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Comprehensive Validation of Cardiovascular Magnetic Resonance Techniques for the Assessment of Myocardial Extracellular Volume
Abstract
Background—: Extracellular matrix expansion is a key element of ventricular remodeling and a potential therapeutic target. Cardiovascular magnetic resonance (CMR) T 1 -mapping techniques are increasingly used to evaluate myocardial extracellular volume (ECV); however, the most widely applied methods are without histological validation. Our aim was to perform comprehensive validation of (1) dynamic-equilibrium CMR (DynEq-CMR), where ECV is quantified using hematocrit-adjusted myocardial and blood T 1 values measured before and after gadolinium bolus; and (2) isolated measurement of myocardial T 1 , used as an ECV surrogate. Methods and Results—: Whole-heart histological validation was performed using 96 tissue samples, analyzed for picrosirius red collagen volume fraction, obtained from each of 16 segments of the explanted hearts of 6 patients undergoing heart transplantation who had prospectively undergone CMR before transplantation (median interval between CMR and transplantation, 29 days). DynEq-CMR–derived ECV was calculated from T 1 measurements made using a modified Look-Locker inversion recovery sequence before and 10 and 15 minutes post contrast. In addition, ECV was measured 2 to 20 minutes post contrast in 30 healthy volunteers. There was a strong linear relationship between DynEq-CMR–derived ECV and histological collagen volume fraction ( P <0.001; within-subject: r =0.745; P <0.001; r 2 =0.555 and between-subject: r =0.945; P <0.01; r 2 =0.893; for ECV calculated using 15-minute postcontrast T 1 ). Correlation was maintained throughout the entire heart. Isolated postcontrast T 1 measurement showed significant within-subject correlation with histological collagen volume fraction ( r =−0.741; P <0.001; r 2 =0.550 for 15-minute postcontrast T 1 ), but between-subject correlations were not significant. DynEq-CMR–derived ECV varied significantly according to contrast dose, myocardial region, and sex. Conclusions—: DynEq-CMR–derived ECV shows a good correlation with histological collagen volume fraction throughout the whole heart. Isolated postcontrast T 1 measurement is insufficient for ECV assessment.
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STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT
Martin Bland, J., & Altman, D. (1986) · The Lancet · doi:10.1016/s0140-6736(86)90837-8 · Cited by 47,965
Cited by
Heidenreich, P. A., Bozkurt, B., Aguilar, D., Allen, L. A., Byun, J. J., Colvin, M. M., Deswal, A., Drazner, M. H., Dunlay, S. M., Evers, L. R., et al. (2022) · Circulation · doi:10.1161/cir.0000000000001063 · Cited by 4,922
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure
Heidenreich, P. A., Bozkurt, B., Aguilar, D., Allen, L. A., Byun, J. J., Colvin, M. M., Deswal, A., Drazner, M. H., Dunlay, S. M., Evers, L. R., et al. (2022) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.12.012 · Cited by 2,862
Myocardial T1 and T2 mapping at 3 T: reference values, influencing factors and implications
von Knobelsdorff-Brenkenhoff, F., Prothmann, M., Dieringer, M. A., Wassmuth, R., Greiser, A., Schwenke, C., Niendorf, T., & Schulz-Menger, J. (2013) · Journal of Cardiovascular Magnetic Resonance · doi:10.1186/1532-429x-15-53 · Cited by 265
Self-citationCarlier, P. G., Marty, B., Scheidegger, O., Loureiro de Sousa, P., Baudin, P.-Y., Snezhko, E., & Vlodavets, D. (2016) · Journal of Neuromuscular Diseases · doi:10.3233/jnd-160145 · Cited by 186
Kanagala, P., Cheng, A. S. H., Singh, A., Khan, J. N., Gulsin, G. S., Patel, P., Gupta, P., Arnold, J. R., Squire, I. B., Ng, L. L., et al. (2019) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2018.11.031 · Cited by 126
Metadata
- Authors
- Miller, C. A., Naish, J. H., Bishop, P., Coutts, G., Clark, D., Zhao, S., Ray, S. G., Yonan, N., Williams, S. G., Flett, A. S., Moon, J. C., Greiser, A., Parker, G. J. M., & Schmitt, M.
- Venue
- Circulation: Cardiovascular Imaging
- Published
- 2013-05
- Volume
- 6
- Issue
- 3
- Pages
- 373-383
- ISSN
- 1941-9651 (ISSN-L)
- 1942-0080
- OpenAlex
- W1993592464
- Cited by
- 384
- References
- 1
- FWCI
- 27.33
- Type
- journal article
- Language
- en
- Open access
- closed
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- Miller, C. A., Naish, J. H., Bishop, P., Coutts, G., Clark, D., Zhao, S., Ray, S. G., Yonan, N., Williams, S. G., Flett, A. S., Moon, J. C., Greiser, A., Parker, G. J. M., & Schmitt, M. (2013). Comprehensive Validation of Cardiovascular Magnetic Resonance Techniques for the Assessment of Myocardial Extracellular Volume. Circulation: Cardiovascular Imaging. https://doi.org/10.1161/circimaging.112.000192
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