Feasibility of Hepatic T1-Mapping and Extracellular Volume Quantification on Routine Cardiac Magnetic Resonance Imaging in Patients with Infiltrative and Systemic Disorders

Dolan, Ryan S.; Stillman, Arthur E.; Davarpanah, Amir H.

doi:10.1016/j.acra.2021.09.018

Cited by 5 publications

(9 citation statements)

References 47 publications

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“…The clinical significance of hepatic T1 mapping assessed by cardiac magnetic resonance has been shown in previous studies. 9 , 12 , 13 , 14 , 16 , 17 Hepatic native T1 and ECV values were shown to be elevated in patients with tetralogy of Fallot repair, Fontan palliation, and idiopathic dilated cardiomyopathy. 9 , 12 , 13 , 14 , 16 , 17 In addition, hepatic T1 mapping analysis can distinguish different degrees of congestive hepatopathy and is strongly correlated with liver stiffness validated by magnetic resonance elastography.…”

Section: Discussionmentioning

confidence: 94%

“… 9 , 12 , 13 , 14 , 16 , 17 Hepatic native T1 and ECV values were shown to be elevated in patients with tetralogy of Fallot repair, Fontan palliation, and idiopathic dilated cardiomyopathy. 9 , 12 , 13 , 14 , 16 , 17 In addition, hepatic T1 mapping analysis can distinguish different degrees of congestive hepatopathy and is strongly correlated with liver stiffness validated by magnetic resonance elastography. 14 , 16 , 17 Bogaert et al 15 confirmed the feasibility of predicting right‐sided filling status on the basis of liver relaxation times in patients with PAH and suggested its potential value in monitoring therapy response, but their study used a small retrospective cohort and provided no evidence for prognosis prediction, which requires further confirmation.…”

Section: Discussionmentioning

confidence: 94%

“… 4 , 5 Nevertheless, both liver biopsy and transient elastography can only provide information on liver injury. In previous studies, T1 mapping sequences of cardiac magnetic resonance imaging (MRI) were a powerful tool for the evaluation of myocardial fibrosis 6 , 7 , 8 and useful in splenic, 9 , 10 skeletal muscle, 11 hepatic, 9 , 12 , 13 , 14 , 15 , 16 inflammation, edema, and fibrosis evaluations. Furthermore, hepatic T1 mapping analysis can distinguish different degrees of congestive hepatopathy and is strongly correlated with liver stiffness validated by magnetic resonance elastography.…”

mentioning

confidence: 99%

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Prognostic Value of Hepatic Native T1 and Extracellular Volume Fraction in Patients with Pulmonary Arterial Hypertension

Guo

Wang

et al. 2022

JAHA

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Background Right heart failure may lead to impaired liver perfusion and venous congestion, resulting in different extents of liver fibrosis. However, whether hepatic tissue deterioration determined by native T1 mapping and extracellular volume fraction using cardiac magnetic resonance imaging is associated with poor outcomes in patients with pulmonary arterial hypertension remains unclear. Methods and Results A total of 131 participants with pulmonary arterial hypertension (mean age, 36±13 years) and 64 healthy controls (mean age, 44±18) between October 2013 and December 2019 were prospectively enrolled. Hepatic native T1 and extracellular volume fraction values were measured using modified Look–Locker inversion recovery T1 mapping sequences. The primary end point was all‐cause mortality; the secondary end point was all‐cause mortality and repeat hospitalization attributable to heart failure. Cox regression models and Kaplan–Meier survival analysis were used to identify the association between variables and clinical outcome. During a median follow‐up of 34.5 months (interquartile range: 25.3–50.8), hepatic native T1 (hazard ratio per 30‐ms increase, 1.22 [95% CI, 1.07–1.39]; P =0.003) and extracellular volume fraction (hazard ratio per 3% increase, 1.18 [95% CI, 1.04–1.34]; P =0.010) values were associated with a higher risk of death. In the multivariate Cox model, hepatic native T1 value (hazard ratio per 30‐ms increase, 1.15 [95% CI, 1.04–1.27]; P =0.009) remained as an independent prognostic factor for the secondary end point. Conclusions Hepatic T1 mapping values were predictors of adverse cardiovascular events in participants with pulmonary arterial hypertension and could be novel imaging biomarkers for poor prognosis recognition.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 94%

mentioning

confidence: 99%

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Prognostic Value of Hepatic Native T1 and Extracellular Volume Fraction in Patients with Pulmonary Arterial Hypertension

Guo

Wang

et al. 2022

JAHA

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“…ECV measurements obtained from routine cardiac MRI scans can evaluate the amyloid infiltration in the liver and spleen, which provide an indication of amyloid typing and offers a noninvasive measure of visceral amyloid burden. [68][69][70][71] Yet, unlike myocardial ECV, liver and spleen ECV did not correspond to NT-proBNP levels and Mayo staging. 69 Amyloid primarily deposits in the peripheral nerves and the heart in patients with familial amyloid polyneuropathy (FAP), and cardiac involvement often dominates the prognosis.…”

Section: Parametric Mappingmentioning

confidence: 86%

“…Hepatic and splenic amyloidosis occurs in AL patients and may affect the prognosis and clinical decisions of patients. ECV measurements obtained from routine cardiac MRI scans can evaluate the amyloid infiltration in the liver and spleen, which provide an indication of amyloid typing and offers a noninvasive measure of visceral amyloid burden 68–71 . Yet, unlike myocardial ECV, liver and spleen ECV did not correspond to NT‐proBNP levels and Mayo staging 69 .…”

Section: Parametric Mappingmentioning

confidence: 98%

State of the Art: Quantitative Cardiac MRI in Cardiac Amyloidosis

Guo

2022

Magnetic Resonance Imaging

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Cardiac amyloidosis (CA) is characterized by amyloid infiltration in the myocardial extracellular space, causing heart failure. Patients with CA are currently underdiagnosed. Cardiac involvement is significantly associated with the prognosis and treatment decision‐making for CA. Early identification and accurate stratification are the crucial first step in patient management. Comprehensive cardiac MRI‐based evaluation of the cardiac structure, function, and myocardial tissue characterization assesses cardiac involvement by tracing disease processes. Emerging quantitative tissue characterization techniques have introduced new measures that can identify early staged CA and monitor disease progression or response after treatment. Quantitative cardiac MRI is becoming an instrumental tool in understanding CA, which leads to changes in individualized patient care. This review aimed to discuss the quantitative cardiac MRI‐based assessment of CA using established and emerging techniques. Evidence Level 5 Technical Efficacy Stage 3

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Liver T1 Mapping Derived From Cardiac Magnetic Resonance Imaging: A Potential Prognostic Marker in Idiopathic Dilated Cardiomyopathy

Wang,

Diao,

et al. 2024

Magnetic Resonance Imaging

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BackgroundHepatic alterations are common aftereffects of heart failure (HF) and ventricular dysfunction. The prognostic value of liver injury markers derived from cardiac MRI studies in nonischemic dilated cardiomyopathy (DCM) patients is unclear.PurposeEvaluate the prognostic performance of liver injury markers derived from cardiac MRI studies in DCM patients.Study TypeProspective.PopulationThree hundred fifty‐six consecutive DCM patients diagnosed according to ESC guidelines (age 48.7 ± 14.2 years, males 72.6%).Field Strength/SequenceSteady‐state free precession, modified Look‐Locker inversion recovery T1 mapping and phase sensitive inversion recovery late gadolinium enhancement (LGE) sequences at 3 T.AssessmentClinical characteristics, conventional MRI parameters (ventricular volumes, function, mass), native myocardial and liver T1, liver extracellular volume (ECV), and myocardial LGE presence were assessed. Patients were followed up for a median duration of 48.3 months (interquartile range 42.0–69.9 months). Primary endpoints included HF death, sudden cardiac death, heart transplantation, and HF readmission; secondary endpoints included HF death, sudden cardiac death, and heart transplantation. Models were developed to predict endpoints and the incremental value of including liver parameters assessed.Statistical TestsOptimal cut‐off value was determined using receiver operating characteristic curve and Youden method. Survival analysis was performed using Kaplan–Meier and Cox proportional hazard. Discriminative power of models was compared using net reclassification improvement and integrated discriminatory index. P value <0.05 was considered statistically significant.Results47.2% patients reached primary endpoints; 25.8% patients reached secondary endpoints. Patients with elevated liver ECV (cut‐off 34.4%) had significantly higher risk reaching primary and secondary endpoints. Cox regression showed liver ECV was an independent prognostic predictor, and showed independent prognostic value for primary endpoints and long‐term HF readmission compared to conventional clinical and cardiac MRI parameters.Data ConclusionsLiver ECV is an independent prognostic predictor and may serve as an innovative approach for risk stratification for DCM.Evidence Level1Technical EfficacyStage 2

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Feasibility of Hepatic T1-Mapping and Extracellular Volume Quantification on Routine Cardiac Magnetic Resonance Imaging in Patients with Infiltrative and Systemic Disorders

Cited by 5 publications

References 47 publications

Prognostic Value of Hepatic Native T1 and Extracellular Volume Fraction in Patients with Pulmonary Arterial Hypertension

Prognostic Value of Hepatic Native T1 and Extracellular Volume Fraction in Patients with Pulmonary Arterial Hypertension

State of the Art: Quantitative Cardiac MRI in Cardiac Amyloidosis

Liver T1 Mapping Derived From Cardiac Magnetic Resonance Imaging: A Potential Prognostic Marker in Idiopathic Dilated Cardiomyopathy

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