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Correlation between right ventricular T1 mapping and right ventricular dysfunction in non-ischemic cardiomyopathy
Christine L Jellis1,2, Teerapat Yingchoncharoen3, Neville Gai4
1Department of Cardiovascular Medicine, Desk J1-5, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. jellisc@ccf.org.
The International Journal of Cardiovascular Imaging
|March 31, 2017
Summary
Right ventricular fibrosis, assessed by cardiac magnetic resonance (CMR) T1 mapping, is linked to impaired RV function and adverse remodeling in non-ischemic cardiomyopathy. Higher fibrosis levels correlate with worse RV function and predict long-term changes.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Right ventricular (RV) fibrosis is a key pathological feature in various heart conditions.
- Cardiac magnetic resonance (CMR) techniques like strain imaging and T1 mapping offer advanced methods to assess RV structure and function.
- Understanding the relationship between RV fibrosis and function is crucial for managing non-ischemic cardiomyopathy (NICM).
Purpose of the Study:
- To evaluate the feasibility of CMR strain imaging and T1 mapping for assessing the right ventricle.
- To explore the correlation between RV function, structure, and myocardial fibrosis.
- To investigate the long-term RV remodeling patterns based on baseline fibrosis levels.
Main Methods:
- 102 patients with NICM underwent echocardiography and CMR, including post-contrast T1 mapping and strain analysis.
- RV parameters like fractional area change (FAC), ejection fraction (RVEF), and strain were measured.
- Post-contrast T1 values served as a marker for myocardial fibrosis.
Main Results:
- CMR T1 mapping and strain imaging were feasible for RV assessment.
- RV function (RVEF, strain) correlated significantly with RV post-contrast T1 values, indicating fibrosis.
- Higher baseline RV fibrosis (T1 values ≥350 ms) predicted improved RV function over 29 months, while lower values predicted deterioration.
Conclusions:
- CMR T1 mapping and strain imaging provide comprehensive, incremental data on RV function and structure in NICM.
- Myocardial fibrosis is a significant factor contributing to RV dysfunction and remodeling in NICM.
- Baseline RV fibrosis levels appear to dictate the trajectory of RV remodeling over time.