Diffuse Myocardial Fibrosis Evaluated by Post-Contrast T₁ Mapping Correlates With Left Ventricular Stiffness

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• 作者：Andris H. Ellims ; MBBS^&lowast ; ; ^&dagger ; ; James A. Shaw ; MBBS ; PhD^&lowast ; ; ^&dagger ; ; Dion Stub ; MBBS ; PhD^&lowast ; ; ^&dagger ; ; Leah M. Iles ; MBChB^&lowast ; ; ^&dagger ; ; James L. Hare ; MBBS ; PhD^&lowast ; ; ^&dagger ; ; Glenn S. Slavin ; PhD^&Dagger ; ; David M. Kaye ; MBBS ; PhD^&lowast ; ; ^&dagger ; ; Andrew J. Taylor ; MBBS ; PhD^&lowast ; ; ^&dagger ; ; ^{andrew.taylor@bakeridi.edu.au" class="auth_mail}
• 关键词：diastolic dysfunction ; magnetic resonance imaging ; myocardial fibrosis ; T1 mapping
• 刊名：Journal of the American College of Cardiology
• 出版年：25 March, 2014
• 年：2014
• 卷：63
• 期：11
• 页码：1112-1118
• 全文大小：366 K

文摘

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Objectives

The purpose of this study was to use cardiac magnetic resonance (CMR) imaging and invasive left ventricular (LV) pressure-volume (PV) measurements to explore the relationship between diffuse myocardial fibrosis and indexes of聽diastolic performance in a cohort of cardiac transplant recipients.

Background

The precise mechanism of LV diastolic dysfunction in the presence of myocardial fibrosis has not previously been established.

Methods

We performed CMR with T₁ mapping and obtained invasive LV PV measurements via a conductance catheter in 20聽cardiac transplant recipients at the time of clinically-indicated coronary angiography.

Results

Both post-contrast myocardial T₁ time and extracellular volume fraction correlated with 尾, the load-independent passive LV stiffness constant (r聽=聽鈭?.71, p聽= 0.001, and r聽= 0.58, p聽= 0.04, respectively). After multivariate analysis, post-contrast myocardial T₁ time remained the only independent predictor of 尾. No significant associations were observed between myocardial T₁ time and 蟿, the active LV relaxation constant, or other load-dependent parameters of diastolic function.

Conclusions

Diffuse myocardial fibrosis, assessed by post-contrast myocardial T₁ time, correlates with invasively-demonstrated LV stiffness in cardiac transplant recipients. In patients with increased diffuse myocardial fibrosis, abnormal passive ventricular stiffness is therefore likely to be a major contributor to diastolic dysfunction.