Korean J Radiol.  2015 Oct;16(5):1153-1162. 10.3348/kjr.2015.16.5.1153.

Relationship between Myocardial Extracellular Space Expansion Estimated with Post-Contrast T1 Mapping MRI and Left Ventricular Remodeling and Neurohormonal Activation in Patients with Dilated Cardiomyopathy

• Yoon JH
• Son JW
• Chung H
• Park CH
• Kim YJ
• Chang HJ
• Hong GR
• Kim TH
• Ha JW
• Choi BW
• Rim SJ
• Chung N
• Choi EY

• KMID: 2160783
• DOI: http://doi.org/10.3348/kjr.2015.16.5.1153

Abstract

OBJECTIVE
Post-contrast T1 values are closely related to the degree of myocardial extracellular space expansion. We determined the relationship between post-contrast T1 values and left ventricular (LV) diastolic function, LV remodeling, and neurohormonal activation in patients with dilated cardiomyopathy (DCM).
MATERIALS AND METHODS
Fifty-nine patients with DCM (mean age, 55 +/- 15 years; 41 males and 18 females) who underwent both 1.5T magnetic resonance imaging and echocardiography were enrolled. The post-contrast 10-minute T1 value was generated from inversion time scout images obtained using the Look-Locker inversion recovery sequence and a curve-fitting algorithm. The T1 sample volume was obtained from three interventricular septal points, and the mean T1 value was used for analysis. The N-Terminal pro-B-type natriuretic peptide (NT-proBNP) level was measured in 40 patients.
RESULTS
The mean LV ejection fraction was 24 +/- 9% and the post-T1 value was 254.5 +/- 46.4 ms. The post-contrast T1 value was significantly correlated with systolic longitudinal septal velocity (s'), peak late diastolic velocity of the mitral annulus (a'), the diastolic elastance index (Ed, [E/e']/stroke volume), LV mass/volume ratio, LV end-diastolic wall stress, and LV end-systolic wall stress. In a multivariate analysis without NT-proBNP, T1 values were independently correlated with Ed (beta = -0.351, p = 0.016) and the LV mass/volume ratio (beta = 0.495, p = 0.001). When NT-proBNP was used in the analysis, NT-proBNP was independently correlated with the T1 values (beta = -0.339, p = 0.017).
CONCLUSION
Post-contrast T1 is closely related to LV remodeling, diastolic function, and neurohormonal activation in patients with DCM.

Keyword

Dilated cardiomyopathy; T1 mapping; Diastolic function

MeSH Terms

Adult
Aged
Algorithms
Blood Pressure
Cardiomyopathy, Dilated/*diagnosis/radiography
Echocardiography
Extracellular Space/physiology/*radiography
Female
Heart Ventricles/physiopathology/radiography
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Multivariate Analysis
Natriuretic Peptide, Brain/analysis
Peptide Fragments/analysis
*Ventricular Remodeling
Natriuretic Peptide, Brain
Peptide Fragments

Figure

• 

  Fig. 1 Representative case of measuring post-T1 value in Look-Locker-based inversion time scout images.

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