Equilibrium contrast cardiovascular magnetic resonance for the measurement of diffuse myocardial fibrosis: preliminary validation in humans.
BACKGROUND: Diffuse myocardial fibrosis is a final end point in most cardiac diseases. It is missed by the cardiovascular magnetic resonance (CMR) late gadolinium enhancement technique. Currently, quantifying diffuse myocardial fibrosis requires invasive biopsy, with inherent risk and sampling error...
| Publicado en: | Circulation Vol. 122; no. 2; pp. 138 - 145 |
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| Autores principales: | , , , , , , , |
| Formato: | clinical trial research Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
7/13/2010
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105052431&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105052431 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00097322 1FV jtl: Circulation issn: 00097322 maglogo: N pubinfo: dt: 7/13/2010 vid: 122 iid: 2 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 105052431 105052431 2010712339 10.1161/CIRCULATIONAHA.109.930636 NLM20585010 105052431 ppf: 138 ppct: 7 formats: tig: atl: Equilibrium contrast cardiovascular magnetic resonance for the measurement of diffuse myocardial fibrosis: preliminary validation in humans. aug: au: Flett AS Hayward MP Ashworth MT Hansen MS Taylor AM Elliott PM McGregor C Moon JC affil: The Heart Hospital, 16-18 Westmoreland St, London W1G 8PH, United Kingdom. james.moon@uclh.nhs.uk. sug: subj: Aortic Valve Stenosis Pathology Cardiomyopathy, Hypertrophic Pathology Contrast Media Administration and Dosage Myocardial Diseases Pathology Magnetic Resonance Imaging Methods Aortic Valve Stenosis Surgery Biopsy Cardiomyopathy, Hypertrophic Surgery Female Human Male Clinical Trials Female Male ab: BACKGROUND: Diffuse myocardial fibrosis is a final end point in most cardiac diseases. It is missed by the cardiovascular magnetic resonance (CMR) late gadolinium enhancement technique. Currently, quantifying diffuse myocardial fibrosis requires invasive biopsy, with inherent risk and sampling error. We have developed a robust and noninvasive technique, equilibrium contrast CMR (EQ-CMR) to quantify diffuse fibrosis and have validated it against the current gold standard of surgical myocardial biopsy. METHODS AND RESULTS: The 3 principles of EQ-CMR are a bolus of extracellular gadolinium contrast followed by continuous infusion to achieve equilibrium; a blood sample to measure blood volume of distribution (1-hematocrit); and CMR to measure pre- and postequilibrium T1 (with heart rate correction). The myocardial volume of distribution is calculated, reflecting diffuse myocardial fibrosis. Clinical validation occurred in patients undergoing aortic valve replacement for aortic stenosis or myectomy in hypertrophic cardiomyopathy (n=18 and n=8, respectively). Surgical biopsies were analyzed for picrosirius red fibrosis quantification on histology. The mean histological fibrosis was 20.5+/-11% in aortic stenosis and 17.1+/-7.4% in hypertrophic cardiomyopathy. EQ-CMR correlated strongly with biopsy histological fibrosis: aortic stenosis, r(2)=0.86, Kendall Tau coefficient (T)=0.71, P<0.001; hypertrophic cardiomyopathy, r(2)=0.62, T=0.52, P=0.08; combined r(2)=0.80, T=0.67, P<0.001. CONCLUSIONS: We have developed and validated a new technique, EQ-CMR, to measure diffuse myocardial fibrosis as an add-on to a standard CMR scan, which allows for the noninvasive quantification of the diffuse fibrosis burden in myocardial diseases. pubtype: Academic Journal doctype: clinical trial research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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