T1-Mapping and Outcome in Nonischemic Cardiomyopathy

Püntmann, Valentina O.; Carr‐White, Gerry; Jabbour, Andrew; Yu, Chung Yao; Gebker, Rolf; Kelle, Sebastian; Hinojar, Rocío; Doltra, Adelina; Varma, Niharika; Child, Nicholas; Rogers, Toby; Suna, Gonca; Arroyo-Úcar, Eduardo; Goodman, Ben; Khan, Safia; Dabir, Darius; Herrmann, Eva; Zeiher, Andreas M.; Nagel, Eike

doi:10.1016/j.jcmg.2015.12.001

Cited by 413 publications

(259 citation statements)

References 31 publications

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“…[1][2][3][4][5][6][7][8] However, there are multiple situations where LGE is not sufficiently sensitive to detect myocardial disease because it is not yet, or not at all, characterized by sufficient regional accumulation of reparative fibrosis. [9][10][11] In NICMs, where LGE is a recognized marker of irreversible damage and advanced disease, early stages are characterized by a multitude of diffuse interstitial disease processes, including low-grade interstitial inflammation, fibrosis, and infiltration, resulting in an expansion of extracellular space. These processes that underpin the pathophysiology of intrinsic myocardial disease in NICM run a protracted subclinical course ahead of the clinically manifest stages of advanced disease ( Figure 3) and are not reliably detected with LGE.…”

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confidence: 99%

T1 Mapping in Characterizing Myocardial Disease

Püntmann

Peker

Chandrashekhar

et al. 2016

Circulation Research

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Cardiovascular magnetic resonance provides insights into myocardial structure and function noninvasively, with high diagnostic accuracy and without ionizing radiation. Myocardial tissue characterization in particular gives cardiovascular magnetic resonance a prime role among all the noninvasive cardiovascular investigations. Late gadolinium enhancement imaging is an established method for visualizing replacement scar, providing diagnostic and prognostic information in a variety of cardiac conditions. Late gadolinium enhancement, however, relies on the regional segregation of tissue characteristics to generate the imaging contrast. Thus, myocardial pathology that is diffuse in nature and affecting the myocardium in a rather uniform and global distribution is not well visualized with late gadolinium enhancement. Examples include diffuse myocardial inflammation, fibrosis, hypertrophy, and infiltration. T1 mapping is a novel technique allowing to diagnose these diffuse conditions by measurement of T1 values, which directly correspond to variation in intrinsic myocardial tissue properties. In addition to providing clinically meaningful indices, T1-mapping measurements also allow for an estimation of extracellular space by calculation of extracellular volume fraction. Multiple lines of evidence suggest a central role for T1 mapping in detection of diffuse myocardial disease in early disease stages and complements late gadolinium enhancement in visualization of the regional changes in common advanced myocardial disease. As a quantifiable measure, it may allow grading of disease activity, monitoring progress, and guiding treatment, potentially as a fast contrast-free clinical application. We present an overview of clinically relevant technical aspects of acquisition and processing, and the current state of art and evidence, supporting its clinical use.

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confidence: 99%

T1 Mapping in Characterizing Myocardial Disease

Püntmann

Peker

Chandrashekhar

et al. 2016

Circulation Research

Self Cite

270

202

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“…Recently, the prognostic relevance of T1 mapping in non-ischemic cardiomyopathy was assessed in a large multicenter study revealing that T1 mapping was signifi- cantly predictive of all-cause mortality and heart failure events in these patients. 43) Not surprisingly, native T1 was again the sole predictor of the endpoint events. In systemic lupus erythematosus, native T1 may also have the potential to detect subclinical myocardial involvement.…”

Section: )mentioning

confidence: 92%

Native Myocardial T1 Mapping, Are We There Yet?

et al. 2016

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SummaryT1 or longitudinal relaxation time is one of the very fundamental magnetic resonance imaging (MRI) time constants and a tissue characterizing parameter. Only during the last decade did it become possible to quantify T1 values of the myocardium through T1 mapping. Evolving from only region of interest analysis and long acquisition times to the pixel-based parametric mapping and short breath-hold sequences, T1 mapping is reaching maturity among cardiac magnetic resonance (CMR) techniques. Both inversion recovery methods such as MOdified Look-Locker Inversion (MOL-LI) and Shortened MOLLI (ShMOLLI) and saturation recovery methods such as Saturation recovery Single-Shot Acquisition (SASHA) are available for T1 quantification with variable degrees of accuracy, precision, and reproducibility. Native (non-contrast) T1 values increase with edema, amyloid deposition, and fibrosis, while they decrease in fat or iron deposition in the myocardium. These features enabled significant expansion of the clinical applications of native T1 mapping where it provides high sensitivity and specificity and even acts as a disease biomarker or a predictor of prognosis. It is of particular usefulness in diffuse myocardial diseases where conventional CMR techniques might be deceiving. A brighter future for the technique is expected if certain challenges are to be faced, examples of which are the need for standardization of normal values, acquisition techniques, and improving analysis tools. (Int Heart J 2016; 57: 400-407)

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“…Multivariate analyses showed native T1 was the sole independent predictor of all-cause and HF composite endpoints (HR, 1.1; 95% CI: 1.06-1.15; HR, 1.1; 95% CI: 1.05-1.1; p<0.001 for both), followed by the models including the extent of LGE and right ventricular EF, respectively (Fig. 4) [44].…”

Section: Dilated Cardiomyopathy (Dcm)mentioning

confidence: 93%

The Prognostic Role of T1 Mapping Sequences: Can T1 Mapping Parameters Have a Role in Risk Stratification?

Choi

Park

Kim

2017

Cardiovasc Imaging Asia

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Cardiovascular disease risk stratification and prognostication are very important for treatment planning. In addition, for a growing number of patients with overt symptomatic heart failure or asymptomatic but have structural heart disease, accurate risk stratification is essential. Conventional clinical cardiovascular risk factors, several biomarkers and echo-Doppler indexes are generally used to satisfy this need. However, non-invasive approaches to direct structural and tissue characterization of the myocardium have not produced satisfactory results. The recent development of the late gadolinium enhancement (LGE) imaging allows fibrosis or myocardial inflammation to be visualized. A growing body of evidence for LGEbased prognostication has been reported. However, not all patients with heart failure or at risk for it have been assessed with LGE. Moreover, the degree of diffuse fibrosis or inflammation cannot be easily quantified with LGE techniques. Recently, introduced T1 mapping-based quantification can provide the volume of extracellular space suggestive of the degree of diffuse tissue fibrosis or inflammation. Even without gadolinium contrast, native T1 values can provide quantitative information on myocardial tissue status. Here, we review current evidence for T1 mapping-based risk stratification and prognostication for various cardiac diseases that can lead to heart failure or lethal arrhythmic events.

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T1-Mapping and Outcome in Nonischemic Cardiomyopathy

Cited by 413 publications

References 31 publications

T1 Mapping in Characterizing Myocardial Disease

T1 Mapping in Characterizing Myocardial Disease

Native Myocardial T1 Mapping, Are We There Yet?

The Prognostic Role of T1 Mapping Sequences: Can T1 Mapping Parameters Have a Role in Risk Stratification?

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