Clinical Impact of Cardiac MRI T1 and T2 Parametric Mapping in                     Patients with Suspected Cardiomyopathy

Warnica, William; Al-Arnawoot, A.; Stanimirovic, Aleksandra; Thavendiranathan, Paaladinesh; Wald, Rachel M.; Pakkal, Mini; Karur, Gauri Rani; Wintersperger, Bernd J.; Rac, Valeria E.; Hanneman, Kate

doi:10.1148/radiol.220067

Cited by 37 publications

(21 citation statements)

References 25 publications

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“…Increasing native T1 independent of T2 raises the possibility of progressive myocardial fibrosis. 9,19,20 To our knowledge, the relationship between AM treatment duration and T1/T2 mapping in patients with SLE has not been described previously. Our results suggest that there may be an inflection point in the relationship between AM treatment duration and native T1 in patients with SLE between 15 and 20 years of AM treatment duration.…”

Section: Discussionmentioning

confidence: 92%

“…Native T1 and T2 relaxation times were assessed by manually drawing a region of interest at the mid-interventricular septum avoiding areas with LGE. As per current guidelines, abnormal high T1 and T2 values were defined as 2 SD above the mean of sequence-specific local normal reference ranges according to current guidelines (high T2 defined as >52 ms at 1.5 T and >45 ms at 3T; high T1 defined as >1067 ms at 1.5 T and >1289 ms at 3 T) 19. To facilitate combined analysis of multi-scanner data, T1 and T2 values were converted to a z -score using scanner-specific local reference values (patient value − mean of the reference range)/(SD of reference range) 27,28.…”

Section: Methodsmentioning

confidence: 99%

“…As per current guidelines, abnormal high T1 and T2 values were defined as 2 SD above the mean of sequence-specific local normal reference ranges according to current guidelines (high T2 defined as > 52 ms at 1.5 T and > 45 ms at 3T; high T1 defined as > 1067 ms at 1.5 T and > 1289 ms at 3 T). 19 To facilitate combined analysis of multi-scanner data, T1 and T2 values were converted to a z-score using scanner-specific local reference values (patient value − mean of the reference range)/(SD of reference range). 27,28 In this case, z-scores provide an assessment of how many SD each patient's T1 or T2 value is above or below the mean for the normal range for each scanner.…”

Section: Cardiac Mri Analysismentioning

confidence: 99%

“…17 Cardiac MRI T1 and T2 mapping allow for the quantification of diffuse myocardial tissue changes and might be useful in detecting early AM treatment-related changes. 9,14,[17][18][19][20][21] The purpose of this study is to evaluate cardiac MRI parametric mapping findings in SLE patients with AMIC and investigate the relationship of T1/T2 mapping to AM treatment duration.…”

mentioning

confidence: 99%

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Cardiac Magnetic Resonance Imaging T1 and T2 Mapping in Systemic Lupus Erythematosus in Relation to Antimalarial Treatment

Shalmon

Thavendiranathan

Seidman

et al. 2023

Journal of Thoracic Imaging

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Purpose: Patients with systemic lupus erythematosus (SLE) are at risk of cardiac disease including antimalarial-induced cardiomyopathy (AMIC). The purpose of this study is to evaluate cardiac magnetic resonance imaging parametric mapping findings in SLE patients with AMIC and investigate the relationship of T1/T2 mapping to antimalarial (AM) treatment duration. Materials and Methods: All patients with SLE who had undergone cardiac magnetic resonance imaging with T1/T2 mapping for evaluation of suspected cardiac disease between 2018 and 2021 were evaluated and compared with healthy controls. To facilitate comparison between scanners, T1/T2 values were converted to a z-score using scanner-specific local reference values. Patients were classified into 3 groups: AMIC, myocarditis, and other (no AMIC or myocarditis). Results: Forty-five SLE patients (47±17 y, 80% female; 8 [18%] with AMIC and 7 [16%] with myocarditis) and 30 healthy controls (39±15 y, 60% female) were included. Patients with AMIC had higher T1 and T2 compared with controls (z-score 1.1±1.3 vs. 0±0.6, P=0.01 and 1.7±1.1 vs. 0±1.0, P<0.01, respectively) and lower values compared with those with myocarditis (3.7±1.6, P<0.01 and 4.0±2.0, P<0.01, respectively). T1 correlated negatively with AM treatment duration in patients without AMIC or myocarditis (r=−0.36, P=0.048) and positively in patients with AMIC (r=0.92, P=0.001). AM treatment duration did not correlate significantly with T1 in patients with myocarditis or with T2 in any group. Conclusions: The relationship between T1 and AM treatment duration differed between groups. Native T1 decreases with longer treatment in patients without AMIC or myocarditis, possibility due to glycosphingolipid accumulation. In patients with AMIC, increasing T1 with longer treatment could reflect fibrosis.

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Section: Discussionmentioning

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Section: Cardiac Mri Analysismentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Cardiac Magnetic Resonance Imaging T1 and T2 Mapping in Systemic Lupus Erythematosus in Relation to Antimalarial Treatment

Shalmon

Thavendiranathan

Seidman

et al. 2023

Journal of Thoracic Imaging

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“…21 Subsequently, T1 and T2 parametric mapping techniques have become more widely available with increased diagnostic sensitivity for myocarditis compared to the initial LLC. 22-24 Therefore, the LLC were revised in 2018 to incorporate parametric mapping findings. 25 In the revised LLC criteria, fulfilment of at least one criterion in each of the following two categories is considered strong evidence of acute myocardial inflammation in patients with high clinical pre-test probability: a T1-based marker of myocardial damage and a T2-based marker of myocardial edema.…”

Section: Cardiac Magnetic Resonance Imagingmentioning

confidence: 99%

Cardiac Imaging in Myocarditis: Current Evidence and Future Directions

et al. 2022

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Myocarditis is defined as a non-ischemic inflammatory disease of the myocardium. It remains a challenge to diagnose given non-specific symptoms and lack of specific blood biomarkers. Cardiac imaging plays an important role in the evaluation of myocarditis with unique strengths and limitations of different imaging modalities, including cardiac magnetic resonance imaging, echocardiography, cardiac computed tomography, and positron emission tomography. The purpose of this review is to discuss the strengths and limitations of various cardiac imaging techniques in the evaluation of myocarditis, review imaging findings in specific causes of myocarditis including COVID-19 and after vaccination, evaluate the role of imaging in differentiating myocarditis from potential mimics and differential considerations, identify current gaps in knowledge, and propose future directions.

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Advances in multimodality imaging and the application of new cardiac imaging technologies for radiation‐induced heart disease

Du,

Lan,

Shen

et al. 2024

iRADIOLOGY

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Radiation‐induced heart disease (RIHD) is a heterogeneous, delayed, and potentially fatal adverse reaction to radiation that can damage all structures of the heart, including the pericardium, myocardium, coronary arteries, valves, and conduction system, leading to a series of diseases. Acute and chronic disease processes play a role in the development of RIHD, the onset times of which range from months to decades. However, the clinical manifestations of RIHD are usually insidious, overlap with several other diseases, and lack specificity. Cardiovascular imaging is essential for early diagnosis, follow‐up, and outcome assessment in patients with RIHD. This review first describes the pathogenesis and clinical manifestations of RIHD before providing an overview of the practical approaches and research advances in multimodal cardiovascular imaging in patients with RIHD, including echocardiography, cardiac magnetic resonance (CMR) and nuclear medicine, and cardiac computed tomography (CT). Then, the value of new cardiac imaging assessments for the early diagnosis of RIHD is described, particularly with relation to speckle‐tracking echocardiography, extracellular volume fraction assessment as a quantitative CMR technique, CMR myocardial strain assessment, positron emission tomography‐CT myocardial perfusion imaging, CT‐ECV, and CT strain assessment, amongst others. In addition, the advantages and disadvantages of each screening technique are compared with the aim of better guiding the follow‐up and diagnosis of subclinical RIHD and preventing cardiovascular events.

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Clinical Impact of Cardiac MRI T1 and T2 Parametric Mapping in Patients with Suspected Cardiomyopathy

Cited by 37 publications

References 25 publications

Cardiac Magnetic Resonance Imaging T1 and T2 Mapping in Systemic Lupus Erythematosus in Relation to Antimalarial Treatment

Cardiac Magnetic Resonance Imaging T1 and T2 Mapping in Systemic Lupus Erythematosus in Relation to Antimalarial Treatment

Cardiac Imaging in Myocarditis: Current Evidence and Future Directions

Advances in multimodality imaging and the application of new cardiac imaging technologies for radiation‐induced heart disease

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