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  • Ovid Technologies (Wolters Kluwer Health)  (2)
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  • Ovid Technologies (Wolters Kluwer Health)  (2)
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  • 1
    Online Resource
    Online Resource
    Abstract 12664: Comprehensive Histological Analysis of Endomyocardial Biopsy and T1 Mapping for Predicting Left Ventricular Reverse Remodeling in Patients with Recent-Onset Dilated Cardiomyopathy
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Circulation Vol. 146, No. Suppl_1 ( 2022-11-08)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 146, No. Suppl_1 ( 2022-11-08)
    Abstract: Background: Cardiomyocyte injury is a key pathological pathway in the progression of heart failure that predicts a poor prognosis; therefore, combined assessment of myocardial fibrosis and cardiomyocyte DNA damage from endomyocardial biopsy (EMB) samples may be of great importance. Meanwhile, cardiovascular magnetic resonance (CMR) native T1 reflects a composite of both intra- and extracellular compartments in the whole myocardium. We sought to assess the performance of native T1 mapping and EMB results to predict left ventricular reverse remodeling (LVRR) in recent-onset dilated cardiomyopathy (DCM). Methods: A total of 29 patients with DCM underwent cine CMR and triple-slice T1 mapping using the MOLLI sequence at 3T, and EMB before receiving guideline-directed medical therapy. Poly ADP-ribose (PAR) nuclear and sirius-red staining were used for quantification of DNA damage and collagen volume fraction (CVF), respectively. LVRR was defined as an increase in LV ejection fraction of ≥10% to the final value of 〉 35%, accompanied by a decrease in LV end-diastolic volume ≥10% at the follow-up CMR. Results: Fifteen patients (52%) achieved LVRR. The mean native T1, histological CVF, and proportion of PAR-positive nuclei were 1376 ± 55 ms, 0.13 ± 0.05, 25 ± 15%, respectively. Native T1 correlated well with CVF (p=0.004) and trended to be higher in DCM patients with increased DNA damage (p=0.17). There was no significant association between CVF and %PAR-positive nuclei. Native T1 〈 1400 ms provided 86% sensitivity and 67% specificity, with the C-statistic of 0.82 (95% CI 0.67-0.98) for predicting LVRR. By contrast, C-statistic of %PAR nuclei, CVF, and combined assessment of %PAR nuclei and CVF were 0.59, 0.61 and 0.66, respectively. Conclusion: CMR T1 mapping may be a promising strategy for noninvasive biopsy of the whole heart and provide a better prediction of LVRR in recent-onset DCM than comprehensive histological analysis of EMB.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.146.suppl_1.12664
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1466401-X
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  • 2
    Online Resource
    Online Resource
    Abstract 14919: Myocardial T 1 Mapping for Prediction of Left Ventricular Reverse Remodeling in Patients With Recent-onset Dilated Cardiomyopathy: a Comparison With Histological Tissue Characterization
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Circulation Vol. 142, No. Suppl_3 ( 2020-11-17)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 142, No. Suppl_3 ( 2020-11-17)
    Abstract: Background: Accurate prediction of left ventricular reverse remodeling (LVRR) in dilated cardiomyopathy (DCM) remains challenging. The purpose of this study is to assess the potential of cardiovascular magnetic resonance (CMR) T 1 mapping to predict LVRR by histological confirmation. Methods: Twenty-one DCM patients (12 male, mean age 49 ± 13 years) underwent cine, late gadolinium enhancement (LGE) CMR, and triple-slice T 1 mapping using a modified Look-Locker inversion recovery sequence at 3T before receiving optimal medical therapy. LVRR was defined as an absolute increase in LV ejection fraction (LVEF) from ≥10% to a final value of 〉 35%, accompanied by a decrease in LV end-diastolic volume (LVEDV) ≧10% at midterm (mean time 18 months) CMR follow-up. Extra-cellular volume (ECV) was quantified from pre and post-contrast T 1 values of the blood and myocardium with hematocrit correction. Biopsy samples were used for quantification of collagen volume fraction (CVF). Results: LVRR was observed in 11 patients (52%). The mean native T 1 , ECV, and histological CVF were 1395 ± 49 ms, 0.33 ± 0.03, 0.13 ± 0.04, respectively. Native T 1 yielded comparable ability to ECV measurements for detecting histological CVF (r=0.49, 0.52, both p 〈 0.05). While 14 patients (67%) showed focal scar on LGE, there was no significant difference in histological CVF between patients with and without focal scarring (p=0.6). Native T 1, but not ECV and CVF, correlated well with absolute LVEF increase and relative percent decrease of LVEDV and LV end-systolic volume (r=-0.55, 0.55, 0.56, all p 〈 0.05). Native T 1 〈 1400 ms provided 90% sensitivity and 82% specificity, with the C-statistic of 0.86 (95% CI 0.64-0.97), for predicting LVRR. On the other hand, the C-statistic of ECV, LGE and histological CVF were 0.72 (95% CI 0.48-0.89), 0.53 (95% CI 0.31-0.75) and 0.66 (95% CI 0.43-0.85), respectively. Conclusions: Myocardial native T 1 have the potential to predict LVRR beyond LGE and histological assessment.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.142.suppl_3.14919
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
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