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Diagnostic and prognostic significance of cardiovascular magnetic resonance native myocardial T1 mapping in patients with pulmonary hypertension.

Title: Diagnostic and prognostic significance of cardiovascular magnetic resonance native myocardial T1 mapping in patients with pulmonary hypertension.
Authors: Saunders, Laura C; Johns, Chris S; Stewart, Neil J; Oram, Charlotte JE; Capener, David A; Puntmann, Valentina O; Elliot, Charlie A; Condliffe, Robin C; Kiely, David G; Graves, Martin J; Wild, Jim M; Swift, Andy J
Publisher Information: BioMed Central; //doi.org/10.1186/s12968-018-0501-8
Publication Year: 2018
Collection: Apollo - University of Cambridge Repository
Subject Terms: Cardiovascular magnetic resonance; MOLLI; Pulmonary hypertension; T1 mapping; Adult; Aged; 80 and over; Disease Progression; Female; Hemodynamics; Humans; Hypertension; Pulmonary; Image Interpretation; Computer-Assisted; Magnetic Resonance Imaging; Cine; Male; Middle Aged; Predictive Value of Tests; Prognosis; Retrospective Studies; Ventricular Function; Left; Right; Ventricular Remodeling
Description: BACKGROUND: Native T1 may be a sensitive, contrast-free, non-invasive cardiovascular magnetic resonance (CMR) marker of myocardial tissue changes in patients with pulmonary artery hypertension. However, the diagnostic and prognostic value of native T1 mapping in this patient group has not been fully explored. The aim of this work was to determine whether elevation of native T1 in myocardial tissue in pulmonary hypertension: (a) varies according to pulmonary hypertension subtype; (b) has prognostic value and (c) is associated with ventricular function and interaction. METHODS: Data were retrospectively collected from a total of 490 consecutive patients during their clinical 1.5 T CMR assessment at a pulmonary hypertension referral centre in 2015. Three hundred sixty-nine patients had pulmonary hypertension [58 ± 15 years; 66% female], an additional 39 had pulmonary hypertension due to left heart disease [68 ± 13 years; 60% female], 82 patients did not have pulmonary hypertension [55 ± 18; 68% female]. Twenty five healthy subjects were also recruited [58 ±4 years); 51% female]. T1 mapping was performed with a MOdified Look-Locker Inversion Recovery (MOLLI) sequence. T1 prognostic value in patients with pulmonary arterial hypertension was assessed using multivariate Cox proportional hazards regression analysis. RESULTS: Patients with pulmonary artery hypertension had elevated T1 in the right ventricular (RV) insertion point (pulmonary hypertension patients: T1 = 1060 ± 90 ms; No pulmonary hypertension patients: T1 = 1020 ± 80 ms p < 0.001; healthy subjects T1 = 940 ± 50 ms p < 0.001) with no significant difference between the major pulmonary hypertension subtypes. The RV insertion point was the most successful T1 region for discriminating patients with pulmonary hypertension from healthy subjects (area under the curve = 0.863) however it could not accurately discriminate between patients with and without pulmonary hypertension (area under the curve = 0.654). T1 metrics did not contribute to prediction of ...
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
Relation: https://www.repository.cam.ac.uk/handle/1810/296841
DOI: 10.17863/CAM.43886
Availability: https://www.repository.cam.ac.uk/handle/1810/296841; https://doi.org/10.17863/CAM.43886
Rights: Attribution 4.0 International ; https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.2566F34B
Database: BASE