Calibration of myocardial T2 and T1 against iron concentration

Carpenter, John-Paul; He, Taigang; Kirk, Paul; Roughton, Michael; Anderson, Lisa; Noronha, Sofia V. de; Baksi, A. John; Sheppard, Mary N.; Porter, John B.; Walker, John M.; Wood, John C.; Forni, Gianluca; Catani, Gualtiero; Matta, Gildo; Fucharoen, Suthat; Fleming, Adam; House, Mike; Black, Greg; Firmin, David N.; Pierre, Timothy G. St.; Pennell, Dudley J.

doi:10.1186/s12968-014-0062-4

Cited by 39 publications

(27 citation statements)

References 50 publications

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“…Recently, it has been shown that myocardial T2 correlates well with myocardial iron concentration. This raises the possibility that T2 may provide additive information to T2* for patients with myocardial siderosis in the future …”

Section: Cardiac Siderosismentioning

confidence: 99%

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Noninvasive imaging in cardiac deposition diseases

Shah

Nucifora

Perry

et al. 2017

Magnetic Resonance Imaging

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Infiltrative cardiomyopathy represents a heterogeneous group of diseases of the heart tissue with similar phenotypic expression. The condition is rare, but can be easily mistaken for other more common conditions of the heart. The diagnosis of infiltrative cardiomyopathy is therefore challenging and has often required the use of invasive procedures in the past. In the last decade there have been great advances in non‐invasive cardiac imaging modalities like echocardiography, cardiovascular magnetic resonance and nuclear imaging. Although no single imaging modality abnormality on its own is pathognomic for infiltrative cardiomyopathy, a combination of these different modalities are synergistic, and can greatly aid in the clinical diagnosis. In this review, we describe these advancements in non‐invasive cardiac imaging modalities with a particular focus on cardiovascular magnetic resonance imaging. Level of Evidence: 1 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:44–59.

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Section: Cardiac Siderosismentioning

confidence: 99%

“…This raises the possibility that T2 may provide additive information to T2* for patients with myocardial siderosis in the future. 94…”

Section: Cardiac Siderosismentioning

confidence: 99%

Noninvasive imaging in cardiac deposition diseases

Shah

Nucifora

Perry

et al. 2017

Magnetic Resonance Imaging

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“…It mainly alters T2 relaxation, an inherent tissue characteristic, by creating focal magnetic field inhomogeneities that cause fast proton dephasing and signal decay. Myocardial T2 can be directly measured by CMR and reflects iron concentration . Preliminary experience with myocardial T2 measurements in humans with iron overload was not satisfactory, as the spin echo sequence used was very susceptible to cardiac and respiratory motion .…”

Section: Assessing the Heart In β‐Thalassemia Major: The Role Of Cmrmentioning

confidence: 99%

Cardiac complications in thalassemia major

Auger

Pennell

2016

Annals of the New York Academy of Sciences

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The myocardium is particularly susceptible to complications from iron loading in thalassemia major. In the first years of life, severe anemia leads to high-output cardiac failure and death if not treated. The necessary supportive blood transfusions create loading of iron that cannot be naturally excreted, and this iron accumulates within tissues, including the heart. Free unbound iron catalyzes the formation of toxic hydroxyl radicals, which damage cells and cause cardiac dysfunction. Significant cardiac siderosis may present by the age of 10 and may lead to acute clinical heart failure, which must be treated urgently. Atrial fibrillation is the most frequently encountered iron-related arrhythmia. Iron chelation is effective at removing iron from the myocardium, at the expense of side effects that hamper compliance to therapy. Monitoring of myocardial iron content is mandatory for clinical management of cardiac risk. T2* cardiac magnetic resonance measures myocardial iron and is the strongest biomarker for prediction of heart failure and arrhythmic events. It has been calibrated to human myocardial tissue iron concentration and is highly reproducible across all magnetic resonance scanner vendors. As survival and patient age increases, endothelial dysfunction and diabetes may become new factors in the cardiovascular health of thalassemia patients. Promising new imaging technology and therapies could ameliorate the long-term prognosis.

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“…Linking cardiac siderosis measured by T2* to therapy improves outcome in Thalassemia Major. Aim of our study is to compare T1 mapping (Modified Lock Locker Inversion recovery, MOLLI) to dark (DB) and bright (BB) blood T2* [3][4] in cardiac iron overload and to support the hypothesis that T1 mapping has higher sensibility to T2* for small amount of iron, which would make it a complementary tool to T2* in borderline iron overload patients. [5][6] Methods In a prospectively large single centre study of 138 Thalassemia Major patients and 32 healthy controls, we compared MOLLI to DB and BB T2* acquired on an Avanto 1.5T scanner (Siemens Healthcare, Erlangen, Germany).…”

mentioning

confidence: 99%

007 Comprehensive echocardiographic and cardiovascular magnetic resonance evaluation differentiates between patients with heart failure with preserved ejection fraction, hypertensive patients and healthy controls and identifies those with reduced exercise capacity on cardiopulmonary exercise testing

Mordi

Singh

Rudd

et al. 2017

Heart

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008 Figure 1 Top: four chamber SSFP cine images in disatole, corresponding late gadalinium anhancement (LGE) images and ECV mapping before and after chemotherapy in a patient who had regression of amyloid burden after chemotherapy. Bottom: four chamber SSFP cine images in disatole, corresponding LGE images and ECV mapping before and after chemotherapy in a patient who had progression of amyloid burden after chemotherapy.

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Calibration of myocardial T2 and T1 against iron concentration

Cited by 39 publications

References 50 publications

Noninvasive imaging in cardiac deposition diseases

Noninvasive imaging in cardiac deposition diseases

Cardiac complications in thalassemia major

007 Comprehensive echocardiographic and cardiovascular magnetic resonance evaluation differentiates between patients with heart failure with preserved ejection fraction, hypertensive patients and healthy controls and identifies those with reduced exercise capacity on cardiopulmonary exercise testing

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