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Pathophysiology of Cardiac Performance01:29

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Typical heart performance is influenced by heart rate, rhythm, myocardial contraction, and metabolism or blood flow. The cardiac muscle exhibits distinct electrophysiological features, including pacemaker activity and calcium channel control, which play a vital role in the heart's response to various drugs. The autonomic nervous system, comprising the sympathetic and parasympathetic branches, regulates heart rate. Sympathetic activation increases heart rate, while parasympathetic activation...
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Related Experiment Video

Updated: Oct 8, 2025

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Tissue Characterization in Cardiology: Moving Beyond Function.

George Markousis-Mavrogenis1, Flora Bacopoulou2,3, Dimitrios Vlachakis4

  • 1Onassis Cardiac Surgery Center, Athens, Greece.

Advances in Experimental Medicine and Biology
|January 1, 2022
PubMed
Summary
This summary is machine-generated.

Cardiovascular Magnetic Resonance (CMR) advanced tissue characterization with T1 mapping and ECV offers new insights into diffuse myocardial disease. These methods improve diagnosis and prognosis, guiding heart failure treatment.

Keywords:
Cardiovascular magnetic resonanceExtracellular volume fractionHeart diseasesT1 mappingT2 mapping

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Area of Science:

  • Cardiovascular Magnetic Resonance (CMR)
  • Advanced Cardiac Imaging Techniques

Background:

  • Late gadolinium enhancement (LGE) is limited in detecting diffuse myocardial disease.
  • Native T1 mapping and extracellular volume fraction (ECV) provide insights into myocardial and interstitial processes.
  • T1 mapping variations correlate with various cardiac conditions, including acute coronary syndromes, myocardial infarction, myocarditis, and systemic diseases like cardiac amyloidosis.

Purpose of the Study:

  • To highlight the capabilities of native T1 mapping and ECV in characterizing diffuse myocardial disease.
  • To emphasize the prognostic value of ECV, comparable to Left Ventricular Ejection Fraction (LVEF), but with added interstitial matrix information.
  • To underscore the potential of these advanced CMR techniques in guiding therapeutic strategies for heart failure (HF).

Main Methods:

  • Utilizing native T1 mapping and post-contrast T1 mapping to calculate ECV.
  • Assessing T2 mapping for evaluating myocarditis activity in recent-onset HF.
  • Comparing the diagnostic and prognostic information from LGE, T1 mapping, ECV, and T2 mapping.

Main Results:

  • Native T1 mapping and ECV detect diffuse myocardial diseases missed by LGE.
  • High T1 mapping values are associated with conditions like cardiac amyloidosis, while low values indicate Anderson-Fabry disease or siderosis.
  • ECV offers prognostic information comparable to LVEF, with added value in assessing the interstitial matrix.
  • T2 mapping demonstrates superiority over T1 mapping and ECV in assessing active myocarditis in HF.

Conclusions:

  • Native T1 mapping and ECV are crucial for comprehensive cardiovascular tissue characterization beyond LGE.
  • These advanced CMR indices significantly impact clinical decision-making for heart failure management.
  • Further multicenter studies and a collaborative approach involving all stakeholders are needed to standardize and implement these techniques widely.