Myocardial T₁ mapping using SMART₁Map and MOLLI mapping in asymptomatic patients with recent extracardiac sarcoidosis

Abstract

Introduction: Sarcoidosis is a systemic granulomatous disease affecting in particular the respiratory tract. Cardiac magnetic resonance (CMR), including a measurement of T 1 relaxation time, could potentially detect early stadia of sarcoidosis of the heart. The study aims to assess T 1 mapping in the detection of early cardiac involvement in asymptomatic patients with sarcoidosis. Methods: One hundred and twenty patients with extracardiac sarcoidosis and without any heart disease history were included. One hundred and thirteen of them underwent a CMR examination. The mean time from the diagnosis of sarcoidosis was 0.8 (0.2-3.3) years. Cine images for the assessment of left ventricular (LV) functional parameters and pre-and post-contrast saturation method using adaptive recovery times for cardiac T 1 mapping (SMART 1 Map) and modified Look-Locker inversion recovery (MOLLI) images were acquired for the assessment of native T 1 relaxation time and extracellular volume (ECV). The measured parameters were compared between sarcoidosis patients and 22 controls. Results: The sarcoidosis patients had normal global and regional systolic LV function-LV ejection fraction 65 ± 5% versus 66 ± 7% (p NS). The mean native T 1 relaxation times were not prolonged-1465 ± 93 ms versus 1480 ± 88 ms (p NS) measured by SMART 1 Map and 1317 ± 60 ms versus 1313 ± 83 ms (p NS) measured using a MOLLI sequence. Similarly, the mean ECV values did not increase-16.9 ± 3.9% versus 17.9 ± 3.7% (p NS) measured by SMART 1 Map and 30.9 ± 2.9% versus 31.6 ± 8.3% (p NS) measured using a MOLLI sequence. Conclusion: Myocardial native T 1 relaxation times were not prolonged and ECV was not increased in asymptomatic patients with extracardiac sarcoidosis.

Left ventricular myocardial deformation assessment in asymptomatic patients with recently diagnosed sarcoidosis of the respiratory tract and/or extrapulmonary sarcoidosis

“…Likewise, no patient in our study had any signs of myocardial edema on T2-weighted images, which was also unexpected. Furthermore, as previously published [ 21 ], myocardial native T1 relaxation times were not prolonged, and the extracellular volume (ECV) was not increased in the cohort. It seems that at the very beginning of the disease, the myocardium could remain unaffected.…”

“…CMR examinations were performed in a single-center using a 3.0 T MR Discovery 750 scanner (GE Healthcare, Chicago, United States). The detailed scanning protocol was published previously [ 21 ] and included a balanced steady-state gradient echo sequence (Fast Imaging Employing Steady-state Acquisition—FIESTA) in a short axis stack and three long-axis; a T2-weighted sequence (Triple Inversion Recovery Fast Spin Echo); native and postcontrast MOLLI (Modified Look-Locker inversion recovery); and SMART 1 Map (Saturation method using adaptive recovery times for cardiac T1 mapping) sequences, and LGE images.…”

“…The study was performed in accordance with the Declaration of Helsinki (2000) of the World Medical Association. The presented analysis is the retrospective one of a previously published study that was approved by the institutional ethics committee (Ethics Committee of St Anne’s University Hospital Brno, reference number 65V/2015) [ 21 ]. Written informed consent was obtained from the subjects and/or their legally authorized representative.…”