Department of Clinical Sciences and Community Health (F.A.), University of Milan, Milano, Italy
| | - Massimo Lombardi
- Multimodality Cardiac Imaging Section (A.C., S.P., M.L.), IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy
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Ferreira VM, Piechnik SK. CMR Parametric Mapping as a Tool for Myocardial Tissue Characterization. Korean Circ J 2020; 50:658-676. [PMID: 32725975 PMCID: PMC7390720 DOI: 10.4070/kcj.2020.0157] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 04/23/2020] [Indexed: 12/23/2022] Open
Abstract
Cardiovascular magnetic resonance (CMR) is the current gold standard for imaging cardiac anatomy, function, and advanced myocardial tissue characterization. After cine, late gadolinium enhancement (LGE), and perfusion imaging, parametric mapping is widely regarded as the 4th era of myocardial CMR development. In contrast to conventional CMR tissue characterization techniques, which rely on relative variations in image intensities to highlight abnormal tissues, parametric mapping provides direct visualization of tissue MR properties such as T1, T2 and T2* in absolute denominations (e.g. in milliseconds). Presentation as pixel-wise parametric maps adds spatial information for a more complete assessment of the myocardium. Advantages of parametric mapping include direct, quantitative comparisons inter- and within-individuals, as well as detection of diffuse disease not evident on conventional CMR imaging, without the need for contrast agents. CMR parametric mapping methods have matured over the past decade into clinical tools, demonstrating not only clinical utility but added value in a wide range of cardiac diseases. They are particularly useful for the evaluation of acute myocardial injury, suspected infiltration and heart failure of unclear etiology. This review discusses the background of parametric mapping, particularly T1-, T2- and ECV-mapping, general magnetic resonance physics principles, clinical applications (including imaging protocols, image analysis and reporting guidelines), current challenges and future directions. CMR parametric mapping is increasingly available on routine clinical scanners, and promises to deliver advanced myocardial tissue characterization beyond conventional CMR techniques, ultimately helping clinicians to benefit patients in their clinical management.
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Affiliation(s)
- Vanessa M Ferreira
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom.
| | - Stefan K Piechnik
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
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Hong YJ, Kim YJ. The Role of Cardiac MRI in the Diagnosis of Fabry Disease. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2020; 81:302-309. [PMID: 36237382 PMCID: PMC9431820 DOI: 10.3348/jksr.2020.81.2.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 03/03/2020] [Accepted: 03/24/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Yoo Jin Hong
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Young Jin Kim
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Nordin S, Kozor R, Vijapurapu R, Augusto JB, Knott KD, Captur G, Treibel TA, Ramaswami U, Tchan M, Geberhiwot T, Steeds RP, Hughes DA, Moon JC. Myocardial Storage, Inflammation, and Cardiac Phenotype in Fabry Disease After One Year of Enzyme Replacement Therapy. Circ Cardiovasc Imaging 2019; 12:e009430. [PMID: 31826677 PMCID: PMC6924943 DOI: 10.1161/circimaging.119.009430] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Supplemental Digital Content is available in the text. Cardiac response to enzyme replacement therapy (ERT) in Fabry disease is typically assessed by measuring left ventricular mass index using echocardiography or cardiovascular magnetic resonance, but neither quantifies myocardial biology. Low native T1 in Fabry disease represents sphingolipid accumulation; late gadolinium enhancement with high T2 and troponin elevation reflects inflammation. We evaluated the effect of ERT on myocardial storage, inflammation, and hypertrophy.
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Affiliation(s)
- Sabrina Nordin
- From the Institute of Cardiovascular Science, University College London, United Kingdom (S.N., J.B.A., K.D.K., G.C., T.A.T., J.C.M.).,Cardiology Department, Barts Heart Centre, London, United Kingdom (S.N., J.B.A., K.D.K., G.C., T.A.T., J.C.M.)
| | - Rebecca Kozor
- Sydney Medical School, University of Sydney, Australia (R.K.)
| | - Ravi Vijapurapu
- Cardiology Department (R.V., R.P.S.), University Hospitals Birmingham, United Kingdom
| | - João B Augusto
- From the Institute of Cardiovascular Science, University College London, United Kingdom (S.N., J.B.A., K.D.K., G.C., T.A.T., J.C.M.).,Cardiology Department, Barts Heart Centre, London, United Kingdom (S.N., J.B.A., K.D.K., G.C., T.A.T., J.C.M.)
| | - Kristopher D Knott
- From the Institute of Cardiovascular Science, University College London, United Kingdom (S.N., J.B.A., K.D.K., G.C., T.A.T., J.C.M.).,Cardiology Department, Barts Heart Centre, London, United Kingdom (S.N., J.B.A., K.D.K., G.C., T.A.T., J.C.M.)
| | - Gabriella Captur
- From the Institute of Cardiovascular Science, University College London, United Kingdom (S.N., J.B.A., K.D.K., G.C., T.A.T., J.C.M.).,Cardiology Department, Barts Heart Centre, London, United Kingdom (S.N., J.B.A., K.D.K., G.C., T.A.T., J.C.M.)
| | - Thomas A Treibel
- From the Institute of Cardiovascular Science, University College London, United Kingdom (S.N., J.B.A., K.D.K., G.C., T.A.T., J.C.M.).,Cardiology Department, Barts Heart Centre, London, United Kingdom (S.N., J.B.A., K.D.K., G.C., T.A.T., J.C.M.)
| | - Uma Ramaswami
- Lysosomal Storage Disorder Unit, Royal Free Hospital, London, United Kingdom (U.R., D.A.H.)
| | - Michel Tchan
- Department of Genetic Medicine, Westmead Hospital, Sydney, Australia (M.T.)
| | - Tarekegn Geberhiwot
- Inherited Metabolic Disorders Unit (T.G.), University Hospitals Birmingham, United Kingdom
| | - Richard P Steeds
- Cardiology Department (R.V., R.P.S.), University Hospitals Birmingham, United Kingdom
| | - Derralynn A Hughes
- Lysosomal Storage Disorder Unit, Royal Free Hospital, London, United Kingdom (U.R., D.A.H.)
| | - James C Moon
- From the Institute of Cardiovascular Science, University College London, United Kingdom (S.N., J.B.A., K.D.K., G.C., T.A.T., J.C.M.).,Cardiology Department, Barts Heart Centre, London, United Kingdom (S.N., J.B.A., K.D.K., G.C., T.A.T., J.C.M.)
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Vajapey R, Eck B, Tang W, Kwon DH. Advances in MRI Applications to Diagnose and Manage Cardiomyopathies. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2019; 21:74. [PMID: 31773390 DOI: 10.1007/s11936-019-0762-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW The prevalence of heart failure continues to rise, and imaging characterization of the cardiomyopathic process is important for identifying myocardial disease, initiating appropriate treatment, and improving outcomes. We aimed to summarize recent advances in cardiac magnetic resonance imaging (CMR) applications for the diagnosis, characterization, and implications on management of various cardiomyopathies. RECENT FINDINGS Parametric mapping by CMR has emerged as an important advancement in quantification of myocardial fibrosis, increased extracellular space, and myocardial edema. In addition, improved assessment of myocardial function with myocardial strain assessment may provide early identification of patients at risk and determining responsiveness to therapeutic interventions. Novel MRI techniques and the advent of artificial intelligence may help to uncover important mechanistic insights into the cardiomyopathic process. Innovative CMR techniques continue to evolve, and it will be of interest to determine how these advances can be incorporated into clinical practice to improve diagnosis, treatment, and management of patients with cardiomyopathies.
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Affiliation(s)
- Ramya Vajapey
- Cleveland Clinic, Heart and Vascular Institute, Cleveland, OH, USA
| | - Brendan Eck
- Cleveland Clinic, Heart and Vascular Institute, Cleveland, OH, USA
| | - Wilson Tang
- Cleveland Clinic, Heart and Vascular Institute, Cleveland, OH, USA
| | - Deborah H Kwon
- Cleveland Clinic, Heart and Vascular Institute, Cleveland, OH, USA. .,Department of Cardiovascular Medicine, Cleveland Clinic, Imaging Institute, 9500 Euclid Avenue, Desk J1-5, Cleveland, OH, 44195, USA.
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Abstract
Fabry disease is a lysosomal storage disease with a variety of cardiac manifestations. Although not specific for a diagnosis of Fabry disease, certain cardiac imaging findings may be highly suggestive of the diagnosis of Fabry disease in previously undiagnosed patients or cardiac involvement for patients with a known diagnosis of Fabry disease. In this review, we explore the current applications of multimodality cardiac imaging in the diagnosis and monitoring of patients with Fabry disease. Additionally, data regarding tissue characterization by cardiac magnetic resonance imaging and novel nuclear imaging techniques and their role in evaluating phenotype development is discussed.
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Affiliation(s)
| | - Wael A Jaber
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH
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Halliday BP, Prasad SK. The Interstitium in the Hypertrophied Heart. JACC Cardiovasc Imaging 2019; 12:2357-2368. [DOI: 10.1016/j.jcmg.2019.05.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 04/06/2019] [Accepted: 05/07/2019] [Indexed: 12/17/2022]
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Karamitsos TD, Arvanitaki A, Karvounis H, Neubauer S, Ferreira VM. Myocardial Tissue Characterization and Fibrosis by Imaging. JACC Cardiovasc Imaging 2019; 13:1221-1234. [PMID: 31542534 DOI: 10.1016/j.jcmg.2019.06.030] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 06/24/2019] [Accepted: 06/28/2019] [Indexed: 12/23/2022]
Abstract
Myocardial fibrosis, either focal or diffuse, is a common feature of many cardiac diseases and is associated with a poor prognosis for major adverse cardiovascular events. Although histological analysis remains the gold standard for confirming the presence of myocardial fibrosis, endomyocardial biopsy is invasive, has sampling errors, and is not practical in the routine clinical setting. Cardiac imaging modalities offer noninvasive surrogate biomarkers not only for fibrosis but also for myocardial edema and infiltration to varying degrees, and have important roles in the diagnosis and management of cardiac diseases. This review summarizes important pathophysiological features in the development of commonly encountered cardiac diseases, and the principles, advantages, and disadvantages of various cardiac imaging modalities (echocardiography, single-photon emission computer tomography, positron emission tomography, multidetector computer tomography, and cardiac magnetic resonance) for myocardial tissue characterization, with an emphasis on imaging focal and diffuse myocardial fibrosis.
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Affiliation(s)
- Theodoros D Karamitsos
- 1st Department of Cardiology, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
| | - Alexandra Arvanitaki
- 1st Department of Cardiology, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Haralambos Karvounis
- 1st Department of Cardiology, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Stefan Neubauer
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Vanessa M Ferreira
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
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Deborde E, Dubourg B, Bejar S, Brehin AC, Normant S, Michelin P, Dacher JN. Differentiation between Fabry disease and hypertrophic cardiomyopathy with cardiac T1 mapping. Diagn Interv Imaging 2019; 101:59-67. [PMID: 31519470 DOI: 10.1016/j.diii.2019.08.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 08/03/2019] [Accepted: 08/27/2019] [Indexed: 01/03/2023]
Abstract
PURPOSE To evaluate the potential of non-contrast myocardial T1 mapping on cardiovascular magnetic resonance examination (CMR) in differentiating patients with Fabry disease (FD) from those with hypertrophic cardiomyopathy (HCM) and healthy control subjects. MATERIALS AND METHODS Seventeen patients with FD (8 men, 9 women; mean age, 48 ±18 [SD] years; [range: 19-73 years]; 53% with left ventricular hypertrophy [LVH]) were matched with 36 patients with hypertrophic cardiomyopathy (HCM) (22 men, 14 women; mean age, 57±16 [SD] years; [range: 22-85 years]) and 70 healthy control subjects (34 men, 36 women; mean age, 38 ±15 [SD] years; [range: 18-65 years]). Cardiac T1 mapping was performed using the modified Look-Locker inversion (MOLLI®) sequence on a 1.5-T magnet. T1 values were calculated, on midventricular section, for septal left ventricular segments (S8-S9) and all mid-ventricular ones (global T1 values; S7-S12). Statistical analysis included unpaired Mann-Whitney test, receiver operating characteristic curve and likelihood ratios. RESULTS Septal native T1 values were significantly decreased in patients with FD (889±61 [SD] ms; range: 784-980ms) compared to those with HCM (995±48 [SD] ms; range: 935-1125ms) (P<0.001) and versus healthy controls (965±29 [SD] ms; range: 910-1028ms) (P<0.001). Global native T1 values were also significantly decreased in patients with FD (891±49 [SD] ms; range 794-970ms) compared to those with HCM (995±34 [SD] ms; range: 952-1086ms) (P<0.001) and versus healthy controls (966±27 [SD] ms; range: 920-1042ms) (P<0.001). A septal left ventricular native T1 cutoff value of 940ms could distinguish FD from HCM with 88% sensitivity (95% CI: 73-100%) and 92% specificity (95% CI: 83-100%). Positive likelihood ratio was 11, negative likelihood ratio was 0.12. Compared to controls, the same threshold could distinguish FD with 88% sensitivity (95% CI: 73-100%) and 86% specificity (95% CI: 78-94%). Positive likelihood ratio was 6.3, negative likelihood ratio was 0.14. T1 value was abnormal in 4 of 8 (50%) of FD patients who did not have LVH. CONCLUSION Native T1 values are significantly lower in patients with FD by comparison with those with HCM and healthy volunteers.
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Affiliation(s)
- E Deborde
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France; Department of Radiology, University Hospital of Strasbourg, 67098 Strasbourg, France.
| | - B Dubourg
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France; INSERM U1096, UFR Médecine Pharmacie, 76183 Rouen, France; Institute for Research and Innovation in Biomedicine, University of Rouen, 76000 Rouen, France
| | - S Bejar
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France
| | - A-C Brehin
- Department of Genetics, University Hospital of Rouen, 76031 Rouen, France
| | - S Normant
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France
| | - P Michelin
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France
| | - J-N Dacher
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France; INSERM U1096, UFR Médecine Pharmacie, 76183 Rouen, France; Institute for Research and Innovation in Biomedicine, University of Rouen, 76000 Rouen, France
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62
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Nordin S, Kozor R, Baig S, Abdel-Gadir A, Medina-Menacho K, Rosmini S, Captur G, Tchan M, Geberhiwot T, Murphy E, Lachmann R, Ramaswami U, Edwards NC, Hughes D, Steeds RP, Moon JC. Cardiac Phenotype of Prehypertrophic Fabry Disease. Circ Cardiovasc Imaging 2019; 11:e007168. [PMID: 29853467 PMCID: PMC6023585 DOI: 10.1161/circimaging.117.007168] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Fabry disease (FD) is a rare and treatable X-linked lysosomal storage disorder. Cardiac involvement determines outcomes; therefore, detecting early changes is important. Native T1 by cardiovascular magnetic resonance is low, reflecting sphingolipid storage. Early phenotype development is familiar in hypertrophic cardiomyopathy but unexplored in FD. We explored the prehypertrophic cardiac phenotype of FD and the role of storage. METHODS AND RESULTS A prospective, international multicenter observational study of 100 left ventricular hypertrophy-negative FD patients (mean age: 39±15 years; 19% male) and 35 age- and sex-matched healthy volunteers (mean age: 40±14 years; 25% male) who underwent cardiovascular magnetic resonance, including native T1 and late gadolinium enhancement, and 12-lead ECG. In FD, 41% had a low native T1 using a single septal region of interest, but this increased to 59% using a second slice because early native T1 lowering was patchy. ECG abnormalities were present in 41% and twice as common with low native T1 (53% versus 24%; P=0.005). When native T1 was low, left ventricular maximum wall thickness, indexed mass, and ejection fraction were higher (maximum wall thickness 9±1.5 versus 8±1.4 mm, P<0.005; indexed left ventricular mass 63±10 versus 58±9 g/m2, P<0.05; and left ventricular ejection fraction 73±8% versus 69±7%, P<0.01). Late gadolinium enhancement was more likely when native T1 was low (27% versus 6%; P=0.01). FD had higher maximal apical fractal dimensions compared with healthy volunteers (1.27±0.06 versus 1.24±0.04; P<0.005) and longer anterior mitral valve leaflets (23±2 mm versus 21±3 mm; P<0.005). CONCLUSIONS There is a detectable prehypertrophic phenotype in FD consisting of storage (low native T1), structural, functional, and ECG changes.
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Affiliation(s)
- Sabrina Nordin
- Cardiology Department, Barts Heart Centre, London, United Kingdom (S.N., A.A.-G., K.M.-M., S.R., G.C., J.C.M.).,Institute of Cardiovascular Science, University College London, United Kingdom (S.N., A.A.-G., K.M.-M., G.C., J.C.M.)
| | - Rebecca Kozor
- Sydney Medical School, University of Sydney, Australia (R.K.)
| | - Shanat Baig
- Cardiology Department (S.B., N.C.E., R.P.S.)
| | - Amna Abdel-Gadir
- Cardiology Department, Barts Heart Centre, London, United Kingdom (S.N., A.A.-G., K.M.-M., S.R., G.C., J.C.M.).,Institute of Cardiovascular Science, University College London, United Kingdom (S.N., A.A.-G., K.M.-M., G.C., J.C.M.)
| | - Katia Medina-Menacho
- Cardiology Department, Barts Heart Centre, London, United Kingdom (S.N., A.A.-G., K.M.-M., S.R., G.C., J.C.M.).,Institute of Cardiovascular Science, University College London, United Kingdom (S.N., A.A.-G., K.M.-M., G.C., J.C.M.)
| | - Stefania Rosmini
- Cardiology Department, Barts Heart Centre, London, United Kingdom (S.N., A.A.-G., K.M.-M., S.R., G.C., J.C.M.)
| | - Gabriella Captur
- Cardiology Department, Barts Heart Centre, London, United Kingdom (S.N., A.A.-G., K.M.-M., S.R., G.C., J.C.M.).,Institute of Cardiovascular Science, University College London, United Kingdom (S.N., A.A.-G., K.M.-M., G.C., J.C.M.)
| | - Michel Tchan
- Department of Genetic Medicine, Westmead Hospital, Australia (M.T.)
| | - Tarekegn Geberhiwot
- Inherited Metabolic Disorders Unit (T.H.), University Hospitals Birmingham, United Kingdom
| | - Elaine Murphy
- Charles Dent Metabolic Unit, National Hospital for Neurology and Neurosurgery, London, United Kingdom (E.M., R.L.)
| | - Robin Lachmann
- Charles Dent Metabolic Unit, National Hospital for Neurology and Neurosurgery, London, United Kingdom (E.M., R.L.)
| | - Uma Ramaswami
- Lysosomal Storage Disorder Unit, Royal Free Hospital, London, United Kingdom (U.R., D.H.)
| | | | - Derralynn Hughes
- Lysosomal Storage Disorder Unit, Royal Free Hospital, London, United Kingdom (U.R., D.H.)
| | | | - James C Moon
- Cardiology Department, Barts Heart Centre, London, United Kingdom (S.N., A.A.-G., K.M.-M., S.R., G.C., J.C.M.). .,Institute of Cardiovascular Science, University College London, United Kingdom (S.N., A.A.-G., K.M.-M., G.C., J.C.M.)
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63
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Heidenreich JF, Weng AM, Donhauser J, Greiser A, Chow K, Nordbeck P, Bley TA, Köstler H. T1- and ECV-mapping in clinical routine at 3 T: differences between MOLLI, ShMOLLI and SASHA. BMC Med Imaging 2019; 19:59. [PMID: 31370821 PMCID: PMC6676542 DOI: 10.1186/s12880-019-0362-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 07/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND T1 mapping sequences such as MOLLI, ShMOLLI and SASHA make use of different technical approaches, bearing strengths and weaknesses. It is well known that obtained T1 relaxation times differ between the sequence techniques as well as between different hardware. Yet, T1 quantification is a promising tool for myocardial tissue characterization, disregarding the absence of established reference values. The purpose of this study was to evaluate the feasibility of native and post-contrast T1 mapping methods as well as ECV maps and its diagnostic benefits in a clinical environment when scanning patients with various cardiac diseases at 3 T. METHODS Native and post-contrast T1 mapping data acquired on a 3 T full-body scanner using the three pulse sequences 5(3)3 MOLLI, ShMOLLI and SASHA in 19 patients with clinical indication for contrast enhanced MRI were compared. We analyzed global and segmental T1 relaxation times as well as respective extracellular volumes and compared the emerged differences between the used pulse sequences. RESULTS T1 times acquired with MOLLI and ShMOLLI exhibited systematic T1 deviation compared to SASHA. Myocardial MOLLI T1 times were 19% lower and ShMOLLI T1 times 25% lower compared to SASHA. Native blood T1 times from MOLLI were 13% lower than SASHA, while post-contrast MOLLI T1-times were only 5% lower. ECV values exhibited comparably biased estimation with MOLLI and ShMOLLI compared to SASHA in good agreement with results reported in literature. Pathology-suspect segments were clearly differentiated from remote myocardium with all three sequences. CONCLUSION Myocardial T1 mapping yields systematically biased pre- and post-contrast T1 times depending on the applied pulse sequence. Additionally calculating ECV attenuates this bias, making MOLLI, ShMOLLI and SASHA better comparable. Therefore, myocardial T1 mapping is a powerful clinical tool for classification of soft tissue abnormalities in spite of the absence of established reference values.
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Affiliation(s)
- Julius F Heidenreich
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany. .,Comprehensive Heart Failure Center, University Hospital Würzburg, Am Schwarzenberg 15, 97078, Würzburg, Germany.
| | - Andreas M Weng
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Julian Donhauser
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | | | | | - Peter Nordbeck
- Comprehensive Heart Failure Center, University Hospital Würzburg, Am Schwarzenberg 15, 97078, Würzburg, Germany.,Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Wurzburg, Germany
| | - Thorsten A Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.,Comprehensive Heart Failure Center, University Hospital Würzburg, Am Schwarzenberg 15, 97078, Würzburg, Germany
| | - Herbert Köstler
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.,Comprehensive Heart Failure Center, University Hospital Würzburg, Am Schwarzenberg 15, 97078, Würzburg, Germany
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64
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Nordin S, Kozor R, Medina-Menacho K, Abdel-Gadir A, Baig S, Sado DM, Lobascio I, Murphy E, Lachmann RH, Mehta A, Edwards NC, Ramaswami U, Steeds RP, Hughes D, Moon JC. Proposed Stages of Myocardial Phenotype Development in Fabry Disease. JACC Cardiovasc Imaging 2019; 12:1673-1683. [DOI: 10.1016/j.jcmg.2018.03.020] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 03/11/2018] [Accepted: 03/30/2018] [Indexed: 11/25/2022]
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65
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Aherne E, Chow K, Carr J. Cardiac T 1 mapping: Techniques and applications. J Magn Reson Imaging 2019; 51:1336-1356. [PMID: 31334899 DOI: 10.1002/jmri.26866] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 06/27/2019] [Accepted: 06/27/2019] [Indexed: 12/18/2022] Open
Abstract
A key advantage of cardiac magnetic resonance (CMR) imaging over other cardiac imaging modalities is the ability to perform detailed tissue characterization. CMR techniques continue to evolve, with advanced imaging sequences being developed to provide a reproducible, quantitative method of tissue interrogation. The T1 mapping technique, a pixel-by-pixel method of quantifying T1 relaxation time of soft tissues, has been shown to be promising for characterization of diseased myocardium in a wide variety of cardiomyopathies. In this review, we describe the basic principles and common techniques for T1 mapping and its use for native T1 , postcontrast T1 , and extracellular volume mapping. We will review a wide range of clinical applications of the technique that can be used for identification and quantification of myocardial edema, fibrosis, and infiltrative diseases with illustrative clinical examples. In addition, we will explore the current limitations of the technique and describe some areas of ongoing development. Level of Evidence: 5 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:1336-1356.
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Affiliation(s)
- Emily Aherne
- Department of Radiology, Northwestern University, Chicago, Illinois, USA
| | - Kelvin Chow
- Department of Radiology, Northwestern University, Chicago, Illinois, USA.,Cardiovascular MR R&D, Siemens Medical Solutions USA, Inc., Chicago, Illinois, USA
| | - James Carr
- Department of Radiology, Northwestern University, Chicago, Illinois, USA
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66
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Esposito R, Santoro C, Sorrentino R, Riccio E, Citro R, Buonauro A, Di Risi T, Imbriaco M, Trimarco B, Pisani A, Galderisi M. Layer-specific longitudinal strain in Anderson-Fabry disease at diagnosis: A speckle tracking echocardiography analysis. Echocardiography 2019; 36:1273-1281. [PMID: 31246327 DOI: 10.1111/echo.14399] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/09/2019] [Accepted: 05/10/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Speckle tracking advancements make now available the analysis of layer-specific myocardial deformation. This study investigated multilayer longitudinal strain in Anderson-Fabry disease (AFD) patients at diagnosis. METHODS In a case-control study, 33 newly diagnosed, untreated AFD patients and 33 healthy age- and sex-matched healthy controls underwent a complete echocardiogram, including assessment of left ventricular (LV) transmural global longitudinal strain (GLS), subendocardial longitudinal strain (LSsubendo), subepicardial longitudinal strain (LSsubepi), and strain gradient (LSsubendo-LSsubpepi). RESULTS Anderson-Fabry disease patients had similar blood pressure, heart rate, and ejection fraction but higher body mass index in comparison with controls. LV mass index, maximal, and relative wall thickness were significantly greater in AFD patients. LSsubendo was significantly higher than LSsubepi in both groups, but GLS (P < 0.0001), LSsubendo (P = 0.003), and particularly LSsubepi (21.4 ± 1.7 vs 18.8 ± 1.4%, P < 0.0001) were lower in AFD patients than in controls. Accordingly, LS gradient was higher in AFD patients (P = 0.003). Three patients symptomatic for dyspnoea presented a combination of LV hypertrophy and reduced LSsubepi. After adjusting for confounders by multivariate analyses, LV mass index or maximal wall thickness were independently and inversely associated with transmural GLS and LSsubepi, but not with LSsubendo in the AFD group. At receiver operating curve curves, LSsubepi best discriminated AFD and normals. CONCLUSIONS In newly diagnosed, untreated AFD patients, layer-specific strain imaging highlights an impairment of LV longitudinal deformation, mainly involving subepicardial strain and causing increase in longitudinal strain myocardial gradient. These findings could be useful for identifying the mechanisms underlying early LV dysfunction in AFD patients.
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Affiliation(s)
- Roberta Esposito
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.,Mediterranea Cardiocentro, Naples, Italy
| | - Ciro Santoro
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Regina Sorrentino
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Eleonora Riccio
- Department of Public Medicine, University Federico II, Naples, Italy
| | - Rodolfo Citro
- Department of Cardiology, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - Agostino Buonauro
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Teodolinda Di Risi
- Department of Molecular Medicine and Medical Biology, University Federico II, Naples, Italy
| | - Massimo Imbriaco
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Bruno Trimarco
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Antonio Pisani
- Department of Public Medicine, University Federico II, Naples, Italy
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
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67
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Seraphim A, Knott KD, Augusto J, Bhuva AN, Manisty C, Moon JC. Quantitative cardiac MRI. J Magn Reson Imaging 2019; 51:693-711. [PMID: 31111616 DOI: 10.1002/jmri.26789] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 04/29/2019] [Indexed: 12/22/2022] Open
Abstract
Cardiac MRI has become an indispensable imaging modality in the investigation of patients with suspected heart disease. It has emerged as the gold standard test for cardiac function, volumes, and mass and allows noninvasive tissue characterization and the assessment of myocardial perfusion. Quantitative MRI already has a key role in the development and incorporation of machine learning in clinical imaging, potentially offering major improvements in both workflow efficiency and diagnostic accuracy. As the clinical applications of a wide range of quantitative cardiac MRI techniques are being explored and validated, we are expanding our capabilities for earlier detection, monitoring, and risk stratification of disease, potentially guiding personalized management decisions in various cardiac disease models. In this article we review established and emerging quantitative techniques, their clinical applications, highlight novel advances, and appraise their clinical diagnostic potential. Level of Evidence: 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2020;51:693-711.
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Affiliation(s)
- Andreas Seraphim
- University College London, Institute of Cardiovascular Science, London, UK.,Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, UK
| | - Kristopher D Knott
- University College London, Institute of Cardiovascular Science, London, UK.,Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, UK
| | - Joao Augusto
- University College London, Institute of Cardiovascular Science, London, UK.,Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, UK
| | - Anish N Bhuva
- University College London, Institute of Cardiovascular Science, London, UK.,Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, UK
| | - Charlotte Manisty
- University College London, Institute of Cardiovascular Science, London, UK.,Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, UK
| | - James C Moon
- University College London, Institute of Cardiovascular Science, London, UK.,Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, UK
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Sardanelli F, Schiaffino S, Zanardo M, Secchi F, Cannaò PM, Ambrogi F, Di Leo G. Point estimate and reference normality interval of MRI-derived myocardial extracellular volume in healthy subjects: a systematic review and meta-analysis. Eur Radiol 2019; 29:6620-6633. [DOI: 10.1007/s00330-019-06185-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/04/2019] [Accepted: 03/20/2019] [Indexed: 12/11/2022]
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69
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Contemporary View of Magnetic Resonance Imaging in Fabry Disease. CURRENT CARDIOVASCULAR IMAGING REPORTS 2019. [DOI: 10.1007/s12410-019-9498-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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70
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Tong X, Li VWY, Liu APY, So EKF, Chan Q, Ho KKH, Yau JPW, Cheuk DKL, Cheung YF, Ng MY. Cardiac Magnetic Resonance T1 Mapping in Adolescent and Young Adult Survivors of Childhood Cancers. Circ Cardiovasc Imaging 2019; 12:e008453. [PMID: 30929466 DOI: 10.1161/circimaging.118.008453] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Xiaowan Tong
- Department of Diagnostic Radiology (X.T., M.-Y.N.), The University of Hong Kong, China
| | - Vivian Wing-Yi Li
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital (V.W.-y.L., A.P.-y.L., E.K.-f.S., D.K.-l.C., Y.-F.C.), The University of Hong Kong, China
| | - Anthony Pak-Yin Liu
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital (V.W.-y.L., A.P.-y.L., E.K.-f.S., D.K.-l.C., Y.-F.C.), The University of Hong Kong, China
| | - Edwina Kam-Fung So
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital (V.W.-y.L., A.P.-y.L., E.K.-f.S., D.K.-l.C., Y.-F.C.), The University of Hong Kong, China
| | | | - Karin Kar-Huen Ho
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong, China (K.K.-h.H.)
| | - Jeffrey Ping-Wa Yau
- Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong, China (J.P.w.Y.)
| | - Daniel Ka-Leung Cheuk
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital (V.W.-y.L., A.P.-y.L., E.K.-f.S., D.K.-l.C., Y.-F.C.), The University of Hong Kong, China
| | - Yiu-Fai Cheung
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital (V.W.-y.L., A.P.-y.L., E.K.-f.S., D.K.-l.C., Y.-F.C.), The University of Hong Kong, China
| | - Ming-Yen Ng
- Department of Diagnostic Radiology (X.T., M.-Y.N.), The University of Hong Kong, China
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Fabry disease in cardiology practice: Literature review and expert point of view. Arch Cardiovasc Dis 2019; 112:278-287. [PMID: 30826269 DOI: 10.1016/j.acvd.2019.01.002] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 01/05/2019] [Accepted: 01/07/2019] [Indexed: 12/14/2022]
Abstract
Fabry disease is an X-linked progressive multisystemic genetic sphingolipidosis caused by deficient activity of lysosomal α-galactosidase A. Men aged>30 years and women aged>40 years most often present with unexplained left ventricular hypertrophy, usually concentric and non-obstructive, but sometimes mimicking sarcomeric hypertrophic cardiomyopathy, particularly when isolated, as in the cardiac or late-onset variant of the disease. In hypertrophic cardiomyopathy cohorts, up to 1% of patients have been diagnosed with Fabry disease. Frequent cardiac symptoms include chronotropic incompetence, severe conduction disturbances and arrhythmias, heart failure and sudden death, and cardiovascular complications are currently the leading cause of death at a mean age of 55 years in men and 66 years in women. Complementary to screening for extracardiac manifestations, the initial cardiac evaluation should include long-duration electrocardiogram recordings, echocardiography and late gadolinium and T1 mapping magnetic resonance imaging. Abnormalities of a non-hypertrophied inferolateral wall at the base of the left ventricle (thinning, decreased strain, midwall fibrosis) and low native T1 signal on magnetic resonance imaging are evocative. Aggressive cardiac management may include the control of cardiovascular risk factors, anticoagulation, permanent cardiac pacing and/or an implantable cardioverter defibrillator device, while antiarrhythmics and beta-blockers should be used with caution. Specific therapy should be initiated at the earliest stage, when the first structural or functional cardiac abnormalities are detected, and should include enzyme replacement therapy (available since 2001) or chaperone therapy (available since 2016) (the use of which is limited to patients with Fabry disease and an amenable α-galactosidase A [GLA] gene mutation).
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Tang CX, Petersen SE, Sanghvi MM, Lu GM, Zhang LJ. Cardiovascular magnetic resonance imaging for amyloidosis: The state-of-the-art. Trends Cardiovasc Med 2019; 29:83-94. [DOI: 10.1016/j.tcm.2018.06.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 06/20/2018] [Accepted: 06/20/2018] [Indexed: 01/01/2023]
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Cardiac Complications Attributed to Chloroquine and Hydroxychloroquine: A Systematic Review of the Literature. Drug Saf 2019; 41:919-931. [PMID: 29858838 DOI: 10.1007/s40264-018-0689-4] [Citation(s) in RCA: 189] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Chloroquine and hydroxychloroquine are widely used in the long-term treatment of connective tissue disease and usually considered safe. However, chloroquine- or hydroxychloroquine-related cardiac disorder is a rare but severe adverse event, which can lead to death. This systematic review investigates cardiac complications attributed to chloroquine and hydroxychloroquine. METHODS PubMED, EMBASE, and Cochrane database searches were conducted using keywords derived from MeSH terms. Reports published prior to 31 July, 2017 were eligible for inclusion, without restriction to study design. Searches were also conducted on reference lists of included studies. RESULTS Eighty-six articles were identified, reporting individual cases or short series, providing information on 127 patients (65.4% female). A majority of patients were treated with chloroquine (58.3%), with the remaining treated with hydroxychloroquine (39.4%), or both in succession. Most patients had been treated for a long time (median 7 years, minimum 3 days; maximum 35 years) and with a high cumulative dose (median 1235 g for hydroxychloroquine and 803 g for chloroquine). Conduction disorders were the main side effect reported, affecting 85% of patients. Other non-specific adverse cardiac events included ventricular hypertrophy (22%), hypokinesia (9.4%), heart failure (26.8%), pulmonary arterial hypertension (3.9%), and valvular dysfunction (7.1%). For 78 patients reported to have been withdrawn from treatment, some recovered normal heart function (44.9%), while for others progression was unfavorable, resulting in irreversible damage (12.9%) or death (30.8%). LIMITATIONS The risk of cardiac complications attributed to chloroquine/hydroxychloroquine was not quantified because of the lack of randomized controlled trials and observational studies investigating the association. CONCLUSIONS Clinicians should be warned that chloroquine- or hydroxychloroquine-related cardiac manifestations, even conduction disorders without repercussion, may be initial manifestations of toxicity, and are potentially irreversible. Therefore, treatment withdrawal is required when cardiac manifestations are present.
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Yogasundaram H, Nikhanj A, Putko BN, Boutin M, Jain‐Ghai S, Khan A, Auray‐Blais C, West ML, Oudit GY. Elevated Inflammatory Plasma Biomarkers in Patients With Fabry Disease: A Critical Link to Heart Failure With Preserved Ejection Fraction. J Am Heart Assoc 2018; 7:e009098. [PMID: 30571380 PMCID: PMC6404196 DOI: 10.1161/jaha.118.009098] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 10/03/2018] [Indexed: 12/16/2022]
Abstract
Background Because systemic inflammation and endothelial dysfunction lead to heart failure with preserved ejection fraction, we characterized plasma levels of inflammatory and cardiac remodeling biomarkers in patients with Fabry disease ( FD ). Methods and Results Plasma biomarkers were studied in multicenter cohorts of patients with FD (n=68) and healthy controls (n=40). Plasma levels of the following markers of inflammation and cardiac remodeling were determined: tumor necrosis factor ( TNF ), TNF receptor 1 ( TNFR 1) and 2 ( TNFR 2), interleukin-6, matrix metalloprotease-2 ( MMP -2), MMP -8, MMP -9, galectin-1, galectin-3, B-type natriuretic peptide ( BNP ), midregional pro-atrial natriuretic peptide ( MR -pro ANP ), and globotriaosylsphingosine. Clinical profile, cardiac magnetic resonance imaging, and echocardiogram were reviewed and correlated with biomarkers. Patients with FD had elevated plasma levels of BNP , MR -pro ANP , MMP -2, MMP -9, TNF , TNFR 1, TNFR 2, interleukin-6, galectin-1, globotriaosylsphingosine, and analogues. Plasma TNFR 2, TNF , interleukin-6, MMP -2, and globotriaosylsphingosine were elevated in FD patients with left ventricular hypertrophy, whereas diastolic dysfunction correlated with higher BNP , MR -pro ANP , and MMP -2 levels. Patients with late gadolinium enhancement on cardiac magnetic resonance imaging had greater levels of BNP , MR -pro ANP , TNFR 1, TNFR 2, and MMP -2. Plasma BNP , MR -pro ANP , MMP -2, MMP -8, TNF , TNFR 1, TNFR 2, galectin-1, and galectin-3 were elevated in patients with renal dysfunction. Patients undergoing enzyme replacement therapy who have more severe disease had higher MMP -2, TNF , TNFR 1, TNFR 2, and globotriaosylsphingosine analogue levels. Conclusions Inflammatory and cardiac remodeling biomarkers are elevated in FD patients and correlate with disease progression. These features are consistent with a phenotype dominated by heart failure with preserved ejection fraction and suggest a key pathogenic role of systemic inflammation in FD .
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Affiliation(s)
- Haran Yogasundaram
- Division of CardiologyDepartment of MedicineUniversity of AlbertaEdmontonCanada
- Mazankowski Alberta Heart InstituteUniversity of AlbertaEdmontonCanada
| | - Anish Nikhanj
- Division of CardiologyDepartment of MedicineUniversity of AlbertaEdmontonCanada
- Mazankowski Alberta Heart InstituteUniversity of AlbertaEdmontonCanada
| | - Brendan N. Putko
- Division of CardiologyDepartment of MedicineUniversity of AlbertaEdmontonCanada
- Mazankowski Alberta Heart InstituteUniversity of AlbertaEdmontonCanada
| | - Michel Boutin
- Division of Medical GeneticsDepartment of PediatricsUniversité de SherbrookeQuébecCanada
| | | | - Aneal Khan
- Department of Medical Genetics and PediatricsUniversity of CalgaryCanada
| | - Christiane Auray‐Blais
- Division of Medical GeneticsDepartment of PediatricsUniversité de SherbrookeQuébecCanada
| | - Michael L. West
- Division of NephrologyDepartment of MedicineDalhousie UniversityHalifaxCanada
| | - Gavin Y. Oudit
- Division of CardiologyDepartment of MedicineUniversity of AlbertaEdmontonCanada
- Mazankowski Alberta Heart InstituteUniversity of AlbertaEdmontonCanada
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75
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Reiter U, Reiter C, Kräuter C, Fuchsjäger M, Reiter G. Cardiac magnetic resonance T1 mapping. Part 2: Diagnostic potential and applications. Eur J Radiol 2018; 109:235-247. [PMID: 30539759 DOI: 10.1016/j.ejrad.2018.10.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 10/07/2018] [Accepted: 10/15/2018] [Indexed: 02/07/2023]
Abstract
Non-invasive identification and differentiation of myocardial diseases represents the primary objectives of cardiac magnetic resonance (CMR) longitudinal relaxation time (T1) and extracellular volume (ECV) mapping. Given the fact that myocardial T1 and ECV values overlap throughout and within left ventricular phenotypes, a central issue to be addressed is whether and to what extent myocardial T1 and ECV mapping provides additional or superior diagnostic information to standard CMR imaging, and whether native T1 mapping could be employed as a non-contrast alternative to late gadolinium enhancement (LE) imaging. The present review aims to summarize physiological and pathophysiological alterations in native T1 and ECV values and summarized myocardial T1 and ECV alterations associated with cardiac diseases to support the translation of research findings into routine CMR imaging.
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Affiliation(s)
- Ursula Reiter
- Division of General Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 19/P, 8036 Graz, Austria.
| | - Clemens Reiter
- Division of General Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 19/P, 8036 Graz, Austria.
| | - Corina Kräuter
- Division of General Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 19/P, 8036 Graz, Austria; Institute of Medical Engineering, Graz University of Technology, Stremayrgasse 16/III, 8010 Graz, Austria.
| | - Michael Fuchsjäger
- Division of General Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 19/P, 8036 Graz, Austria.
| | - Gert Reiter
- Division of General Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 19/P, 8036 Graz, Austria; Research & Development, Siemens Healthcare Diagnostics GmbH, Strassgangerstrasse 315, 8054 Graz, Austria.
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76
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Myocardial Imaging with CMR Parametric Mapping: Clinical Applications. CURRENT RADIOLOGY REPORTS 2018. [DOI: 10.1007/s40134-018-0306-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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77
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Vijapurapu R, Nordin S, Baig S, Liu B, Rosmini S, Augusto J, Tchan M, Hughes DA, Geberhiwot T, Moon JC, Steeds RP, Kozor R. Global longitudinal strain, myocardial storage and hypertrophy in Fabry disease. Heart 2018; 105:470-476. [PMID: 30282640 DOI: 10.1136/heartjnl-2018-313699] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 08/28/2018] [Accepted: 08/30/2018] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Detecting early cardiac involvement in Fabry disease (FD) is important because therapy may alter disease progression. Cardiovascular magnetic resonance (CMR) can detect T1 lowering, representing myocardial sphingolipid storage. In many diseases, early mechanical dysfunction may be detected by abnormal global longitudinal strain (GLS). We explored the relationship of early mechanical dysfunction and sphingolipid deposition in FD. METHODS An observational study of 221 FD and 77 healthy volunteers (HVs) who underwent CMR (LV volumes, mass, native T1, GLS, late gadolinium enhancement), ECG and blood biomarkers, as part of the prospective multicentre Fabry400 study. RESULTS All FD had normal LV ejection fraction (EF 73%±8%). Mean indexed LV mass (LVMi) was 89±39 g/m2 in FD and 55.6±10 g/m2 in HV. 102 (46%) FD participants had left ventricular hypertrophy (LVH). There was a negative correlation between GLS and native T1 in FD patients (r=-0.515, p<0.001). In FD patients without LVH (early disease), as native T1 reduced there was impairment in GLS (r=-0.285, p<0.002). In the total FD cohort, ECG abnormalities were associated with a significant impairment in GLS compared with those without ECG abnormalities (abnormal: -16.7±3.5 vs normal: -20.2±2.4, p<0.001). CONCLUSIONS GLS in FD correlates with an increase in LVMi, storage and the presence of ECG abnormalities. In LVH-negative FD (early disease), impairment in GLS is associated with a reduction in native T1, suggesting that mechanical dysfunction occurs before evidence of sphingolipid deposition (low T1). TRIAL REGISTRATION NUMBER NCT03199001; Results.
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Affiliation(s)
- Ravi Vijapurapu
- Department of Cardiology, Queen Elizabeth Hospital, Birmingham, UK.,Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Sabrina Nordin
- Department of Cardiology, Barts Heart Centre, London, UK
| | - Shanat Baig
- Department of Cardiology, Queen Elizabeth Hospital, Birmingham, UK.,Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Boyang Liu
- Department of Cardiology, Queen Elizabeth Hospital, Birmingham, UK.,Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | | | - Joao Augusto
- Department of Cardiology, Barts Heart Centre, London, UK
| | - Michel Tchan
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | | | - Tarekegn Geberhiwot
- Department of Inherited Metabolic Disorders, Queen Elizabeth Hospital, Birmingham, UK
| | - James C Moon
- Department of Cardiology, Barts Heart Centre, London, UK
| | - Richard Paul Steeds
- Department of Cardiology, Queen Elizabeth Hospital, Birmingham, UK.,Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Rebecca Kozor
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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78
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Militaru S, Ginghină C, Popescu BA, Săftoiu A, Linhart A, Jurcuţ R. Multimodality imaging in Fabry cardiomyopathy: from early diagnosis to therapeutic targets. Eur Heart J Cardiovasc Imaging 2018; 19:1313-1322. [DOI: 10.1093/ehjci/jey132] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 08/23/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Sebastian Militaru
- Emergency Institute for Cardiovascular Diseases “Prof. Dr. C. C. Iliescu”, Bucharest, Romania
- University of Medicine and Pharmacy, Craiova, Romania
| | - Carmen Ginghină
- Emergency Institute for Cardiovascular Diseases “Prof. Dr. C. C. Iliescu”, Bucharest, Romania
- University of Medicine and Pharmacy“Carol Davila”, Bucharest, Romania
| | - Bogdan A Popescu
- Emergency Institute for Cardiovascular Diseases “Prof. Dr. C. C. Iliescu”, Bucharest, Romania
- University of Medicine and Pharmacy“Carol Davila”, Bucharest, Romania
| | - Adrian Săftoiu
- University of Medicine and Pharmacy, Craiova, Romania
- Emergency County Hospital, Craiova, Romania
| | - Ales Linhart
- 2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Ruxandra Jurcuţ
- Emergency Institute for Cardiovascular Diseases “Prof. Dr. C. C. Iliescu”, Bucharest, Romania
- University of Medicine and Pharmacy“Carol Davila”, Bucharest, Romania
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79
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Wilson HC, Ambach S, Madueme PC, Khoury PR, Hopkin RJ, Jefferies JL. Comparison of Native T1, Strain, and Traditional Measures of Cardiovascular Structure and Function by Cardiac Magnetic Resonance Imaging in Patients With Anderson-Fabry Disease. Am J Cardiol 2018; 122:1074-1078. [PMID: 30075896 DOI: 10.1016/j.amjcard.2018.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 06/02/2018] [Accepted: 06/06/2018] [Indexed: 01/18/2023]
Abstract
Cardiovascular magnetic resonance imaging (CMR) has emerged as a powerful tool to illuminate cardiovascular pathology in Anderson-Fabry disease (AFD); however, further study is required to develop clinically useful monitoring paradigms. The objective of this study was to retrospectively evaluate strain, native septal T1 values, and standard CMR measurements in a cohort of AFD patients to characterize useful measures of cardiovascular dysfunction that may be derived from a CMR platform. Eighteen patients were identified (n = 8 males) and divided according to presence or absence of left ventricular hypertrophy (LVH). Biometric data were gathered and native T1 and strain values were measured for all patients. Patients with LVH were older and had significantly lower native T1 measured at the apical septal (893 ± 78 vs 1044 ± 217 ms, p = 0.035), midventricular septal (864 ± 76 vs 988 ± 67 ms, p = 0.016), and basal septal (867 ± 58 vs 1027 ± 84 ms, p = 0.006) regions. Circumferential strain was more positive in patients with LVH (-13.5% ± 5.0% vs -18.7% ± 2.7%, p = 0.042), but longitudinal strain was not significantly different between groups. Patients with LVH had higher stroke volumes (114.5 ± 9.7 vs 96.7 ± 17.8 ml, p = 0.050), but other standard CMR measures were not significantly different. In conclusion, AFD patients with LVH have reduced native T1 and more positive circumferential strain compared to those without. The basal septum may be an appropriate region for standard measure of native T1 in this population.
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Affiliation(s)
- Hunter C Wilson
- Department of Pediatrics and Communicable Diseases, Division of Cardiology, C. S. Mott Children's Hospital and University of Michigan, Ann Arbor, Michigan
| | - Stephanie Ambach
- Heritage College of Osteopathic Medicine, Ohio University, Cleveland, Ohio
| | - Peace C Madueme
- Cardiac Center, Nemours Children's Hospital, Orlando, Florida
| | - Philip R Khoury
- Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Robert J Hopkin
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - John L Jefferies
- Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
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80
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Pagano JJ, Chow K, Paterson DI, Mikami Y, Schmidt A, Howarth A, White J, Friedrich MG, Oudit GY, Ezekowitz J, Dyck J, Thompson RB. Effects of age, gender, and risk-factors for heart failure on native myocardial T1
and extracellular volume fraction using the SASHA sequence at 1.5T. J Magn Reson Imaging 2018; 48:1307-1317. [DOI: 10.1002/jmri.26160] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 04/07/2018] [Indexed: 12/14/2022] Open
Affiliation(s)
- Joseph J. Pagano
- Department of Biomedical Engineering; University of Alberta; Edmonton AB Canada
| | - Kelvin Chow
- Cardiovascular MR R&D, Siemens Medical Solutions USA, Inc; Chicago Illinois USA
| | - D. Ian Paterson
- Mazankowski Alberta Heart Institute; University of Alberta; Edmonton AB Canada
- Department of Medicine; University of Alberta; Edmonton AB Canada
| | - Yoko Mikami
- Stephenson Cardiac Imaging Centre, Libin Cardiovascular Institute of Alberta; Calgary AB Canada
- Departments of Cardiac Sciences and Radiology; University of Calgary; Calgary AB Canada
| | - Anna Schmidt
- Stephenson Cardiac Imaging Centre, Libin Cardiovascular Institute of Alberta; Calgary AB Canada
- Departments of Cardiac Sciences and Radiology; University of Calgary; Calgary AB Canada
| | - Andrew Howarth
- Stephenson Cardiac Imaging Centre, Libin Cardiovascular Institute of Alberta; Calgary AB Canada
- Departments of Cardiac Sciences and Radiology; University of Calgary; Calgary AB Canada
| | - James White
- Stephenson Cardiac Imaging Centre, Libin Cardiovascular Institute of Alberta; Calgary AB Canada
- Departments of Cardiac Sciences and Radiology; University of Calgary; Calgary AB Canada
| | - Matthias G. Friedrich
- Departments of Cardiac Sciences and Radiology; University of Calgary; Calgary AB Canada
- Department of Medicine; Heidelberg University; Heidelberg Germany
- Department of Radiology; Université de Montréal; Montréal QC Canada
- Departments of Medicine and Diagnostic Radiology; Mc;Gill University Health Centre; Montréal QC Canada
| | - Gavin Y. Oudit
- Mazankowski Alberta Heart Institute; University of Alberta; Edmonton AB Canada
- Department of Medicine; University of Alberta; Edmonton AB Canada
| | - Justin Ezekowitz
- Mazankowski Alberta Heart Institute; University of Alberta; Edmonton AB Canada
- Department of Medicine; University of Alberta; Edmonton AB Canada
| | - Jason Dyck
- Mazankowski Alberta Heart Institute; University of Alberta; Edmonton AB Canada
- Department of Pediatrics; University of Alberta; Edmonton AB Canada
| | - Richard B. Thompson
- Department of Biomedical Engineering; University of Alberta; Edmonton AB Canada
- Mazankowski Alberta Heart Institute; University of Alberta; Edmonton AB Canada
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81
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Patel AR, Kramer CM. Role of Cardiac Magnetic Resonance in the Diagnosis and Prognosis of Nonischemic Cardiomyopathy. JACC Cardiovasc Imaging 2018; 10:1180-1193. [PMID: 28982571 DOI: 10.1016/j.jcmg.2017.08.005] [Citation(s) in RCA: 164] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 08/04/2017] [Accepted: 08/10/2017] [Indexed: 12/11/2022]
Abstract
Cardiac magnetic resonance (CMR) is a valuable tool for the evaluation of patients with, or at risk for, heart failure and has a growing impact on diagnosis, clinical management, and decision making. Through its ability to characterize the myocardium by using multiple different imaging parameters, it provides insight into the etiology of the underlying heart failure and its prognosis. CMR is widely accepted as the reference standard for quantifying chamber size and ejection fraction. Additionally, tissue characterization techniques such as late gadolinium enhancement (LGE) and other quantitative parameters such as T1 mapping, both native and with measurement of extracellular volume fraction; T2 mapping; and T2* mapping have been validated against histological findings in a wide range of clinical scenarios. In particular, the pattern of LGE in the myocardium can help determine the underlying etiology of the heart failure. The presence and extent of LGE determine prognosis in many of the nonischemic cardiomyopathies. The use of CMR should increase as its utility in characterization and assessment of prognosis in cardiomyopathies is increasingly recognized.
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Affiliation(s)
- Amit R Patel
- Department of Medicine and Radiology, University of Chicago, Chicago, Illinois
| | - Christopher M Kramer
- Departments of Medicine and Radiology and the Cardiovascular Imaging Center, University of Virginia Health System, Charlottesville, Virginia.
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82
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Cammarata G, Scalia S, Colomba P, Zizzo C, Pisani A, Riccio E, Montalbano M, Alessandro R, Giordano A, Duro G. A pilot study of circulating microRNAs as potential biomarkers of Fabry disease. Oncotarget 2018; 9:27333-27345. [PMID: 29937989 PMCID: PMC6007950 DOI: 10.18632/oncotarget.25542] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 05/16/2018] [Indexed: 11/25/2022] Open
Abstract
Patients suffering from Fabry disease (FD), a lysosomal storage disorder, show a broad range of symptoms and the diagnosis followed by the therapeutic decision remains a great challenge. The biomarkers available today have not proven to be useful for predicting the evolution of the disease and for assessing response to therapy in many patients. Here, we used high-throughput microRNA profiling methodology to identify a specific circulating microRNA profile in FD patients. We discovered a pattern of 10 microRNAs able to identify FD patients when compared to healthy controls. Notably, two of these: the miR199a-5p and the miR-126-3p are able to discriminate FDs from the control subjects with left ventricular hypertrophy, a frequent but non-specific FD symptom. These same microRNAs are also sensitive to enzyme replacement therapy showing variation in the subjects under treatment. Furthermore, two other microRNAs of the profile, the miR-423-5p and the miR-451a, seem useful to highlight cardiac involvement in FD patients. A literature and database search revealed that miR-199a-5p, miR-126-3p, miR-423-5p and miR-451a are known to be linked to pathological states that occur during the FD development. In particular, miR-199a-5p, and miR-126-3p are involved in endothelial dysfunction and miR-423-5p and miR-451a in myocardial remodeling. In conclusion, in this study we identified a common plasma microRNA profile in FD patients, useful not only for the correct classification of Fabry patients regardless of sex and age, but also to evaluate the response to therapy. Furthermore, our observations suggest that some microRNAs of this profile demonstrate prognostic qualities.
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Affiliation(s)
- Giuseppe Cammarata
- Institute of Biomedicine and Molecular Immunology, National Research Council, Palermo, Italy
| | - Simone Scalia
- Institute of Biomedicine and Molecular Immunology, National Research Council, Palermo, Italy
| | - Paolo Colomba
- Institute of Biomedicine and Molecular Immunology, National Research Council, Palermo, Italy
| | - Carmela Zizzo
- Institute of Biomedicine and Molecular Immunology, National Research Council, Palermo, Italy
| | - Antonio Pisani
- Department of Public Health, Section of Nephrology, Federico II University of Naples, Naples, Italy
| | - Eleonora Riccio
- Department of Public Health, Section of Nephrology, Federico II University of Naples, Naples, Italy
| | - Michaela Montalbano
- Institute of Biomedicine and Molecular Immunology, National Research Council, Palermo, Italy
| | - Riccardo Alessandro
- Institute of Biomedicine and Molecular Immunology, National Research Council, Palermo, Italy
- Department of Biopathology and Medical Biotechnology, University of Palermo, Palermo, Italy
| | | | - Giovanni Duro
- Institute of Biomedicine and Molecular Immunology, National Research Council, Palermo, Italy
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83
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Schelbert EB, Bering P. Constancy of Spatial Variation in Diffuse Myocardial Disease: Implications for Diagnosing Disease. Circ Cardiovasc Imaging 2018; 11:e007836. [PMID: 29853468 DOI: 10.1161/circimaging.118.007836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Erik B Schelbert
- UPMC Cardiovascular Magnetic Resonance Center, Heart and Vascular Institute, UMPC, Pittsburgh, PA (E.B.S., P.B.). .,Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, PA (E.B.S.)
| | - Patrick Bering
- UPMC Cardiovascular Magnetic Resonance Center, Heart and Vascular Institute, UMPC, Pittsburgh, PA (E.B.S., P.B.)
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84
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Schelbert EB, Miller CA. Myocardial tissue characteristics undoubtedly differ by gender but not age. Eur Heart J Cardiovasc Imaging 2018; 19:611-612. [PMID: 29648631 DOI: 10.1093/ehjci/jey057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Erik B Schelbert
- UPMC Cardiovascular Magnetic Resonance Center, Heart and Vascular Institute, Pittsburgh, PA, USA.,Department of Medicine, University of Pittsburgh School of Medicine, 200 Lothrop Street, PUH E E354.2, Pittsburgh, PA 15101, USA
| | - Christopher A Miller
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester M13 9PL, UK.,Manchester University NHS Foundation Trust, Wythenshawe Hospital, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK.,Division of Cell-Matrix Biology & Regenerative Medicine, School of Biology, Faculty of Biology, Medicine & Health, Wellcome Centre for Cell-Matrix Research, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester M13 9PT, UK
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85
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Karur GR, Robison S, Iwanochko RM, Morel CF, Crean AM, Thavendiranathan P, Nguyen ET, Mathur S, Wasim S, Hanneman K. Use of Myocardial T1 Mapping at 3.0 T to Differentiate Anderson-Fabry Disease from Hypertrophic Cardiomyopathy. Radiology 2018; 288:398-406. [PMID: 29688154 DOI: 10.1148/radiol.2018172613] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Purpose To compare left ventricular (LV) and right ventricular (RV) 3.0-T cardiac magnetic resonance (MR) imaging T1 values in Anderson-Fabry disease (AFD) and hypertrophic cardiomyopathy (HCM) and evaluate the diagnostic value of native T1 values beyond age, sex, and conventional imaging features. Materials and Methods For this prospective study, 30 patients with gene-positive AFD (37% male; mean age ± standard deviation, 45.0 years ± 14.1) and 30 patients with HCM (57% male; mean age, 49.3 years ± 13.5) were prospectively recruited between June 2016 and September 2017 to undergo cardiac MR imaging T1 mapping with a modified Look-Locker inversion recovery (MOLLI) acquisition scheme at 3.0 T (repetition time msec/echo time msec, 280/1.12; section thickness, 8 mm). LV and RV T1 values were evaluated. Statistical analysis included independent samples t test, receiver operating characteristic curve analysis, multivariable logistic regression, and likelihood ratio test. Results Septal LV, global LV, and RV native T1 values were significantly lower in AFD compared with those in HCM (1161 msec ± 47 vs 1296 msec ± 55, respectively [P < .001]; 1192 msec ± 52 vs 1268 msec ± 55 [P < .001]; and 1221 msec ± 54 vs 1271 msec ± 37 [P = .001], respectively). A septal LV native T1 cutoff point of 1220 msec or lower distinguished AFD from HCM with sensitivity of 97%, specificity of 93%, and accuracy of 95%. Septal LV native T1 values differentiated AFD from HCM after adjustment for age, sex, and conventional imaging features (odds ratio, 0.94; 95% confidence interval: 0.91, 0.98; P = < .001). In a nested logistic regression model with age, sex, and conventional imaging features, model fit was significantly improved by the addition of septal LV native T1 values (χ2 [df = 1] = 33.4; P < .001). Conclusion Cardiac MR imaging native T1 values at 3.0 T are significantly lower in patients with AFD compared with those with HCM and provide independent and incremental diagnostic value beyond age, sex, and conventional imaging features. © RSNA, 2018.
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Affiliation(s)
- Gauri R Karur
- From the Toronto Joint Department of Medical Imaging, Toronto General Hospital, University of Toronto, 585 University Ave, 1 PMB-298, Toronto, ON, Canada M5G 2N2 (G.R.K., S.R., P.T., E.T.N., S.M., K.H.); Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada (R.M.I., A.M.C., P.T.); and Fred A. Litwin Centre in Genetic Medicine, University Health Network & Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada (C.F.M., S.W.)
| | - Sean Robison
- From the Toronto Joint Department of Medical Imaging, Toronto General Hospital, University of Toronto, 585 University Ave, 1 PMB-298, Toronto, ON, Canada M5G 2N2 (G.R.K., S.R., P.T., E.T.N., S.M., K.H.); Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada (R.M.I., A.M.C., P.T.); and Fred A. Litwin Centre in Genetic Medicine, University Health Network & Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada (C.F.M., S.W.)
| | - Robert M Iwanochko
- From the Toronto Joint Department of Medical Imaging, Toronto General Hospital, University of Toronto, 585 University Ave, 1 PMB-298, Toronto, ON, Canada M5G 2N2 (G.R.K., S.R., P.T., E.T.N., S.M., K.H.); Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada (R.M.I., A.M.C., P.T.); and Fred A. Litwin Centre in Genetic Medicine, University Health Network & Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada (C.F.M., S.W.)
| | - Chantal F Morel
- From the Toronto Joint Department of Medical Imaging, Toronto General Hospital, University of Toronto, 585 University Ave, 1 PMB-298, Toronto, ON, Canada M5G 2N2 (G.R.K., S.R., P.T., E.T.N., S.M., K.H.); Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada (R.M.I., A.M.C., P.T.); and Fred A. Litwin Centre in Genetic Medicine, University Health Network & Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada (C.F.M., S.W.)
| | - Andrew M Crean
- From the Toronto Joint Department of Medical Imaging, Toronto General Hospital, University of Toronto, 585 University Ave, 1 PMB-298, Toronto, ON, Canada M5G 2N2 (G.R.K., S.R., P.T., E.T.N., S.M., K.H.); Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada (R.M.I., A.M.C., P.T.); and Fred A. Litwin Centre in Genetic Medicine, University Health Network & Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada (C.F.M., S.W.)
| | - Paaladinesh Thavendiranathan
- From the Toronto Joint Department of Medical Imaging, Toronto General Hospital, University of Toronto, 585 University Ave, 1 PMB-298, Toronto, ON, Canada M5G 2N2 (G.R.K., S.R., P.T., E.T.N., S.M., K.H.); Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada (R.M.I., A.M.C., P.T.); and Fred A. Litwin Centre in Genetic Medicine, University Health Network & Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada (C.F.M., S.W.)
| | - Elsie T Nguyen
- From the Toronto Joint Department of Medical Imaging, Toronto General Hospital, University of Toronto, 585 University Ave, 1 PMB-298, Toronto, ON, Canada M5G 2N2 (G.R.K., S.R., P.T., E.T.N., S.M., K.H.); Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada (R.M.I., A.M.C., P.T.); and Fred A. Litwin Centre in Genetic Medicine, University Health Network & Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada (C.F.M., S.W.)
| | - Shobhit Mathur
- From the Toronto Joint Department of Medical Imaging, Toronto General Hospital, University of Toronto, 585 University Ave, 1 PMB-298, Toronto, ON, Canada M5G 2N2 (G.R.K., S.R., P.T., E.T.N., S.M., K.H.); Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada (R.M.I., A.M.C., P.T.); and Fred A. Litwin Centre in Genetic Medicine, University Health Network & Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada (C.F.M., S.W.)
| | - Syed Wasim
- From the Toronto Joint Department of Medical Imaging, Toronto General Hospital, University of Toronto, 585 University Ave, 1 PMB-298, Toronto, ON, Canada M5G 2N2 (G.R.K., S.R., P.T., E.T.N., S.M., K.H.); Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada (R.M.I., A.M.C., P.T.); and Fred A. Litwin Centre in Genetic Medicine, University Health Network & Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada (C.F.M., S.W.)
| | - Kate Hanneman
- From the Toronto Joint Department of Medical Imaging, Toronto General Hospital, University of Toronto, 585 University Ave, 1 PMB-298, Toronto, ON, Canada M5G 2N2 (G.R.K., S.R., P.T., E.T.N., S.M., K.H.); Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada (R.M.I., A.M.C., P.T.); and Fred A. Litwin Centre in Genetic Medicine, University Health Network & Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada (C.F.M., S.W.)
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86
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Hazari H, Belenkie I, Kryski A, White JA, Oudit GY, Thompson R, Fung T, Dehar N, Khan A. Comparison of Cardiac Magnetic Resonance Imaging and Echocardiography in Assessment of Left Ventricular Hypertrophy in Fabry Disease. Can J Cardiol 2018; 34:1041-1047. [PMID: 29935990 DOI: 10.1016/j.cjca.2018.03.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 03/22/2018] [Accepted: 03/22/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Cardiac hypertrophy in Fabry disease can be assessed using the left ventricular mass index (LVMI) with either echocardiography (LVMI-ECHO) or magnetic resonance imaging (LVMI-CMR). METHODS A retrospective case series of patients with Fabry disease in Alberta involved a cross-sectional analysis of 32 patients and a longitudinal analysis of 14 of these patients with at least 4 serial CMR measurements. RESULTS The cross-sectional analysis showed the mean LVMI-ECHO was 97.8 ± 26.0 g/m2, which was higher compared with LVMI-CMR at 81.1 ± 26.9 g/m2 with a mean bias of 16.7 g/m2 (P < 0.001). In the longitudinal analysis, LVMI-ECHO was higher, with an estimated marginal mean of 96.21 ± 6.13 (mean ± standard error of the mean [SEM]) compared with 71.18 ± 5.99 for LVMI-CMR (P < 0.01; generalized estimating equations). There was an association between an increase in LVMI-CMR over time with the presence of cardiac fibrosis, and patients treated with enzyme replacement therapy (ERT) had slower increases than those without therapy. LVMI-ECHO failed to detect these associations owing to the higher variability and tendency to overestimate the LVMI. CONCLUSIONS We propose the preferred method for measuring LVMI is CMR in patients with Fabry disease.
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Affiliation(s)
- Hassan Hazari
- Faculty of Graduate Studies, Department of Medical Genetics and Pediatrics, University of Calgary Cumming School of Medicine, Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Israel Belenkie
- Departments of Cardiac Sciences and Medicine, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Albert Kryski
- Department of Cardiac Sciences and Medicine, Libin Cardiovascular Institute, Cumming School of Medicine, Calgary, Alberta, Canada
| | - James A White
- Stephenson Cardiac Imaging Centre, Libin Cardiovascular Institute, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Gavin Y Oudit
- Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Richard Thompson
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Tak Fung
- Information Technologies, University of Calgary, Calgary, Alberta, Canada
| | - Navdeep Dehar
- Biotechnology Program, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Aneal Khan
- Department of Medical Genetics and Pediatrics, University of Calgary Cumming School of Medicine, Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.
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Abstract
Heart failure is a growing cardiovascular disease with significant epidemiological, clinical, and societal implications and represents a high unmet need. Strong efforts are currently underway by academic and industrial researchers to develop novel treatments for heart failure. Biomarkers play an important role in patient selection and monitoring in drug trials and in clinical management. The present review gives an overview of the role of available molecular, imaging, and device-derived digital biomarkers in heart failure drug development and highlights capabilities and limitations of biomarker use in this context.
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88
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Scully PR, Bastarrika G, Moon JC, Treibel TA. Myocardial Extracellular Volume Quantification by Cardiovascular Magnetic Resonance and Computed Tomography. Curr Cardiol Rep 2018; 20:15. [PMID: 29511861 PMCID: PMC5840231 DOI: 10.1007/s11886-018-0961-3] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW This review article discusses the evolution of extracellular volume (ECV) quantification using both cardiovascular magnetic resonance (CMR) and computed tomography (CT). RECENT FINDINGS Visualizing diffuse myocardial fibrosis is challenging and until recently, was restricted to the domain of the pathologist. CMR and CT both use extravascular, extracellular contrast agents, permitting ECV measurement. The evidence base around ECV quantification by CMR is growing rapidly and just starting in CT. In conditions with high ECV (amyloid, oedema and fibrosis), this technique is already being used clinically and as a surrogate endpoint. Non-invasive diffuse fibrosis quantification is also generating new biological insights into key cardiac diseases. CMR and CT can estimate ECV and in turn diffuse myocardial fibrosis, obviating the need for invasive endomyocardial biopsy. CT is an attractive alternative to CMR particularly in those individuals with contraindications to the latter. Further studies are needed, particularly in CT.
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Affiliation(s)
- Paul R. Scully
- Cardiac Imaging Department, Barts Heart Centre, St Bartholomew’s Hospital, 2nd Floor, King George V Building, West Smithfield, London, EC1A 7BE UK
- Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT UK
| | - Gorka Bastarrika
- Clínica Universidad de Navarra, University of Navarra, Avda/Pio XII 55, 31008 Pamplona, Spain
| | - James C. Moon
- Cardiac Imaging Department, Barts Heart Centre, St Bartholomew’s Hospital, 2nd Floor, King George V Building, West Smithfield, London, EC1A 7BE UK
- Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT UK
| | - Thomas A. Treibel
- Cardiac Imaging Department, Barts Heart Centre, St Bartholomew’s Hospital, 2nd Floor, King George V Building, West Smithfield, London, EC1A 7BE UK
- Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT UK
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89
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Clinical applications of multiparametric CMR in left ventricular hypertrophy. Int J Cardiovasc Imaging 2018; 34:577-585. [DOI: 10.1007/s10554-018-1320-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 01/16/2017] [Indexed: 12/22/2022]
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90
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91
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Messroghli DR, Moon JC, Ferreira VM, Grosse-Wortmann L, He T, Kellman P, Mascherbauer J, Nezafat R, Salerno M, Schelbert EB, Taylor AJ, Thompson R, Ugander M, van Heeswijk RB, Friedrich MG. 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). J Cardiovasc Magn Reson 2017; 19:75. [PMID: 28992817 PMCID: PMC5633041 DOI: 10.1186/s12968-017-0389-8] [Citation(s) in RCA: 1000] [Impact Index Per Article: 142.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 09/25/2017] [Indexed: 12/14/2022] Open
Abstract
Parametric mapping techniques provide a non-invasive tool for quantifying tissue alterations in myocardial disease in those eligible for cardiovascular magnetic resonance (CMR). Parametric mapping with CMR now permits the routine spatial visualization and quantification of changes in myocardial composition based on changes in T1, T2, and T2*(star) relaxation times and extracellular volume (ECV). These changes include specific disease pathways related to mainly intracellular disturbances of the cardiomyocyte (e.g., iron overload, or glycosphingolipid accumulation in Anderson-Fabry disease); extracellular disturbances in the myocardial interstitium (e.g., myocardial fibrosis or cardiac amyloidosis from accumulation of collagen or amyloid proteins, respectively); or both (myocardial edema with increased intracellular and/or extracellular water). Parametric mapping promises improvements in patient care through advances in quantitative diagnostics, inter- and intra-patient comparability, and relatedly improvements in treatment. There is a multitude of technical approaches and potential applications. This document provides a summary of the existing evidence for the clinical value of parametric mapping in the heart as of mid 2017, and gives recommendations for practical use in different clinical scenarios for scientists, clinicians, and CMR manufacturers.
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Affiliation(s)
- Daniel R. Messroghli
- Department of Internal Medicine and Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
- Department of Internal Medicine and Cardiology, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - James C. Moon
- University College London and Barts Heart Centre, London, UK
| | - Vanessa M. Ferreira
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Lars Grosse-Wortmann
- Division of Cardiology in the Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON Canada
| | - Taigang He
- Cardiovascular Science Research Centre, St George’s, University of London, London, UK
| | | | - Julia Mascherbauer
- Department of Internal Medicine II, Division of Cardiology, Vienna, Austria
| | - Reza Nezafat
- Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Michael Salerno
- Departments of Medicine Cardiology Division, Radiology and Medical Imaging, and Biomedical Engineering, University of Virginia Health System, Charlottesville, VA USA
| | - Erik B. Schelbert
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
- UPMC Cardiovascular Magnetic Resonance Center, Heart and Vascular Institute, Pittsburgh, PA USA
- Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA USA
| | - Andrew J. Taylor
- The Alfred Hospital, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Richard Thompson
- Department of Biomedical Engineering, University of Alberta, Edmonton, Canada
| | - Martin Ugander
- Department of Clinical Physiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Ruud B. van Heeswijk
- Department of Radiology, Lausanne University Hospital (CHUV) and Lausanne University (UNIL), Lausanne, Switzerland
| | - Matthias G. Friedrich
- Departments of Medicine and Diagnostic Radiology, McGill University, Montréal, Québec Canada
- Department of Medicine, Heidelberg University, Heidelberg, Germany
- Département de radiologie, Université de Montréal, Montréal, Québec Canada
- Departments of Cardiac Sciences and Radiology, University of Calgary, Calgary, Canada
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Walter TC, Knobloch G, Canaan-Kuehl S, Greiser A, Sandek A, Blaschke D, Denecke T, Hamm B, Makowski MR. Segment-by-segment assessment of left ventricular myocardial affection in Anderson-Fabry disease by non-enhanced T1-mapping. Acta Radiol 2017; 58:914-921. [PMID: 27799574 DOI: 10.1177/0284185116675657] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background Anderson-Fabry disease (AFD) is an X-linked lysosomal enzyme disorder associated with an intracellular accumulation of sphingolipids, which shorten myocardial T1 relaxation times. Myocardial affection, however, varies between different segments. Purpose To evaluate the specific segmental distribution and degree of segmental affection in AFD patients. Material and Methods Twenty-five patients with AFD, 14 patients with hypertrophic cardiomyopathy (HCM), and 21 controls were included. A Modified Look-Locker Inversion Recovery sequence (MOLLI) was used for non-enhanced T1 mapping at 1.5 T in addition to standard cardiac imaging in 10-12 short axis views. T1 values were evaluated with a mixed model ANOVA and regression analysis to determine the best diagnostic cutoff values for T1 for each myocardial segment. Results Regression analysis showed the best diagnostic cutoff compared to controls in cardiac segments 1-4, 8-9, and 14. Mean differences between T1 for AFD versus HCM were greatest in segment 3, 4, and 9 (99 ms, 103 ms, 86 ms, respectively). Overall T1 times were 888 ± 70 ms and 903 ± 14 ms (AFD with and without LVH); 1014 ± 17 ms and 1001 ± 22 ms (HCM and controls, P < 0.05). Conclusion Myocardial segments are affected by a varying degree of T1 shortening in AFD patients. Segment-specific cutoff values allow the most specific detection and quantification of the extent of myocardial affection.
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Affiliation(s)
| | | | | | | | - Anja Sandek
- Department of Cardiology, University of Goettingen Medical School, Germany
| | | | | | - Bernd Hamm
- Department of Radiology, Charité, Germany
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Yogasundaram H, Kim D, Oudit O, Thompson RB, Weidemann F, Oudit GY. Clinical Features, Diagnosis, and Management of Patients With Anderson-Fabry Cardiomyopathy. Can J Cardiol 2017; 33:883-897. [DOI: 10.1016/j.cjca.2017.04.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 04/09/2017] [Accepted: 04/23/2017] [Indexed: 12/14/2022] Open
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Abstract
Quantitative myocardial and blood T1 have recently achieved clinical utility in numerous pathologies, as they provide non-invasive tissue characterization with the potential to replace invasive biopsy. Native T1 time (no contrast agent), changes with myocardial extracellular water (edema, focal or diffuse fibrosis), fat, iron, and amyloid protein content. After contrast, the extracellular volume fraction (ECV) estimates the size of the extracellular space and identifies interstitial disease. Spatially resolved quantification of these biomarkers (so-called T1 mapping and ECV mapping) are steadily becoming diagnostic and prognostically useful tests for several heart muscle diseases, influencing clinical decision-making with a pending second consensus statement due mid-2017. This review outlines the physics involved in estimating T1 times and summarizes the disease-specific clinical and research impacts of T1 and ECV to date. We conclude by highlighting some of the remaining challenges such as their community-wide delivery, quality control, and standardization for clinical practice.
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Affiliation(s)
- Dina Radenkovic
- Barts Heart Center, The Cardiovascular Magnetic Resonance Imaging Unit, St Bartholomew's Hospital, West Smithfield, London, UK
- University College London Medical School, Bloomsbury Campus, Gower Street, London, UK
| | - Sebastian Weingärtner
- Computer Assisted Clinical Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer, Mannheim, Germany
- Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Lewis Ricketts
- University College London Medical School, Bloomsbury Campus, Gower Street, London, UK
| | - James C Moon
- Barts Heart Center, The Cardiovascular Magnetic Resonance Imaging Unit, St Bartholomew's Hospital, West Smithfield, London, UK
- NIHR University College London Hospitals Biomedical Research Center, Tottenham Court Road, London, UK
- UCL Institute of Cardiovascular Science, University College London, London, UK
| | - Gabriella Captur
- Barts Heart Center, The Cardiovascular Magnetic Resonance Imaging Unit, St Bartholomew's Hospital, West Smithfield, London, UK.
- NIHR University College London Hospitals Biomedical Research Center, Tottenham Court Road, London, UK.
- UCL Institute of Cardiovascular Science, University College London, London, UK.
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95
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Towards accurate and precise T 1 and extracellular volume mapping in the myocardium: a guide to current pitfalls and their solutions. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2017; 31:143-163. [PMID: 28608328 PMCID: PMC5813078 DOI: 10.1007/s10334-017-0631-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 05/05/2017] [Accepted: 05/24/2017] [Indexed: 01/27/2023]
Abstract
Mapping of the longitudinal relaxation time (T1) and extracellular volume (ECV) offers a means of identifying pathological changes in myocardial tissue, including diffuse changes that may be invisible to existing T1-weighted methods. This technique has recently shown strong clinical utility for pathologies such as Anderson-Fabry disease and amyloidosis and has generated clinical interest as a possible means of detecting small changes in diffuse fibrosis; however, scatter in T1 and ECV estimates offers challenges for detecting these changes, and bias limits comparisons between sites and vendors. There are several technical and physiological pitfalls that influence the accuracy (bias) and precision (repeatability) of T1 and ECV mapping methods. The goal of this review is to describe the most significant of these, and detail current solutions, in order to aid scientists and clinicians to maximise the utility of T1 mapping in their clinical or research setting. A detailed summary of technical and physiological factors, issues relating to contrast agents, and specific disease-related issues is provided, along with some considerations on the future directions of the field.
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96
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97
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Schwaiger M, Kunze K, Rischpler C, Nekolla SG. PET/MR: Yet another Tesla? J Nucl Cardiol 2017; 24:1019-1031. [PMID: 27659455 DOI: 10.1007/s12350-016-0665-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 08/19/2016] [Indexed: 12/20/2022]
Abstract
After the successful introduction of PET/CT as a multimodality imaging technique, PET/MR has subsequently emerged as an attractive instrumentation for applications in neurology, oncology, and cardiology. Simultaneous data acquisition combining structural, functional, and molecular imaging provides a unique platform to link various aspects of cardiac performance for the non-invasive characterization of cardiovascular disease phenotypes. Specifically, tissue characterization by MR techniques with and without contrast agents allows for functional parameters such as LGE, myocardial perfusion, and T1 maps as well as an estimate of extracellular volume. PET tracers excel by their high sensitivity and specificity, thus supplementing the functional tissue characterization by MRI. Although the clinical applications are yet to be validated , the first experience with PET/MR suggests future applications in the area of vascular imaging (unstable plaque) as well as in the characterization of inflammatory processes involving the heart. Ischemic heart disease can be comprehensively assessed by integrating regional function, perfusion, and viability. Future technical improvements leading to less costly PET/MR instrumentation are necessary to support routine clinical application of this promising technique in cardiology.
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Affiliation(s)
- Markus Schwaiger
- Department of Nuclear Medicine, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, 81675, Munich, Germany.
| | - Karl Kunze
- Department of Nuclear Medicine, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, 81675, Munich, Germany
| | - Christoph Rischpler
- Department of Nuclear Medicine, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, 81675, Munich, Germany
| | - Stephan G Nekolla
- Department of Nuclear Medicine, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, 81675, Munich, Germany
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98
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Vasanji Z, Sigal RJ, Eves ND, Isaac DL, Friedrich MG, Chow K, Thompson RB. Increased left ventricular extracellular volume and enhanced twist function in type 1 diabetic individuals. J Appl Physiol (1985) 2017; 123:394-401. [PMID: 28522755 DOI: 10.1152/japplphysiol.00012.2017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 05/10/2017] [Accepted: 05/15/2017] [Indexed: 02/05/2023] Open
Abstract
Individuals with type 1 diabetes (T1D) characteristically have high glycemic levels that over time can result in reactive fibrosis and abnormalities in myocardial function. T1 mapping with magnetic resonance imaging (MRI) can estimate the extent of reactive fibrosis by measurement of the extracellular volume fraction (ECV). The extent of alterations in the ECV and associated changes in left ventricular (LV) function and morphology in individuals with T1D is unknown. Fourteen individuals with long-term T1D and 14 sex-, age-, and body mass index-matched controls without diabetes underwent MRI measurement of myocardial T1 and ECV values as well as LV function and morphology. Ventricular mass, volumes, and global function (LVEF and circumferential/longitudinal/radial strain) were similar in those with T1D and controls. However, those with T1D had larger myocardial ECV (22.1 ± 1.8 vs. 20.1 ± 2.1, P = 0.008) and increased native (noncontrast) myocardial T1 values (1,211 ± 44 vs. 1,172 ± 43 ms, P < 0.001) as compared with controls. Both the ECV and native T1 values significantly correlated with several components of torsion and circumferential-longitudinal shear strain (Ecl, the shear strain component associated with twist). Individuals with T1D had increased systolic torsion (P = 0.035), systolic torsion rate (P = 0.032), peak Ecl (P = 0.001), and rates of change of systolic (P = 0.007) and diastolic (P = 0.007) Ecl Individuals with T1D, with normal structure, LVEF, and strain, have increased extracellular volume and increased native T1 values with associated augmented torsion and Ecl These measures may be useful in detecting the early stages of diabetic cardiomyopathy and warrant larger prospective studies.NEW & NOTEWORTHY Individuals with type 1 diabetes, with normal left ventricular structure and function (ejection fraction and strain), have signs of interstitial fibrosis, measured with MRI as increased extracellular volume fraction and increased native myocardial T1, which significantly correlated with a number of measures of augmented left ventricular twist function. These measures may be useful in detecting the early stages of diabetic cardiomyopathy.
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Affiliation(s)
- Zainisha Vasanji
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Ronald J Sigal
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Neil D Eves
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.,Centre for Heart, Lung and Vascular Health, University of British Columbia, Kelowna, British Columbia, Canada
| | - Debra L Isaac
- Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Matthias G Friedrich
- Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.,Stephenson Cardiac MRI Centre, University of Calgary, Calgary Alberta, Canada.,McGill University Health Centre, McGill University, Montreal, Quebec, Canada.,Department of Medicine, Heidelberg University, Heidelberg, Germany; and
| | - Kelvin Chow
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Richard B Thompson
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
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Shah R, Nucifora G, Perry R, Selvanayagam JB. Noninvasive imaging in cardiac deposition diseases. J Magn Reson Imaging 2017; 47:44-59. [DOI: 10.1002/jmri.25720] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 03/16/2017] [Indexed: 01/13/2023] Open
Affiliation(s)
- Ranjit Shah
- Department of Cardiovascular Medicine; Flinders Medical Centre; Bedford Park Adelaide Australia
- Department of Heart Health; South Australian Health & Medical Research Institute; Adelaide Australia
| | - Gaetano Nucifora
- Department of Heart Health; South Australian Health & Medical Research Institute; Adelaide Australia
- School of Medicine; Flinders University; Bedford Park Adelaide Australia
| | - Rebecca Perry
- Department of Cardiovascular Medicine; Flinders Medical Centre; Bedford Park Adelaide Australia
- Department of Heart Health; South Australian Health & Medical Research Institute; Adelaide Australia
- School of Medicine; Flinders University; Bedford Park Adelaide Australia
| | - Joseph B. Selvanayagam
- Department of Cardiovascular Medicine; Flinders Medical Centre; Bedford Park Adelaide Australia
- Department of Heart Health; South Australian Health & Medical Research Institute; Adelaide Australia
- School of Medicine; Flinders University; Bedford Park Adelaide Australia
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100
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Pontone G, Di Bella G, Castelletti S, Maestrini V, Festa P, Ait-Ali L, Masci PG, Monti L, di Giovine G, De Lazzari M, Cipriani A, Guaricci AI, Dellegrottaglie S, Pepe A, Marra MP, Aquaro GD. Clinical recommendations of cardiac magnetic resonance, Part II. J Cardiovasc Med (Hagerstown) 2017; 18:209-222. [DOI: 10.2459/jcm.0000000000000499] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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