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Extracellular volume quantification in isolated hypertension - changes at the detectable limits?

Thomas A Treibel1, Filip Zemrak2, Daniel M Sado1

  • 1Department of Cardiology, The Heart Hospital, University College London Hospitals NHS Trust, London, UK.

Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance
|August 13, 2015
PubMed
Summary

T1 mapping shows diffuse myocardial fibrosis in hypertensive patients, particularly those with left ventricular hypertrophy. This non-invasive technique aids in assessing cardiovascular disease progression.

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Area of Science:

  • Cardiovascular Imaging
  • Cardiac MRI
  • Biomarkers

Background:

  • Diffuse myocardial fibrosis (DMF) is a key factor in cardiovascular disease.
  • Previously, DMF assessment required invasive myocardial biopsy.
  • T1 mapping offers a non-invasive method to evaluate DMF.

Purpose of the Study:

  • To investigate if T1 mapping detects elevated DMF in isolated systemic hypertension.
  • To compare DMF in hypertensive patients versus healthy controls.
  • To explore the relationship between DMF and left ventricular hypertrophy (LVH).

Main Methods:

  • Cardiac MRI (CMR) with T1 mapping (ShMOLLI) for extracellular volume (ECV) quantification.
  • Study included 46 hypertensive patients and 50 healthy volunteers.
  • Patients underwent Automated Blood Pressure Monitoring, echocardiography, and biomarker analysis.

Main Results:

  • CMR identified unexpected pathologies (myocardial infarction, HCM) in 13% of hypertensive patients.
  • No significant difference in native myocardial T1 or ECV between hypertensives and controls overall.
  • ECV was significantly higher in hypertensive patients with LVH compared to those without.

Conclusions:

  • Conventional CMR detected significant underlying diseases missed by echocardiography.
  • T1 mapping indicated increased DMF in well-controlled hypertensive patients, but only when LVH was present.
  • Non-invasive T1 mapping is valuable for assessing myocardial fibrosis in hypertension.