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Jang J, Whitaker J, Leshem E, Ngo LH, Neisius U, Nakamori S, Pashakhanloo F, Menze B, Manning WJ, Anter E, Nezafat R. Local Conduction Velocity in the Presence of Late Gadolinium Enhancement and Myocardial Wall Thinning: A Cardiac Magnetic Resonance Study in a Swine Model of Healed Left Ventricular Infarction. Circ Arrhythm Electrophysiol 2020; 12:e007175. [PMID: 31006313 DOI: 10.1161/circep.119.007175] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Conduction velocity (CV) is an important property that contributes to the arrhythmogenicity of the tissue substrate. The aim of this study was to investigate the association between local CV versus late gadolinium enhancement (LGE) and myocardial wall thickness in a swine model of healed left ventricular infarction. METHODS Six swine with healed myocardial infarction underwent cardiovascular magnetic resonance imaging and electroanatomic mapping. Two healthy controls (one treated with amiodarone and one unmedicated) underwent electroanatomic mapping with identical protocols to establish the baseline CV. CV was estimated using a triangulation technique. LGE+ regions were defined as signal intensity >2 SD than the mean of remote regions, wall thinning+ as those with wall thickness <2 SD than the mean of remote regions. LGE heterogeneity was defined as SD of LGE in the local neighborhood of 5 mm and wall thickness gradient as SD within 5 mm. Cardiovascular magnetic resonance and electroanatomic mapping data were registered, and hierarchical modeling was performed to estimate the mean difference of CV (LGE+/-, wall thinning+/-), or the change of the mean of CV per unit change (LGE heterogeneity, wall thickness gradient). RESULTS Significantly slower CV was observed in LGE+ (0.33±0.25 versus 0.54±0.36 m/s; P<0.001) and wall thinning+ regions (0.38±0.28 versus 0.55±0.37 m/s; P<0.001). Areas with greater LGE heterogeneity ( P<0.001) and wall thickness gradient ( P<0.001) exhibited slower CV. CONCLUSIONS Slower CV is observed in the presence of LGE, myocardial wall thinning, high LGE heterogeneity, and a high wall thickness gradient. Cardiovascular magnetic resonance may offer a valuable imaging surrogate for estimating CV, which may support noninvasive identification of the arrhythmogenic substrate.
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Affiliation(s)
- Jihye Jang
- Cardiovascular Division, Department of Medicine (J.J., E.L., L.H.N., U.N., S.N., F.P., W.J.M., E.A., R.N.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.,Department of Computer Science, Technical University of Munich, Germany (J.J., B.M.)
| | - John Whitaker
- Division of Imaging Sciences and Biomedical Engineering, King's College London, United Kingdom (J.W.)
| | - Eran Leshem
- Cardiovascular Division, Department of Medicine (J.J., E.L., L.H.N., U.N., S.N., F.P., W.J.M., E.A., R.N.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Long H Ngo
- Cardiovascular Division, Department of Medicine (J.J., E.L., L.H.N., U.N., S.N., F.P., W.J.M., E.A., R.N.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Ulf Neisius
- Cardiovascular Division, Department of Medicine (J.J., E.L., L.H.N., U.N., S.N., F.P., W.J.M., E.A., R.N.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Shiro Nakamori
- Cardiovascular Division, Department of Medicine (J.J., E.L., L.H.N., U.N., S.N., F.P., W.J.M., E.A., R.N.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Farhad Pashakhanloo
- Cardiovascular Division, Department of Medicine (J.J., E.L., L.H.N., U.N., S.N., F.P., W.J.M., E.A., R.N.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Bjoern Menze
- Department of Computer Science, Technical University of Munich, Germany (J.J., B.M.)
| | - Warren J Manning
- Cardiovascular Division, Department of Medicine (J.J., E.L., L.H.N., U.N., S.N., F.P., W.J.M., E.A., R.N.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.,Department of Radiology (W.J.M.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Elad Anter
- Cardiovascular Division, Department of Medicine (J.J., E.L., L.H.N., U.N., S.N., F.P., W.J.M., E.A., R.N.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Reza Nezafat
- Cardiovascular Division, Department of Medicine (J.J., E.L., L.H.N., U.N., S.N., F.P., W.J.M., E.A., R.N.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
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Huelnhagen T, Hezel F, Serradas Duarte T, Pohlmann A, Oezerdem C, Flemming B, Seeliger E, Prothmann M, Schulz-Menger J, Niendorf T. Myocardial effective transverse relaxation time T2* Correlates with left ventricular wall thickness: A 7.0 T MRI study. Magn Reson Med 2016; 77:2381-2389. [PMID: 27342430 DOI: 10.1002/mrm.26312] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/23/2016] [Accepted: 05/25/2016] [Indexed: 12/13/2022]
Abstract
PURPOSE Myocardial effective relaxation time T2* is commonly regarded as a surrogate for myocardial tissue oxygenation. However, it is legitimate to assume that there are multiple factors that influence T2*. To this end, this study investigates the relationship between T2* and cardiac macromorphology given by left ventricular (LV) wall thickness and left ventricular radius, and provides interpretation of the results in the physiological context. METHODS High spatio-temporally resolved myocardial CINE T2* mapping was performed in 10 healthy volunteers using a 7.0 Tesla (T) full-body MRI system. Ventricular septal wall thickness, left ventricular inner radius, and T2* were analyzed. Macroscopic magnetic field changes were elucidated using cardiac phase-resolved magnetic field maps. RESULTS Ventricular septal T2* changes periodically over the cardiac cycle, increasing in systole and decreasing in diastole. Ventricular septal wall thickness and T2* showed a significant positive correlation, whereas the inner LV radius and T2* were negatively correlated. The effect of macroscopic magnetic field gradients on T2* can be considered minor in the ventricular septum. CONCLUSION Our findings suggest that myocardial T2* is related to tissue blood volume fraction. Temporally resolved T2* mapping could be beneficial for myocardial tissue characterization and for understanding cardiac (patho)physiology in vivo. Magn Reson Med 77:2381-2389, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Till Huelnhagen
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Fabian Hezel
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Teresa Serradas Duarte
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Andreas Pohlmann
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Celal Oezerdem
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Bert Flemming
- Institute of Physiology, Charité University Medicine, Berlin, Germany
| | - Erdmann Seeliger
- Institute of Physiology, Charité University Medicine, Berlin, Germany
| | - Marcel Prothmann
- Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany
| | - Jeanette Schulz-Menger
- Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany
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Harms HJ, Stubkjær Hansson NH, Tolbod LP, Kim WY, Jakobsen S, Bouchelouche K, Wiggers H, Frøkiaer J, Sörensen J. Automatic Extraction of Myocardial Mass and Volume Using Parametric Images from Dynamic Nongated PET. J Nucl Med 2016; 57:1382-7. [PMID: 27127219 DOI: 10.2967/jnumed.115.170613] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 03/26/2016] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED Dynamic cardiac PET is used to quantify molecular processes in vivo. However, measurements of left ventricular (LV) mass and volume require electrocardiogram-gated PET data. The aim of this study was to explore the feasibility of measuring LV geometry using nongated dynamic cardiac PET. METHODS Thirty-five patients with aortic-valve stenosis and 10 healthy controls underwent a 27-min (11)C-acetate PET/CT scan and cardiac MRI (CMR). The controls were scanned twice to assess repeatability. Parametric images of uptake rate K1 and the blood pool were generated from nongated dynamic data. Using software-based structure recognition, the LV wall was automatically segmented from K1 images to derive functional assessments of LV mass (mLV) and wall thickness. End-systolic and end-diastolic volumes were calculated using blood pool images and applied to obtain stroke volume and LV ejection fraction (LVEF). PET measurements were compared with CMR. RESULTS High, linear correlations were found for LV mass (r = 0.95), end-systolic volume (r = 0.93), and end-diastolic volume (r = 0.90), and slightly lower correlations were found for stroke volume (r = 0.74), LVEF (r = 0.81), and thickness (r = 0.78). Bland-Altman analyses showed significant differences for mLV and thickness only and an overestimation for LVEF at lower values. Intra- and interobserver correlations were greater than 0.95 for all PET measurements. PET repeatability accuracy in the controls was comparable to CMR. CONCLUSION LV mass and volume are accurately and automatically generated from dynamic (11)C-acetate PET without electrocardiogram gating. This method can be incorporated in a standard routine without any additional workload and can, in theory, be extended to other PET tracers.
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Affiliation(s)
- Hendrik Johannes Harms
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | | | - Lars Poulsen Tolbod
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Won Yong Kim
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; and
| | - Steen Jakobsen
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Kirsten Bouchelouche
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Wiggers
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; and
| | - Jørgen Frøkiaer
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Jens Sörensen
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark Department of Nuclear Medicine and PET, Uppsala University, Uppsala, Sweden
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